PRESIDENTIAL ELECTION PETITION FOR 2012A.D.


Petition To Add Joseph Rice To Presidential Ballot Via Independent Party In 2012

Information Needed To Count Towards Our Petition
Please Copy, Complete, And Mail Back This Form.
Thank You
Joe



1. Print Name:________________________________________________

2. Email Address:____________________________________________

3. Your Address: ____________________________________________

4. Your City:____________________________________________

5. Your State:____________________________________________

6. Zip Code:____________________________________________


7. Your Signature: ____________________________________________(Please Sign Here)

8. Todays Date:____________________________________________


Please Mail To:

Joseph Rice For President
11811 Peoria St
Sun Valley CA. 91352

Any Questions Just Email Me At EMAIL: me@josephrice.com