North Dakota Statutes § 16.1-11-10 Applicant's name placed upon ballot - Affidavit to accompany petition

Upon receipt by the secretary of state of the petition or certificate of endorsement provided for in section 16.1-11-06 accompanied by the following affidavit, the secretary of state shall place the applicant's name upon the primary election ballot in the columns of the applicant's party as provided or within the no-party office for which the applicant desires nomination. Upon receipt by the county auditor of the petition provided for in section 16.1-11-11 accompanied by the following affidavit, the county auditor shall place the applicant's name upon the primary election ballot within the no-party office for which the applicant desires nomination. The affidavit may be filed electronically, through the mail, or by personal delivery. However, the affidavit must be in the possession of the appropriate filing officer before four p.m. on the sixty-fourth day before the primary election. If the affidavit is filed electronically, the candidate shall retain the original copy. The affidavit must be substantially as follows:

State of North Dakota )

) ss.

County of ________ )

I, ______________, being sworn, say that I reside at ________________, in the city of _______________, in the county of ______________ of North Dakota; and zip code of ________________; that I am a candidate for nomination to the office of _____________ to be chosen at the primary election to be held on _____________, ______, and I request that my name be printed upon the primary election ballot as provided by law, as a candidate of the ______________ party for said office. I am requesting that my name be listed on the ballot as I have identified my ballot name below. I understand that nicknames are allowed as part of my ballot name, but titles and campaign slogans are not permissible. I have reviewed the requirements to hold office and I certify that I am qualified to serve if elected.

_______________________________________

Ballot name requested

Candidate's signature

_______________________________________

Subscribed and sworn to before me on ______________, _____.

_______________________________________

Notary Public

NOTARY SEAL My Commission Expires ____________________