PRESIDENT & VICE PRESIDENT CANDIDATE PETITION - NO PARTY AFFILIATION
Notes: - All information on this form becomes a public record upon receipt by the Supervisor of Elections.
- It is a crime to knowingly sign more than one petition for a candidate. [Section 104.185, Florida Statutes]
- If all requested information on this form is not completed, the form will not be valid as a Candidate Petition form.
I,
the undersigned, a registered voter
(print name as it appears on your voter information card)
in said state and county, petition to have the name of
for President and _________________________________________________________________ for Vice President placed on the
General Election Ballot for the presidential election occuring in ______________ as no party affiliation candidates.
(insert year)
Date of Birth or
(MM/DD/YY)
Voter Registration Number Address
City County State Zip Code
Signature of Voter Date Signed (MM/DD/YY)
[to be completed by voter]
Rule 1S-2.045, F.A.C. DS-DE 18A (Eff. 09/11)
