NOMINATION PAPER FOR PARTISAN OFFICE

Candidate's name as it will appear on the ballot; no abbreviations or titles may be used. Street, fire, or rural route number; box number (if rural route); and name of street or road

Shelly Moore
Name of municipality for mailing purposes State Zip code

350 Nicole Lane #6B

Name of municipality for voting purposes Town Village x City

River Falls

River Falls
Title of office

WI 54022

Type of election General x Special

Election date

Name of Party or Statement of Principle (5 words or less)

July12, 2011 Democratic

Name of jurisdiction or district in which candidate seeks office

State Senator

District of Jurisdiction x District number ____________________________________

10

Jurisdiction (county) ________________________________

10th Senate District

I, the undersigned, request that the candidate, whose name and address are listed above, be placed on the ballot at the election described above as a candidate representing the party or statement of principle indicated above, so that voters will have the opportunity to vote for him or x her for the office listed above. I am eligible to vote in the jurisdiction or district in which the candidate named above seeks office. I have not signed the nomination paper of any other candidate for the same office at this election. THE MUNICIPALITY USED FOR MAILING PURPOSES, WHEN DIFFERENT THAN MUNICIPALITY OF RESIDENCE, IS NOT SUFFICIENT. THE NAME OF THE MUNICIPALITY OF RESIDENCE MUST ALWAYS BE LISTED.
SIGNATURES OF ELECTORS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. PRINT NAME STREET & NUMBER OR RURAL ROUTE Rural address must also include box or fire no. MUNICIPALITY OF RESIDENCE Indicate Town, Village, or City
Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City

DATE OF SIGNING

/2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011

CERTIFICATION OF CIRCULATOR I, ___________________________________________________________________, certify: I reside at ___________________________________________________________________.

(NAME OF CIRCULATOR) (CIRCULATOR'S RESIDENCE - INCLUDE NUMBER, STREET, AND MUNICIPALITY.)

I personally circulated this nomination paper and personally obtained each of the signatures on this paper. I know that the signers are electors of the jurisdiction or district the candidate seeks to represent. 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 candidate. I am aware that falsifying this certification is punishable under S. 12.13(3)(a), Stats.

__________________________________
(DATE)

________________________________________________________________________
(SIGNATURE OF CIRCULATOR)

EB-168 (Rev.6/2003) The information on this form is required by SS. 8.15, 8.20, 8.50, 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

Page No.

