COUNTY COMMITTEE PETITION REQUIRED NUMBER OF SIGNATURES:

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Atlantic County Clerk's Office EDWARD P. McGETTIGAN, COUNTY CLERK 5901 Main St Mays Landing, NJ 08330-1797 609-625-4011 FAX 609-909-5111 WWW.ATLANTICCOUNTYCLERK.ORG COUNTY COMMITTEE PETITION REQUIRED NUMBER OF SIGNATURES: Please contact the Municipal Clerk's Elections Department, for candidate petition information. The required number of signatures on petitions may vary according to districts and office sought.

COUNTY COMMITTEE PETITION NOTE: This petition may be copied to circulate for voters signatures, but every petition shall have attached to it the affidavit of at least one signer stating that the other signers have signed the petition in good faith and that he or she actually saw the voters sign the petition (NJSA 19:13-7). NOTE: All candidates are required by law to comply with the provisions of the New Jersey Campaign Contributions and Expenditures Act. For further information, please call (609) 292-8700, New Jersey Election Law Enforcement Commission (NJSA 19:23-7). NOTE: no person shall be eligible to become a candidate for any local elective office, or be appointed to any local elective office, unless he is registered to vote in the local unit to which the office pertains, and has been a resident of that local unit for at least 1 year immediately prior to the date upon which the election for the office is to be held, or prior to the date upon which the appointment is made. (NJSA 40A:9-1.13) TO THE HONORABLE,CLERK: We, the undersigned, hereby certify that we reside in the of, County of Atlantic, State of New Jersey, and that we are qualified voters therein; that we are members of the Party, and at the last election for Members of the General Assembly preceding the execution of this petition we voting for a majority of the candidates of the political party herein named; and that we intend to affiliate with the said party at the ensuing election; that we endorse the man and woman hereinafter mentioned as candidates for nomination to the office of County Committee Unit # (Unit of Representation), and we request that you cause to be printed upon the official primary ballot of said party the names of said persons as candidates for such nomination. We further certify that the candidates correct names and addresses are as follows: COMMITTEEMAN: COMMITTEEWOMAN: Name: P.O. Address Name: P.O. Address Rev 2/05 Page 1 of 4

NAME OF CANDIDATE: TITLE OF OFFICE SOUGHT: _ ATTENTION: PETITION SIGNERS: YOU MUST PRINT YOUR NAME AND ADDRESS AFTER YOUR SIGNATURE! 1. Signature Printed Name 2. Signature Printed Name 3. Signature Printed Name 4. Signature Printed Name 5. Signature Printed Name 6. Signature Printed Name 7. Signature Printed Name 8. Signature Printed Name 9. Signature Printed Name 10. Signature Printed Name 11. Signature Printed Name 12. Signature Printed Name 13. Signature Printed Name 14. Signature Printed Name 15. Signature Printed Name Page 2 of 4

NAME OF CANDIDATE(S): TITLE OF OFFICE SOUGHT: _ ATTENTION: PETITION SIGNERS: YOU MUST PRINT YOUR NAME AND ADDRESS AFTER YOUR SIGNATURE! 16. Signature Printed Name 17. Signature Printed Name 18. Signature Printed Name 19. Signature Printed Name 20. Signature Printed Name 21. Signature Printed Name 22. Signature Printed Name 23. Signature Printed Name 24. Signature Printed Name 25. Signature Printed Name 26. Signature Printed Name 27. Signature Printed Name 28. Signature Printed Name 29. Signature Printed Name 30. Signature Printed Name Page 3 of 4

STATE OF NEW JERSEY} COUNTY OF ATLANTIC} ss: COUNTY COMMITTEE, being duly sworn, upon his oath says that he is one of the signers of the petition hereto annexed; that such petition is signed by each of the signers thereof in his own proper handwriting; that each of the signers are, to the best knowledge and belief of deponent, legal voters of the municipality of, of the State of New Jersey, as stated in said petition and belong to the political party named in said petition, and that said petition is prepared and filed in absolute good faith for the sole purpose of endorsing the person or persons therein named in order to secure his or their nominations or selection as stated in said petition. Signature of Signer CANDIDATE S REQUEST FOR DESIGNATION ON OFFICIAL PRIMARY BALLOT The above candidates, having been endorsed for the office mentioned in this petition do hereby request that there be printed opposite their names on the said primary ticket, the following designation: Must not exceed 6 words Must not exceed 46 total spaces CERTIFICATE OF ACCEPTANCE We, the undersigned, hereby certify that we are members of the Party and qualified for the office mentioned in said petition; that we are residents of and legal voters in the jurisdiction for the office for which the nomination is to be made; that we consent to stand at the ensuing Primary Election, and that if nominated, we agree to accept the nomination. OATH OF ALLEGIANCE I,, do sincerely profess and swear, that I do and will bear true faith and allegiance to the Government established in this State, under the authority of the people. So help me God. OATH OF ALLEGIANCE I,, do sincerely profess and swear, that I do and will bear true faith and allegiance to the Government established in this State, under the authority of the people. So help me God. Page 4 of 4