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NomPapers 05.11 11x8.5 Clark
NomPapers 05.11 11x8.5 Clark
Candidate's name as it will appear on the ballot; no abbreviations or titles may be used. Street, fire, or rural route number; box number (if rural route); and name of street or road
Fred Clark
Name of municipality for mailing purposes State Zip code
E12367 County Rd W
Greenfield
Baraboo
Title of office
WI 53913
Election date
State Senator
14
I, the undersigned, request that the candidate, whose name and address are listed above, be placed on the ballot at the election described above as a candidate representing the party or statement of principle indicated above, so that voters will have the opportunity to vote for x him or her for the office listed above. I am eligible to vote in the jurisdiction or district in which the candidate named above seeks office. I have not signed the nomination paper of any other candidate for the same office at this election. THE MUNICIPALITY USED FOR MAILING PURPOSES, WHEN DIFFERENT THAN MUNICIPALITY OF RESIDENCE, IS NOT SUFFICIENT. THE NAME OF THE MUNICIPALITY OF RESIDENCE MUST ALWAYS BE LISTED.
SIGNATURES OF ELECTORS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. PRINT NAME STREET & NUMBER OR RURAL ROUTE Rural address must also include box or fire no. MUNICIPALITY OF RESIDENCE Indicate Town, Village, or City
Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City
DATE OF SIGNING
/2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011
I personally circulated this nomination paper and personally obtained each of the signatures on this paper. I know that the signers are electors of the jurisdiction or district the candidate seeks to represent. I know that each person signed the paper with full knowledge of its content on the date indicated opposite his or her name. I know their respective residences given. I intend to support this candidate. I am aware that falsifying this certification is punishable under S. 12.13(3)(a), Stats.
__________________________________
(DATE)
________________________________________________________________________
(SIGNATURE OF CIRCULATOR)
EB-168 (Rev.6/2003) The information on this form is required by SS. 8.15, 8.20, 8.50, Wis. Stats. This form is prescribed by the State Elections Board, P.O. Box 2973, Madison, WI 53701-2973, 608 266-8005. http://elections.state.wi.us seb@seb.state.wi.us
Page No.
DAY
GREEN VALLEY
BERGEN
County Road O
nty H
County Highway P
ighw
ay
KNOWLTON
GUENTHER
BEVENT
J ad
FRANZEN
State Highway 49
GERMANIA
FAIRBANKS
County Trunk Hwy J
Uni ted S
PELLA
tate sH ighw ay
County Highway D
BELLE PLAINE
M ain
WAUKECHON
County Highway CC
HARTLAND
State Highway 47
Coun ty Ro
I-39
Marion
County Highway G
45
Embarrass
Cty Hwy
22
County Highway S
County Road I
County Road Y
ALBAN
County Road A
HARRISON
Auburndale
State Highway 186
County Road H
Rosholt SHARON
DUPONT
Stat e
AUBURNDALE
United States
MILLADORE
EAU PLEINE
State Highway 34
County Road G
DEWEY
Hig hw
County Road H
ay
Cty
County Road X
County Highway P
LARRABEE
County Highway C
MATTESON
County Highway Y
NAVARINO
State Highway 156
LESSOR
County Highway S
County Highway E
Clintonville
