HomeMy WebLinkAboutCC AG PKT 2007-01-22 #T
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AGENDA REPORT
DATE:
January 22, 2007
TO:
Honorable Mayor and Ci.ty Council
THRU:
John B. Bahorski, City Manager
FROM:
Linda Devine, City Clerk
SUBJECT:
SPECIAL MUNICIPAL ELECTION 2007
SUMMARY OF REOUEST
Approve ordinance/resolutions and give direction relating to the proposed City of Seal
Beach Special Municipal Election on Ordinance Number 1553:
CJ Ordinance calling and giving notice of holding all mail ballot special election
on April 24, 2007
o Resolution requesting County services
CJ Resolution setting priorities for filing written arguments and directing the City
Attorney impartial analysis
CJ Resolution for filing Qf rebuttal arguments
CJ Cancel April 23, 2007 Council meeting
CJ Give direction regarding mail ballot pre-paid postage on return envelopes.
CJ Alternate option: Give direction to staff to provide Council with proposed
language for additional ballot measures to be place on ballot (which would
require an election date later than April 24, 2007):
- charter amendments
increase in street sweeping fees
- increase in tree trimming fees
BACKGROUND
After receiving the qualified referendum submitted by Save Our Seal Beach, the City
Council at their December 11, 2006 meeting voted to have staff prepare the necessary
documents to call and give notice of an aU mail ballot Special Municipal Election on
Tuesday April 24, 2007 for the submission of Ordinance Number 1553.
SHALL ORDINANCE NUMBER 1553 AMENDING Y
THE SEAL BEACH MUNICIPAL CODE TO ALLOW E
A MAXIMUM HEIGHT OF 25 FEET AND 2 S
STORIES IN THE RESIDENTIAL ZONES IN N
ZONING DISTRICT 1 (OLD TOWN) BE ADOPTED? 0
Agenda Item r
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ELECTION PROCESS
The all mail ballot election process will be used in the April 24, 2007 Special Municipal
Election. The voter pamphlets and ballots will be mailed out to all registered voters in
the City. The voters will either return their ballots by mail or drop their ballots off at City
Hall - Office of the City Clerk from March 27th to Election Day (there will be only one
additional drop-off site in Leisure World on Election Day from 7:00 a.m. to 8:00 p.m. -
location to be announced at a later date). City Hall will be the only drop-off site open on
Saturday April 22nd from 10:00 a.m. to 2:00 p.m. All ballots must be returned to City
Hall - Office of the City Clerk by 8:00 p.rn. on April 24th - no postmarks will be
counted. The ballot~ will be tallied in the City Council Chambers on April 24th after
8:00 p.m. and results will be live on SBTV.
The proposed election calendar:
April 14
April 22
April 24
May 1
July 31
ACTION
Council Adopt Resolutions
Post Notice of Deadline for Filing Arguments
Last Day to Call Election for additional ballot measures
Last Day to withdraw measures from ballot
Last Day to file campaign expenditure statements
(semi-annual statement)
Last Day to file arguments
(14 days after Council call election)
Last Day to file rebuttal arguments
(10 days after arguments)
Last Day to file campaign expenditure statements
(1st pre-election statement)
First Day to mail out ballots
Drop-off ballots - Office of the City Clerk - City Hall
Last Day to register to vote
Last Day to file campaign expenditure statements
(2nd pre-election statement)
First Day to process returned ballots
Drop-off ballots - Office of the City Clerk - City Hall
ELECTION DAY
Declaration of the Results
Last Day to file campaign expenditure statements
(semi-annual statement)
DAlE
January 22
January 23
January 26
January 31
January 31
February 5
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February 15
March 15
March 26
March 27 - April 24
April 9
April 12
NOTE: If the Council sets the Election Day for April 24, 2007, staff is recommending
that the regular Council meeting the prior night (April 23rd) be canceled.
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FINANCIAL IMPACT
The estimated cost will range from $50,000 to $70,000. The City has used the single
source election consultant, Martin & Chapman, Inc. to assist in the conducting of the
ele~tions and will be having them provide their services in the April 24, 2007 mail ballot
Special Election. Other costs: Orange County Registrar of Voters services, election
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workers, supplies, etc. The cost for returned postage in the March 28th, 2006 election
was approximately $2,100 (about 5,373 ballots returned by US mail).
