PETITION OR REFERENDUM ELECTION |
(Underline Whichever Applies) |
DATE:
NAME:
ADDRESS:
CITY _____ COUNTY _____ STATE _____ ZIP CODE _____
COMPLETE ONE OF THE FOLLOWING:
DATE OF BIRTH ___________________________
DRIVER'S LICENSE _________________________
SOCIAL SECURITY NUMBER _________________
Ala. Code § 45-22-83.20 (1975)