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H. MISCELLANEOUS INFORMATION <br />32. Have you ever failed to file your state or federal income tax return? If so, please explain. <br />NO <br />33. Have you been found by the Colorado Department of Revenue, IRS, or any other agency or <br />court to have willfully failed to properly disclose your income during the last five years? If so, <br />please give details. <br />NO <br />34. Do you owe any unpaid taxes or past -due child support? If so, please explain. <br />NO <br />CERTIFICATE OF APPLICANT <br />I understand the submission of this application expresses my willingness to accept appointment <br />to the position of municipal judge for the City of Louisville, Colorado, and my willingness to <br />abide by the Louisville City Charter and the Louisville Municipal Code, if appointed. I hereby <br />certify that the information given in this application is correct and complete. <br />Date: <br />Signe of Applicant <br />KRISTAN K. WHEELER <br />Print or Type Name <br />WAIVER <br />I grant the City of Louisville, Colorado the right to examine the records of the Attorney <br />Regulation Counsel (formerly maintained by the Supreme Court Grievance Committee) and the <br />records of the Commission on Judicial Discipline. I consent to the release of information by <br />employers, schools, law enforcement agencies, and other authorized personnel to verify the <br />information contained in this application. <br />A <br />Date: &--1.(4/ <br />Signature of Applicant <br />KRISTAN K. WHEELER <br />Print or Type Name <br />Applications must be submitted by June 20, 2016. <br />Page 6 of 6 <br />