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Forms for Election Law.

PREPARED BY THE SECRETARY OF STATE.

(Form No. 1.)

[For filling this certificate, see section 59, chapter 680, Laws 1892.]

Party Convention Certificate of Nomination for a State, Congressional, Senatorial or Judicial Office, in a Division or District greater than a County.

To the Secretary of State, Albany, N. Y.:

party, held ...

We certify that at a convention of delegates representing the 189.., a party, which, at the last preceding election, polled at least one per cent of the entire vote cast in the ...

(State, division or district).

for which the nomination is made, the following named persons were placed in nomination for offices to be filled at the next ensuing general election:

Office to be filled. Name of the candidate.

Party or political Place of residence of principle represented. candidate.*

(Signed)

......

......

Presiding Officer of Convention.

(Residence, city or town, street and number, if any.)

Attest:

Secretary of Convention.

(Residence, city or town, street and number, if any.)

STATE OF NEW YORK, }

COUNTY OF... . .

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A B and C D, being severally sworn, each for himself, says that the said AB was the presiding officer of the convention of delegates mentioned and described in the foregoing certificate, and that the

* If in a city, the street and number of his residence and place of business.

said CD was the secretary of such convention, and that said certificate and the statements therein contained are true to the best of his knowledge and belief.

Severally subscribed and sworn to before

me, this....day of.......

.189..

EF,

(Notary Public or Justice of the Peace.)

A B.

C D.

(Form No. 2.)

[For filling this certificate see section 59, chapter 680, Laws 1892.]

Party Committee Certificate of Nomination for a State, Congressional, Senatorial or Judicial Office, in a Division or District greater than a County.

To the Secretary of State, Albany, N. Y.:

....

We certify that a meeting of the (...) Committee representing the party, held........, 189.., a party which, at the last preceding election, polled at least one per cent of the entire vote cast in the State, said committee, acting under authority of the following resolution, passed..... ., 189.., at a convention of delegates:

..........

(Here insert resolution passed by convention.)

placed in nomination for the offices to be filled at the next ensuing election the following named persons:

Party or political

Office to be filled. Name of the candidate. principle represented. Place of residence."

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*If in a city, the street and number of his residence and place of business.

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A B and CD, being severally sworn, each for himself, says the said A B is the chairman of the State Committee of the........party mentioned, and presided at the meeting described in the foregoing certificate, and that the said CD is the secretary of the State Committee of the party mentioned, and acted as secretary of the meeting described in said certificate, and that said certificate and the statements therein contained are true, to the best of his knowledge and belief.

.......

Severally subscribed and sworn to before me, this....day of ....

189..

EF,

(Notary Public or Justice of the Peace.)

A B.

C D.

NOTE.-The above form of certificate can be used in committee nominations in divisions less than a State.

(Form No. 3.)

[For filling this certificate, see section 59, chapter 680, Laws 1892.]

Nomination Certificate for any Office, when made otherwise than by a
Convention, Committee or Primary Meeting, Pursuant to Section 5.
To the Secretary of State, Albany, N. Y.:

We, the undersigned, duly qualified voters of the State of New York, at a meeting held.. 189.., in accordance with the provisions of the election law, hereby make the following nomination for offices to be filled at the next ensuing election in the.....

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If in a city, also the street and number of residence and place of business.

to represent the signers of this certificate for the purposes set forth in section 66 of chapter 680 of the Laws of 1892.

(Name.)....

(Residence.).....

(Give city or town, street and number, if any.)

Signature.*

Residence, town or city, street and street number, if any.

Acknowledgment and Affidavit of each Signer to be Annexed to the

Certificate signed by him.

STATE OF NEW YORK, }

COUNTY OF

88.:

On this......day of........189.., before me personally appeared A B, to me known to be one of the persons described in and who signed the foregoing certificate and acknowledged that he signed the same, and the said A B, being by me duly sworn, deposes and says that he is a voter in the............of...... in said county, and that he has truly stated his residence in his statement of his place of residence added to his said signature.

...

A B.

Acknowledged, subscribed and sworn to

....

sworn to }

EF,

(Notary Public, or Justice of the Peace.)

NOTE. It is not necessary that each signer should acknowledge separately. All or any number may be included in one acknowledgment and affidavit.

(Form No. 4.)

[For filing this certificate, see section 59, chapter 680, Laws 1892.]

Convention Certificate of Nomination for a Candidate Voted for by the Voters of only one County or a Portion of a County.

To the county clerk of .....

county, State of New York:

We certify that at a convention of delegates representing the...... 189.., a party which, at the

party, held...

*As to the number of names to be signed to this certificate, see section 5, chapter 296, Laws of 1891.

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