Chairperson of the State Central Committee of the Democratic Party. |
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) |
Certificate of County Elections Official to Nomination Papers To the Secretary of State: I, Elections Official of the County of ____, hereby certify that I have examined the nomination papers to which this certificate is attached, of the candidate or uncommitted delegation, as the case may be, for purposes of qualifying for placement on the ballot at the ensuing presidential primary, that the number of names which I have not marked “not sufficient” is ____. Dated this ____ day of ____, 20__. | ||
(seal) | ,County Elections Official By , Deputy |
Certified List of Presidential Candidates and Uncommitted Delegations To the County Elections Official of ____ County: I, ____, Secretary of State, do hereby certify that the following list contains the name of each person who is entitled to be voted for as a candidate of the Democratic Party at the presidential primary election to be held on the ____ day of ____, 20__, and the name of each chairperson of a steering committee of an uncommitted delegation which is entitled to be voted for on the ballot. | |
List of Presidential Candidates and Uncommitted Delegations Linda Adams Joseph Black John Reardon Unpledged delegation Paul Minor, Chairperson | |
Dated at Sacramento, California, this ____ day of ____, 20__. | |
(seal) | Secretary of State |
List of Delegates Pledged to Presidential Candidates and Uncommitted Delegations In the _____ Congressional District | |
Delegates Pledged to Rosaly Lever Deborah Seiler Elaine Ginnold George Mann Darren Chesin | Delegates Pledged to Janice Atkinson John Mott-Smith Rosa Garcia-Viteri Bruce Bolinger Mary DeLost |
Delegates Pledged to Christopher Zirkle | Delegates Pledged to Unpledged Delegation, James Ashford, Chairperson |
Mark Terry Romulo Lopez Linda M. Gonzalez Joe Ayala Lori Joseph | Abra Reynaga Sylvia Cheng Michael Ognisty Bill Pitts Lynne Chinn |
Dated at Sacramento, California, this ________ day of ________, 20__. | |
(seal) | Secretary of State |