For Board of Elections use only .- Do not write in this space Office Sought: Filing Fee Signature Requirements Last Filing Date!Time PETITION RECALL OF ELECTIVE OFFICER PURSUANT TO R.C. For Useyin Villages of Less Than 2,000' Population. We, the undersigned, qualified electors of the State of Ohio, whose voting residence is in the County, City, Village, or Touigship, set opposite our names, hereby request an election to determine -the recall of as {l of. the Village' of ('ii if'; pursuant to Ohio Revised Code'? We further request that the legislatiue authority order and fix a day. for holding an election to determine the question of removal of the elective officer, and for the selection of a successor to said elective officer not more than forty (40) days from the finding of sufficiency of this petition, pursuant to Ohio Revised Code BOARDIUSE ONLY WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY City, Ward Precinct OF A FELONY OF THE FIFTH DEGREE. Vote; 11) - SIGNATURE INITIALS GENERAL STATEMENT OF THE GROUNDS FOR REMOVAL (NOT MORE We, the undersigned qualified electors, hereby request an election to recall and for the selection of a successor of Mayor Jo Ann Toczek because she has been unable to perform her duties due to serious health issues. Mayor Toczek has been" absent from over 25% of Council proceedings in the previous two years, and has been hospitalized multiple times in recent months. Furthermore, Mayor Toczek recently relinquished her mayoral duties indefinitely to other officials due--to her health Signatures on this petition must be from only one county and must be written in ink. SIGNATURES STREET ADDRESS I DATE (Must be Written in ink) OF (Must be the with the Board of /2022 Qace l2 elm ii- M230 Age. or/Ds?cizio VJ, 7370/ Llil/010.1% qqgg; of paw/Q; f4' i ,2 is Afiillcze avaflifi at 823 Z: Form No; 3--3M (4/9/2012) 3 (Signature of Circulator) ts" - E5 GUILTY CF A jg FELONY QF THE FIFTH DEGREE. fit (2)0 flutfiofi iafkf. i "fit 3. Jr}. II 'yo - . afgrgidifrfii2:32.32 as :1 "fr/3/2:3 . we J, rant rt-are it lC