Kansas Independent Nomination Petition Ip - Affidavit Of Petition Circulator Page 2
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Affidavit of petition circulator
}
STATE OF KANSAS
ss.
COUNTY OF
____________________________________________
I,
,
Print Name
(check one):
____
I am the circulator of this petition. I am qualified to circulate this petition and I personally
witnessed the signing of the petition by each person whose name appears thereon.
____
I am the candidate
_______________________________________________________
Signature
_______________________________________________________
Circulator's residence address
Subscribed and sworn to before me this ______ day of ____________________ , 20 ____ .
(SEAL)
____________________________________
Person authorized to administer oaths
My appointment expires ______________________________ , 20 ____ .
Kansas law states that a petition circulator is a person who is a U.S. citizen, at least 18 years of age, and has not
been convicted of a felony, or if convicted of a felony has been pardoned or restored to such person's civil rights.
K.S.A. 25-303(e)
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