County Highway I
Highway
10
Milladore
Junction City
County Highway N
Main
I-39
County Highway D
County Highway M
I-39
County Highway E
State Highway 47
County Highway C
Iola
Cty J
County Highway C
County Highway C
Oak
County Highway S
Vesper SIGEL
Assembly District 40
LINWOOD RUDOLPH
P
Cou dP nty Roa
Plo ver
Rudolph
Whiting
STOCKTON
Nelsonville
County Highway WW
County Road M
ood County
te Sta H hw ig ay 13
I-39
County Highway D
ou nty
I-39
Wisconsin Rapids
2n d
County
igh w
County Highway O
Assembly District 42
County Highway FF
Road A
tate
sH
ig hw
ghwa e Hi Stat
y 54
Shawano
ay
County Highway D
County Highway BB
ghwa yE
State Highway 73
Coun ty Hi
Nekoosa
County Highway M
45
I-39
Water
Sta te H ig hw ay 73
County Road D
PINE GROVE
WEYAUWEGA
ALMOND
County Road A
BELMONT
County Road AA
DAYTON
County Highway K
LIND
County Highway X
GREENVILLE
United States Highway 10
GRAND CHUTE
State Highway 96
DALE
Wisconsin
Municipal
Appleton
Almond
County Highway J
I-39
FREMONT
County Road I
Fremont
Hi unty Co
Lind
MENASHA
United States Highway 45
County Highway D
State Highway 73
Plainfield
County Highway P
County Highway A
hway y Hig Count
County Highway A
ROME
State Highway 13
LEOLA
ARMENIA
County Highway A
te Sta
Wild Rose
yG County Highwa
State Highway 22
I-39
Badger
County Highway O
ty un Co
h Hig
y wa
JJ
Neenah
County Highway G
Mai n
Hancock
County Highway C
County Highway C
North Lake
County
WAUTOMA
County Highway C
Highwa yB
VINLAND Winneconne
te s H hw ig
ay
County
Wautoma
State Highway 21
Highway
ay
ig hw
WINNECONNE
OSHKOSH
Winnebago County
State Highway 21
ighw
nty H
Cou
Redgranite
County Highway
Lohrville
116
Omro WARREN
County Highway
State Highway 21
County Highway FF
DAKOTA
State Highway 22
State Highw ay
Necedah NECEDAH
STRONGS PRAIRIE
State Highway 21
PRESTON
RICHFIELD
MARION
AURORA
OMRO RUSHFORD
County Highway E
ALGOMA
Oshkosh
State Highway 175
ighw
uth So
rk Pa
ay
Co un ty
MONROE
BIG FLATS
COLBURN
HANCOCK
DEERFIELD
ou nty
Waushara County
County Highway D
ed nit
Sta
Hig hw
ay
POYGAN
ay
41
Com
PLAINFIELD
OASIS
ROSE
SPRINGWATER
SAXEVILLE
BLOOMFIELD
NEENAH
mer cial
WOLF RIVER
WINCHESTER
County Highway M
Menasha
CLAYTON
Richmond
GRANT
Nash
County Highway E
County Highway F
County Road D
State Highway 66
County Road Z
Nichols
County Road K
HULL
I-39
County Road XX
State Highway 34
County Highway O
County Road F
ARPIN Arpin
County Highway N
SHERRY
County Highway F
CARSON
County Road O
I-39
n Divisio
Legend
County Highway S
NEW HOPE
County Road A
IOLA
HELVETIA
UNION
BEAR CREEK
State Highway 22
County Highway T
DEER CREEK
State Highway 76
MAINE
Deer View
CICERO
County Road G
County Highway M
9 I-3
nle Sta
Bear Creek
State Highway 22
st Po
County Highway O
HANSEN
Portage County
Plover
I-39
County Road B
County Highway B
ty B Coun
Amherst Junction
County Highway B
AMHERST
Waupaca County
Ogdensburg Manawa LITTLE WOLF
ay
54
Assembly District 41
ay hw Hig ay U nty Highw Cou County
Amherst
County Road J
Hig hw
County Highway A
ay
Biron
49
e Stat
County Highway 5
PLOVER
hw H ig
ay
54
LIBERTY
County Highway M
Uni ted S
Outagamie Cou
County Highway S
State Highway 76
New London
ay
County
10
Highway
WAUPACA
State Highway 22
Counties
County Highway Z
