Printable Nomination Form

Instructions


Completed forms should be sent to:

Neumann For Congress, 4500 Stone Bridge Rd, La Crosse, WI, 54601

Requirements

The Signers (or Electors) of Dr. Mark’s Nomination Petition have two requirements:

1a) They must be eligible to vote somewhere in the Third Congressional District of Wisconsin. If you are unsure of eligibility, go to https://www.govtrack.us/congress/members/WI/3. Type in your address and click “Find My District”. If you are eligible to vote in the Third district, the pop-up window “That address is in the same congressional district.” will appear.

1b) They have not signed a nomination form for other any candidate for the same office at this election.

The Elector or Signer’s Information

2a) The Signer’s signature goes in the box of the first column titled “Signature of Electors”.

2b) The Signer’s name is printed in the adjacent box, or the second column titled “Printed Name of Electors”.

2c) The Signer’s street ADDRESS* goes in the adjacent box, or the third column titled “Residential Address”.

*The residential address is the physical address where a person lives. It is NOT a mailing address like a post office box number.

2d) The Signer’s WHERE A PERSON RESIDES**, is a city, township or village name, and goes in the adjacent box, or the fourth column titled “Municipality of Residence”. Check the box that describes whether the municipality is a Town, Village or City.

**The same goes for the city, town or village of residence designation. This refers to the place where one lives and is not necessarily the same as the mailing address.

2e) The Signer enters the date of the signing in the adjacent box, or the fifth column titled “Date of Signing”.

Certification of Circulator

3a) The person circulating the petition (the Circulator) can correct, or make legible, any of the information entered for each Signer (except for the signature, obviously).

3b) The person who is the Circulator can also be one of the Signers of the petition. And most importantly, if you have any questions about functioning as a circulator of the petition, please contact me at 608-345-7572.

3c) After circulating the petition within his/her COVID-19 “safe-at-home” space, the Circulator should draw a line through all open rows of the form that do not contain signatures.

3d) In the open spaces at the bottom of the form, the Circulator enters his/her name, residential address, and then signs and dates the statement.