RECOMMENDATION
OPTION 1: Approve the following items related to the April 24, 2007 all mail ballot
Special Municipal Election:
1) Ordinance NumberJ calling and giving notice of the holding of
a mail ballot Special Municipal Election to be held in the City on Tuesday
April 24th, 2007 on proposed Ordinance Number 1553.
2) Resolution Number requesting that the Board of Supervisors of
the County of Orange to render specified services to the City relating to the
conduct of the mail ballot Special Municipal Election to be held on Tuesday,
April 24th, 2007.
3) Resolution Number setting priorities for filing written argument
regarding the referendum on Ordinance Number 1553 and directing the City
Attorney to prepare an impartial analysis. Determine wordine: for Section 1.
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4) Resolution Number providing for the filing of rebuttal
arguments for city measure submitted at municipal elections. Determine
wordine: for Section 3.
5) Give direction regarding the City paying the postage on ballot return
envelopes.
OPTION 2: Direct staff to come back with a revised ordinance setting date of election
and revised resolutions to include additional ballot measures.
~}~ J1..~J
Lin a Devine, City Clerk
NOTED AND APPROVED:
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n B. orski, CIty Manager
Attachments
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ORDINANCE NUMBER
AN ORDINANCE OF THE CITY OF SEAL BEACH
OROERING, CALLING, AND GIVING NOTICE OF THE
HOLDING OF AN ALL MAIL BALLOT SPECIAL
MUNICIPAL ELECTION ON TUESDAY, APRIL 24, 2007,
FOR THE SUBMISSION TO THE QUALIFIED VOTERS
ORDINANCE NUMBER 1553 REGARDING CERTAIN
HEIGHT LIMITS IN DISTRICT 1
RECITALS:
A. On October 8, 2006, Ihe City Council adopted Ordinance Number 1553
("the Ordinance") amending Seal Beach Municipal Code Sections 28-701 and
28-801 to allow 2 storias and a maximum height of 25 feet in the Residential
Medium Density and Residential High Density, District 1 (Zone Text Amendment
08-1).
B. The City published the Ordinance in accordance with City Chartar
("Charter") !i 414.
C. Save Our Seal Beach, Inc. filed a referendum petition, signed by more
than 10% of Ihe City's registered volers, seeking to repeal Ihe Ordinance or
submit tt to a vote of the voters. Charter!i 514 governs referenda and
incorporales by reference applicable provisions of Ihe California Election Code.
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D. Based upon its examinalion of the records of regislralion, the Orange
County Registrar of Voters has ascertained that the requistte number of voters
have signed the petition. Accordingly, the Registrar has delivered to the City
Clerk a Certificate as 10 Verification of Signatures.
E, The City Council has not voled to repeal the Ordinance.
F, The Charter authorizes and directs the City Council to submit the
Ordinance to the voters,
NOW, THEREFORE, the City Council of the City of Seal Beech, Califomla, does
ordain as follows:
SECTION 1. Pursuant to the requirements of the Charter, The Council hereby
calls, orders, and provides notice of an all mail ballot Special Municipal Election
to be held on Tuesday, April 24, 2007 ("Election Day") for the purpose of
submitting the following measure to the voter of the City:
SHALL ORDINANCE NUMBER 1553 AMENDING Y
THE SEAL BEACH MUNICIPAL CODE TO ALLOW E
A MAXIMUM HEIGHT OF, 25 FEET AND 2 S
STORIES IN THE RESIDENTIAL ZONES IN N
ZONING DISTRICT 1 (OLD TOWN) BE ADOPTED? 0
SECTION 2. The text of \he OI'dlnance submitted 10 the voters is attached as
Exhibit 'A".
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SECTION 3, The mail ballots to be used at Ihe election shall be in form and
conlenl as required by law,
SECTION 4. The Council hereby authorizes, inslructs, and directs \he City Clerk
10 procure and furnish any and all official ballots, notices, printed mailer and all
supplies, equipmenl, and paraphernalia Ihal may be necessary in order 10
properiy and lawfully conduct Ihe eJection.
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SECTION 5. The Office of the City Clerk shall be open 29 days before Election
Day on weekdays (excluding hoildays) from 8:00 a.m. to 5:00 p,m. and on
Election Day from 7:00 a.m. to 8:00 p.m" and at that time, shall be closed.
