WHITE NOMINATION PETITION 08-11-2016.PDF

Nonpartisan Nomination Petition
2 0 the undersigned, a qualified elector of the county o , state of Arizona, and of (here name political division or district from which the
00 2/ Put optional photo nomination is sought) hereby nominate k-412.6161/ who resides at 39/7, i)-2_6(2igtervn , A' in the county of for the
here
000 office of 1.30246/ t21LePh-7 to be voted at the CZ ejection ton to be held-Ittieni1/476-4‘, and hereby declare that I am
4 qualified to vote for thisoffice and that I have not signed and will not sign any nomination petitions for more persons that the number of candidates necessary to fill such office at the next
ensuing election. I further declare that if I choose to use a post office box address on this petition, my residence address has not changed since I last reported it to the county recorder for
purposes of updating my voter registration file.
Signature - Printed name Actual residence address, description of place of residence, or Arizona post office box address, city or town Date of signing
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15. CLERK BOARD OF SUPERVISORS
Secretary of State, Revised 2/1412011

Instructions for Circulators
. All petitions shall be- signed ,by tircUlatbr: . '
2. Circulator must be qualified to register to vote in this state.
3. Circulator's narne Shall bá typed or printed udder suchperson's . . signature. - • ,
4. Circulator's residence address or if no street address, - a description of residence location shall be inclkled on the , petition.
Z. _
ttg TT' . vA, i-VJ ; _ her6bV•verity that I arn . ilualified . -to register.to Vote in the County of • trim c. afS ', state-6f Arizona', that each of the • • _
(Printed Name) - 74- s 0817
ames, On the _ petition was signed in my presence grill:lie _date indicated; that.in.rny - belief each signer, was a qualified • elector who resides at the • , address . . given - asitheir . residence • on the date indicated. 6 9888
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;. : • • ,Signature ofCircurator ,
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Type-d or,Printed.Name of Circulator, :
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Circulator's Actual Residence Address
(If no street address, a description of residence location shall be included n the petition)
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'City or Town and Zip Code
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Secretary of State, Revised 2/14/2011