New Hampshire Statutes § 655:51 Certification of Delegates Selected

All delegates and their alternates selected by each candidate in the presidential primary shall file with the secretary of state the following certification:

I, __________, certify that my domicile is in ward __________ in the city (or town) of __________, county of __________, state of New Hampshire, and am a qualified voter therein; that I am a registered member of the __________ party; that, if selected, I shall serve as delegate or alternate to the national convention of the __________ party next to be held for the nomination of candidates of said party for president and vice-president of the United States. I further certify that, if selected as delegate or alternate delegate, I will attend such convention unless I shall be prevented by sickness or other occurrence over which I have no control. I pledge myself, if selected as delegate or alternate delegate to said convention, whenever I shall vote, to vote for the nomination of (inserting the name of any person) as the candidate for said party for president so long as he shall be a candidate before said convention.