Public Policy Petition

We, the undersigned registered and duly qualified voters of the County of Macoupin, State of Illinois, do hereby
petition, pursuant to Article 28 of the Illinois Election Code, that the following advisory question of public policy be placed
before the voters in all precincts of the County of Macoupin, State of Illinois, to be voted upon at the General Election to
be held on November 6, 2018:

Should the General Assembly pass any additional legislation that restricts a citizen’s ability to own YES
and possess guns or firearms?
NO
COUNTY
PRINTED NAME VOTER’S SIGNATURE STREET ADDRESS AND MUNICIPALITY &
STATE
1. Macoupin
County, IL
2. Macoupin
County, IL
3. Macoupin
County, IL
4. Macoupin
County, IL
5. Macoupin
County, IL
6. Macoupin
County, IL
7. Macoupin
County, IL
8. Macoupin
County, IL
9. Macoupin
County, IL
10. Macoupin
County, IL

State of ___________________ )
) SS.
County of _________________ )

I, ___________________________ (circulator’s printed name) do hereby certify that I reside at

_____________________________________ in the City/Village/Unincorporated Area (circle one) of
__________________________ (if unincorporated, list municipality that provides postal service) Zip Code __________, County of
_________________, State of _________________that I am 18 years of age or older (or 17 years of age and otherwise qualified to
vote in Illinois), that I am a citizen of the United States, and that the signatures on this sheet were signed in my presence and are
genuine; that all of the signatures on this sheet were signed between June 15, 2018 and August 6, 2018; and that to the best of my
knowledge and belief the persons so signing were at the time of signing the petition duly qualified and registered voters of the County
of Macoupin, State of Illinois, and that their respective residences are correctly stated, as above set forth.
_____________________________________
(Circulator’s Signature)

Signed and sworn to (or affirmed) by ___________________________________ before me, on ____________________, 2018.
(Name of Circulator) (insert month, day)

(SEAL) ______________________________________
(Notary Public’s Signature)

SHEET NO. _______