PETITION FOR NOMINATION

(To Form a New Political Party)

We, the undersigned, qualified voters of the County Of Peoria in the State of Illinois do declare that it is our intention to form a new political party in the political division aforesaid, to be known and designated as the Libertarian Party, and do hereby petition that the following named persons shall be candidates for the offices hereinafter specified, to be voted on at the General Election to be held on November 3, 2020 (date of election).

NAME OFFICE ADDRESS CITY STATE ZIPCODE
Joe Rusch Peoria County Auditor 1903 W Casecreek Drive, Peoria, IL 61615
Ann Agama Peoria County Clerk (Two Year Unexpired Term) 3512 W Upper Creek Court, Dunlap, IL 61525
K. Eric Shaffer Peoria County Coroner 11912 N. Hickory Grove Road, Dunlap, IL 61525
If required pursuant to 10 ILCS 5/7-10.2, 8-8.1 or 10-5.1, complete the following (this information will appear on the ballot)
(List all names during last 3 years) (List date of each name change)
FORMERLY KNOWN AS (None) UNTIL NAME CHANGED ON (N/A)

Voter's Info:
Full Legal Name: County:
Address: Unit: Zip:

Email:


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