2014 Independent Nominating Petition Sec.

6-140, ELECTION LAW

I, the undersigned, do hereby state that I am a registered voter of 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 do hereby nominate the following named persons as candidates for election to public offices to
be voted for at the election to be held on the 4
th
day of November 2014, and that I select the name
StopCommonCore as the name of the independent body making the nominations and as the emblem of
such body.

Names of Candidates Public Office Place of Residence
Rob Astorino New York State Governor 281 Pythian Avenue
Hawthorne, NY 10532
Chris Moss New York State Lieutenant
Governor
382 Stiles Road
Elmira, NY 14901
Robert Antonacci New York State Comptroller 5015 Brittany Lane
Syracuse, NY 13215
John Cahill New York State Attorney General 84 Northview Terrace
Yonkers, NY 10703
Steven F. McLaughlin Member of New York State
Assembly 107th Assembly
District, State of New York
52 Avenue A
Melrose, NY 12121


I do hereby appoint Michael V. Lawler, 31 Michael Roberts Ct, Pearl River, NY 10965; Lynn Krogh, 125
Lake Street, Cooperstown, NY 13326; Brian P. Renna, 5050 Yellow Wood Parkway, Jamesville, NY
13078; Anthony J. Casale, 11 Pioneer Street, Cooperstown, NY 13326, Christopher Jon Giambrone, 15
Maria Court, Holbrook, NY 11741 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 the year placed opposite my
signature.

Date

Signature


Residence


Town or City
(County in
NYC)
1.


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12.





Statement of Witness



I (name of witness) ___________________________________________ state: I am a duly qualified voter of
the State of New York.

I now reside at ________________________________________,
_____________________________________ NY, ___________.
(residence address)
Each of the individuals whose names are subscribed to this petition sheet containing _______ signatures,
subscribed the same in my
(fill in number)
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: ________________, 2014 Signature of Witness:
_______________________________________

Witness identification information: (The following information for the witness named above must be completed
prior to filing with the board of elections in order for this petition sheet to be valid)

Town or City: _________ ________________ County______________________________
(fill in Town or City of the subscribing witnesss residence) (fill in County
of the subscribing witnesss residence)



Sheet No. __________