Form 3-I - Nominating Petition - Judge Or Clerk Of The Municipal Court (Page 2 of 2) in pdf

Form 3-I - Nominating Petition - Judge Or Clerk Of The Municipal Court Page 2

VOTING RESIDENCE

CITY, VILLAGE

DATE OF

SIGNATURE

ADDRESS

COUNTY

OR TOWNSHIP

SIGNING

STREET AND NUMBER

10.

11.

12.

13.

14.

15.

16.

17.

18.

–

CIRCULATOR STATEMENT

Must be completed and signed by circulator.

I, ______________________________________, declare under penalty of election falsification that I reside

(Printed Name of Circulator)

at the address appearing below my signature; that I am the circulator of the foregoing petition containing

___________ signatures; that I witnessed the affixing of every signature; that all signers were to the best of

(Number)

my knowledge and belief qualified to sign; and that every signature is to the best of my knowledge and belief

the signature of the person whose signature it purports to be or of an attorney in fact acting pursuant to

section 3501.382 of the Revised Code.

_________________________________________

(Signature of Circulator)

WHOEVER COMMITS ELECTION

_________________________________________

WHOEVER COMMITS ELECTION

FALSIFICATION IS GUILTY OF A

(Permanent residence address)

FALSIFICATION IS GUILTY OF

FELONY OF THE FIFTH DEGREE.

_________________________________________

A FELONY OF THE FIFTH DEGREE

(City or Village, State and Zip Code)

Form 3-I - Nominating Petition - Judge Or Clerk Of The Municipal Court Page 2