November 3, 2020 Candidate Packet - Flipping Book Version

REQUEST FOR VIETNAMESE NAME ACCENTS Election Date: November 3, 2020 Presidential General Election

Candidate Name:

_______________________ ___________________________ ________________________ FIRST MIDDLE (do not include hyphenated last name) LAST (include all or hyphenated last names)

Office Title: Jurisdiction: GENDER PREFERENCE (check one) : I understand my name will be transliterated. For proper transliteration, my name is: Masculine Feminine Transgender Masculine Transgender Feminine Other: ________________________________________________________________________________ Note: Candidate who choose to put a candidate statement in the Sample Ballot Pamphlet and would like to put accents on their Vietnamese name in the Vietnamese version of the Sample Ballot Pamphlet must complete the appropriate box below and return this form to the Office of the Registrar of Voters. CANDIDATE’S VIETNAMESE NAME WITH ACCENTS: (Print characters clearly and in large print)

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Candidate Signature

Date

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I DO NOT elect to put accents on my Vietnamese name. I understand that accents will not be added to my Vietnamese name in the candidate statement in the Sample Ballot Pamphlet.

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Candidate Signature

Date