Republican Party Designating Petition COVER SHEET [Name of Candidateis) Public Office or Paty Postion Place of residence Supenssor 6020 Fate 0+, Clarence, New York 4032 Toumot arene County tere State New Yor Volume Number: Total Number of Volumes in Petition’ 4 Identfication Number: ‘The Petition contains the number, or in excess of the number, of valid signatures, required by the Election Law. Contact Person to Correct Deficiencies; Name: David GHartell Residence Address: 6020 Fairlane Dr. Clarence, NY 14032 Mailing Address: 6020 Fairlane Dr. Clarence, NY 14032 Phone Number: 718-741-2794 thereby authorize that notice, of any determination made by the Board of Elections be transmitted to the person named above by facsimile transmission.Document. 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