2016 GENERAL ELECTION CANDIDATE WITHDRAWAL (CAN-24) State Form 46416 (R13 19-15) Indiana Election Ohision (C3-8-2-2.7, 38-2254; 3:8-5-10.5, 38-5-14.5, 386-13. 3-8-7-11, $-8-7-20, 38-7-21, 3.8-7-28) INSTRUCTIONS: This form is used by a nominee chosen ina primary, nominated by pein, orchesen By a convention who wishes to remove the ‘nominee's name fromthe genera lection balla. This form is aso used by a write-in candidate who wishes to withdraw. DEADLINE: Except a otherwise provided by aw, this withdrawal must be receved by tho offal wth whom th Declaration of Candidacy or Pion of Nomination was fled (circuit court clork or the Indiana Election Dvision) by NOON, July 15, 2016, f nominated at the primary election, party ‘convention, or by petition of nomination. A write-in candidate {for an ofce other than school board) must fie this form by NOON, July 15, 2016. For School Board offices: A schoo! board candidate (including a wite-in candidal for that office) must fle this form by NOON, August 29, 2018, For Small Town offices: A candidate who flas a declaraion of candidaoy for a town office in a lown with a population of lass than 3,500 may withdraw by fing this stalemant by NOON, August 1, 2046, A candidate nominated by a town convention must fle this withdcawal vith the circu court ork o town election board no later than NOON, 3 day ater theexjovmnment of the town convention. A candidate for cy or town office in a municipal eleaion year uses CAN-6 frm fo wa Tothe Clerk of Marion Circuit Court, the Lake or Tippecanoe County Board of Elections and Registration, or Indiana Election Division: CANDIDATE WITHDRAWAL “yh ‘Theodore Edward Rokita ‘Hetundersigned, Tisertname on previously fled candidacy withdraw as a candidate of the Republican Party for nomination to the-oftice of US Representative . District, A general election to be held on November 8, 2016. (2) My residence address is: % £8823 Woodacre Lane Indianapolis Indiana 46123 Complalo Residence Addrass Must Be isered iy ZIP Code (8) | request at you act under IC 3-8-7-17 or IC 3-8-7-28 to notify each appropriate county election board to remove my namerom the balfbl as the nominee of the above mentioned party for this office. Ll 7 Mee Cay sree ‘Signalure Date Signed aavinortyy “Telephone Numbor CERTIFICATE OF ee STATE OF INDIANA } Ss: COUNTY OF AALOW. ) Before me, the ~~ ‘a nolary publ (or ole officer authorized fo take acknowledgments) nan! for Hoson County andthe State of Insiona, personaly speared Theodlons Edward Rove) 10. testonamed sai anes fhe chow and orgoegnsument. Wino myhand and ofl ea ts _\ ton 2016. ‘or Other Official Administering Oath according to IC 93-42-4-4, : dy is ae pan cy cia reg NG), 11. coryrrasene YLORAQ