2006 New York Code - Designating Petition; Form.

 
    §  6-204.  Designating  petition;  form.  1.  Party  designations  for
  elective village  offices  shall  be  made  on  a  designating  petition
  containing  the  signatures  in  ink of residents of the village who are
  registered to vote with the appropriate county board of elections at the
  time of signing and who are enrolled in such political party. The sheets
  of such a petition shall be numbered. A signer need not himself fill  in
  the  date  or  residence.  Each  sheet  of  such  petition  must  be  in
  substantially the following form and shall contain all  the  information
  required therein:
 
                         PARTY DESIGNATING PETITION
 
  I,  the  undersigned do hereby state that I am a registered voter of the
  Village of ............. and a duly enrolled voter of the  .............
  party  and  entitled to vote at the next primary election of such party,
  that my place of residence is truly stated opposite my signature hereto,
  and I hereby designate the following named  person  (or  persons)  as  a
  candidate  or  (candidates)  for nomination of such party for the public
  office or (public offices) to be voted for at the primary election to be
  held on the ...... day of ............ 20.... as hereinafter specified.
 
     Name of Candidate      Public Office      Term       Residence
 
   ....................   .................  ..........  ............
   ....................   .................  ..........  ............
 
    I do hereby appoint (insert names and  addresses  of  at  least  three
  persons,  all  of  whom  shall  be  enrolled  voters of said party) as a
  committee to fill vacancies in accordance with  the  provisions  of  the
  election law.
    In  witness  whereof,  I  have  hereunto set my hand, the day and year
  placed opposite my signature.
 
   Date            Name           Residence
 
   .............  .............  ...............
   .............  .............  ...............
 
                            STATEMENT OF WITNESS
 
    I ............... (name of witness) state: I am a duly qualified voter
  of the State of New York; and an enrolled voter of the .........   party
  and now reside in the Village of ......... County of .........  State of
  New  York  at  ............  (residence  address)  therein.  Each of the
  persons whose names are subscribed to  this  petition  sheet  containing
  ......... signatures, subscribed his name in my presence.
    I  understand that this statement will be accepted for all purposes as
  the equivalent of an affidavit and, if  it  contains  a  material  false
  statement,  shall subject me to the same penalties as if I had been duly
  sworn.
 
   ........................         .................................
       Date                                Signature of witness
 
    In lieu of the signed statement of a witness who is a  duly  qualified
  voter  of  the  state  qualified  to  sign  the  petition, the following
  statement signed by a notary public shall be accepted:
    On the dates above indicated before me personally  came  each  of  the
  voters  whose  signatures  appear  on  this  petition  sheet  containing
  .............   (fill in number)  signatures,  who  signed  same  in  my
  presence  and  who,  being by me duly sworn, each for himself, said that
  the foregoing statement made and subscribed by him, was true.
  Date..................
 
                       ...............................
                       (Signature and official title
                       of officer administering oath)
 
      Page No........
 
    2.   Notwithstanding  any  other  provision  of  law,  the  number  of
  signatures required on a designating petition shall be five  percent  of
  the number of enrolled voters of the party residing in the village.