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2. 

4. I, being a registered voter at the address listed below, 
   do hereby declare that I wish to affiliate with the following political party or political group:

6. 1. Democratic
7. 1. Republican
8. 1. Conservative*
10. 1. Green*
11. 1. Libertarian*
12. 1. Natural Law Party*
14. 1. Reform Party*
15. 1. U.S. Constitution Party*
16. 1. Socialist Party of New Jersey*

18. OR

20. I, being a registered voter at the address listed below, 
    do hereby declare that I do not want to be affiliated with any political party or group.

22. 1. Unaffiliated**

26. Last Name

28. First Name
29. Middle Initial
31. Date of Birth (Month)
32. (day)
33. (year)
35. New Jersey Residence:
37. Street
38. Apt. No
40. Municipality
42. County
43. Zip Code

45. ____________________________________________________________________

    Signature or mark of registered voter

46. Date

48. *If you are a registered member of the Green Party, Libertarian Party, Natural Law Party, Reform Party, U.S. Constitution Party, Conservative Party or the Socialist Party of New Jersey you can participate in the convention of that party, according to its bylaws, but you cannot vote in either the Democratic or Republican Primary.

    **If you are a previously affiliated voter who is changing to an unaffiliated voter, you must file a declaration form no later than 55 days before the primary election in order to be registered as unaffiliated for the primary election.

    Declaration must be filed no later than 55 days preceding the primary in which the voter wishes to vote. An unaffiliated voter can affiliate with the Democratic or Republican Party on the day of the primary.

50. NJ Division of Elections

51. Return form to:
     Hunterdon County Board of Elections
    71 Main Street, PO Box 2900, Building 3A, Old Court House (3rd Floor)
    Flemington, NJ 08822

52. NJ Division of Elections - 02/27/16

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