CERTIFICATE OF ACCEPTANCE
(Section 6-146, Election Law)
I, (Candidate’s Name) ,
residing at (Address)
,
having been designated/nominated by the Libertarian Party, as a candidate for the office of Presidential Elector for the State of New York, do hereby ACCEPT such designation/nomination and consent to be such candidate of such party at a General Election to be held on Tuesday, November 8, 2016.
(Date) (Signature of Candidate)
State of New York :
County of : ss:
On this day of 2016 , before me personally appeared
_________________________________________________________________________,
to me known and known to me to be the individual described therein, and who executed the foregoing instrument, and acknowledged to me that he/she executed the same.
Notary Public
(Sample Prepared by State Board of Elections) Rev. 04/2012
