Fillable ELECTION REPORT FOR COUNTY (Information Technology Services)

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ELECTION REPORT FOR COUNTY (Information Technology Services)

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Version 4.4.12
DSWC Form 200
http://www.ncagr.gov/swc/districts/forms.html
DIVISION OF SOIL AND WATER CONSERVATION
North Carolina Department of Agriculture & Consumer Services
1614 Mail Service Center • Raleigh, NC 27699-1614
919.707.3770 • www.ncagr.gov/swc/
ELECTION REPORT FOR COUNTY
Complete and submit online through SharePoint; keep original for district file
Date:
Supervisor’s name:
Address:
City:
State:
Zip:
Phone number:
Email address:
Has be
en elected to the office of Soil and Water Conservation District Supervisor for County of
for a four-year term, beginning the first Monday in December 20____.
____________________________________________
Chairman, County Board of Elections
Sworn
to and subscribed before me,
this ______ day of, __________________ 20_____.
_____________
_____________________________________
Notary Public
My Co
mmission Expires: ___________________________
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ELECTION REPORT FOR COUNTY (Information Technology Services)

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Completed 14 August 2020

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