Section 110. Any registered voter of the city who is eligible for election to any elective municipal body shall be entitled to have his name printed as a candidate therefor on the official ballot to be used at the regular municipal election; provided, that at least twenty-eight days prior to such election there shall be filed with the city clerk a statement in writing of his candidacy, signed by him, and with such statement the petition of not less than fifty nor more than one hundred registered voters of the city, whose signatures shall have been certified as required by law. Except as aforesaid, no person shall be entitled to have his name printed as a candidate on such ballot. Said statement and petition shall be in substantially the following form:

STATEMENT OF CANDIDATE

I ( ), on oath declare that I reside at (number, if any) on (name of street) in the city of ; that I am a voter therein, qualified to vote for a candidate for the hereinafter mentioned office; that I am a candidate for the office of (name of office) to be voted for at the regular municipal election to be held on Tuesday, the day of , nineteen hundred and ; and I request that my name be printed as such candidate on the official ballot for use at said election.

(Signed)

COMMONWEALTH OF MASSACHUSETTS

ss.

Subscribed and sworn to at ( ) on this day of , nineteen hundred and before me,

(Signed)

Justice of the Peace.

(or Notary Public).

PETITION ACCOMPANYING STATEMENT OF CANDIDATE

Whereas (name of candidate) is a candidate for the office of (state the office), we, the undersigned, voters of the city of , duly qualified to vote for a candidate for said office, do hereby request that the name of said (name of candidate) as a candidate for said office be printed on the official ballot to be used at the regular municipal election to be held on the Tuesday of , nineteen hundred and .

The petition may be on one or more papers and need not be sworn to.