I, the undersigned, hereby seek the recall of ___________ from the office of ____________, on the ground(s) that _____________, (state specific grounds) and declare that I am a registered elector of ______________ County, Kansas, and of the election district of the officer named above.
Name of Signer | Street Number or RR (as Registered) | Name of City | Date of Signing |
NOTE:
1. | It is a class B misdemeanor to sign a name other than your own name to this petition, to knowingly sign more than once for the recall of the same officer at the same election or to sign this petition knowing you are not a registered elector. |
2. | The following comprise the recall committee: (names and resident addresses) |
3. | A list of all petition cirulators, as defined in K.S.A. 25-3608, and amendments thereto, authorized to circulate petitions for this recall may be examined in the office of the ____________ County election officer. |
K.S.A. 25-4320