NOMINATION PAPER FOR PARTISAN OFFICE

Candidate's name as it will appear on the ballot; no abbreviations or titles may be used. Street, fire, or rural route number; box number (if rural route); and name of street or road

Nancy Nusbaum
Name of municipality for mailing purposes State Zip code

1319 N Summer Range Rd.

Name of municipality for voting purposes Town Village x City

De Pere

De Pere
Title of office

WI 54115

Type of election General x Special

Election date

Name of Party or Statement of Principle (5 words or less)

July12, 2011 Democratic

Name of jurisdiction or district in which candidate seeks office

State Senator

District of Jurisdiction x District number ____________________________________

Jurisdiction (county) ________________________________

2nd Senate District

I, the undersigned, request that the candidate, whose name and address are listed above, be placed on the ballot at the election described above as a candidate representing the party or statement of principle indicated above, so that voters will have the opportunity to vote for him or x her for the office listed above. I am eligible to vote in the jurisdiction or district in which the candidate named above seeks office. I have not signed the nomination paper of any other candidate for the same office at this election. THE MUNICIPALITY USED FOR MAILING PURPOSES, WHEN DIFFERENT THAN MUNICIPALITY OF RESIDENCE, IS NOT SUFFICIENT. THE NAME OF THE MUNICIPALITY OF RESIDENCE MUST ALWAYS BE LISTED.
SIGNATURES OF ELECTORS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. PRINT NAME STREET & NUMBER OR RURAL ROUTE Rural address must also include box or fire no. MUNICIPALITY OF RESIDENCE Indicate Town, Village, or City
Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City Town Village City

DATE OF SIGNING

/2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011 /2011

CERTIFICATION OF CIRCULATOR I, ___________________________________________________________________, certify: I reside at ___________________________________________________________________.

(NAME OF CIRCULATOR) (CIRCULATOR'S RESIDENCE - INCLUDE NUMBER, STREET, AND MUNICIPALITY.)

I personally circulated this nomination paper and personally obtained each of the signatures on this paper. I know that the signers are electors of the jurisdiction or district the candidate seeks to represent. I know that each person signed the paper with full knowledge of its content on the date indicated opposite his or her name. I know their respective residences given. I intend to support this candidate. I am aware that falsifying this certification is punishable under S. 12.13(3)(a), Stats.

__________________________________
(DATE)

________________________________________________________________________
(SIGNATURE OF CIRCULATOR)

EB-168 (Rev.6/2003) The information on this form is required by SS. 8.15, 8.20, 8.50, Wis. Stats. This form is prescribed by the State Elections Board, P.O. Box 2973, Madison, WI 53701-2973, 608 266-8005. http://elections.state.wi.us seb@seb.state.wi.us

Page No.

