1) A “CAN-3” Form (see instructions below). MUST BE NOTARIZED

2) A list of Presidential electors, residents of Indiana. The candidate must list at least 1 elector, name(s) only, and no more than 11. The sheet that contains this list should make reference to the “CAN-3” Form like this, or words to this effect: “This list is incorporated by reference in the CAN-3 form executed by me on (this date).”

Mail to:

Indiana Secretary of State
Elections Division
302 West Washington Street
Room E-204
Indianapolis, IN 46204

INSTRUCTIONS for CAN-3 Form:

On questions 1, 7, and 8, concerning residence, simply include the
correct information regarding your residence, but cross out “Indiana“,
and insert the name of the applicable state.

With regard to the presidential electors needed, Indiana Code
3-8-2-2.5(f) states that a write -in candidate must list at least 1
candidate for presidential elector, and may not list more than the total
number of presidential electors to be chosen in Indiana (11). This list
would be considered part of the CAN-3 document, which is notarized by the candidate. You may wish to include a statement to the effect of
“This list is incorporated by reference in the CAN-3 form executed by me on this date”, or words to that effect.

Brad King
Co-Director
Indiana Election Division
(317) 232-3939
(800) 622-4941