The certificate of nomination for an Independent candidate shall be in the following form:
CERTIFICATE OF NOMINATION FOR INDEPENDENT CANDIDATE
____________________________________
INSTRUCTIONS TO CANDIDATE: The heading of this petition and the declaration of candidacy must be fully completed before the petition is circulated for signatures.
_________________________________________
WE, THE UNDERSIGNED qualified voters of _____________ (here insert the jurisdiction in which the office is sought: name of county, number of legislative district or "state") of South Dakota, nominate ________________ of ___________ County, whose mailing address is ____________________, SD _________, and whose principal residence address is _______________________, ____________, SD ______, as an Independent candidate for the office of (if a legislative candidate insert "State House of Representatives" or "State Senate") ____________________________ at the general election to be held November ____, 20____.
_________________________________________
DECLARATION OF CANDIDATE
I, _________________________ (print name here exactly as you want it on the election ballot), under oath, declare that I am eligible to seek the office for which I am a candidate and that if I am a legislative or county commission candidate I reside in the district from which I am a candidate. If elected, I will qualify and serve in that office.
(Signed) ________________________________
Sworn to before me this _____ day of __________, 20____.
(Seal) ________________________________
Signature of Officer Administering Oath
My commission expires _________.
________________________________
Title of Officer Administering Oath
________________________________
The balance of this petition form is prescribed in § 5:02:08:00.03.
S.D. Admin. R. 5:02:08:05
General Authority: SDCL 12-1-9(7).
Law Implemented: SDCL 12-6-5, 12-6-7.1, 12-6-8, 12-7-1.