Sbe No P 27 Form – Fill Out and Use This PDF

10 ILCS 5/7-10, 7-10.2	X...BIND HERE...X	Suggested
		Revised May, 2009
		SBE No. P-27
	PRECINCT COMMITTEEMAN
	PRIMARY PETITION

We, the undersigned, members of and affiliated with the _________________________ Party and qualified primary electors of the

_________________________ Party, in ______________________________ (township name and precinct number) in the County of

___________________,State of Illinois, do hereby petition that ________________________________________ who resides at

___________________________________ in the City, Village, Unincorporated Area (circle one) of _________________________ (if

unincorporated, list municipality that provides postal service) Zip Code __________, County of ____________________ and State of Illinois,

shall be a candidate of the ____________________ Party for election to the office of PRECINCT COMMITTEEMAN , for

______________________________ (township name and precinct number), to be voted for at the primary election to be held on

____________________ (date of election).

If required pursuant to 10 ILCS 5/7-10.2, complete the following (this information will appear on the ballot)

FORMERLY KNOWN AS ________________________________ UNTIL NAME CHANGED ON ______________________________

(List all names during last 3 years)(List date of each name change)

NAME		STREET ADDRESS OR	CITY, TOWN OR
(VOTER’S SIGNATURE)		RR NUMBER	VILLAGE		COUNTY
1				IL
2				IL
3				IL
4				IL
5				IL
6				IL
7				IL
8				IL
9				IL
10				IL
11				IL
12				IL
State of _________________________	)
	) SS.
County of ________________________	)

I, ___________________________________ (Circulator’s Name) do hereby certify that I reside at _______________________________,

in the City/Village/Unincorporated Area (circle one) of __________________________ (if unincorporated, list municipality that provides

postal service) Zip Code __________, County of ____________________, State of ____________________ that I am18 years of age or

older, that I am a citizen of the United States, and that the signatures on this sheet were signed in my presence, not more than 90 days preceding the last day for filing of the petitions and are genuine and that to the best of my knowledge and belief the persons so signing were at the time of signing the petition qualified voters of the _________________________ Party in the political division in which the candidate is

seeking elective office, and that their respective residences are correctly stated, as above set forth.

__________________________________________________

(Circulator’s Signature)

Signed and sworn to (or affirmed) by _________________________________________ before me, on ________________________.

	(Name of Circulator)	(insert month, day, year)
(SEAL)	__________________________________________________
		(Notary Public’s Signature)

SHEET NO. __________