CERTIFICATE OF ACCEPTANCE - Presidential Elector

                                               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