Speech #780170126

States -------------- ----- . that on January I of last year he was a legal resident of -------------------- - at. (City or town and (Street and number) State) and. on January 1 of this year. of .......... (City or town and -------- at ----------------- . that he is State) (Street and number) now a legal resident of --------------------(City or town and State) at --------------------- . that he was born (Street and number) in -------------------on (City or town and State (Date of birth) or country) and that he has legally resided in the Commonwealth of Massachusetts for 1 year and in the city or town of ---------------for 6 months next preceding the election at which his right to vote is now being claimed. I hereby further declare that I am -of the person herein named in (Degree of relationship) whose behalf this application for qualification as a voter at said election is claimed. (Signature of applicant) ---- (date) 19_. Personally appeared before me the above named ------------ and made oath that the foregoing statements are true to the best of his knowledge and belief. -----------------------------(Registrar of voters) (If the person In whose behalf the application is made is a naturalized citizen or has derived United States citizenship through the naturalization of another. the registrars shall record in the space below. from the papers presented by the applicant. the facts required to show the citizenship of the person in service.) (Not to be filled in by applicant) We. the undersigned. a majority of the registrars of voters of the --------------- of (City or town) -- . acting under authority of (Name of city or town) section ---- of chapter.___of the acts of 1943. do hereby determine that --------------- is (Name of person in service) (is not) qualified to vote at the (Name of election) to be held in ward ----. precinct ----- of the city or town of ----------- on --------------- 19. (Four blank lines for signatures or registrars) (e) Blank forms of report of police investigation. worded substantially as follows: This is to certify that. after Investigation. I find that. on January first of this year. (Name of person in whose behalf application for qualification as voter is made) was a resident of ----------. and that he is (City or town and State) now a legal resident of ----------------- at (City or town and State) ----............ This information was fur(Street and number) nished to me by --------------residing at (Name of informant) -- -----------------------------...(Place of residence of informant) (Signed) ---------------------------(Police officer) (f) Suitable forms of certificates of listing. notices of omitted. additional or corrected listings to assessors and collectors of taxes and notices to registrars of voters of other cities or towns.