To the Honorable ______, county clerk of ______ County: | |||||
We, the undersigned, citizens and registered voters of ______ County, respectfully order that the following question be placed on the official ballot, for acceptance or rejection, at the next general election to be held on the ______ day of ______, ______: | |||||
Should a board of election commissioners be established in ______ County to assume responsibility for the registration of voters and the conduct of elections?; | |||||
and each for himself or herself says: I have personally signed this petition; I am a registered voter of the state of Missouri and ______ County; my registered voting address and the name of the city, town or village in which I live are correctly written after my name. | |||||
CIRCULATOR'S AFFIDAVIT | |||||
STATE OF MISSOURI, COUNTY OF ______ | |||||
I, ______, a resident of the state of Missouri, being first duly sworn, say (print or type names of signers) | |||||
REGISTERED | |||||
VOTING | |||||
NAME (Signature) | DATE SIGNED | ADDRESS (Street) | ZIP CODE | CONG DIST. | NAME (Printed or |
(City, | Typed) | ||||
Town or | |||||
Village) | |||||
(Here follow numbered lines for signers) | |||||
signed this page of the foregoing petition, and each of them signed his or her name thereto in my presence; I believe that each has stated his or her name, registered voting address and city, town or village correctly, and that each signer is a registered voter of the state of Missouri and ______ County. | |||||
__________________ | |||||
Signature of Affiant | |||||
(Person obtaining signatures) | |||||
__________________ | |||||
Address of Affiant | |||||
Subscribed and sworn to before me this ____ day of ____, A.D. ____ | |||||
__________________ | |||||
Signature of Notary | |||||
Notary Public (Seal) | |||||
My commission expires ______ |
If this form is followed substantially, it shall be sufficient, disregarding clerical and merely technical errors.
"Should a board of election commissioners be established in ______ County to assume responsibility for the registration of voters and the conduct of elections?"
§ 115.019, RSMo