2014 SPECIAL GENERAL ELECTION U.S.

HOUSE OF REPRESENTATIVES, DISTRICT 1

COMPLETE ALL INFORMATION ON THIS PAGE PRIOR TO CIRCULATION

(Petition filing deadline before 4 p.m. on June 3, 2014)
(See N.J.S.A. 19:13-9)

Congressional District No.

Total number of signatures on this Petition _____

Total number of signatures on all Petitions _____

PETITION OF NOMINATION FOR THE

SPECIAL GENERAL ELECTION
PETITION FOR U.S. HOUSE OF REPRESENTATIVES
50 SIGNATURES REQUIRED
(See N.J.S.A. 19:13-5)

To:

The Honorable Lt. Governor Kim Guadagno

Secretary of State
New Jersey Division of Elections
225 West State Street 5th Floor
Trenton, New Jersey 08608
(See N.J.S.A. 19:13-3)

Each singer of this Petition certifies that the following statements are true:
1.)
2.)
3.)
4.)

I reside in the State of New Jersey in the Third Congressional District;

I am a qualified voter therein;
I have not signed any other Petition of Nomination for the Primary or
for the General Election for such office; and
I request that you cause to be printed upon the Official General
Election Ballot the name of the Candidate listed below.
(See N.J.S.A. 19:13-4)

Name of Candidate:

DONALD E LETTON

(Please print or type name)

Residential and Post Office Address:

City / Town:

Zip Code:

1509 Burlington Avenue

Delanco

08075

(Residential Address)

1509 Burlington Avenue

(City / Town)

Delanco
1

(Zip Code)

08075

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

(Post Office Address)

(City / Town)

(Zip Code)

CANDIDATES REQUEST FOR SLOGAN ON THE

OFFICIAL SPECIAL GENERAL ELECTION BALLOT
The Candidate named in this Petition requests that there be printed on the
General Election Ballot the following Slogan: (Slogan must not exceed three
words and must be in accordance with N.J.S.A. 19:13-4. If the Slogan includes
the name of any person other than the Candidate or any incorporated association
of the State, written consent of such person or incorporated association of the
State must be attached.)

COUNTY:

SLOGAN:(*)

BURLINGTON

Democratic-Republican

CAMDEN

Democratic-Republican

GLOUCESTER

Democratic-Republican

(*) Alternate slogan is D-R Party.

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
1.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

2.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

8.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

7.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

6.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

5.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

4.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

3.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________

(Residential Address Number and Street)

(City / Town)

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
9.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

10.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

16.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

15.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

14.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

13.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

12.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

11.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________

(Residential Address Number and Street)

(City / Town)

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
17.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

18.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

24.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

23.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

22.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

21.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

20.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

19.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________

(Residential Address Number and Street)

(City / Town)

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
25.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

26.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

32.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

31.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

30.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

29.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

28.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

27.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________

(Residential Address Number and Street)

(City / Town)

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
33.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

34.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

40.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

39.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

38.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

37.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

36.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

35.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________

(Residential Address Number and Street)

(City / Town)

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
41.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

42.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

48.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

47.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

46.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

45.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

44.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

43.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________

(Residential Address Number and Street)

(City / Town)

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
49.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

50.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

56.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

55.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

54.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

53.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

52.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

51.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________

(Residential Address Number and Street)

(City / Town)

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
57.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

58.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________
(Residential Address Number and Street)

(Zip Code)

(Print Name)

(Residential Address Number and Street)

64.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

63.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

62.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

61.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

60.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

59.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________
(City / Town)

10

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
65.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

66.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________
(Residential Address Number and Street)

(Zip Code)

(Print Name)

(Residential Address Number and Street)

72.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

71.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

70.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

69.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

68.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

67.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________
(City / Town)

11

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

SIGNATURE SHEET
73.

_______________________________________

(Signature)

_______________________________________

______________________________________

(Residential Address Number and Street)

74.

(City / Town)

_______________________________________

(Signature)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

(City / Town)

_______________________________________

______________________________________

______________________________________
(City / Town)

_______________________________________

(Signature)

_______________________________________
(Residential Address Number and Street)

(Zip Code)

(Print Name)

(Residential Address Number and Street)

80.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

79.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

78.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

77.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

76.

______________________________________

______________________________________

(Signature)

_______________________________________

(Zip Code)

(Print Name)

(Residential Address Number and Street)

75.

______________________________________
(Print Name)

(Zip Code)

______________________________________
(Print Name)

______________________________________
(City / Town)

12

(Zip Code)

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

AFFIDAVIT OF PERSON WHO CIRCULATED THIS

PETITION AND WITNESSED SIGNATURES
The circulator / witness taking the Affidavit below must be the person who
obtained the names on this set of signatures or several sets of signatures. The
circulator / witness must take the affidavit for each set he/she solicits and sign in
the presence of a person authorized to administer affidavits (e.g., Notary Public).

State of New Jersey

: ss.
County of ______________ :
I, ____________________________, being duly sworn, upon my oath say
(Print Name of circulator / witness)

that such petition was made in good faith; was signed by each of the signers in
his/her own handwriting; and that each signer is, to the best of my knowledge
and belief, a legal voter of the State of New Jersey.
Sworn and Subscribed to before me in
___________________________________,

________________________________

(County where the Affidavit was signed and Notarized)

(Signature of circulator / witness)

this _______ day of _____________, 2014.

________________________________

(Residential address of circulator / witness)

___________________________________________
(City / Town of circulator / witness)
(zip code)

___________________________________
(Notary signature)

___________________________________
(Date my commission expires)

13

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

OATH OF ALLEGIANCE
(Candidate need only sign this page once for all Petitions)

State of New Jersey

: ss.
County of ______________ :

I,

DONALD E LETTON , do solemnly swear (or affirm) that I will

(Print Name of United States House of Representatives Candidate)

support the Constitution of the United States and the Constitution of the State of
New Jersey; that I will bear true faith and allegiance to the same and to the
Governments established in the United States and in this State, under the
authority of the people. So help me GOD.
Sworn and Subscribed to before me in
___________________________________,

_____________________________________

(County where the Affidavit was signed and Notarized)

(Signature of U.S. House of Representatives Candidate)

this _______ day of _____________, 2014.

___________________________________
(Notary signature)

___________________________________
(Date my commission expires)

14

2014 SPECIAL GENERAL ELECTION U.S. HOUSE OF REPRESENTATIVES, DISTRICT 1

CERTIFICATE OF ACCEPTANCE
TO BE SIGNED BY CANDIDATE
(N.J.S.A. 19:13-8)

I, the undersigned, hereby certify that I am qualified(*) for the office.

_____________________________________
(Signature of U.S. House of Representatives Candidate)

__DONALD E
LETTON__________________
(Printed name of U.S House of Representatives Candidate)

1509 Burlington Avenue

(Residential Address of U.S. House of Representatives Candidate)

Delanco
(City / Town)

08075
(Zip Code)

(*) Qualifications for U.S. House of Representatives:

-

Minimum age requirement: 25 years

Citizen of the United States for 7 years

A resident of New Jersey

15