SECTION 6. In all particulars nOl reelled in this ordinance, the election shail be
held and conducted as provided by applicable law for holding mail bailOl
municipal elections.
SECTION 7. Pursuant to the City Charter and City ordinances the Special
Election shail be conducted by ail mail ballot, and shail be conducted pursuant to
Chapter 2 of DMsion 4 (Commencing with i 4100) of the Calffomia Elections
Code only Insofar as required by law, and only where not Inconsistent with the
Charter and City ordinances. NOlwithstanding Elections Code i 4103, ballots
cast in this Special Election shall be retumed to the Office of the City Clerk no
later than 8:00 p.m. on election day. Only ballots received in the Office of the
City Clerk by 8:00 p,m. on Election Day shail be counted.
SECTION 8. The Council hereby directs the City Clerk to provide further or
additional nollce of the election, in time, fonn, and manner as required by law.
SECTION 9. Pursuant to ~ 416, this ordinance shail take effect and be In force
immediately upon its adoption.
SECTION 10, The City Cieri< shail certify to the passage and adoption of this
ordinance, shall cause same to be published as required by law, and entered Into
the book of original ordinances.
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PASSED, APPROVED AND ADOPTED by the City Council of the City of Seal
Beach at a meeting thereof held on the 22nd deyof Januarv . 2007.
Mayor
ATTEST:
City Cieri<
STATE OF CALIFORNIA )
COUNTY OF ORANGE ) SS
CliY OF SEAL BEACH )
I, Linda Devine, City Cieri< of the City of Seal Beach, California, do hereby certify
that the foregoing Ordinance was passed, approved and adopted by the City
Council of the City ot Seal Beach at a meeting thereof held on the 22nd day
of Januarv, 2007, by the foilowing vOle:
AYES: Council Members
NOES: Council Members
ABSENT: Council Members
ABSTAIN: Council Members
. City Clerk
EXHIBIT "A"
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OROINANCE NUMBER..UY
AN ORDINANCE OF THE CITY OF SEAL BEACH AMENDING SECTIONS 28-701
AND 28-8111 OF THE MUNICIPAL CODE OF THE CITY OF SEAL BEACH TO
ALLOW 2 STORIES AND A MAXIMUM HEIGHT OF 25 FEET IN THE
RESIDENTIAL MEDIUM DENSITY AND RESIDENTIAL HIGH DENSITY, DISTRICT
1 (ZONE TEXT AMENDMENT 06-1)
_n 1. The CIty Councll hereby an'oOI1d!I Seal Beach Mun,-' Cads _on 21l-701.A.l
(Maximum Height, Main Bulldlngs and Second Dwelling Units for the Residential Medium Density
Zone) to read as fellows:
"Section 28-7Cl1 General ProvisIons lot Size DDen SDBce Bulk and Vards.
A. ProvIsions applYing In all d1stricls:
1. Maximum Height, Main BuIlding and Second DwelUng Units:
........ ........ ......... .....................2 stories, 25 ft. maximum"
~. The City Council hereby amends Seal Beach Munlcfpal COde Section 28-S01.F (MBXlmum
Height, Main BulJdlngs and Second Dwelling Units for 1hB Residential High Density Zone) to raad as
foJJows:
"Section 28.801 GRnBml Provisions Lot Slm Doen SOBCR Bulk Bnd Yams.
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F. MaxJmum Height, Main Building and Second Dwelling Units:
District I...... . ......................2 SIorles, 25 ft. rnaxlm.J:m
Dlstrfctll, Vi.......... ...... ................. ....... .......35 ft..
Sflctian 3. The CIty Council hereby determlnes tha.t dev&loprTl8l (I projects tor 3-story resIdences
located on the rear half of lots 31 5 feet wide Dr wider In the Residential Medium Density and
Residential High Density, DlstnC11 Zones that have rec81ved "Coastal Commission Concept AppCOY&l-
by the DlrBctor of Oeve\opment Services no laler than May 31, 2007 and have obtained a buikllng
permit no later than May 31, 2008 may proceed 10 devalop in accordance wfth the halght standards in
effect pnor to tha adopUon 01 Ordinance No. 1553 and In substantial compIiBr'08 with the plans
approved by the "Coastal Commission Concept Approval - CII)' staff shall note on any -COastal
COmmlSl!lIon Concept Approval- obUuned prior to May 31, 2007 that such approvaf Is rendered null and
VOid if t:hd: applicant falla to obtain B. City building permI'l to build a structure 1n excess of 25 feet by Ma)'
31. 2008
~ The City Clerk shall certify to the adoption of thiS Ordinance and shall CBUse the same to be
publiShed In the manner prescribed by law.
