Petition for Placing a New Party on the Ballot, To the Honorable Secretary of the State of Missouri
We, the undersigned, citizens and registered voters, of the state of Missouri, Greene County, and the 138th State Representative District, respectfully order that the Democratic Socialist Party and its candidates be placed on the ballot, for election or rejection to such public offices at the next election, to be held on the 6th day of August, 2004, and each for himself or herself says: I have personally signed this petition; I am a registered voter of the State of Missouri, Greene County and the 138th State Representative District, my registered voting address and the name of the city, town or village in which I live are correctly written after my name.
CIRCULATORS AFFIDAVIT STATE OF MISSOURI, COUNTY OF GREENE, (Circulators Registered voting name) I,___________ _____________________, a resident of the state of Missouri, being first duly sworn, say: The following signatures of registered voters of the 138th State Representative District of the state of Missouri, signed this page of the forgoing petition, and each of them signed his/her name thereto in my presence; I believe that each has stated his/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 Greene County and the 138th District. (Circulators signature)__________________,
Date_________, Address and Zip Code_______________________________, 7th Congressional District.
Registered Voter
Printed Name Date Address, City, Zip Signature
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Notarization
(signature of Circulator of petition)_________________________, Address__________________
_______________________________, subscribed and sworn before me this ______day of ______
__________A.D., Signature of Notary Public____________________________(Seal)__________.
My Commission expires___________________________________________________________
