1. A candidate for the office of State Senator, Assemblyman or Assemblywoman must execute and file, with his or her declaration of candidacy, a declaration of residency which must be in substantially the following form: I, the undersigned, do swear or affirm under penalty of perjury that I have been a citizen resident of this State as required by NRS 218A.200 ; that I understand that knowingly and willfully filing a declaration of residency which contains a false statement is a crime punishable as a gross misdemeanor and also subjects me to a civil action disqualifying me from entering upon the duties of the office; and that I have actually, as opposed to constructively, resided at the following residence or residences since November 1 of the preceding year: ............................................................... Street Address Street Address ............................................................... City or Town City or Town ............................................................... State State From................... To.................... From....................... To.................... Dates of Residency Dates of Residency ............................................................... Street Address Street Address ............................................................... City or Town City or Town ............................................................... State State From................... To.................... From....................... To.................... Dates of Residency Dates of Residency (Attach additional sheet or sheets of residences as necessary) 2. Each address of a candidate which must be included in the declaration of residency pursuant to subsection 1 must be the street address of the residence where the candidate actually, as opposed to constructively, resided or resides in accordance with NRS 281.050 , if one has been assigned. The declaration of residency must not be accepted for filing if any of the candidates addresses are listed as a post office box unless a street address has not been assigned to the residence. 3. Except for any information required to be kept confidential pursuant to NRS 293.906 , a declaration of residency filed pursuant to this section is a public record and the filing officer shall make the declaration of residency available to the public in an electronic format. 4. Any person who knowingly and willfully files a declaration of residency which contains a false statement in violation of this section is guilty of a gross misdemeanor.
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