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Straw for Congress Ballot-Access Petition

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To the SECRETARY OF STATE OF INDIANA OR THE INDIANA ELECTION DIVISION OR THE RELEVANT COUNTY CIRCUIT COURT CLERK: Each of the undersigned represents that: 1) the individual resides at the address by the individual's signature, 2) the individual is a duly qualified registered voter in INDIANA, and 3) the individual desires to be able to vote for the candidate(s) listed below, and each of the undersigned respectfully requests you to place the following names as legally-qualified candidates on the 11/6/2012 General Election Ballot as candidates on the GREEN PARTY ticket.

CANDIDATE 1 Name: Jill Stein
Address: 17 Trotting Horse Dr., Lexington, MA 02421
Office: President of the United States

CANDIDATE 2 Name: Andrew U.D. Straw
Address: 64711 Apple Ridge Rd, Goshen, IN 46526
Office: U.S. House of Representatives, Indiana, District 2

Please sign to get this Green Party U.S. House candidate on the ballot in Indiana.
Here's more info about the candidate you are helping:

Petition Authorized and Paid for By Straw for Congress.


Andrew U.D. Straw, Green Party candidate, U.S. House, IN-2


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