2011 California Code
Elections Code
DIVISION 6. PRESIDENTIAL ELECTIONS [6000 - 6954]
ARTICLE 6. Nomination Papers
Section 6108

SECTION OF NOMINATION PAPER SIGNED BY VOTER ON BEHALF OF A PRESIDENTIAL CANDIDATE OR UNCOMMITTED DELEGATE

Section ____Page _

County of ____. Nomination paper of a candidate or uncommitted delegation for the presidential primary ballot.

State of California

County of

ss.

SIGNER S STATEMENT

I, the undersigned, am a voter of the County of ____, State of California, and am registered as affiliated with the Democratic Party. I hereby nominate ____ for the presidential primary to be held on the ____ day of ____, 20__. I have not signed the nomination paper of any other candidate or uncommitted delegation, and I further declare that I intend to support the candidate or uncommitted delegation named herein.

Number _____ Signature _____ Printed name _____ Residence

1.

2.

3.

etc.

CIRCULATOR S AFFIDAVIT

I, ____, solemnly swear (or affirm) that I secured signatures in the County of ____ to the nomination paper of a candidate or uncommitted delegation for the presidential primary ballot named in the signer s statement above; that all the signatures on this section of the nomination paper numbered from 1 to __, inclusive, were made in my presence, and that to the best of my knowledge and belief each signature is the genuine signature of the person whose name it purports to be. The signatures were obtained between ____, 20__, and ____, 20__.

(Signed)

Circulator

Subscribed and sworn to before me this ____ day of ____, 20__.

(SEAL)

Notary Public (or other official)