Form Eb 172 PDF Details

Form Eb-172 is a form used to request an exception to the Department of Motor Vehicles' rule that requires all out-of-state drivers to obtain a New York State driver license within 30 days of moving to New York. The form can be used by individuals who have a valid driver's license from another state and are temporarily living in New York, as well as military personnel and their families. There are a number of exceptions that can be made using Form Eb-172, including for members of the military and their families. Download the form today and get started on your exemption request!

QuestionAnswer
Form NameForm Eb 172
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesgab_172_petitio n_for_direct_le gislation_pdf_6 1119 gab direct legislation form

Form Preview Example

PETITION FOR DIRECT LEGISLATION

I, the undersigned, a qualified elector of the (city or village) of, request that the

attached proposed (ordinance or resolution), without alteration, either be adopted by the (common council or village board) or referred to a vote of the electors pursuant to the provisions of S. 9.20, Wis. Stats.

POST OFFICE ADDRESS WHEN DIFFERENT THAN MUNICIPALITY IS NOT SUFFICIENT. THE NAME OF THE MUNICIPALITY OF RESIDENCE MUST ALWAYS BE LISTED.

SIGNATURES OF ELECTORS

STREET & NUMBER OR RURAL ROUTE

MUNICIPALITY OF RESIDENCE

DATE OF

 

Rural address must also include box or fire no.

Indicate City or Village

SIGNING

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Certification of Circulator

I,

 

 

, certify:

 

 

(Name of circulator)

I reside at

 

.

 

 

(Circulator's residence - Include number, street, and municipality)

I personally circulated this petition for direct legislation and personally obtained each of the signatures on this petition. I know that the signers are electors of the municipality listed above. I know that each person signed the paper with full knowledge of its content on the date indicated opposite his or her name. I know their respective residences given. I intend to support this petition. I am aware that falsifying this certification is punishable under S. 12.13(3)(a), Wis. Stats.

___________________________________________________________

(Date)

(Signature of circulator)

 

EB-172 (Rev. 11/2003) The information on this form is required by S. 9.20, Wis. Stats.

This form is prescribed by the State Elections Board, P.O. Box 2973, Madison, WI 53701-2973, 608-266-8005, http://elections.state.wi.us, seb@seb.state.wi.us

INSTRUCTIONS FOR PREPARING

PETITION FOR DIRECT LEGISLATION

This is a sample petition for direct legislation. It conforms to the statutory requirements for petitions. All information concerning the ordinance or resolution must be completed in full before circulating this form to obtain signatures of electors. The complete ordinance or resolution must be attached to each petition sheet. All information concerning the signing electors and the circulator must be completed in full before filing with the appropriate filing officer. This form may be reproduced in any way. The State Elections Board has determined that no disclaimer or other attribution statement is required on this form.

Name of Municipality - Insert the name of the city or village.

Signatures of Electors - Only qualified electors of the municipality may sign the petition. Each elector’s municipality of residence must be listed on the petition along with the post office address, including any street name or number, rural route, box or fire number. The circulator may add any missing or illegible address information before the papers are filed with the filing officer. The address listed for each signing elector must clearly identify where the elector's voting residence is located. A post office box number alone does not show where the elector actually resides.

Signature of Circulator - The circulator should carefully read the language of the CERTIFICATION OF CIRCULATOR. The circulator must personally present the petition to each signer. PETITIONS MAY NOT BE

LEFT UNATTENDED ON COUNTERS OR POSTED ON BULLETIN BOARDS. The circulator's complete address

(including municipality of residence) must be listed in the certification. After obtaining signatures of electors, the circulator must sign and date the certification.

Other Instructions - Circulators should review ElBd 2.09, 2.11, Wis. Adm. Code.

Petitions for Direct Legislation must be in the physical custody of the appropriate filing officer by the filing deadline. The required number of signatures must be obtained within a 60-day period. A postmark on the filing deadline is NOT sufficient. Petitions CANNOT be faxed to the filing officer.

If a circulator has any questions, he or she should contact the filing officer.

EB-172 Instructions (Rev. 7/2003)

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