PASSED, APPROVED AND ADOPTED by tho City Council oIlhe City 01 Seal Seech elo meeting thereof
held OIl tho --ID!l.. day 01 October 2006.
ATTEST:
John Larsbn
Mayor
City Clerk
STATE OF CAUFOANIA }
COUNTY OF ORANGE ) SS
CITY OF SEAL BEACH }
I, Linda DevIne, City CJetk of the City of Seal Beach, CalIfornIa, do hereby certJfy that the foregoing
Ordinance Is an origInal cop)' of Ordinance NUmber~on file In the offICe of the CIty Clerk, IntrodUced
at 0 _ _ on 1he-.!olL day 01 Oduber 2006. ond paasad, opproved and BdopIad by the City
Council of 1he City of Seal Beach ala meeting held on the..JUt!.. day of OclobBr , 2006 by the following
vote:
AVES: CounCIlmembers AntnR Shanks YbBbBn
NOES: Councllmembers Lst'Rcn levitt
ABSENT: CourdmBl,.be1& NOIl8
ABSTAIN: Ccun::llmembacs None
anddoh8rebyfurtherC8l'11fythatOrdinanceNunmr~has been pubUshed pursuant to the Seal
Beach City Charter and. Resolution Number 2836.
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unda DBVlne
CltyClell<
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RESOLUTION NUMBER
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEAL
BEACH, CAUFORNIA, REQUESTING THE BOARD OF
SUPERVISORS OF THE COUNTY OF ORANGE TO RENDER
SPECIFIED SERVICES TO THE CITY RELATING TO THE
CONDUCT OF AN ALL MAIL BALLOT SPECIAL MUNICIPAL
ELECTION TO BE HELD ON TUESDAY, APRIL 24,2007.
WHEREAS, a Special Municipal Election is to be held in the City of Seal Beach,
CalWomia, on April 24, 2007; and
WHEREAS, in the course of conduct of the election II is necessary for the City to
request services of the County; and
WHEREAS, all necessary expenses in performing these services shall be paid
by the City of Seal Beach;
NOW, THEREFORE, the Clly Council of the City of Seal Beach, California, does
resolve, declare, determine, and order as follows:
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SECTION 1. That pursuant to the provisions of ~ 1 0002 of the Elections Code of
the State of California, this City Council requests the Board of Supervisors of the
County to permit the County Election Department to prepare and fumlsh to the
City for use In conducting the election the computer record of the names and
address of all eligible registered voters in the City In order that the City may print
labels to be attached to self-mailer sample ballot pamphlets; and will make
available to the City additional election equipment to hold an all mail ballot
election and assistance according to state law,
SECTION 2. That the Clly shall reimburse the County for services performed
when the work is completed and upon presentation to the City of a properly
approved bill.
SECTION 3. That the City Clerk is directed to forward without deley to the Board
of Supervisors and to the County Election Department, each a certified copy of
this resolution.
SECTION 4. That the City Clerk shall certify to the passage and adoption of this
Resolution and enter it Into the book of original Resolutions.
PASSED, APPROVED AND ADOPTED BY THE City Council of Seal Beach, at a
meeting hereof held on the ~ day of Januarv, 2007 by the following vote:
AYES: Council Members
NOES: Council Members
ABSENT: Council Members
ABSTAIN: Council Members
Mayor
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ATTEST:
City Clerk
STATE OF CALIFORNIA J
COUNTY OF ORANGE J SS
CITY OF SEAL BEACH I
I, Linda Devine, City Clerk for the City of Seal Beach, California, do hereby cert~y
that the foregoing resolutions Is the original copy of Resolution Number
on file in the office of the Cny Clerk, passed, approved an adopted by the City
Council of the City of Seal Beach at a regular meeting hereof held on the 22nd
day of Januarv , 2007.
