Form 307 "Questionnaire for Prospective Appointment as a Member, Director, or Deputy Director of the County Board of Elections" - Ohio

This version of the form is not currently in use and is provided for reference only.
Download this version of Form 307 for the current year.

What Is Form 307?

This is a legal form that was released by the Ohio Secretary of State - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2018;
  • The latest edition provided by the Ohio Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 307 by clicking the link below or browse more documents and templates provided by the Ohio Secretary of State.

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Download Form 307 "Questionnaire for Prospective Appointment as a Member, Director, or Deputy Director of the County Board of Elections" - Ohio

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Form No. 307 (12-18)
Questionnaire for Prospective Appointment as a Member, Director, or Deputy
Director of the County Board of Elections
County Board of
Position of Appointee
Elections
Appointee Name, Residence Address, and Other Information
Street
Courtesy Title
Address
First Name
City
Middle Name
State
OH
Last Name
Zip Code
Suffix
Office Phone
(Numbers and hyphens only)
Alias/Maiden Name
Home Phone
(Numbers and hyphens only)
Ohio Driver's License/
Cell Phone
State ID Number
(Numbers and hyphens only)
Email
Social Security Number
Address
Date of Birth
(MM/DD/YYYY)
Previous Address Information
Have you resided at the same address for the past 10 years? If no, please provide the years
of residence, city, and state for each previous address in the space below.
Question instructions:
Please provide a response for 1-7 below. If you respond yes to any of the following
questions, please provide details as requested. If more space is needed, please include further detail on a separate
document.
1. Are you currently holding any elected office? If yes, please identify the office.
2. Are you currently holding any appointed office for which you must subsequently be elected?
If yes, please identify the office.
Form No. 307 (12-18)
Questionnaire for Prospective Appointment as a Member, Director, or Deputy
Director of the County Board of Elections
County Board of
Position of Appointee
Elections
Appointee Name, Residence Address, and Other Information
Street
Courtesy Title
Address
First Name
City
Middle Name
State
OH
Last Name
Zip Code
Suffix
Office Phone
(Numbers and hyphens only)
Alias/Maiden Name
Home Phone
(Numbers and hyphens only)
Ohio Driver's License/
Cell Phone
State ID Number
(Numbers and hyphens only)
Email
Social Security Number
Address
Date of Birth
(MM/DD/YYYY)
Previous Address Information
Have you resided at the same address for the past 10 years? If no, please provide the years
of residence, city, and state for each previous address in the space below.
Question instructions:
Please provide a response for 1-7 below. If you respond yes to any of the following
questions, please provide details as requested. If more space is needed, please include further detail on a separate
document.
1. Are you currently holding any elected office? If yes, please identify the office.
2. Are you currently holding any appointed office for which you must subsequently be elected?
If yes, please identify the office.
3. Have you ever been convicted of a misdemeanor (other than minor-traffic related offenses) or a
felony? If yes, please provide details of the conviction (what, when, where and final disposition).
4. Are there any circumstances which might present a conflict of interest with the administrative
duties for you as a member, director or deputy director of the board of elections (see SOS ethics
policy)? If yes , please identify.
5. Have you had any employment or interests in contracts with the board of elections within the
last 24 months? If yes, please describe.
6. Have you ever been required, as a candidate or campaign treasurer, to file a campaign finance
report with any board of elections or the Secretary of State? If yes, please list all campaigns, political
parties, political action committees, etc. for which a campaign finance report was filed by you as a
candidate or treasurer.
7. Has a campaign in which you were involved as a candidate or treasurer ever been the subject
of a referral or complaint to the Ohio Elections Commission? If yes, please explain.
Business Address Information
(prospective member appointees only)
Business
Address
Name
Occupation
City
Phone
State
OH
(Numbers and hyphens only)
Zip Code
Background Check Disclosure, Authorization and Release for Prospective
Appointment as a Member, Director or Deputy Director of a Board of Elections
Section I: Disclosure
This form, which you should read carefully, has been provided to you because the Ohio Secretary of State's office
may request investigative reports on you from various public and private reporting agencies. The Ohio Secretary of
State's office will use any such report(s) solely for appointment and employment related purposes.
Investigative reports may be obtained from a background check vendor and/or public agencies and provided to the
Ohio Secretary of State's office. The types of information that may be obtained include but are not limited to: Social
Security Number verification, criminal records checks, public court records checks, driving record checks, state tax
information, etc.
Any such reports are public records under Ohio's public records laws unless specifically exempt from disclosure.
Section II: Authorization and Release
I have carefully read and understand this Disclosure, Authorization and Release form. By my signature below, I
consent to the release of investigative reports to the Ohio Secretary of State in conjunction with my application for
prospective appointment as a Member, Director or Deputy Director of a county board of elections. I also authorize
disclosure to the Ohio Secretary of State and/or the background check vendor of information concerning my motor
vehicle history and standing, criminal history, state tax information and all other information the Ohio Secretary of
State deems pertinent by any individual, corporation or other private or public entity, including without limitation to
the following: law enforcement agencies; federal, state and local courts; motor vehicle records agencies; state tax
agencies; and other applicable sources. I hereby release and hold the vendor and the Ohio Secretary of State and
his employees and appointees harmless from any and all liability with respect to the investigations, verifications, and/
or the use of any information relevant to my appointment or employment.
I understand that if I am appointed or hired, my consent will apply throughout the term of my appointment or
employment to the extent permitted by law.
This Disclosure, Authorization and Release form, in original, faxed, photocopied, or electronic form, will be valid for
any reports that may be requested by the Ohio Secretary of State.
I understand that providing any false information or omitting any material information on my resume and/or
Questionnaire for Prospective Appointment as a Member, Director or Deputy Director of a County Board of Elections
may be sufficient grounds for rejection of the application or termination of the appointment or employment whenever
discovered.
Date Signed
(MM/DD/YYYY)
Prospective Appointee Signature
(Required)
The signed and completed form and resume (member appointees only) must then be transmitted to the Ohio
Secretary of State by one of the following methods:
Email to: MNewbern@ohiosecretaryofstate.gov
Mail to: Ohio Secretary of State
Attn: Myra Hawkins-Newbern, Elections Division
PO Box 2828
Columbus, OH 43216
NOTE:
All prospective appointees as members of the board of elections must submit a résumé
that includes educational and employment history.
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