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Document Dallascountyiowa_doc_10472a34bc_1

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Prescribed by the Iowa Secretary of State Revised 4/2021 State of Iowa Nomination Petition for Non-Partisan Office Candidate Information Name of Candidate: Office Sought: Candidate’s County of Residence: Candidate’s City of Residence: Type and Date of Election: General on Special on City/School on Is the candidate running to fill a vacancy due to the death, resignation, removal, or temporary appointment of an office holder? No Yes For School Elections Only School District: School Director District (if any): For City Elections Only For Other Elections Only Office Ward (if any): Office District (if any): We, the undersigned eligible electors of the appropriate county, city, school district, school or community college director district, or other district as established by law, and the state of Iowa hereby make the nomination outlined above. If the candidate named above accepts the nomination, we believe the candidate is or will be a resident of the appropriate county, city, school district, school or community college director district, or other district established by law as required by law. Sign your name Address where you live in Iowa Today’s Date House number and street City 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.