Example Initial Application

Below is the initial application for the Citizens Redistricting Commission. In this section of the application you will be asked to provide personal information that will assist the Applicant Review Panel in processing your application.

You do not have to complete the entire application at one time. At any point, you can save your application using the "Save Application" button. After the application has been saved, you can return to this site to complete the application using your email and password if you choose to set one. Be sure to submit your initial application on or before August 19, 2019.

All fields with * are required to submit the application.

Identification Information
Physical Address
Mailing Address (If different than Physical Address)
Phone Number

Gender

Gender*

Racial or Ethnic Background

Select the circle that best describes your race/ethnicity*
Latino Group
Pacific Islander Group
Asian Group
Other Groups

The Voters FIRST Act is designed to produce a Citizens Redistricting Commission that is reasonably representative of the state's diversity. This information is required to help the Applicant Review Panel identify a diverse pool of the most qualified applicants. Although your specific date of birth will remain confidential, your age may be calculated from your date of birth and made public.

Birthdate / /

Economic Status

What was your total household income during the past 12 months?*

Eligibility Information

If you are uncertain about your prior voting registration, voting record, or party affiliation, we suggest that you contact the county clerk or voter registrar in the county in which you resided during the period of time in question. The contact information and address for California's county elections offices can be found at https://voterstatus.sos.ca.gov/.

1. Have you been continuously registered to vote in the State of California since July 1, 2015?*

2. With what party are you registered?*

3. Has your political party affiliation remained the same since July 1, 2015?

4. Indicate in which of the last three statewide general elections you voted, (check all that apply)*:

Conflicts of Interest

The Voters FIRST Act (Act) is designed to produce a Citizens Redistricting Commission that is independent from legislative influence and, therefore, disqualifies from service any person having a conflict of interest as defined by the Act. The information below is required to help the State Auditor and the Applicant Review Panel identify any conflicts of interest you may have.

5. Have you done any of the following within 10 years of the date you submit this application:

5a. Have you within 10 years of the date you submit this application been appointed to, elected to, or a candidate for a California congressional or state office (Appointed means appointed by the Governor, a member of the Legislature, or a member of the State Board of Equalization; or served at the pleasure of the Governor, a member of the Legislature, or a member of the State Board of Equalization)?*

5b. Have you within 10 years of the date you submit this application served as an officer, employee, or paid consultant of a California political party or of the campaign committee of a candidate for a California congressional or elective state office?*

5c. Have you within 10 years of the date you submit this application served as an elected or appointed member of a political party central committee in California?*

5d. Have you within 10 years of the date you submit this application been a lobbyist registered with the State of California or a California local government?*

5e. Have you within 10 years of the date you submit this application been a registered federal lobbyist?*

5f. Have you within 10 years of the date you submit this application served as a paid California congressional, legislative, or State Board of Equalization staff?*

5g. Have you within 10 years of the date you submit this application contributed $2,500 or more to any California congressional, state, or local candidate for elective public office within any single calendar year?(This amount has been adjusted using the California Consumer Price Index.)*

6. Are you currently serving as staff, or as a consultant to the Governor of California, a member of the California Legislature, a California member of Congress, or a member of the State Board of Equalization?*

7. Are you currently under contract with the Governor of California, a member of the California Legislature, a California member of Congress, or a member of the State Board of Equalization?*

When answering questions 8 and 9, immediate family means your parents, step-parents, spouse, registered domestic partner, children, step-children, siblings, step-siblings, parents-in-law, siblings-in-law, and sons- and daughters-in-law with whom you have done the following:

8. Do you have an immediate family relationship with the Governor of California, a member of the California Legislature, a California member of Congress, or a member of the State Board of Equalization?*

9. Has a member of your immediate family done any of the following within 10 years of the date you submit this application:

9a. Has a member of your immediate family within 10 years of the date you submit this application been appointed to, elected to, or a candidate for a California congressional or state office? (Appointed means appointed by the Governor, a member of the Legislature, or a member of the State Board of Equalization, or served at the pleasure of the Governor, a member of the Legislature, or a member of the State Board of Equalization)?*

9b. Has a member of your immediate family within 10 years of the date you submit this application served as an officer, employee, or paid consultant of a California political party or of the campaign committee of a candidate for a California congressional or elective state office?*

9c. Has a member of your immediate family within 10 years of the date you submit this application served as an elected or appointed member of a political party central committee in California?*

9d. Has a member of your immediate family within 10 years of the date you submit this application been a lobbyist registered with the State of California or a California local government?*

9e. Has a member of your immediate family within 10 years of the date you submit this application been a registered federal lobbyist?*

9f. Has a member of your immediate family within 10 years of the date you submit this application served as a paid California congressional, legislative, or State Board of Equalization staff?*

