"Statement of Withdrawal by Candidate" - Colorado

Statement of Withdrawal by Candidate is a legal document that was released by the Colorado Secretary of State - a government authority operating within Colorado.

Form Details:

  • Released on May 12, 2015;
  • The latest edition currently provided by the Colorado Secretary of State;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Colorado Secretary of State.

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Download "Statement of Withdrawal by Candidate" - Colorado

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Office Use Only:
Statement of Withdrawal by Candidate
Complete, sign, and return this form to the Colorado Secretary of State. Please type or print legibly.
Candidate Information
Name
of Candidate
Office Information
Assembly delegates
Petition
Vacancy Committee
Write-in
Designated/nominated by:
Office Title
Party Affiliation
Residence & Mailing Address
Residence Street Address
Apt/Unit
City
State
Zip Code
Mailing Street Address
Apt/Unit
City
State
Zip Code
Telephone & E-mail Address
Business Phone #
Extension
Residence Phone #
E-mail Address
Signature
Applicant's Affirmation
I affirm that I hereby withdraw my candidacy for the office listed above. I acknowledge that it is my responsibility to report this withdrawal to the persons
designated in Section 1-4-1002, C.R.S., to fill this vacancy. Furthermore, the information provided on this form is, to the best of my knowledge, true and
correct.
[seal]
______________________________________________
__________________
Signature of Candidate
Date of Signing
STATE OF COLORADO
COUNTY OF
___________________
Subscribed and sworn to before me this ________ day of _______________________, 20_____ by ____________________________________________________ .
Day
Month
Year
Printed name of Candidate Above
Signature (and Title) of Notary / Official Administering Oath ____________________________________________________________________________________
My Commission Expires: ___________________
Colorado Secretary of State
1700 Broadway, Suite 200
Denver, Colorado 80290
Phone: (303) 894-2200
F
ax: (303) 869-4861
SOS Revised May 12, 2015
Print Form
Email: ballot.access@sos.state.co.us
Section 1-4-1001, C.R.S.
Office Use Only:
Statement of Withdrawal by Candidate
Complete, sign, and return this form to the Colorado Secretary of State. Please type or print legibly.
Candidate Information
Name
of Candidate
Office Information
Assembly delegates
Petition
Vacancy Committee
Write-in
Designated/nominated by:
Office Title
Party Affiliation
Residence & Mailing Address
Residence Street Address
Apt/Unit
City
State
Zip Code
Mailing Street Address
Apt/Unit
City
State
Zip Code
Telephone & E-mail Address
Business Phone #
Extension
Residence Phone #
E-mail Address
Signature
Applicant's Affirmation
I affirm that I hereby withdraw my candidacy for the office listed above. I acknowledge that it is my responsibility to report this withdrawal to the persons
designated in Section 1-4-1002, C.R.S., to fill this vacancy. Furthermore, the information provided on this form is, to the best of my knowledge, true and
correct.
[seal]
______________________________________________
__________________
Signature of Candidate
Date of Signing
STATE OF COLORADO
COUNTY OF
___________________
Subscribed and sworn to before me this ________ day of _______________________, 20_____ by ____________________________________________________ .
Day
Month
Year
Printed name of Candidate Above
Signature (and Title) of Notary / Official Administering Oath ____________________________________________________________________________________
My Commission Expires: ___________________
Colorado Secretary of State
1700 Broadway, Suite 200
Denver, Colorado 80290
Phone: (303) 894-2200
F
ax: (303) 869-4861
SOS Revised May 12, 2015
Print Form
Email: ballot.access@sos.state.co.us
Section 1-4-1001, C.R.S.