VIc-Nomination Petition NOMINATION PETITION
We, the undersigned electors of the City of Atlantic Beach, hereby nominate
______________________________________, whose residence is
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for the office of City Commissioner, Seat No. __________, to be voted for at the
election to be held on the 25th day of August, 2015, A.D., and we individually
certify that our names appear on the rolls of registered voters, and that we are
qualified to vote for a candidate for election to the Atlantic Beach City
Commission.
PRINTED NAME ADDRESS DATE OF BIRTH SIGNATURE DATE
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* * * * Signatures must be verified * * * *
STATEMENT OF CIRCULATOR
The undersigned is the circulator of the foregoing paper containing ______ signatures. Each signature appended
hereto was made in my presence and is the genuine signature of the person whose name it purports to be.
SIGNATURE OF CIRCULATOR_________________________________
ADDRESS___________________________________________________________________________________
ACCEPTANCE OF NOMINATION
I hereby accept the nomination for Seat No. ______ on the City Commission. I have been a full time resident of the
City of Atlantic Beach for at least one year prior to qualifying and am qualified to be a candidate for this office.
SIGNATURE________________________________________________
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