OFFICIAL TOP FUNDERS. Valid only for May 2021. Petition circulation paid for by Committee to Support the Recall of Board of Education Commissioners López, Collins and Moliga. Latest info recallsfschoolboard.org Each of the undersigned states for himself/herself that he or she is a registered and qualified voter of the City and County of San Francisco. 1.________________________________________________________________________________________ PRINT YOUR NAME FULL RESIDENCE ADDRESS (no p.o. box) __________________________________________________________________________________________ YOUR SIGNATURE AS REGISTERED TO VOTE CITY (spell out) ZIP 2.________________________________________________________________________________________ PRINT YOUR NAME FULL RESIDENCE ADDRESS (no p.o. box) _________________________________________________________________________________________ YOUR SIGNATURE AS REGISTERED TO VOTE CITY (spell out) ZIP 3.________________________________________________________________________________________ PRINT YOUR NAME FULL RESIDENCE ADDRESS (no p.o. box) __________________________________________________________________________________________ YOUR SIGNATURE AS REGISTERED TO VOTE CITY (spell out) ZIP 4.________________________________________________________________________________________ PRINT YOUR NAME FULL RESIDENCE ADDRESS (no p.o. box) __________________________________________________________________________________________ YOUR SIGNATURE AS REGISTERED TO VOTE CITY (spell out) ZIP 5.________________________________________________________________________________________ PRINT YOUR NAME FULL RESIDENCE ADDRESS (no p.o. box) __________________________________________________________________________________________ YOUR SIGNATURE AS REGISTERED TO VOTE CITY (spell out) ZIP DECLARATION OF PERSON CIRCULATING SECTION OF RECALL PETITION (MUST BE IN CIRCULATOR’S OWN HANDWRITING) I, solemnly swear or affirm all of the following (1) That I am 18 years of age or older. (2) That my residence address, including street and number, is ____________________________________________________________________. (If no street or number exists, a designation of my residence adequate to readily ascertain its location is _________________________________.) (3) That the signatures on this section of the petition form were obtained between ____/____/21 and ____/____/21; that I circulated the petition and witnessed the signatures on this section of the petition form being written and that, to the best of my information and belief, each signature is the genuine signature of the person whose name it purports to be. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on ____/____/21 at ____________________________ , CA. Signature of Circulator: _____________________________________________________