Paid for by Moore for Senate, Robert Dueholm, Treasurer

SENATE DISTRICT 10 ASSEMBLY DISTRICTS 28, 29, AND 30

State Highway 77
Sta

State Highway 77

Ro

ad

35

Lenroot town Chicog town

County Highway F

Swiss town

te

Webb Lake town

Gull Lake town Brooklyn town

Stinnett town

Hayward town Hayward city

Legend
ay FF

County Highway E

County Highway F
County Road C

State Highway 27

Assembly District 28 Assembly District 29

County Road F

Union town

County Highw

Oakland town

Jackson town

Scott town

Casey town

Springbrook town Trego town

Bass Lake town

County Highway A

Assembly District 30 Counties Cities, Towns and Villages Water

Webster village West Marshland town

Burnett
Meenon town
Daniels 70

Cou

nty

Hig

hway

County Highway E
County Highway K

Washburn
County Highway A

Sand Lake town

Rusk town
County Highway H

Evergreen town

Crystal town Spooner town

Stone Lake town State H Cou

ig hw

ay

70

County Highway X

nty High

way F

Spooner city
3rd

County Highway D

County Highway W

Daniels town

State Highway 35

Grantsburg village Grantsburg town

Wood River town

M ay hw

Siren village Siren town

County Road B

La Follette town

Dewey town
County Road B

Bashaw town

Beaver Brook town

te Sta
County High

Madge town
County Highway M
way B

Hig

County Highway B County Highway B

Hig

nty

6th

hw

175th

Cou

350th

Birchwood town
Co un

345th
335th

Anderson town

County Road O

Trade Lake town

State Highway 87

West Sweden town

Oak

County Highw

ay D

Clam Falls town

Edgewater town

Lorain town
15th

Roosevelt town

Barronett town

Sarona town

Long Lake town

County Highway D

50th

Frederic village
County Highway B

100th

305th

300th

Birchwood village

110th

Sterling town

275th

Laketown town
250th

270th

Luck town
100th

10th

Bone Lake town

270th

60th

McKinley town
State Highway 48

Maple Plain town

25 24

Haugen village Lakeland town Bear Lake town Cedar Lake town
State Highway 48

County Highway N

240th

Luck village

State Highway 87

105th

th
24th

230th
220th

60th

Milltown village Milltown town Georgetown town

County Highway G

Cumberland city

22 1/2

Eureka town

State Highway 48

23rd

Johnstown town

Crystal Lake town

County Highway P

Cumberland town

Stanfold town
State Highway 25

Rice Lake town Rice Lake city

Doyle town

County Highway G

Wilkinson town
County Road W

Balsam Lake village Centuria village St. Croix Falls town

Polk
County Highway H

County Highway E

County Highway I

Barron town Clinton town

13 1/ 2 - 14 th

Balsam Lake town St. Croix Falls city

United States
198th
120th

Apple River town

60th

Beaver town
United States Highway 8

Almena town Almena village

Highwa y 8

Barron
Barron city Maple Grove town
State Highway 25

Stanley town Cameron village

Sumner town

Strickland town
County Highway W

State Highway 46

Turtle Lake village

County Highway JJ

Dresser village
State wa High y 35

County Highway Y

County Highway D

Garfield town
State Highway 65
13 0th

Lincoln town

Osceola village
State Highway 35

Osceola town
Coun

Clayton town Clayton village

Turtle Lake town

County Road K

County Highway P

Arland town

9th

Prairie Lake town

19 1/2

Chetek town
8th

130th

28th

200th

60th

75th

ty Hig

hway

Amery city

68th

County Highway J

County Road D 7 1/2

8th

County Road F
Old Co unty Rd D

Chetek city
Co un ty

4-

8 3/

Farmington town

20

75th

d 2n

9th

40th 220th

45th

Upper Pine

Alden town
hw ay 65
20th

State Highway 46

25th

Black Brook town Clear Lake town Clear Lake village 20th
County Road A

30th

Vance Creek town

1 1/2

Prairie Farm town Prairie Farm village

Dallas village Dallas town

Sioux Creek town

Dovre town

Sta
County Highway H

te

Hig

20th

Sampson town
County Highway M

County Highway H

State Highway 65

Deer Park village

State Highway 46

County Highway V

Ridgeland village

Hig

hw

ay

County Highway Q

New Auburn village

County Highway F

Star Prairie village

Cou

nty

ty

Hig

State Highway 48

350th

hw

Shell Lake city

ay

ay 25

175th

County Highway T

55th

Hig hw ay SS

Star Prairie town Somerset town Somerset village

hw ay 64

Stanton town
State Highway 64

Cylon town
United States Highway 63

Forest town
State Highway 64

New Haven town

Sheridan town

Wilson town

Sand Creek town Auburn town

State Road 64

Bloomer town
State Highway 40

County Highway T

New Richmond city

County Highway S

State

Hig hw

ay 64

State Highway 64

