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<br />. <br /> <br />Statement of Endorsement for <br />City of Eugene Voters' Pamphlet <br /> <br />November 7, 2006 General Election <br /> <br />Use this form to state your approval of the use of your name in the Voters' Pamphlet statement. <br /> <br />STATEMENT OF ENDORSEMENT FOR: <br /> <br />o Candidate's Statement: <br /> <br />(name of candidate) <br /> <br />o Political Party Statement: <br /> <br />(name of political party) <br /> <br />o Measure Argument: <br /> <br />(measure # and name of person who furnished argument) <br /> <br />I, (printed name), consent to the use of my name or the name of the <br />organization I am authorized to represent exactly as it appears in the box below. <br /> <br />In this box, type or print the name of individual and/or organization the person is authorized to <br />represent exactly as it should appear in the voters' pamphlet statement or argument. An <br />organization's name should be used only if the organization is endorsing the argument or statement. <br />The person's title must also be listed if it is to appear in the voters' pamphlet statement/argument. <br /> <br />Signature of individual <br /> <br />Date Signed <br /> <br />NOTE: SUBMITTING A FALSE SIGNATURE ON THIS STATEMENT IS A VIOLATION OF ORS 251.405. <br />