We, the undersigned, registered and qualified voters of the city or township |
(strike 1) |
of |
, in the county of | ||
and state of Michigan, nominate, |
, |
(Name of Candidate) |
, |
(Street Address or Rural Route) | (City or Township) |
as a candidate of the ................... party for the office of ................... , |
(District, if any) |
to be voted for at the primary election to be held on the .......... day of ......., 20...... |
WARNING |
A person who knowingly signs more petitions for the same office than there are persons to be elected to the office, signs a petition more than once, or signs a name other than his or her own is violating the provisions of the Michigan election law. |
Printed | Street Address |
Name and | or | Date of Signing |
Signature | Rural Route | Zip Code | Mo. | Day | Year |
1. | ||
2. | ||
3. | ||
4. |
numbered lines as above |
(Printed Name and Signature of Circulator) | (Date) | ||
(Complete Residence Address (Street and Number or Rural Route)) | ||
Do not enter a post office box | ||
(City or Township, State, Zip Code) | ||
(County of Registration, if Registered to Vote, of a Circulator who is not a Resident of Michigan) |
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