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Annex 2 Signature List
Election of Deputies of the State Duma of the Federal Assembly of the Russian Federation ________ , _____
(the federal list of candidates was certified by the Central Election Commission of the Russian Federation
on _______ , ___ )
We, the undersigned, support nomination of the federal list of candidates for election as deputies of the State Duma from the Russia Electoral Association, headed by:
1. Ivan Ivanovich Ivanov, born August 10, 1950, working as engineer-designer at Vympel, Moscow Production Association, residing in Moscow.
2. Petr Petrovich Petrov, born November 17, 1965, working as milling machine operator at Shtamp Factory (Tver), residing in Tver.
3. Sergei Sergeevich Sergeev, born December 12, 1969, working as physician of the ambulance service, Aleksandrovsk district hospital, residing in Saratov.
A regional group of candidates on the list has been nominated by the Siberia group of regions. The group is headed by:
1. Valentina Ivanovna Pavlova, born March 2, 1948, housewife, residing in the village of Vysoky, Irkutsk Oblast.
2. Vasily Vasiljevich Vasiljev, born December 12, 1969, working as broker in NNN, a joint-stock company (Lesnoy, Omsk Oblast), residing in Omsk.
3. Aliya Serafimovna Ibragimova, born September 1, 1932, pensioner, residing in Surgut, Tyumen Oblast.
No.
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First, middle, last name
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Year of birth (for 18 years, also day and month of birth)
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Address of place of residence
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Series, number, date of issuance of the passport or equivalent identity paper
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Signature and date
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I hereby certify the signature list:
____________________________________________________________
(first, middle and last name, address of the place of residence, series, number, date of issuance of the passport or equivalent identity paper of the signature collector, the collector's signature and date)
Authorized representative of the electoral association, electoral bloc:
____________________________________________________________
(first, middle and last name, signature and date)
____________________________________________________________
(name of the Subject of the Russian Federation where signatures were collected)
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