Nebraska Revised Statutes Chapter 32. Elections § 32-617.01. Nomination by petition filed with Secretary of State; form of petition

In addition to the requirements of sections 32-617 and 32-619, if the Secretary of State is the filing officer for a petition for nomination for partisan and nonpartisan offices, the form of the petition shall be substantially as follows:

Petition for Office for General Election

Name of Candidate: ____________

Residence Address: ____________

City, State, and Zip Code: ____________

Name of Office: ____________

District (if applicable): ____________

Party Affiliation (if applicable): ____________

To the Honorable____________, Secretary of State for the State of Nebraska:

We, the undersigned residents of the State of Nebraska and the county of____________, respectfully demand that the above-named candidate be placed on the ballot at the general election to be held on the ____ day of __________ 20____, and each for himself or herself says:

I have personally signed this petition on the date opposite my name;

I am a registered voter of the State of Nebraska and the county of ____________ and am qualified to sign this petition or I will be so registered and qualified on or before the date on which this petition is filed with the Secretary of State; and

My printed name, date of birth, street and number or voting precinct, and city, village, or post office address are correctly written after my signature.

(Here follow numbered lines for signature, printed name, date of birth, date, street and number or voting precinct, and city, village, or post office address.)