NOMINATIONPAPERFORPARTISANOFFICE

Candidate'sname;notitlesmaybeused. Street,fire,orruralroutenumber;boxnumber(ifruralroute);andname
ofstreetorroad
Nameandtypeofmunicipalityforvotingpurposes.
Townof
Villageof
Cityof
Nameofmunicipalityformailingpurposes State
WI
Zip code Typeofelection
general
special
Electiondate NameofPartyorStatementofPrinciple(5wordsorless)
Titleofoffice DistrictorJurisdiction
Districtnumber_______
Jurisdiction(county)______________________________________
Nameofjurisdictionordistrictinwhichcandidateseeksoffice
I,theundersigned,requestthatthecandidate,whosenameandaddressarelistedabove,beplacedontheballotattheelectiondescribedaboveasacandidaterepresentingthepartyorstatementof
principleindicatedabove,sothatvoterswillhavetheopportunitytovoteforhimorherfortheofficelistedabove.Iameligibletovoteinthejurisdictionordistrictinwhichthecandidatenamed
aboveseeksoffice.Ihavenotsignedthenominationpaperofanyothercandidateforthesameofficeatthiselection.
Themunicipalityusedformailingpurposes,whendifferentthanmunicipalityofresidence,isnotsufficient.Thenameofthemunicipalityofresidencemustalwaysbelisted.
SignaturesofElectors PrintedNameofElectors StreetandNumberorRuralRoute
Ruraladdressmustalsoincludeboxorfireno
MunicipalityofResidence
Providenameofmunicipality
DateofSigning
1.

Town
Village
City

2. Town
Village
City
3. Town
Village
City
4. Town
Village
City
5. Town
Village
City
6. Town
Village
City
7. Town
Village
City
8. Town
Village
City
9. Town
Village
City
10.

Town
Village
City

CERTIFICATIONOFCIRCULATOR
I,,certify:Iresideat____________________________________________________________.

(Nameofcirculator) (Circulator'sresidenceIncludenumber,street,andmunicipality.)
IfurthercertifyIameitheraqualifiedelectorofWisconsin,oraU.S.citizen,age18orolderwho,ifIwerearesidentofthisstate,wouldnotbedisqualifiedfromvotingunderWis.Stat.6.03.Ipersonallycirculatedthis
nominationpaperandpersonallyobtainedeachofthesignaturesonthispaper.Iknowthatthesignersareelectorsofthejurisdictionordistrictthecandidateseekstorepresent.Iknowthateachpersonsignedthepaperwithfull
knowledgeofitscontentonthedateindicatedoppositehisorhername.Iknowtheirrespectiveresidencesgiven.Iintendtosupportthiscandidate.IamawarethatfalsifyingthiscertificationispunishableunderWis.Stat.
12.13(3)(a).
_____________________________________ ___________________________________________________________
(Date)
(Signatureofcirculator)
GAB-168 | Rev. 2014-04 | Government Accountability Board, P.O. Box 7984, Madison, WI 53707-7984 | 608-261-2028 | web: gab.wi.gov | email: gab@wi.gov
PageNo.
Michael Krsiean
360 144th Ave
St. Joseph
Houlton 54082

11/4/2014 Democratic Party
Representative in Congress
7
Congressional District 7
/ /2014
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INSTRUCTIONSFORPREPARINGNOMINATIONPAPERSFORPARTISANOFFICE

Thisisasamplenominationpaperform.Itconformstothestatutoryrequirementsfornominationpapersforpartisanoffice.Allinformationconcerningthecandidatemustbecompletedinfullbefore
circulatingthisformtoobtainsignaturesofelectors.Allinformationconcerningthesigningelectorsandthecirculatormustbecompletedinfullbeforefilingwiththeappropriatefilingofficer.This
formmaybereproducedinanyway.Acandidate'spictureandcampaigninformationmayalsobeaddedtothisform.TheGovernmentAccountabilityBoard(G.A.B.)hasdeterminedthatnodisclaimer
orotherattributionstatementisrequiredonnominationpapers.Candidatesareadvisedtosendasampleoftheircompletedformtothefilingofficerforreviewbeforecirculation.Federalandstate
candidatesfilewiththeG.A.B.CountycandidatesfilewiththeCountyClerk.

