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Neely Petition 2012
Neely Petition 2012
026 Little Rock, Arkansas 72201-1094 We, the undersigned qualified electors propose that Charles Neely, whose address is 311 East 8th Street, Suite #302, Little Rock, AR 72202 be placed on the ballot as a Independent Candidate, 2nd Congressional District United States House of Representatives, in the General Election to be held on November 6, 2012. Each of us for him or herself says: I have personally signed this petition; I am a legal voter of the State of Arkansas and the designated district to be represented, and my printed name, date of birth, residence, city or town of residence, and date of signing are correctly written after my signature.
Signature Printed Name Date of Birth Residence (Street Address) City or Town of Residence Date Of Signing
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