DURHAM COUNTY BOARD OF ELECTIONS NOTICE OF CHALLENGE I challenge

							                    DURHAM COUNTY BOARD OF ELECTIONS
                          NOTICE OF CHALLENGE

I challenge the right of ____________________________________________ to ( ) Register
                                                                         ( ) Remain Registered
                                                                         ( ) Vote

in __________________________ precinct, City of Durham, County of Durham, State of North Carolina.

This challenge is made for the reason (s) indicated below (Mark appropriate reason):

(   )   The person is not a resident of the State of North Carolina.
(   )   The person is not a resident of the county in which he is registered.
(   )   The person is not a resident of the municipality in which he is registered.
(   )   The person is not a resident of the precinct in which he is registered.
(   )   The person is not eighteen years of age.
(   )   This challenge is made within 60 days before a primary, and the person will not be eighteen years
        of age by the next general election.
( )     The person has been adjudged guilty of a felony, and his rights of citizenship have not been
        restored.
( )     The person is dead.
( )     The person is not a citizen of the United States.

I do solemnly swear (or affirm) that the statements and information given above with respect to my
Challenge constitutes the truth, the whole truth, and nothing but the truth, so help me God (or I do so
affirm).
                        __________________________________
                        Printed Name
                        __________________________________
                        Signature
                        __________________________________
                        Street and No.
                        __________________________________
                        City              State            Zip code
                        __________________________________
                        Telephone No.

Sworn to and subscribed before me. This the _____ day of _____, 20_____

_______________________________
Notary Public or  Election Official

My commission expires: ______________________