Upon receipt by the secretary of state of the certificate of nomination provided for in section 16.1-12-02 accompanied by the following affidavit, the secretary of state shall place the applicant's name upon the general election ballot. The affidavit may be filed electronically, through the mail, or by personal delivery, and must be in the possession of the appropriate filing officer before four p.m. on the sixty -fourth day before the general or special 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_________________, state of North Dakota; and zip code of____________; that I am a candidate for nomination to the office of _________________ to be chosen at the general election to be held on _____________, ____, and I request that my name be printed upon the general election ballot as provided by law, as a candidate of __________ 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 Date ______________ _______________________________________ Candidate's signature Subscribed and sworn to before me on ______________, ______. _______________________________________ Notary Public NOTARY SEAL My Commission Expires ____________________
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