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Petition for Recall (Cover Sheet) SEL 350 rev 2/08: ORS 249.865 please print or type legibly in black ink J. petition for recall of: name of public officer title of publk office, [date p,"spectlve petition filed m/d/y Use this space for statement of reasons for demanding recall. The statement may not exceed 200 words. J. name of Chief Petitioner or name of treasurer of Chief Petitioner Committee (from SEL 222) residence address of Chief Petitioner or residence address of treasurer of Chief Petitioner Committee (from SEL 222) street, city, state, zip code I "d d " f h" f " " J. prante name an signature 0 c Ie petitioner printed name of chief petitioner, and -+ signature of chief petitioner* A Warning Supplying false information on this form V may result in con victionpf a felpflt;,,';1'ifh a fiIJ!!cQf up to $125,000 and or prison for up to 5 years. (ORS 260.715) * by signing this document, I hereby state that any factual information (not a matter of opinion) in the above statement of reasons for demanding a recall is true to the best of my knowledge. Instructions for Circulators -+Only active registered voters of the public official's electoral district may sign a petition. -+AII signers on anyone signature sheet must be active registered voters of the same county. -+It is advisable to have signers use a pen for signing petitions or for certifying petitions. -+Only one circulator may collect signatures on anyone sheet of a petition. -+Each circulator must personally witness all signatures the circulator collects. -+Circulators must not write, alter, correct, clarify or obscure on a signature sheet any information about the signer unless the signer initials changes made or the signer is disabled and requests assistance in completing optional information. -+Circulators must not cause to be circulated a petition knowing it to contain a false signature. -+Circulators must not knowingly make any false statement to any person who signs it or requests information about it. -+Circulators must not attempt to obtain the signature of a person knowing that the person is not qualified to sign it. -+Circulators must not offer money or any thing of value to another person to sign or not sign a petition. -+Circulators must not sell or offer to sell signature sheets. o Instructions for Signers -+ Only active registered voters of the public official's electoral district may sign a petition. Sign your full name, as you did when you registered to vote. -+Fill in the date you signed the petition, your printed name and your residence or mailing address in the space provided. -+It is advisable to use a pen for signing petitions. -+Initial changes you or the circulator make to your printed name, residence or mailing address or date you signed the petition. -+It is unlawful to sign any person's name other than your own. Do not sign another person's name under any circumstances. -+It is unlawful to sign a petition more than once. -+It is unlawful for a person to knowingly sign a petition when the person is not qualified to sign it.