Form 3-K Nominating Petition and Statement of Candidacy for Member of County Charter Commission (Single Candidate) - Ohio

Form 3-K or the "Nominating Petition And Statement Of Candidacy For Member Of County Charter Commission (single Candidate)" is a form issued by the Ohio Secretary of State.

The form was last revised in September 1, 2017 and is available for digital filing. Download an up-to-date Form 3-K in PDF-format down below or look it up on the Ohio Secretary of State Forms website.

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Form No. 3-K Prescribed by the Ohio Secretary of State (09-17)
Nominating Petition and Statement of Candidacy
For Member of County Charter Commission (Single Candidate)
To be filed with the Board of Elections.
Constitution of the State of Ohio – Article X, Section 4; Revised Code 3513.261, 3501.38
Statement of Candidacy
NOTE - The candidate must fill in, sign and date this statement of candidacy before the signatures of electors are
affixed.
I,
, the undersigned, hereby declare under penalty of election falsification that
Name of Candidate
my voting residence address is
,
, Ohio
,
Street Number and Address, if any,
City or Village
Zip Code
(or rural route and number)
and I am a qualified elector.
I further declare that I desire to be a candidate for election to the office of Member of the Charter Commission of the
County of
, Ohio at the general election to be held on the
day of November,
.
County
Day
Year
I further declare that I am an elector qualified to vote for the office I seek.
Dated this
day of
,
.
Day
Month
Year
Signature of Candidate
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE
I,
, hereby designate the persons named below as a committee to represent me:
Name of Candidate
Name
Residence
Nominating Petition
We, the undersigned, qualified electors of the State of Ohio, whose voting residence is in the county, city,
village, or township set opposite our names, hereby nominate
as a
Name of Candidate
candidate for election to the office of Member of the Charter Commission of the County of
,
County
Ohio to be voted for at the next general election to be held on the
day of November,
, and
Day
Year
certify said person is, in our opinion, well qualified to perform the duties of the office or position to which the
person desires to be elected.
Signatures on this petition must be from one county and must be written in ink. Signatures on this petition must
be those of electors residing in the above name municipality
Voting Residence
City, Village, or
Date of
Signature
County
Street Number and Address
Township
Signing
1.
2.
3.
4.
5.
6.
Form No. 3-K Prescribed by the Ohio Secretary of State (09-17)
Nominating Petition and Statement of Candidacy
For Member of County Charter Commission (Single Candidate)
To be filed with the Board of Elections.
Constitution of the State of Ohio – Article X, Section 4; Revised Code 3513.261, 3501.38
Statement of Candidacy
NOTE - The candidate must fill in, sign and date this statement of candidacy before the signatures of electors are
affixed.
I,
, the undersigned, hereby declare under penalty of election falsification that
Name of Candidate
my voting residence address is
,
, Ohio
,
Street Number and Address, if any,
City or Village
Zip Code
(or rural route and number)
and I am a qualified elector.
I further declare that I desire to be a candidate for election to the office of Member of the Charter Commission of the
County of
, Ohio at the general election to be held on the
day of November,
.
County
Day
Year
I further declare that I am an elector qualified to vote for the office I seek.
Dated this
day of
,
.
Day
Month
Year
Signature of Candidate
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE
I,
, hereby designate the persons named below as a committee to represent me:
Name of Candidate
Name
Residence
Nominating Petition
We, the undersigned, qualified electors of the State of Ohio, whose voting residence is in the county, city,
village, or township set opposite our names, hereby nominate
as a
Name of Candidate
candidate for election to the office of Member of the Charter Commission of the County of
,
County
Ohio to be voted for at the next general election to be held on the
day of November,
, and
Day
Year
certify said person is, in our opinion, well qualified to perform the duties of the office or position to which the
person desires to be elected.
Signatures on this petition must be from one county and must be written in ink. Signatures on this petition must
be those of electors residing in the above name municipality
Voting Residence
City, Village, or
Date of
Signature
County
Street Number and Address
Township
Signing
1.
2.
3.
4.
5.
6.
Voting Residence
City, Village, or
Date of
Signature
County
Street Number and Address
Township
Signing
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE
Circulator Statement
Must be completed and signed by the circulator.
I,
, declare under penalty of election falsification that I reside at the address
Printed Name of Circulator
signatures;
appearing below my signature; that I am the circulator of the foregoing petition containing
Number
that I witnessed the affixing of every signature; that all signers were to the best of my knowledge and belief
qualified to sign; and that every signature is to the best of my knowledge and belief the signature of the person
whose signature it purports to be or of an attorney in fact acting pursuant to section 3501.382 of the Revised Code.
Signature of Circulator
Permanent Residence Address
City or Village
State
Zip Code

Download Form 3-K Nominating Petition and Statement of Candidacy for Member of County Charter Commission (Single Candidate) - Ohio

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