County Highway V

Richmond town
State Highway 65
Ro ad A

Erin Prairie town

Emerald town

Glenwood town
County Highway G

Tiffany town Hay River town Otter Creek town

County Highway N

County Highway A

Bloomer city

Grant town

St. Joseph town

C

n ou

ty

County Highway E

County Highway D

County Highway Q

Warren town North Hudson village

Vine

Hudson town
I-94

65

Cou

United States Highway 12

nty

Roberts village
State High way

Baldwin town Hammond village

Springfield town

Roa

United States Highway 12

yE

Cty Hwy D

dO

Hammond town

County Highwa

State Road 170

State Highway 40

Sherman town
Cty Hw yD

Colfax village Howard town

Cty Hwy B

Hudson city
Cou nty Hig

Tainter town Colfax town

hway

I-94

FF

County Highway N

I-94

I-94

I-94

Woodville village
I-94

State Highway 79

I-9

Baldwin village
I-94
County Highway B
I-94

Wilson village Knapp village

I-94

County Highway F

County Highway J

County Highway N

Dunn
Cty

County Highway N
Cty
I-94

Troy town

Kinnickinnic town

I-94

Rush River town

Cady town

I-94

Lucas town

State

I-94 I-94

Hig hw

ay 29

Elk Mound town Menomonie city

United States Highway 12
I-9

State Highway 29

Wheaton town
County Highway T

Menomonie town River Falls city

County Highway FF

Red Cedar town

County Highway F

St. Croix

Glenwood City city Downing village Boyceville village

Cooks Valley town Woodmohr town

Wheeler village

Tilden town

Elk Mound village

County Highway H

Hallie town

State Highway 29
State Highway 29

I-94
County Highway EE

Spring Valley village

Cty Hwy X

Clifton town
County Highway E

County Highway O

Gilman town
County Highway BB

State Highway 25

River Falls town

Martell town

Coun

ghwa ty Hi

yD
Cou

Co
nty

un

ty

Ro

ad

Spring Lake town

Weston town

Hig

hw

Prescott city Oak Grove town

Sta

County Highway G

te

Hig

United States Highway 10

County Highway G Elmwood

village

State Highway 72

County Highway C

hw

ay 65

County Highway N

ay

ghwa e Hi Stat

y 29

ay

County Highway E

Eau Claire city

85

Spring Brook town

State

County Highway C

Altoona city

ElEcToRS - only qualified electors of the jurisdiction or the district the candidate seeks to represent may sign the nomination papers. Each elector's municipality of residence must be listed on the nomination paper along with the mailing address, including any street, fire or rural route number, box number (if rural route) and street or road name. The Municipality of Residence listed for each signing elector must clearly identify the town, village or city where the elector's voting residence is located. A post office box number alone does not show where the elector actually resides. The date the elector signed the nomination paper, including month, day and year, must be indicated. Ditto marks that follow correct and complete address or date information are acceptable. The circulator may add any missing or illegible address or date information before the papers are filed with the filing officer. SignATuRE of ciRculAToR - The circulator should carefully read the language of the certification of circulator. THE ciRculAToR MuST PERSonAllY PRESEnT THE noMinATion PAPER To EAcH SignER. THE noMinATion PAPER 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.

County Highway W

Hig

County Road I

Sta

te

Dunn town Rock Elm town

County Highway O

Trimbelle town Ellsworth villageEllsworth town

United States Highway 63

County Road B

Peru town
ty Hig
yZ

County Highway C

County Highway V

County Highway CC

Diamond Bluff town

Sta

Waubeek town

te Sta

Hig

Hartland town
County Highway D

te

Trenton town
Hig hw ay 35

Plum City village

Waterville town

County Highway V

Salem town

Durand cityDurand town

pe ct Pro s

Pepin

County Highway A

County Highwa

hw

ay

85

County Highway HH

Pleasant Valley town Drammen town

37

Lima town

Albany town

Sta

te

Bay City village Isabelle town Maiden Rock village Maiden Rock town

Hig

County Highway SS
County

hw

ay

Coun

ty

ay Highw

County Road A Mondovi

city

United States

Highw ay 10

Eleva village Albion town

State Highway 25

Frankfort town

Maxville town

Canton town

Mondovi town

Naples town

Stockholm town

Pepin town

Nelson town

Modena town

Gilmanton town

Dover town

State Highway 93

Sta te Hig hw ay 35
Hig hw

I-94

El Paso town

Washington town

Pierce

Eau Galle town Rock Creek town

Co un

Brunswick town

County Highwa yX
Highwa yN

hw ay D

County Highway H