Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout07/01/2002 Item 025
I
REQUEST FOR APPOINTMENT
I Precinct f1:,tru)/r Y :;t/ G .5"
County/District jr)tJlf-,[{J[.
'2..
I
,
i
i I
Requ~st IS hereby made to the Chairman of the above designated County/district,
that the following named person be appointed to the office indicated below:
PRECINCT COMMITTEEMAN
Mr. EJ Miss
i\1s IlfiJJvt
:FE /l ~ II} C LII-~/I)
Name as registered to vote
i
,
or?' ?/ JC rJ ..vAl
ILvt.
Complete Street Address
'1
Ga /'12.
i?u 9"9',;(
.is t{ L crf 'i: ~J I
City
I I State Zip
I
I
I
J
,(9~g)7t3~ 5/'T4
( t'tt-'~) SS.3-Co:t V7
,,' Home Phone
Business Phone
Reason For Vacancy:
I
Be certain to list the. names of the person as they are REGISTEREDI Please
make
sure appointees are registered to vote at the above address.
Date:
.5 i,u/o;;.
Applicant's Signature
~~ /J!c K~
:=--:>
.............~-
Precinct Captain's Signature
"..~r"---.
~
---- ---.
....:-
: County/District Chairman's Signature C<
,. .
d5