New Hampshire Code § 655:17

Declaration of Candidacy
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Declarations of candidacy shall be in the appropriate following form and signed by the candidate: I. For candidates for delegate to the state party convention: I, __________ , declare that I am domiciled in Ward ___ , in the city (or town or unincorporated place) of __________ , county of __________ , state of New Hampshire, in state representative district county __________ and district ___ , and am a registered voter herein; that I am a registered member of the __________ party; that I am a candidate for delegate to the state convention to be made at the primary election to be held on the ___ day of __________ ; and I hereby request that my name be printed on the official primary ballot of the party in which I am registered as a candidate for such election. I declare that I am not a federal employee which makes me ineligible to file as a candidate for this office. If I have been convicted of a felony, I declare that I have completed my sentence as required in RSA 607-A:2. I further declare that, if elected as such delegate, I will not withdraw; and that, if elected, I will be qualified for and will assume the duties of said office. II. For all other declarations of candidacy: I, __________ , declare that I am domiciled in Ward ___ , in the city (or town or unincorporated place) of __________ , county of __________ , state of New Hampshire, and am a registered voter herein; that I am a registered member of the __________ party; that I am a candidate for nomination for the office of __________ to be made at the primary election to be held on the ___ day of __________ ; and I hereby request that my name be printed on the official primary ballot of the party in which I am registered as a candidate for such nomination. I declare that I am not a candidate for incompatible offices as defined in RSA 655:10, and that I am not a federal employee which makes me ineligible to file as a candidate for this office. If I have been convicted of a felony, I declare that I have completed my sentence as required in RSA 607-A:2. I further declare that, if nominated as a candidate for said office, I will not withdraw; and that, if elected, I will be qualified for and will assume the duties of said office.

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