During the last consecutive Monday, Tuesday, and Wednesday in June in the even years and during the thirty-ninth (39th) and fortieth (40th) days preceding a primary election for a special election for state or local office, or for an election for state or local office regularly scheduled for a time other than the biennial general statewide election, or during the sixty-seventh (67th) and sixty-eighth (68th) days preceding a primary election for a special election for federal office, or for an election for federal office regularly scheduled for a time other than the biennial general statewide election, each voter desiring to be a candidate at the upcoming primary or an independent candidate on final nomination papers shall, on a form that shall be provided by the secretary of state, file a declaration of their candidacy not later than four o’clock (4:00) p.m. of the last day for the filing with the secretary of state for congressional and statewide general offices, or with the local board of the place of the candidate’s voting residence for general assembly, or state committee or senatorial and representative district committee, or with the appropriate local board for local officers. The declaration shall be signed by the candidate as the candidate’s name appears on the voting list. The signature shall be accepted as valid if it can be reasonably identified to be the name and signature of the voter it purports to be. A variation of the voter’s signature by the insertion or omission of identifying titles or by the substitution of initials for the first or middle names or both shall not in itself be grounds for invalidation of the signature. The declaration shall also include the following information:

(1)  The candidate’s name as it appears on the voting list, subject to the same provisions as relate to the voter’s signature on the declaration;

(2)  The address as it appears on the voting list, provided that an address that is substantially the same as the address on the voting list shall be valid;

(3)  The party declaration if seeking to run in a party primary;

(4)  The office sought;

(5)  The place and date of birth;

(6)  The length of residence in the state and in the town or city where the candidate resides;

(7)  A certification that the candidate is neither serving a sentence, including probation or parole, for which the candidate was imprisoned upon final conviction of a felony imposed on any date nor serving any sentence, whether incarcerated or suspended, on probation or parole, upon final conviction of a felony committed after November 5, 1986;

(8)  A certification that the candidate has not been lawfully adjudicated to be non compos mentis, of unsound mind;

(9)  In the case of candidates for party nomination, a certification that the candidate has not been a member of a political party other than the declared party within ninety (90) days of the filing date, except in the case of candidates for party nomination for a special election for federal office, or for an election for federal office regularly scheduled for a time other than the biennial general statewide election, that person shall not have been a member of a political party other than the declared political party within thirty (30) days of the filing of their declaration of candidacy; and

(10)  If a person is a candidate for a state or local office, a certification that the person has not within the preceding three (3) years served any sentence, incarcerated or suspended, on probation or parole, for a crime committed after November 5, 1986, upon a plea of nolo contendere or guilty or upon a conviction of a felony or for a misdemeanor for which a sentence of imprisonment for six (6) months or more, whether suspended or to be served was imposed.