ED-633 [Rev. 2/16] (G:\st-elec\16\ed-633)--List of Cands. S/G Mun. Offices Town of: ______________________
List Of Nominees For Municipal Office - November 8, 2016
1. Under §9-461 of the General Statutes, this list is to be filed with the Secretary of the State not later than August 16. Please file immediately and file again after minor-party nomination if applicable (see accompanying letter).
2. Please carefully type the information required, and date and sign the certification. Where 2 or more candidates are to be elected to the same office for the same term, names should be listed in the order as determined by the
Registrars of Voters by lot in a public ceremony pursuant to Conn. Gen. Stats. §9-253.
3. If any minor party entitled to nominate candidates for municipal office has done so, please so indicate on a photocopy of this form.
Number For Order and Title of Office
Which Each to Be Filled
Elector No. to be (including supplementary Term
May Vote Elected language, if any) From To Democratic Nominee Address + Zip Republican Nominee Address + Zip
1 1 State Representative 01/09/17 01/07/19
_____ Assembly District
1 2 Registrar of Voters 01/04/2017 -- 01/09/19
(check one) or 01/06/21
I hereby certify that I have compared the name of each major party candidate with the candidate's name as the candidate has authorized his name to appear on the ballot (on the certificate filed under §9-391(c) or consent (state
representative) filed under §9-409) and have verified and corrected the same. I hereby certify that I have compared the name of each other candidate with his name as it appears on the registry list and have verified and corrected the
Dated at__________________________________, Connecticut, this ______ day of __________, 2016.
Signature of Town Clerk
(*Please Note: After filing of above list, Municipal Clerk must forthwith notify the Secretary of the State in writing of any errors or any changes in the above list.
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