Form 3-R - Nominating Petition - Township Office printable pdf download

Form No. 3-R Prescribed by Secretary of State (06-10)

NOMINATING PETITION AND STATEMENT OF CANDIDACY

FOR TOWNSHIP OFFICE

To be filed with the Board of Elections not later than 4 p.m. of the 90

day before the general election.

Revised Code 3501.38, 3513.253, 3513.261, 3513.263

NOTE – THE CANDIDATE MUST FILL IN, SIGN AND DATE THIS STATEMENT OF CANDIDACY

BEFORE PETITIONS ARE CIRCULATED.

STATEMENT OF CANDIDACY

I, _____________________________________________, the undersigned, hereby declare under penalty of

(Name of Candidate)

election falsification that my voting residence address is__________________________________________,

(Street and Number, if any, or Rural Route Number)

________________________________, Ohio ________________; and I am a qualified elector.

(City or Village)

(Zip Code)

I further declare that I desire to be a candidate for election to the office of ____________________________

in the Township of ____________________________________________ for the:

full term, or

(check one)

unexpired term ending ___________________________, in ____________________________ County,

(Fill in the appropriate date)

Ohio at the general election to be held the ___________ day of ____________________, ___________.

I further declare that I am an elector qualified to vote for the office I seek.

Dated this ______ day of _______________________, _____________.

________________________________________________

(Signature of Candidate)

WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE.

I, ___________________________________, hereby designate the persons named below as a committee to

(Name of Candidate)

represent me:

NAME

RESIDENCE

NOMINATING PETITION

We, the undersigned, qualified electors of the State of Ohio, whose voting residence is in the county, city,

village, or township set opposite our names, hereby nominate _____________________________________

as a candidate for election to the office of ______________________________________ in the township of

____________________________________, for the:

full term, or

unexpired term ending

(check one)

____________________________, to be voted for at the next general election, and certify said person is, in

(Fill in the appropriate date)

our opinion, well qualified to perform the duties of the office or position to which the person desires to be

elected.

Signatures on this petition must be from only one county and must be written in ink.

VOTING RESIDENCE

CITY, VILLAGE

DATE OF

SIGNATURE

ADDRESS

COUNTY

OR TOWNSHIP

SIGNING

STREET AND NUMBER

Form 3-R - Nominating Petition - Township Office

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