Petition in Lieu of Qualifying Fee - Sample
CITY OF MIAMI BEACH
PETITION IN LIEU OF QUALIFYING FEE
Sample onlv
I. ((name)), candidate for ((Mayor/Commissioner)) of the city of Miami Beach ask you to help me qualify for the ((Election
date)) election by signing and providing the information below.
Translate the above to Spanish
Date of birth or Registration #
Fecha de nacimiento 0
numero de inscripci6n
Dat nesans oswa nimewo
enskripsyon
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Print name
Escriba su nombre en letra de molde
Ekri non an gwo let
Residence address
Domicilioo
Adres kay
Signature
Firma
Siyati
1)
Date/F echaJDat:
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2)
Date1FechalDat:
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3)
Date1FechalDat:
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4)
Date/Fecha/Dat:
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Date/FechalDat:
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6)
Date/FechalDat:
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Date1FechaIDat:
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Date/FechalDat:
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DatelFecha/Dat:
....; Check if change of address/Marque aqui si cambi6 de domicilio IMake si se chanjrnan adres
F:\CLER\CLER\ELECTION\2007 Nov 6 General Election\Petitiion in Lieu of Qualifying fee form-blank,doc