REJECTION OF APPLICATION FOR ADDITION TO CHECKLIST
The Board of Civil Authority of ......................................... ,
(Town/City)
having met on ..................................., 20 ....... to consider applications for addition to the checklist, has found probable cause, as stated below, to reject the application of .........................................
...................................................
(Name)
Cause for rejection:
The Board of Civil Authority will meet on the ................................ day of ......................................, 20 ......., at ....... o'clock at the following location: ................................................ to reconsider your application and give you an opportunity to appear before the Board. You may present any information or witnesses you wish at that time, or you may appeal directly to any Superior judge in this county or district.
..................................................
Town Clerk or Chair of Board of Civil Authority
17 V.S.A. § 2146