Paid for by Nusbaum for Senate, Rich Langan, Treasurer

SENATE DISTRICT 2 ASSEMBLY DISTRICTS 4, 5, AND 6

County Highway I County Highway V

County Highway BB

State Highway 52

DOTY

hway ty Hig Coun

County Highway P
State Highway 64

ANTIGO igo
United States Highway 45

POLAR
County Highway S

EVERGREEN
County Highway P

White Lake
County Highway T
County Highway WW
County Highway M

County Highway W

MOUNTAIN
County Highway S

BEAVER
County Highway PP

County Highway F

Legend
County Highway AA

State Highway 64

BRAZEAU Pound

Assembly District 4
NORWOOD
State Highway 47

ING
Sugar Bush

BREED
County Highway AA

BAGLEY

County Highway Z

County Highway B

Coleman POUND
United States Highway 141

Coun ty Hig hway

County Highway Z

Mattoon

Counties
State Highway 47

County Highway

MENOMINEE

County Highway M

County Highway M

Suring HOW MAPLE VALLEY

State Highway 32

WA HUTCHINS
County Highway D

Cities, Towns and Villages

SPRUCE
County Highway B
County Highway A

LENA LITTL
County Highway I

Lena

County Highway A

County Highway V

County Highway N

County Highway H

GILLETT Gillett
County Highway BB

Stat e

High wa

y 47

County Highway R

WOOD

ALMON
County Highway Q

BARTELME
County Highway A

RED SPRINGS
hway y Hig Count VV

UNDERHILL
County Highway VV

OCONTO FALLS
hw Hig ay CC

State Highway 22

STILES

OCONTO

Co unty Hi

County Highway U

ghwa y VV

Oconto Falls
County Road J

Timm
County Highway Q

Bowler
Co un ty

Cou

nty

Hig hw

ay

County Highway H

WASHINGTON Cecil

berg

Grand
Cty Hwy J

County Highway A

WESCOTT

State Highway 29

NBERG
State Highway 153

Shawano
County Highway M
ty Hi Coun yD ghwa

Oak

Shawano
County Road B State Highway 29 Cty Hwy K

6
Cty Hwy T

e Stat

High

y 22 wa

County Highway E

County Road E

County Highway C

MORRIS

SENECA
County Highway G

County Highway G

HERMAN

RICHMOND

GREEN VALLEY

County Road BB

Gresham

MORGAN

ABRAMS

PENSAUKEE

County Highway D
State Highw

Stat e

Sta te
High way 29

Hig hw

ay

29

Tigerton
County Highway M

Bonduel HARTLAND
County Highway F

County Highway J

Assembly District 6

Menominee

Oconto

County Highway G

County Highway B

Assembly District 5
AA

MANIA

yY

ighw

Cty

County Highway SS

Cou

County Trunk

Hwy SS

Embarrass
22 ay H ig hw

State Highway 47

Marion Marion

Hw

ay

nty H

Cty Hwy

High

Scho ol

RISON
County Highway J

WYOMING Big Falls

County Highway E

DUPONT
County Highway S

Stat e

County Highway I

State Highway 156

State Highway 47

County Road M

County Highway M

State Highway 187

County Highway O

County Highway D

Howard
ty Ro Coun ad VV

Cty

Hw

Co unty Rd

Stat e

County Highway F

Hig hw

ay

County Road F

Nichols CICERO
Deer View

32

Howard
County Road J

Lakevie w

Cedar
Cty Hwy J

County Highway K

County Highway G

County Highway G

County Highway J

FAIRBANKS
United States Highway 45

GRANT
County Highway GG

PELLA
County Highway D

BELLE PLAINE

State Highw ay 55
State Highw ay 55

Fireside

State Highway 55

State Highway 117

ay 32

WAUKECHON
Cty Hwy CC

ANGELICA

Cty Hwy C

CHASE

County Highway S

LITTLE SUAMICO

Cty Hwy T

PulaskiPulaski Pulaski
te Sta hw Hig ay 29

County Road

School

County Highway G

Cty

LARRABEE Clintonville
County Highway C

MATTESON
County Highway Y

State Highway 156

NAVARINO
State Highway 156

LESSOR

MAPLE GROVE

PITTSFIELD
State Highway 32
County Trunk C

SUAMICO
United States Highway 41

State Highway 168

County Highway VV

nit ed

Sta

County Road XX

LA
Sta te Hig hw ay 49

HELVETIA

UNION
State Highway 110

Main

State Highway 22

County Road M

DEER CREEK BEAR CREEK Bear Creek

County Highway T
State Highway 76

MAINE

SEYMOUR
Mason
Stat e
ale

te

ig

hw

ay

14 1
I-43

County Road G

High

wa y 54

Seymour
State Highway 54
State Highway 54

Iola
State Highway 49

State Highway 161

Riv

Green Bay
n Mai

Cou

GV

ndinavia AVIA Ogdensburg ST. LAWRENCE

County Highway E

Hig hw

ay

County

WaupacaManawa
Bridge
County Highway B

32

LEBANON

te Sta
Old Hwy 45

hw Hig

County Road EE

Shiocton
County Highway A

Stat e

MAPLE CREEK

BOVINA
ay 54

Black Creek

ONEIDA
County Highway H

nty H

ighw

County Highway N

County Highway WW

ay

County Highway N
Cty J

5
State Highway 55
Co un ty

Ashwaubenon Allouez De Pere

Ash

HOBART

County Road V

BLACK CREEK OSBORN

BELLEV

Brown
LEDGEVIEW
Her itage

ELEcToRS - only qualified electors of the jurisdiction or the district the candidate seeks to represent may sign the nomination papers. Each elector's municipality of residence must be listed on the nomination paper along with the mailing address, including any street, fire or rural route number, box number (if rural route) and street or road name. The Municipality of Residence listed for each signing elector must clearly identify the town, village or city where the elector's voting residence is located. A post office box number alone does not show where the elector actually resides. The date the elector signed the nomination paper, including month, day and year, must be indicated. Ditto marks that follow correct and complete address or date information are acceptable. The circulator may add any missing or illegible address or date information before the papers are filed with the filing officer. SigNATuRE of ciRcuLAToR - The circulator should carefully read the language of the certification of circulator. THE ciRcuLAToR MuST PERSoNALLY PRESENT THE NoMiNATioN PAPER To EAcH SigNER. THE NoMiNATioN PAPER MAY NoT BE LEfT uNATTENDED oN couNTERS oR PoSTED oN BuLLETiN BoARDS. The circulator's complete address (including municipality of residence) must be listed in the certification. After obtaining signatures of electors, the circulator must sign and date the certification.

Lo t

County Road C

erd

land

LITTLE WOLF
State Highway 22
State Highway 54

LIBERTY
County Highway M

New London New London

Ro ad X

Outagamie
CENTER
County Road O

Co unty Ro

ad

Ro

ad

County Road

NGTON
State Highway 54

ROYALTON
ty un Co
State Highway

MUKWA
Olk
County Highway W

ELLINGTON
Wege

Cou ZZ nty R

WAUPACA Waupaca
hway y Hig Count

County Highway S

FREEDOM
County Highway N

oad D

Nash

Richmond

ghwa yE

ay

ay

96

Hig hw

County Highway M

Coun ty Hi

YTON
County Highway K

LIND
County Highway X

WEYAUWEGA FREMONT Fremont

CALEDONIA
Count y Hig hway H
United States Highway 10

GRAND CHUTE GREENVILLE

United States Highway 10

Sta te

53703-3219

County Trunk Hwy J

County Highway A
EE

State Highway 55

County Highway D

County Road U

County Road D

State Highway 22

County Highway C

State Highw ay 57

State Highway 76

County Road G

County Highway S

LAWRENCE ROCKLAND
State Highway 57
County Road PP County Road W

County Highway O

GLEN
Dickinson

County Road A

KAUKAUNA

HORTONIAHortonville
Uni ted S tate sH ighw 45

County Road JJ

Weyauwega

County Highway JJ

Edgewood

Wrightstown VANDENBROEK

WRIGHTSTOWN
State Highway 96
County Road G

110

County Highway E

ty un Co

Lynndale

County Road PP

Ro ad W

Gree nville
State Highway 96

DALE

Wisconsin
Municipal

Appleton

State Highway 125

Little ChuteKaukauna BUCHANAN KimberlyCombined Locks

County Highway CE
County Highway N

MORRI
County Road Z

HOLLAND

County Road D

County Road

Crooks

CE

AppletonAppleton

County Highway K County Highway K

Lind

Cth K