PageNumbersNumbereachpageconsecutively,beginningwith1,beforesubmittingtothefilingofficer.Aspaceforpagenumbershasbeenprovidedinthelowerrighthandcorneroftheform.
Candidate'sNameInsertthecandidate'sname.Acandidatemayusehisorherfulllegalname,oranycombinationoffirstname,middlename,andinitialsornicknamewithlastname.The
GovernmentAccountabilityBoardhasdeterminedthat,absentanyevidenceofanattempttomanipulatetheelectoralprocess,candidatesarepermittedtochooseanyformoftheirname,including
nicknames,bywhichtheywanttoappearontheballot.
Notitlesarepermitted.Inaddition,namessuchasRedorSkiparepermitted,butnamesthathaveanapparentelectoralpurposeorbenefit,suchasLowertaxes,NoneoftheaboveorLower
Spendingarenotpermitted.Itisalsonotpermissibletoaddnicknamesinquotesorparenthesesbetweenfirstandlastnames.Forexample,JohnJackJonesorJohn(Jack)Jonesarenotacceptable,
butJohnJones,JackJonesorJohnJackJonesareacceptable.
Candidate'sResidenceIfacandidatesmunicipalityofresidenceisdifferentfromthemunicipalityusedformailingpurposes,bothmustbegiven.Indicateifthemunicipalityofresidenceisatown,
villageorcity.
DateofElectionInsertthedateoftheelection.Ifthenominationpaperisbeingcirculatedforageneralelection,thedateistheTuesdayafterthefirstMondayinNovemberofanevennumbered
year.Iftheelectionisaspecialpartisanelection,thedateofthespecialelectionmustbelisted.
PartyorStatementofPrincipleInsertthenameofthepartythecandidaterepresents.IndependentcandidatesmayprovideaStatementofPrinciple,nottoexceed5words.
TitleofOfficeThenameoftheofficemustbelistedalongwiththejurisdictionordistrictnumberthatclearlyidentifiestheofficethecandidateisseeking,forexample,Representativetothe
Assembly1
st
districtorDaneCountyDistrictAttorney.
NameofJurisdictionThenominationpapersmustalsoindicatethemunicipalityorjurisdictioninwhichthesigningelectorsarequalifiedtovote,asitrelatestotheofficesoughtbythecandidate
namedonthenominationpaper.Forexample,forastatewideofficethejurisdictionistheStateofWisconsin.Otherexamplesare1
st
CongressionalDistrict,24
th
AssemblyDistrictorBrownCounty.
SignaturesandPrintedNamesofElectorsOnlyqualifiedelectorsofthejurisdictionorthedistrictthecandidateseekstorepresentmaysignthenominationpapers.Eachsignermustalso
legiblyprinttheirname.Eachelector'smunicipalityofresidencemustbelistedonthenominationpaperalongwiththemailingaddress,includinganystreet,fireorruralroutenumber,boxnumber(if
ruralroute)andstreetorroadname.TheStreet&NumberorRuralRoutesectionforeachelectorsaddressissplitintotwolines.Thefirstlineisforthestreetaddress.Thesecondlineisforthe
municipalityformailingpurposes.TheMunicipalityofResidencelistedforeachsigningelectormustclearlyidentifythetown,villageorcitywheretheelector'svotingresidenceislocated.Apostoffice
boxnumberalonedoesnotshowwheretheelectoractuallyresides.Thedatetheelectorsignedthenominationpaper,includingmonth,dayandyear,mustbeindicated.Dittomarksthatfollowcorrect
andcompleteaddressordateinformationareacceptable.Thecirculatormayaddanymissingorillegibleaddressordateinformationbeforethepapersarefiledwiththefilingofficer.
SignatureofCirculatorThecirculatorshouldcarefullyreadthelanguageoftheCertificationofCirculator.THECIRCULATORMUSTPERSONALLYPRESENTTHENOMINATIONPAPERTOEACHSIGNER.THENOMINATION
PAPERMAYNOTBELEFTUNATTENDEDONCOUNTERSORPOSTEDONBULLETINBOARDS.Thecirculator'scompleteaddressmustbelistedinthecertification.Afterobtainingsignaturesofelectors,thecirculatormustsign
anddatethecertification.
OtherInstructions - CandidatesandcirculatorsshouldreviewCh.GAB2.05,2.07,Wis.Adm.Code.
Originalnominationpapersmustbeinthephysicalcustodyoftheappropriatefilingofficerbythefilingdeadline.ApostmarkonthefilingdeadlineisNOTsufficient.Nominationpaperscannot
befaxed/emailedtothefilingofficer.Ch.GAB6.04(2),Wis.Adm.Code.
Nominationpaperswiththerequirednumberofsignaturesmustbefiledwiththeappropriatefilingofficernolaterthan5:00p.m.onJune1
st
(orthenextdayifJune1
st
isaholidayor
weekend)beforethegeneralelection.NominationpapersmaynotbecirculatedbeforeApril15.Specialelectionsmayhavedifferentcirculationtimeframesandfilingdeadlines.Checkwith
thefilingofficer.
Inorderforacandidate'snametobeplacedontheballot,acandidatemustfileaCampaignRegistrationStatement(GAB1),aDeclarationofCandidacy(GAB162),andNominationPapers
(GAB168)containingtheappropriatenumberofsignaturesfortheofficesoughtnolaterthanthefilingdeadline.Wis.Stat.8.15(6).Candidatesforstateofficeandmunicipaljudgemustalso
fileaStatementofEconomicInterestswiththeGovernmentAccountabilityBoardbythethirdbusinessdayafterthenominationpaperfilingdeadline.Wis.Stat.19.43.Ifanyoneofthese
requiredformsisnotfiledbythedeadline,thecandidate'snamewillnotbeplacedontheballot.Wis.Stat.8.30.
Ifacandidateorcirculatorhasanyquestions,heorsheshouldcontactthefilingofficer.