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12 <br />Name of any Durham County or City of Durham Board/Commission/Committee on which you <br />presently serve: <br />If reapplying for a position you presently hold, how many consecutive terms have you served? <br />Based on your qualifications and experiences, briefly describe why your services on this Authority/ <br />Board/Commission/Committee would be beneficial to the County of Durham: <br />Are your taxes current (e.g. animal, property, vehicle)? Yes No <br />Are your City and County property and motor vehicle taxes paid in full on a current basis? <br />Yes No <br />Other information you consider pertinent: (i.e., civic memberships, related work experience, etc.): <br />(If necessary, you. may add additional pages.) (Check if additional pages are added: ) <br />Note: All information on this document will be released to the public on request. <br />Date: Applicant's Signature: <br />Return application to: Clerk to the Board of County Commissioners <br />2nd Floor -- 8:30 a.m.-5:00 p.m. <br />Mailing Address: Durham County Government Administrative Complex <br />200 East Main Street <br />Durham, NC 27701 <br />Fax Number: (919) 560-0013 <br />userdata\board-ap.doc <br />