State Highway 54
GRAND RAPIDS
BUENA VISTA
County Road A
LANARK
County Road J
State Highway 54
FARMINGTON
County Highway Q
ROYALTON
MUKWA
ad X
ELLINGTON
Wege
CENTER
County Road O
County Road A
Waupaca
ty un Co
Ro
Olk
CRANMOOR
Port Edwards
County Highway W
HORTONIA
County Highway G
County Highway W
County Road D
Hortonville
Uni ted S tate sH
County Road JJ
County Highway A
Weyauwega
Lynndale
ighw
ay
I-39
EE
County Road AA
County Highway AA
yH ghwa
County Highway G
State Highway 22
County Highway I
County Highway G
nty H
County Highway J
Friendship Adams
County Highway M
County Highw ay M
County Trunk
ghwa yE
County Highway
Oregon
Cou
ad 26
nty
County Highway Z
GERMANTOWN
County Highway F
ADAMS
11th
County Road M
County Highw
Cou
nty H
State Ro
County Highway HH
Mauston
County Highway M
State Highwa y 22
County Highway G
County Highway O
County Highway
igh w
ay N
ay
KILDARE
Co un ty
and 16
nty H
Cou
County Highway HH
ad A
Count y Ro
Count y Ro
ad F
County Highway A
County Highway HH
I-90
NEWPORT
State High
County Highw
County Road E
RANDOLPH
County Road M
County Highway F
ay M
ay 3
County Road P
Unite d St ates
County Road K
Reedsburg
Main
State Highwa y 33
DELTON
I-90
Pardeeville
Randolph
High way
Hig hw
State Highway 23
I-90
Portage
County Road P
151
Sta te
78
Columbia County
Rio
County Road B
County Road E
Beaver Dam
C
Sta te
Rock Springs
CALEDONIA
oa d
REEDSBURG
67 /2 8
WESTFIELD
Sauk County
FREEDOM
County Highway PF
Sta te
Loganville
Hw
way 26
Cty
16
FRANKLIN
HONEY CREEK
State Road 78
MerrimacWEST POINT
LODI
ARLINGTON
State
LOWELL
High
County Highway F
County Highway G
Cou H nty ighw ay V
County Highway T
hw H ig
County Highway B
State Highway 49
ay 73
I-39
County Road FF
e Stat
County Highway G
hw Hig ay 110
County Highway CH
County Highway E
State Road 91
State Highway 91
County Highway J
Coun ty Hi
Neshkoro
County Highway E
Berlin
County Highway F
SENECA
State
High
44 way
County Highway N
Un ite d
Sta
te
sH
Adams County
County Highway E
igh w
LINCOLN
SPRINGFIELD
NEWTON
CRYSTAL LAKE
State Highway 22
NESHKORO BERLIN
State Road 49
ay te Sta hw Hig
NEPEUSKUN
UTICA
Cou H nty ighw
ay
NEKIMI
United States Highway 41
ay
45
BLACK WOLF
County Highway Z
igh w
ay
FF
QUINCY
County Road E
ST. MARIE
Westfield
Co un ty
County Highway E
BROOKLYN
State Road 23 and 49
Hig hw
RIPON
ay FF High
County Highway J
State
te Sta
way 23
hw Hig
4 ay
FRIENDSHIP
State Highway 175
EASTON
County Highway G
County Highway A
County Highway H County Highway B
NEW CHESTER
HARRIS
SHIELDS
Princeton
State Road 23 and 73
ROSENDALE
ELDORADO
Cou H nty
State Road 23
Green Lake
Ripon
State Road 23
Marquette County
State 82 Road
te Sta
R oa
d 23
MECAN
PRINCETON
State Road 73
County Highway KK
State Highway 23
Rosendale
County Road C
State Road 82
State Highway 23
C County Road K County Highway
Montello
4th 4th
State Highway 23
LEMONWEIR
I-9 0
SPRINGVILLE
State Highway 82
Oxford JACKSON
3rd
MONTELLO
PACKWAUKEE
County Highway D
METOMEN
OXFORD
County Highway O
Fairwater
Hig hw
County Highway TC
County Road E & As
US Hwy 12
Lyndon Station
County Highway K
Endeavor
County Highway B
Markesan
State Road 44
DELL PRAIRIE
BUFFALO
State
County Road A
KINGSTON
e Stat High y 44 wa
