APPLICATION FOR NOMINATION OR ELECTION BY PARTY PRIMARY
State of Wyoming | ) |
) | ss |
County of .... | ) |
I, ...., swear or affirm that I was born on ...., ....(year), that I have been a resident of the state of Wyoming since ...., and that I am a registered voter of Election District No....., in Precinct No....., residing at ...., in County of ...., (if for the office of state senator or representative) in Senate (House) District ...., state of Wyoming, and registered as a member of ....party, (if for the office of governor) and that I resided at the physical residential addresses listed below during the past five (5) years, and I hereby request that my name be printed upon the official party ballot at the next primary election as a candidate for the office of ...., and hereby declare that if nominated and elected, I will qualify for the office.
(If for the office of United States senator or representative in congress) I have not, at any time when knowingly seeking nomination or election to this office, claimed or been currently claiming any residence or received the benefits of residency from any other state, excluding the benefits of residency related to or incidental from maintaining a residence at or near the United States capital.
(If for the office of governor) I have resided at the following physical residential addresses during the past five (5) years:
(Residence) | (Date) |
1........................... | ...................... |
2........................... | ...................... |
Dated the ....day of ...., ....(year). | |
.....................(Signature) |
W.S. 22-5-204