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Salt Lake City
Salt Lake County
State of Utah

"AFFIDAVIT OF IMPECUNIOSITY”

State of Utah )
) ss.
County of Salt Lake )

Affidavit of Write-in Candidate for Mayor of Salt Lake City, Utah:

For the November 4, 2003 A.D., General Municipal Election:

Name: Lawrence Rey Topham Address:406 8th Avenue, Salt Lake City, Utah.

Phone Number: No Phone E-mail: lrtopham@hotmail.com or lrtopham@lycos.com

I, _____________Lawrence Rey Topham___________, do solemnly [swear] [affirm] that owing to my poverty, I am unable to pay the filing fee required by law.

Date: October 29, 2003 A.D.

Signature:_________________________________________________,Affiant.

Subscribed and sworn to before me on ______________________ (month/day/year)

_____________________________________________________________________

(Signature) Name and Title of Officer Authorized to Administer Oath ________________________________________Seal_________________________
Notary Public or
Title of Public officer______________________________________________