MANCHESTER
MACKFORD
ALTO
BYRON
LYNDON
County Highway E
County Highway J
State Road 23
County Road AA
ay
County Highway Y
ElECToRs - only qualified electors of the jurisdiction or the district the candidate seeks to represent may sign the nomination papers. Each elector's municipality of residence must be listed on the nomination paper along with the mailing address, including any street, fire or rural route number, box number (if rural route) and street or road name. The Municipality of Residence listed for each signing elector must clearly identify the town, village or city where the elector's voting residence is located. A post office box number alone does not show where the elector actually resides. The date the elector signed the nomination paper, including month, day and year, must be indicated. Ditto marks that follow correct and complete address or date information are acceptable. The circulator may add any missing or illegible address or date information before the papers are filed with the filing officer. signATuRE of CiRCulAToR - The circulator should carefully read the language of the Certification of Circulator. THE CiRCulAToR MusT PERsonAllY PREsEnT THE noMinATion PAPER To EACH signER. THE noMinATion PAPER MAY noT BE lEfT unATTEnDED on CounTERs oR PosTED on BullETin BoARDs. The circulator's complete address (including municipality of residence) must be listed in the certification. After obtaining signatures of electors, the circulator must sign and date the certification.
Old Oregon
County Road G
County Highway N
Shore Lake
73
County Highway D
6th
County Highway C
State Highway 13
ay B
Lakeshore
I-39
J
Ro unty Co
ad
ighw ay
County Highway
County Highway C
County Highway E
State Highway 26
County Highway M
11
WINFIELD
County Highway W
hw Hig ay 12
County Highway D
State Highway 49
Road 22
County Highway YY
Wisconsin Dells
e Stat
High
y 68 wa
Waupun
State Highway 26
12
State Highway 49
Brownsville
County Highway V
County Highway YY
State Highway 44
DELLONA
County Highway P
Lake Delton
I-90
I-90
LEWISTON
way 16
FORT WINNEBAGO
MARCELLON
State Highway 22
SCOTT
Friesland
CHESTER
LEROY
LOMIRA
Lomira
State Highway 33
County Highway Y
County Road SS
TRENTON
County Highway C
I-90
I-90
United States Highway 12
Cambria
State Highway 146
County Road TW
FAIRFIELD PACIFIC
United States Highway 51
State Highway 16
Kekoskee
State Highway 67
Cou
Theresa
EXCELSIOR
WYOCENA
County Road G
nty H
State Road 73
ighw
SPRINGVALE
ay
COURTLAND
WESTFORD
Wyocena
County Road G
BURNETT
State Road 26
WILLIAMSTOWN Mayville
THERESA
County Highway P
ty un Co
County Road B
Cou nty R
hw Hig A ay
County Highway W
County Highway D
oa dZ
ou nty
State Highway 33
R oa d
Horicon
County Road E
State Road 33
State Road 33
County Road BZ
OAK GROVE
W
State Highway 67
te Sta Ro
Doylestown
County Highway C
ty un Co Ro ad V
DEKORRA
County Road Q
LOWVILLE
State Highway 22
OTSEGO
FOUNTAIN PRAIRIE
Stat e
CALAMUS
BEAVER DAM
County Highway S
Dodge County
Juneau
State High way 115
HUBBARD
County Road E
HERMAN
SUMPTER
MERRIMAC
ad 3 11
County Highway A
Iron Ridge
County Highway S
County Road CS
Poynette
Hig hw
ay
County Road R
LEEDS
HAMPDEN
COLUMBUS
CLYMAN
HUSTISFORD
RUBICON