Petition for Local Option Election
We, the undersigned legally qualified voters, resident within the county (magisterial district) (municipality) of
_______________, do hereby petition that a special election be held within the county (city, town) of __________________ on the ___________ day of __________________, 19____, upon the following question:
Shall the sale of alcoholic beverages under the West Virginia alcohol beverage control commissioner be permitted in __________________?
Name Address Date
(Post office or street and number)