City Clerk
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RESOWTION NUMBER_
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEAL
BEACH, CALIFORNIA, SEtTING PRIORITIES FOR RLlNG A
WRItTEN ARGUMENT REGARDING THE REFERENDUM ON
ORDINANCE NUMBER 1553 AND DIRECTING THE CITY
AtTORNEY TO PREPARE AN IMPARTIAL ANALYSIS
WHEREAS, an all mall ballot Special Municipal Election Is to be hald in the CIty
of Saal Beach, Califomla, on April 24, 2007 at which there will be submitted to
the voters the following measure:
1 ~HALL ORDINJ\NCE NUMBER 1553 AMENDING Y
THE SEAL BEACH MUNICIPAL CODE TO ALLOW E
A MAXIMUM HEIGHT OF 25 FEET AND 2 S
STORIES IN THE RESIDENTIAL ZONES IN iii
ZONING DISTRICT I (OLD TOWN) BE ADOPTED? 0
NOW, THEREFORE, the City Council of the City of Seal Beach, California, does
resolve, declare, determine, and order as follows:
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[SECTION 1. That the City Council authorizes Councllmember
to file a written argument in fevor of the City measure specified above, and
Council member to file a written argument against the Clly
measure specified above, accompanied by the printed name(s) and signature(s)
of the Councilm&mb&ls submi\\lng the arguments, in accordance with Article 4,
Chapter 3, Division 9 of the Elections Code of Ihe State of Cellfomia and 10
change Ihe argument until end including the date Ilxed by the City Clerk after
which no arguments for or egainsl the City measure may be submitted to the City
Clerk.]
[SECTION 1. That the City Council aultIoliZElS ALL membe<ll G\ the City Council
10 file (a) written argumenl(s) In Favor of or Againsl City measurers),
accompanied by the prinled narne(s) and signature(s) of the Councilmember(s)
submitting ii, in accordance with Article 4, Chapler 3, Division 9 of the Elections
Code of the Slale of California and 10 change Ihe argumenl until and Including
Ihe dale fixed by Ihe Cily Clerk alter which no arguments for or againsllhe City
measure may be submitted to the City Clerk,]
The arguments shall be filed with the City Clerk, signed, wi!h the prinled narne(s)
and signature(s) of Ihe aulhor(s) submi\\lng it, or if submitted on behalf of an
organizalion, Ihe name of the organizalion, and the printed name and signature
of at least one of its principal officers who is the author of the argument. The
arguments shall be accompanied by the Form of Statement To Be Filed By
Author(s) of Argument (see altachment ""'0),
SECTION 2. That the City Council directs the City Clerk to transmll a copy of the
measure to the city attomey, unless the organization or salaries of the office of
the city allorney are affected. The city a\\omey shall prepare an impartial
analysis of Ihe measure showing the effect of the measure on the existing law
and the operation of the measure. 1\ the measure affects the organization or
salaries of the office of the city allorney, the city clerk shall prepare the impartial
analysis. The impartial analysis shell be filad by the date sat by the City Clerk \or
the filing of primary arguments.
SECTION 3. That the City Clerk shall certify to the passage and adopbon of this
resolution and enter it Into the book of original resolutions.
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PASSED, APPROVED AND ADOPTED BY THE City Council of Seal Beach, at a
meeting hereof held on the 22nd day of Januarv ,2007 by the following vote:
AYES: Council Members
NOES: Council Members
ABSENT: Council Members
ABSTAIN: Council Members
Mayor
ATTEST:
City Clerk
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STATE OF CALIFORNIA )
COUNTY OF ORANGE ) SS
CITY OF SEAL BEACH )
I, Linda Devine, CRY Clerk for the City of Seal Beach, Califomia, do hereby certify
that the foregoing resolutions is the original copy of Resolution Number
on file in the office of the City Clerk, passed, approved an adopted by the City
Council of the City of Seal Beach at a regular meeting hereof held on the 22nd
day of Januarv , 2007.
City Clerk
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Attachment "A"
FORM OF STATEMENT TO BE FILED BY
AUTHOR Of ARGUMENT
.
All arguments concerning measures flied pursuant to Division 9, Chapter 3
(beginning wtth S 9200) of the Elections Code shall be accompanied by the
following form statement to be signed by each proponent, and by each author, if
different, of the argument:
The undersigned proponent (s) or author(s) of the (primary/rebuttal) argument (in
tavor of/against) ballot measurll regarding Ordinance Number 1553 at the
Special Municipal Election for the City Of Saal Beach to be held on Tuesday,
April 24. 2!J07 hareby state that the argument is true and COllect to the best ot
(hislher/their) knowledge and belief.
