FCRCFAYETTE COUNTYREPUBLICAN COMMITTEE
Official Proxy for the Fayette County Republican Committee
This proxy may be written, emailed, faxed, text, or on a GOP-issued form (this form) and include the information below. If the submitted form is not the original, if questioned, the original written form must be submitted within 72 hours of the question. This proxy may be used only for the date of the meeting recorded on this form.
I,
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Your name
certify that I am a member of the Fayette County Republican Committee. I offer my proxy vote to
(Member Name)
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Committee member that will hold your proxy
That he/she may vote on any issue at the meeting.
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Month
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Day
Year
Date
If there are any questions contact me at the phone number listed below.
Signature:
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Printed Name
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Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Date Signed:
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Month
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Day
Year
Date
Precinct:
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Continue
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Should be Empty: