ANTI-PROHIBITION P ART Y

ANTI-PROHIBITION
NOMINATING P E T I T I O N
NOMINATING
To the Board of Elections:
I, the undersigned, do hereby state that I am a registered voter for the political unit for which a nomination for public
office is hereby being made, that my present place of residence is truly stated opposite my signature hereto, and that
I hereby nominate the following named person (or persons) as a candidate (or candidates) for election to public office
(or public offices) to be voted for at the election to be held on the 2nd day of November, 2010, and that I select the
name Anti-Prohibition Party as the name of the independent body making the nomination (or nominations) and as
the emblem of such body.
NAME(S) OF CANDIDATE(S) PUBLIC OFFICE(S) PLACE(S) OF RESIDENCE

GOVERNOR OF THE STATE 232 East 74th Street, Apt. 4D

KRISTIN M. DAVIS OF NEW YORK New York, New York 10021

LIEUTENANT GOVERNOR OF 17 Dougherty Street

LINDA ESPEJO THE STATE OF NEW YORK Glen Cove, New York 11542
Member of the United States
14 7th Avenue
RANDY A. CREDICO S tat
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erm Brooklyn, New York 11217
Member of the United States
636 Brooklyn Avenue, Apt. 2D
VIVIA MORGAN Senate
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for term ending Dec. 31, 2012
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Brooklyn, New York 11203
I DO HEREBY APPOINT — NAMES ADDRESSES
Andrew J. Miller 6810 Ditmars Boulevard, Astoria, New York 11105
Shannon Melissa Figa 39 Deans Bridge Road, Somers, New York 10589
Frank Morano 1026 Sinclair Avenue, Staten Island, New York 10309
Kyle F. O’Brien 832 Sixth Avenue, New York, New York 10001
Guy R. Zoda 254 Midland Avenue, Staten Island, New York 10306
as a committee to fill vacancies in accordance with the provisions of the Election Law.
In witness whereof, I have hereunto set my hand, the day and year placed opposite my signature.
Date Name of Signer (Signature Required) Residence Town or City

1. ..............., 2010
, New York

2. ..............., 2010
, New York

3. ..............., 2010
, New York

4. ..............., 2010
, New York

5. ..............., 2010
, New York

6. ..............., 2010
, New York

7. ..............., 2010
, New York

8. ..............., 2010
, New York

9. ..............., 2010
, New York

10. ............., 2010

, New York

STATEMENT OF WITNESS
I, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . state: I am a duly qualified voter of the State of New York.
(Name of Witness)
I now reside at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , New York.
(Residence Address)
Each of the individuals whose names are subscribed to this petition sheet containing signatures, subscribed the same in
(Fill in Number)
my presence on the dates above indicated and identified himself or herself to be the individual who signed this sheet. I understand that
this statement will be accepted for all purposes as the equivalent of an affidavit and, if it contains a material false statement, shall
subject me to the same penalties as if I had been duly sworn.

Date . . . . . . . . . . . . . . . . . . . . . ., 2010 ...............................................................................

Signature of Witness
WITNESS IDENTIFICATION INFORMATION:
The following information must be completed prior to filing with the Board of Elections in order for this petition sheet to be valid:
........................ ........................
City/Town County
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