20___ FIRE DISTRICT VOTER REFERENDUM TO AUTHORIZE DEBT (N.J.S.A. 40A:14-85 and 86)
RESULTS CERTIFICATION
CAPITAL PROJECTS (add additional project columns as necessary (N.J.S.A. 40A:14-85AND 86) | |||
Capital #1 Description of Project: | Capital #2 Description of Project: | Capital #3 Description of Project: | |
Amount | $ | $ | $ |
Total Votes | # | # | # |
Total "Yes" Votes | # | # | # |
Total "No" Votes | # | # | # |
% of Yes Votes* | % | % | % |
I hereby certify that this voter referendum was held in compliance with the requirements of N.J.S.A. 40A:14-85 and 86, and Title 19 if the referendum was held during the November general election:
Signature: | Date: | |
Printed Name: | ||
Title: | ||
Telephone: | Fax: | |
E-mail: |
Please return this form to the Division within seven (7) calendar days of the election, along with a copy of the election ballot upon which the question was placed.
N.J. Admin. Code Tit. 5, ch. 31, subch. 2, app E