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NOMINATING PETITION The undersigned residents of Millcreek, being 18 years old or older and registered voters of Millcreek, nominate to the office of (Print candidate's name as it is to appear on the ballot) Mayor – (four-year term) Council Member – (four-year term) NAME ADDRESS PHONE ---PAGE BREAK--- The undersigned person who is submitting this petition to the City Recorder further states the above named nominee is: • A United States Citizen; • A resident of Millcreek and will have been such for a period of 12 consecutive months immediately preceding the date of the election. • A registered voter. Submitted by: Name Address Phone Received by: City Recorder Date ---PAGE BREAK--- WITHDRAWAL OF CANDIDACY I, say that I have filed a declaration of candidacy or have been nominated as a candidate by a nominating petition. I hereby request that my name be removed from the official primary/general ballot for nomination to the office of: Mayor – (four-year term) Council Member – (four-year term) Pursuant to Utah Code Annotated §78B-5-705 (2008) I declare under criminal penalty of the State of Utah that the foregoing is true and correct. Executed on 2019 Signature