37 Neb. Admin. Code, ch. 1, § 003

Current through September 17, 2024

Section 37-1-003 - Form

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PETITIONERS

NAME (Please print)	COUNTY OF RESIDENCE	SIGNATURE	DATE
1. ___________________	______________	_____________________	_____________
2. ___________________	______________	_____________________	_____________
3. ___________________	______________	_____________________	_____________
4. ___________________	______________	_____________________	_____________
5. ___________________	______________	_____________________	_____________
6. ___________________	______________	_____________________	_____________
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8. ___________________	______________	_____________________	_____________
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10. ___________________	______________	_____________________	_____________
11. ___________________	______________	_____________________	_____________
12. ___________________	______________	_____________________	_____________
13. ___________________	______________	_____________________	_____________
14. ___________________	______________	_____________________	_____________
15. ___________________	______________	_____________________	_____________
16. ___________________	______________	_____________________	_____________
17. ___________________	______________	_____________________	_____________
18. ___________________	______________	_____________________	_____________
19. ___________________	______________	_____________________	_____________
20. ___________________	______________	_____________________	_____________
21. ___________________	______________	_____________________	_____________
22. ___________________	______________	_____________________	_____________
23. ___________________	______________	_____________________	_____________
24. ___________________	______________	_____________________	_____________
25. ___________________	______________	_____________________	_____________
26. ___________________	______________	_____________________	_____________
27. ___________________	______________	_____________________	_____________
28. ___________________	______________	_____________________	_____________
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30. ___________________	______________	_____________________	_____________
31. ___________________	______________	_____________________	_____________
32. ___________________	______________	_____________________	_____________
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34. ___________________	______________	_____________________	_____________
35. ___________________	______________	_____________________	_____________
36. ___________________	______________	_____________________	_____________
37. ___________________	______________	_____________________	_____________
38. ___________________	______________	_____________________	_____________
39. ___________________	______________	_____________________	_____________
40. ___________________	______________	_____________________	_____________
41. ___________________	______________	_____________________	_____________
42. ___________________	______________	_____________________	_____________
43. ___________________	______________	_____________________	_____________
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51. ___________________	______________	_____________________	_____________
52. ___________________	______________	_____________________	_____________
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54. ___________________	______________	_____________________	_____________
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55. ___________________	______________	_____________________	_____________
56. ___________________	______________	_____________________	_____________
57. ___________________	______________	_____________________	_____________
58. ___________________	______________	_____________________	_____________
59. ___________________	______________	_____________________	_____________
60. ___________________	______________	_____________________	_____________

37 Neb. Admin. Code, ch. 1, § 003