Fillable Partisan Nomination Petition Form (Page 2 of 2) in pdf

Partisan Nomination Petition Form Page 2

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Instructions for Circulators

1. All petitions shall be signed by circulator.

2. Circulator is not required to be a resident of this state but otherwise must be qualified to register to vote in this state and, if not a resident of this

state, shall register as a circulator with the secretary of state.

3. Circulator’s name shall be typed or printed under the circulator’s signature.

4. Circulator’s actual residence address or, if no street address, a description of residence location shall be included on the petition.

I, ___________________________________ a person who is not required to be a resident of this state but who is otherwise qualified to register to

(Printed Name)

vote in the county of ____________________________, in the state of Arizona, hereby verify that each of the names on the petition was signed in my

presence on the date indicated; that in my belief each signer was a qualified elector who resides at the address given as their residence on the date

indicated. I further verify that each signer is a member of the party from which the candidate is seeking nomination, or the signer is a member of a political

party that is not entitled to continued representation on the ballot, or the signer is registered as independent or no party preferred.

___________________________________________________________________

Signature of Circulator

___________________________________________________________________

Typed or Printed Name of Circulator

___________________________________________________________________

Circulator’s Actual Residence Address

(If no street address, a description of residence location shall be included on the

petition)

___________________________________________________________________

City or Town and Zip Code

Secretary of State, Revised 7/17/2012