Form Sfn 18440 - Certificate Of Write-In Candidacy President Of The United States
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4CERTIFICATE OF WRITE-IN CANDIDACY
Secretary of State
State of North Dakota
PRESIDENT OF THE UNITED STATES
600 E Boulevard Ave Dept 108
SECRETARY OF STATE
Bismarck ND 58505-0500
SFN 18440 (11-09)
Telephone
701-328-4146
Toll Free
800-352-0867
Fax
701-328-3413
Web Site:
INSTRUCTIONS
1.
A person who intends to be a write-in candidate for the President of the United States shall file this sworn certificate of
write-in candidacy with the Secretary of State by 4 p.m. on the 21st day before the general election. If the certificate is
mailed, the certificate must be in the possession of the Secretary of State no later than 4 p.m. on the 21st day before
the general election. If the filing date falls on a Saturday, Sunday or holiday on which the office of the Secretary of
State is closed, the certificate shall be filed on the next day following the filing date on which the Secretary of State's
office is open.
2.
The sworn certificate of write-in candidacy must contain the complete post-office address of the candidate and the
names and the complete post-office addresses of the candidate's presidential electors.
3.
At the same time the certificate of write-in candidacy is submitted to the Secretary of State, there shall be a sworn
certificate of acceptance signed by the candidate's presidential electors. The certificate of acceptance for each elector
is part of this form.
4.
If the presidential candidate has a vice-presidential running mate, his/her name and complete post-office address shall
be contained on the certificate of write-in candidacy. If there is no vice-presidential running mate, the certificate shall
be appropriately marked. The sworn vice-presidential certificate of acceptance is a part of this form.
CERTIFICATE OF WRITE-IN CANDIDACY
President of the United States
I, ______________________________________________________, being duly sworn, depose and say that I reside
candidate name
at ________________________________________________________, City of ________________________________,
street or route address
city
_______________________, ___________________________; that I'm a write-in candidate for the President of the
state
zip code
United States of America to be voted upon at the general election to be held on the _________ day of November,
________, and do hereby request that a canvass and official tally be made of my vote and be entered upon the official
abstract of votes for the State of North Dakota provided the total write-in votes for the office of President are greater than
five percent of the total votes cast for the candidate receiving the greatest number of votes, for that office, in North Dakota
according to NDCC 16.1-12-02.2. The names and complete addresses of the electors representing my candidacy are
provided herein:
Signature of presidential candidate
VERIFICATION
State of _________________________
)
) ss.
County of ________________________
)
Subscribed and sworn to before me this _________ day of _____________________________, 20____.
(Notary Seal/Stamp)
Notary Public
My Commission Expires_____________________________________
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