HICKMAN NOMINATION PETITIONS 11-10-2016.PDF

NOMINATING PETITION
We, the undersigned, each a qualified elector of the ELECTRICAL DISTRICT NUMBER EIGHT,
Division hereby nominate 23z L L y/7/16-qt who resides at
7d 7 1u (1,-? , $:c.ig for the office of Director, from said
Division to be voted for at the election to be held in said Division on January 14, 2017 and each declares that
he/she has not signed and will not sign a Nominating Petition for more persons than the number of Director
positions to be filled for such Division at said election.
Print Name Sign Name Actual Residence Address Date
liw4,6 N. &Jr- tat
kut-DtP SCOW ali. A 2_ gfa.54
VERmA
/47(Cg.4/ i'6VP C-47 473
CERTIFICATE
I, the undersigned, a qualified elector of ELECTRICAL DISTRICT NUMBER EIGHT, and qualified to
vote for the candidate whose name appears on this nomination paper, do hereby certify to the best of my
knowledge and belief that all the signers of this Nominating Petition are qualified electors of said Division of
said District.
DATED this /5-2.-14 day of 0a0,6er , 2016 at ,AZ.
_ .41111 ...........Grei ...../ ..e. _____
gna re of Circul or
Instructions for Circulators
(see reverse side)
RECEIVED
By Clerk of the Board at 10:29 am, Nov 10, 2016

NOMINATION PAPER
for
ELECTRICAL DISTRICT NUMBER EIGHT
The undersigned ("Candidate") hereby offers his candidacy for the office of:
O Director of Electrical District Number Eight, Division
O Candidate's actual residence address is:
6'?
O The date of the election is January it-1, 20/
O Candidate desires to have his/her name appear on the official ballot in the following
form:
[type or print]
%,t A
Signed this /day 0f , 20 /It
[signature]
[type or print namey56,1/7/VI-C/Z64/1------
This completed form is to be filed no later than 90 days before the election date, with:
Electrical District Number Eight
Elections Officer
P 0 Box 99
Salome, AZ 85348