To: [TITLE] [FIRST NAME] [LAST NAME]
Washington, DC

VERDICT

As a citizen of the United States of America, a registered Republican and/or a Voter who entrusted the Republican Party with my support in 2010, 2012, 2014 and/or 2016 and the recipient of this JUROR's BALLOT whose name is signed below, I do hereby find that this Republican Voter has:

[ ]No Confidence [ ]Confidence

in House Speaker John Boehner, or in Senate Majority Mitch McConnell, or in their "leadership" teams as the SOLD-OUT, ESTABLISHMENT elitist faction running the GOP legislative agenda.

Despite well-grounded concerns over past history and accountability, I supported in 2016 a full Republican Majority of House, Senate and a Republican Executive Branch because of GOP PROMISES made to restore Constitutional governance to these United States.

I do seek resignation or replacement of the present weak and failed "leaders" of the Republican Congress and DEMAND new leadership of BOTH the Republican House and Senate that will perform its sworn duty to the people of these United States.

Signed,

[YOUR NAME]
[ADDRESS]
[CITY], [STATE] [ZIP]