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.
Date of Filing
CFR I.D. No.
I. CANDIDATE IDENTIFICATION
Have you changed your name within the last 10 years for reasons other than marriage?
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.)
Ward # (if any)
q City q Township of
. Resident of