Free affidavit of identity 44Free affidavit of identity 44
Download the document to the computer for easy use
There are more pages to preview,Read on

school board candidate
AFFIDAVIT OF IDENTITY AND RECEIPT OF FILING
PLEASE COMPLETE SECTIONS I, II, III AND IV BELOW (Print or Type) – See Reverse Side for Important Notifications

OFFICE USE ONLY

No. of Petition Sheets or Receipt No.

Received by

Date of Filing

Reviewed by

CFR I.D. No.

I. CANDIDATE IDENTIFICATION
Name

Birth date
(Last)

(First)

(Middle)

Have you changed your name within the last 10 years for reasons other than marriage?

/
(Month)

q Yes

/
(Day)

(Year)

q No

If yes, enter full former name here (See “Section A” on reverse)
I WISH TO HAVE MY NAME APPEAR ON THE BALLOT AS PRINTED BELOW

(Please print upper and lower case - nicknames/titles not permitted. See “Section B” on reverse.)

Residence Address (Street Address, City, Zip Code)

Mailing Address (If different from Residence Address, see “Section C” on reverse.)

(Street Address)

(Street Address)

(City)

(Zip)

Phone (

)

(City)

(Zip)

Email
Ward # (if any)

q City q Township of
County of

. Resident of