N.Y. Elec. Law § 6-132

§ 6-132. Designating petition; form. 1. Each sheet of a designating\npetition shall be signed in ink and shall contain the following\ninformation and shall be in substantially the following form:\n I, the undersigned, do hereby state that I am a duly enrolled voter of\nthe.................... party and entitled to vote at the next primary\nelection of such party, to be held on..............., 20...; that my\nplace of residence is truly stated opposite my signature hereto, and I\ndo hereby designate the following named person (or persons) as a\ncandidate (or candidates) for the nomination of such party for public\noffice or for election to a party position of such party.\n________________________________________________________________________\n **(JOINTLY DESIGNATED CANDIDACY FOR GOVERNOR AND LIEUTENANT GOVERNOR)**\n Name of Governor Residence of Candidate\n Candidate for Governor\n for Governor\n ............ .........................\n ............ .........................\n Name of\n Candidate for\n Lieutenant Lieutenant Governor Residence of Candidate\n Governor for Lieutenant Governor\n ............ .........................\n ............ .........................\n________________________________________________________________________\n Public Office\n or party position Place of Residence\n Names of (include district number, (also post office address,\n candidates if applicable) if not identical)\n ............ ................ .........................\n ............ ................ .........................\n I do hereby appoint .............................. (insert the names\nand addresses of at least three persons, all of whom shall be enrolled\nvoters of said party) as a committee to fill vacancies in accordance\nwith the provisions of the election law.\n In witness whereof, I have hereunto set my hand, the day and year\nplaced opposite my signature.\n Date Name of Signer Residence\n ............ .............. .........................\n ............ .............. .........................\n Town or city (except\n in the city of New\n York, the county)\n ..................\n ..................\n 2. There shall be appended at the bottom of each sheet a signed\nstatement of a witness who is a duly qualified voter of the state, who\nis an enrolled voter of the same political party as the voters qualified\nto sign the petition and who has not previously signed a petition for\nanother candidate for the same office. Such a statement shall be\naccepted for all purposes as the equivalent of an affidavit, and if it\ncontains a material false statement, shall subject the person signing it\nto the same penalties as if he or she had been duly sworn. The form of\nsuch statement shall be substantially as follows:\n STATEMENT OF WITNESS\n I,..................... (name of witness) state: I am a duly qualified\nvoter of the State of New York and am an enrolled voter of\nthe....................... party. I now reside at....................\n(residence address).\n Each of the individuals whose names are subscribed to this petition\nsheet containing................. (fill in number) signatures,\nsubscribed the same in my presence on the dates above indicated and\nidentified himself or herself to be the individual who signed this\nsheet.\n I understand that this statement will be accepted for all purposes as\nthe equivalent of an affidavit and, if it contains a material false\nstatement, shall subject me to the same penalties as if I had been duly\nsworn.\n Date:....................... ..........................\n Signature of Witness\n Witness identification information: The following information must be\ncompleted prior to filing with the board of elections in order for this\npetition sheet to be valid.\n Town or City County\n ............ ........\n 3. In lieu of the signed statement of a witness who is a duly\nqualified voter of the state, the following statement signed by a notary\npublic or commissioner of deeds shall be accepted:\n On the dates above indicated before me personally came each of the\nvoters whose signatures appear on this petition sheet containing\n.............. (fill in number) signatures, who signed same in my\npresence and who, being by me duly sworn, each for himself or herself,\nsaid that the foregoing statement made and subscribed by him or her, was\ntrue.\nDate:..................\n .............................\n (Signature and official title\n of officer administering oath)\n 4. The state board of elections shall prepare a sample form of a\ndesignating petition which meets the requirements of this section and\nshall distribute or cause such forms to be distributed to each board of\nelections. Such forms shall be made available to the public, upon\nrequest, by the state board of elections and each such board. Any\npetition that is a copy of such a sample shall be deemed to meet the\nrequirements of form imposed by this section.\n