NOMINATING PETITION FOR GENERAL ELECTION INDEPENDENT CANDIDATES

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1 of 6 INSTRUCTIONS NOMINATING PETITION FOR GENERAL ELECTION INDEPENDENT CANDIDATES FOR MUNICIPAL OFFICE(S) PETITION MUST BE FILED WITH THE COUNTY CLERK BY 4:00 PM OF THE DAY OF THE PRIMARY (N.J.S.A. 19:13-9) 1. Read Petition carefully. The Candidate(s) must sign the certificate of acceptance stating that they are qualified for the office. 2. The Circulator must sign his/her name & address, and attest that they collected all of the signatures for the Candidate; and have it notarized. 3. When using Joint Petition for Council, list the names in the order that they are to appear on the ballot. Mayor files a separate petition. 4. The Candidate(s) must take Oath of Allegiance before an officer authorized by law to take oaths. INFORMATION ON CIRCULATING AND FILING A PETITION (N.J.S.A. 19:13-4) One or more petitions may be circulated and filed on behalf of Candidate(s) providing: 1. That all petitions are filed on or before 4:00 p.m. on the day of the Primary Election (N.J.S.A. 19:13-9). 2. That in the aggregate the number of valid signers of the petition(s) equal or exceed the number required by Law (N.J.S.A. 19:13-5). 3. The circulator of the petition must complete affidavit portion, and must witness signatures he/she is gathering (N.J.S.A. 19:13-7). 4. That the signers are qualified voters and reside in the Municipality for which the Candidate is the nominee for office (N.J.S.A. 19:13-5). 5. The circulator does not have to be a signer of the petition, but must be 18 years of age or older, a citizen of the United States, and reside within the State of New Jersey (N.J.S.A. 19:13-7). 6. That the candidate(s) endorsed in the petition fully complete and execute one or more petitions with respect to qualification, consent and acceptance. 7. No individual shall be eligible to be a Candidate unless individual is a Registered Voter in that Municipality and or ward. Individual was or will be a resident of the Municipality and or ward one year prior to the date of the election, and must be 18 years of age or older. NOTICE: All candidates are required by law to comply with the provisions of the New Jersey Campaign Contributions and Expenditures Reporting Act. For further information, please call the Election Law Enforcement Commission at 609-292-8700 or toll-free within New Jersey at 1-888-313-ELEC (3532)

2 of 6 Petition for: Municipal Office (See s Required, N.J.S.A. 19:13-5) We the undersigned hereby certify that we reside in the municipality of in the County of Bergen, of the State of New Jersey, and that we are legally qualified to vote for such candidate(s), and pledge ourselves to support and vote for the person(s) named in such petition, and that we have not signed any other petition of nomination for the primary or for the General Election for such office, and request that you cause to be printed upon the Official General Election Ballot the name of the candidate and his/ designation of party or party principle. We further certify that the office for which said person is named, the residence and post-office address of said person so endorsed is as follows: FOR THE OFFICE OF _ WARD IF ANY CANDIDATE(S) INFORMATION 1. (Name must appear the same as registered to vote) Address: Phone #: 2. (Name must appear the same as registered to vote) Address: Phone #: CANDIDATE S REQUEST FOR SLOGAN The candidate(s) herein, having been endorsed for the office mentioned in this petition, does hereby request that there be printed opposite his/her name on said General ballot, the following slogan: (NOTE: Slogan must not exceed three words and must be in accordance with N.J.S.A. 19:13-4)

AFFIDAVIT OF PERSON WHO CIRCULATES THIS PETITION AND WITNESSES SIGNATURES (To be signed by Circulator) (N.J.S.A. 19:13-7) 3 of 6 The witness taking the affidavit below must be the person who obtained the signatures on this petition. The circulator must take the affidavit for a petition he/she solicits and sign in the presence of a person authorized to administer affidavits (e.g. notary public). State of New Jersey } S.S. County of Bergen } I,, being duly sworn or affirmed upon (Print name of Circulator/Witness) his/her oath, depose and say that such petition is signed by each of the signers thereof in his/her own proper handwriting; that each of such signers is, to the best knowledge and belief of deponent, a legal voter of the municipality of in the County of Bergen of the State of New Jersey, as stated in said petition, and that such petition is prepared and filed in absolute good faith for the sole purpose of endorsing the person therein named in order to secure his/her nomination or selection as stated in said petition; and further affirms that he/she is a registered voter in the State of New Jersey. Subscribed and sworn before me at:, N.J., This day of, 20. of Circulator/Witness Street Address of Circulator/Witness City or Town, Zip Code of Notary or Attorney at Law of New Jersey of Notary or Attorney at Law of New Jersey Commission Expiration Date of Notary

4 of 6 OATH OF ALLEGIANCE (To be signed by Candidate) State of New Jersey } S.S. County of Bergen } I,, do solemnly swear (or affirm) that I will support the Constitution of the United States and the Constitution of the State of New Jersey; that I will bear true faith and allegiance to the same and to the Governments established in the United States and in this State, under the authority of the people. So help me God. Subscribed and sworn before me at:, N.J., of Candidate (1) This day of, 20. of Notary or Attorney at Law of New Jersey of Notary or Attorney at Law of New Jersey Commission Expiration Date of Notary Subscribed and sworn before me at:, N.J., of Candidate (2) This day of, 20. of Notary or Attorney at Law of New Jersey of Notary or Attorney at Law of New Jersey Commission Expiration Date of Notary

5 of 6 CERTIFICATE OF ACCEPTANCE (To be signed by Candidate) I, or we, the undersigned, hereby certify that I or we am/are a resident of and a legal voter in the jurisdiction of the office for which the nomination is made, and that I or we have not signed an acceptance for the primary nomination or any other petition of nomination under this chapter for such office. (R.S. 19:13-8) of Candidate (1) Type or of Candidate of Candidate (2) Type or of Candidate

Candidate(1) Municipality Candidate(2) Office 6 of 6 1) 2) 3) 4) 5) 6) 7) 8) 9) 10)