9g. Has a member of your immediate family within 10 years of the date you submit this application contributed $2,500 or more to any California congressional, state, or local candidate for elective public office within any single calendar year?(This amount has been adjusted using the California Consumer Price Index.)*

PRIVACY NOTIFICATION AND WAIVER

LEGAL AUTHORITY AND REASON FOR COLLECTION OF PERSONAL INFORMATION

The Voters FIRST Act (Act) and the regulations implementing the Act require that the selection of commissioners for the Citizens Redistricting Commission (Commission) be open to public scrutiny and the press (California Constitution, Article XXI, section 2, subdivision (c); Government Code sections 8252, 11120, 11121, and 11125.1; California Code of Regulations, title 2, sections 60835, 60836, 60842, and 60846). The Act also requires the California State Auditor's Office (State Auditor's Office) to select 60 of the most qualified applicants based upon their voter affiliation; eligibility to serve pursuant to Article XXI of the California Constitution; the absence of any conflicts of interest; relevant analytical skills; ability to be impartial; appreciation for California's diverse demographics and geography; and racial, ethnic, geographic, gender, and economic diversity. To determine each applicant's identity and qualifications to serve on the Commission and to track the demographic information of the applicant pool, this application seeks personal information about applicants that will be provided to the Applicant Review Panel, State Auditor's Office staff, and the public, including members of the press, the Legislature, and the Commission.

CONSEQUENCE OF NOT PROVIDING ALL REQUESTED INFORMATION

Failure to provide all of the requested information will result in your disqualification and the removal of your name from the applicant pool. Thus, if you wish to serve on the Commission, it is mandatory that you submit a response for each item of information requested.

PERMISSION TO USE AND RELEASE PERSONAL INFORMATION

By submitting this application, you acknowledge that the application, all documents submitted in support of your application, including a Statement of Economic Interests (FPPC Form 700) if you are asked to submit one, letters of recommendation, materials generated as a result of any State Auditor's Office or Applicant Review Panel investigation of you, and all public comments and responses to public comments about your application are public records. You agree that the State Auditor's Office shall provide copies of these materials to members of the public and the press, members and staff of the Applicant Review Panel, State Auditor's Office staff, the Legislature, the Commission, and as otherwise compelled by law. You understand that members of the Applicant Review Panel and the public may make public statements about you. You authorize the State Auditor's Office to use the information submitted by and about you as the State Auditor's Office deems necessary to select commissioners, replacement commissioners, or otherwise comply with its legal duties. You also authorize the State Auditor's Office to post all materials related to your application to serve on the Commission on its website and any website authorized by the State Auditor's Office.

VOLUNTARY WAIVER OF PRIVACY RIGHTS AND STATE AUDITOR'S OFFICE LIABILITY

By applying to be a commissioner, you are waiving your privacy and other rights under various state and federal laws including, but not limited to, the Information Practices Act (Cal. Civil Code section 1798 et seq.), and any defamation, invasion of privacy, and negligence claim you may have against the State Auditor's Office and those acting on its behalf. Accordingly, by waiving your privacy rights, you are agreeing to permit the State Auditor's Office to release any and all information submitted by or about you, EXCEPT that the State Auditor's Office will not post on the Internet your date of birth; physical, mailing, and email addresses (excluding the city and county); telephone numbers; the addresses and telephone numbers of your immediate family members; or any materials that the State Auditor's Office deems offensive. At this point in the process, the State Auditor's Office will not collect, and you should not voluntarily submit to the State Auditor's Office, your social security number, driver's license number, financial account numbers, or health information. By submitting your application, you acknowledge and consent to the release of the information you and others are providing related to you and, except as specifically provided above, you are waiving your right to privacy regarding all information relating to you and your application to serve as a commissioner. This waiver authorizes the State Auditor's Office to make public information submitted by or about you for a period of 12 years from the date of your application, even if you are not selected as a commissioner. You are providing this waiver voluntarily, understanding that the State Auditor's Office shall not be legally liable as a result of the release of information submitted by or about you or as the result of comments made about you by others, and that the State Auditor's Office will post on its website or otherwise release publicly. This includes claims of defamation, invasion of privacy, negligence, and any other statutory or common law claims.

WHOM TO CONTACT

You have a right to review personal information the State Auditor's Office maintains about you and to verify its accuracy. Please contact the State Auditor's Office's Information Privacy Officer at (916) 445-0255; 621 Capitol Mall, Suite 1200, Sacramento, California, 95814; if you would like to view or obtain information about the location of your records and the categories of persons who use the information in your records.

Affirmation

I affirm, by entering my initials in the box, that the statements contained in this application are true and correct to the best of my knowledge, and that I have read and understand the Privacy Notification and Waiver.