Request To Remove Signature From Petition Form
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1REQUEST TO REMOVE SIGNATURE FROM PETITION
All fields required. A voter may not submit this form by email or other electronic means.
Name:
Address (resident address at which the voter is registered to vote):
Title of Petition:
Last four digits of social security:
Driver license or identification card number:
In pursuance of UCA 20A-7-205, I hereby request my signature be removed from
the petition named above. I understand that this completed form must be received
by the county clerk no later than May 15* before the general election in order for
my signature to be removed.
___________________________________________________________________
(Signature of voter)
*Deadlines falling on a Saturday, Sunday, or legal
Date Received
holiday are extended to the next business day
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