N.H. Rev. Stat. § 655:21
Primary petitions shall be made in the following form:
State of New Hampshire
County of ____________________ ss.
City (Town) of ____________________
I do hereby join in a petition for the printing on the primary ballot of the name of __________ whose domicile is in the city (town) of __________ (ward, street, and number, if in a city), in the county of __________, for the office of __________ to be voted for on Tuesday, the __________ day of September, _____ (year), and certify that I am qualified to vote for a candidate for said office, that I am a registered member of the __________ party, and am not at this time a signer of any other similar petition for any other candidate for the above office; that my domicile is in the city (town) of __________ (ward, street, and number, if in a city), in the county of __________. I certify that to my knowledge the above-named candidate is not a candidate for incompatible offices as defined in RSA 655:10, and that he or she is not a federal employee which makes him or her ineligible to file as a candidate for this office. I further certify that I believe the above-named person is especially qualified to fill said office.
I hereby swear, under the penalties for voting fraud set forth below, that the information above is true and correct to the best of my knowledge and belief.
Print Voter's name Voter's Signature
In accordance with RSA 659:34, the penalty for knowingly or purposefully providing false information when registering to vote or voting is a class A misdemeanor with a maximum sentence of imprisonment not to exceed one year and a fine not to exceed $2,000. Fraudulently registering to vote or voting is subject to a civil penalty not to exceed $5,000.
RSA 655:21
1979, 436:1. 1991, 218:3. 1998, 356:2. 2003, 289:34, eff. Sept. 1, 2003.