PETITION REQUEST FORM
Please complete PART I of the form and submit either to your county board of elections office for single county
districts and local petitions or to the NC State Board of Elections for multi-county and statewide petitions and for
district and superior court judges.
PART I: INFORMATION TO BE COMPLETED BY PETITIONER
NAME OF CANDIDATE/PETITION
NAME OF CONTACT PERSON
PRIMARY PHONE
SECONDARY PHONE
EMAIL ADDRESS
CONTACT ADDRESS
CONTACT ADDRESS
Select ONE petition type (candidate, new party, or “other” category)
CANDIDATE PETITION
PETITION TO RUN AS AN UNAFFILIATED CANDIDATE WRITE IN CANDIDATE
OFFICE
DISTRICT
JURISDICTION
MUNICIPAL
SINGLE COUNTY
MULTI-COUNTY
STATEWIDE
JUDICIAL
NEW POLITICAL PARTY
NAME OF PARTY
OTHER PETITION PLEASE SELECT TYPE BELOW
ABC (ALCOHOLIC BEVERAGE SALE) PETITION
MUNICIPAL INCORPORATION or ANNEXATION
IN LIEU OF PAYING FILING FEE
MUNICIPAL CHARTER AMENDMENT
BOND REFERENDUM
REPEAL OF LEVY
SCHOOL TAX
PRESIDENTIAL PARTY NOMINATION
OTHER LOCAL PETITION PLEASE SPECIFY TYPE:
Please ensure efficient processing by using only forms provided by the State Board of Elections.
Signatures must be collected on separate sheets for each county. Do not combine voter signatures from multiple
counties on one sheet. Signed sheets must be submitted to the relevant county to be checked. All signatures
should be in ink and must be original (not digital). No one may sign for another person. By checking this box, I
confirm that I have read and understand this information.
PART II COUNTY OR STATE WILL COMPLETE AND RETURN COPY TO PETITIONER
*when based on
registered voters on a future date, this will be an estimate)