A certificate of endorsement filed with the proper officer as provided in this chapter must be in substantially the following form:
CERTIFICATE OF ENDORSEMENT
I, ______________, do certify that I am the state (district) chairman of the ______________ political party of the ______________ legislative district (if appropriate) of the state of North Dakota and that ______________ (insert name of endorsee), residing at ____________, whose nongovernment issued electronic mail address is ______________, was duly endorsed for nomination to the office of ______________ on the ______________ day of __________, by the ______________ political party of the ______________ legislative district (if appropriate), duly convened and organized in accordance with the bylaws of the ______________ political party and the laws of this state, and do hereby request ______________ name be printed upon the ballot as a candidate for nomination to the office of ______________ at the forthcoming primary election to be held on ______________ of this year.
Dated this ____________ day of _________.
_________________________________________
(signature of state or district chairman)
N.D.C.C. § 16.1-11-09