STATEMENT OF CANDIDACY
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STATE OF MISSOURI
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COUNTY OF BENTON
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I, _________________________, being first duly sworn, state
that I reside at _________________________, City of Warsaw, County
of Benton, Missouri; that I am a qualified voter; that I do hereby
declare myself a candidate for the office of _________________________,
to be voted upon at the municipal election to be held on the first
(1st) Tuesday after the first (1st) Monday in April, _____, and I
meet all the qualifications required of a candidate for said office,
and I hereby request that my name be printed upon the official ballot
for said election for said office, and state that I will serve as
such officer, if elected.
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Signed:
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Subscribed and sworn to before me this ______ day of __________________,
______.
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City Clerk
City of Warsaw
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(SEAL)
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