The nomination paper for the presidential primary ballot shall be in substantially the following form:
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 intending to affiliate 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.
NumberSignaturePrinted nameResidence
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)