Sign Name
Print Name
Date
1\
21
31
4\
51
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RESOLUTION NUMBER_
A RESOLUTION OF TliE CITY COUNCIL OF THE CITY OF SEAL
BEACH, CALIFORNIA, PROVIOING FOR THE FlUNG OF
REBUTTAL ARGUMENTS FOR CITY MEASURE SUBMmED
AT AN ALL MAIL BALLOT SPECIAL MUNICIPAL ELECTION.
WHEREAS, !i 9220 and 9285 of the Elactions Code of the State of California
authorize the Citt Council, by majority vote, to adopt provisions to provide lor Ihe
filing of rebuttal arguments for city measures submilled at municipal elections;
NOW, THEREFORE, the City Council of the City of Seal Beach, California, does
resolve, declare, deten11ine, and order as follows:
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SECTION 1, That pursuant to !i 9220 and 9285 of the Elections Code of the
State of California, when the elections official has selected the arguments for and
against the measure which will be printed and distributed to the voters, the
elections official shall send a copy of an argument in favor of the proposnion to
the authors of any argument against the measure and a copy of an argument
against Ihe measure to Iha authors of any argument in lavor of tha measure
immediately upon receiving the arguments.
The author or a majority of the authors of an argument relating to a city measure
may prepare and submn a rebuttal argument not exceeding 250 words or may
authorize in wtning any other person or persons to prepare, submit, or sign the
rebuttal argument.
A rebuttal argument may not be signed by more than live. The rebuttal
. arguments shall be flied with the City Clerk, signed, with the printed name(s) and
signature(s) of the authOr(s) submitting n, or il submllled on behall 01 an
organization, the name 01 the organization, and the printed name and signature
of at least one of its principal officers, not more than 10 days aller Ihe final date
lor filing direct arguments. The rebuttal arguments shall be accompanied by the
Form 01 Statement To Be Filed By Author(s) of Argument (see attachment "A').
Rebuttal arguments shall be printed in the same manner as the direct arguments.
Each rebuttal argument shall Immediately follow the direct argument which it
seeks to rebut.
SECTION 2. That all previous resolutions providing for the filing of rebuttal
arguments lor city measures are repealed.
[SECTION 3. That the provisions of Section 1 shall apply at the next ensuing
municipal election and at each municipal election aller thai lime].
[SECTION 3. Thai the provisions of Section 1 shall apply only to the election to
be held on and shalllhen be repealed].
SECTION 4. That the City Clerk shall certify to the passage and adoption 01 this
Resolution and enter it into the book of original Resolutions.
PASSED, APPROVED AND ADOPTED BY THE City Council of Seal Beach, at a
meeting hereof held on the 22nd day 01 Januarv ,2007 by the lollowing vote:
AYES: Council Members
NOES: Council Members
ABSENT: Council Members
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Mayor
ATTEST:
City Clerk
STATE OF CALIFORNIA }
COUNTY OF ORANGE } SS
CITY OF SEAL BEACH )
I, Linda Devine, City Clerk for the City of Seal Beach, CalKomla, do hereby certify
that the foregoing resolutions is the original copy of Resolution Number
on .tUe in the office of the City Clerk, passed, approved an adopted by the City
CouncU of the City of Seal Beach at a regular meeting hereof held on the 22nd
day of Januarv , 2007.
City Clerk
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Attachment" An
FORM OF STATEMENT TO BE FILED BY
AUTHOR OF ARGUMENT
All arguments concerning measures filed pursuant to Division 9, Chapter 3
(beginning with ~ 9200) of the Elections Code shall be accompanied by the
following form statement to be signed by each proponent, and by each author, if
different, of the argument:
The undersigned proponent (s) or author(s} of the (primary/rebuttal) argument (in
favor of/against) ballot measure regarding Ordinance Number 1553 at the
Special Municipal Election for the City Of Seal Beach to be held on Tuesday,
April 24, 2007 hereby state that the argument is true and correct to the best of
(his/her/their) knowledge and belief.
Sign Name Print Name Date
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2)
3)
4)
5)
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