RSA 654:17 Absentee Registration Affidavit.

I. The absentee registration affidavit shall be prepared by the secretary of state and shall be in substantially the following form:
Affidavit (Absence from town)
I, ____________________ do hereby swear or affirm, under the penalties for voting fraud set forth below, the following:
1) That I am a citizen of the United States, my legal domicile is in the town of ____________________ , New Hampshire, I will be of the age of 18 years or over on election day and am entitled to vote in the election to be held in said town on ____________________ , __________ (date), except for the fact that my name does not appear on the checklist to be used in said town at such election;
2) That I do not intend to be present within said town at such time prior to said election as