AFFIDAVIT OF SIGNATURE WITHDRAWAL
State of Georgia
County of __________________
I, __________________ (Name as it appears on the application or recall petition), being first duly sworn, say that I am an elector of the __________________ (electoral district) in which the recall election will be conducted.
That my residence address is __________________
__________________
(Number and street or route) (City)
That I signed or caused to be signed the application or the petition for the recall of __________________ (Name and office of person sought to be recalled) and that the recall application or petition has been assigned number __________________.
That it is my intention by the signing and filing of this affidavit to withdraw my signature therefrom.
__________________
Signature of elector
Subscribed and sworn to
before me this __________________
day of __________________, __________________.
Notary public
__________________
__________________, Georgia
My commission expires on the __________________ day of __________________, __________________.
OCGA § 21-4-9