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LAST DAY TO SUBMIT: October 16, 2017 (by 5:00 p.m.) WITHDRAWAL OF CANDIDACY of (Print name of Candidate) I, , being first duly sworn, say that I reside at , City of Ogden, County of Weber, State of Utah; and that I am a qualified voter therein. I hereby request that my name be removed from the official ballot for nomination to the office of: Council Member – Municipal Ward 1 Council Member – Municipal Ward 3 Council Member – At-Large Seat A Council Member – At-Large Seat B Signature (Must be signed in front of a Notary.) Date State of Utah) County of ) Subscribed and sworn to before me by on this day of , 2017. Notary Public Utah Code Annotated 20A-9-203 Any person who filed a declaration of candidacy, or any person who was nominated by a Nominating Petition, may at any time up to 23 days before the general election withdraw by filing this written affidavit with the City Recorder. That date is October 16, 2017. §