I, ______, affirm
all of the following: 1.That I am 18 years of age or older. 2.That my residence address, including street and number, is . [If no street or number exists, a designation of my residence adequate to readily ascertain its location is .] 3.That I secured signatures in the County of ____ to the nomination paper of a candidate in the presidential preference primary of the Peace and Freedom Party, that all the
signatures on this section of the nomination paper numbered from 1 to ____, inclusive, were made in my presence, that the signatures were obtained between ____, 20_, and ____, 20_, 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. I declare under penalty of perjury that the foregoing is true and correct.
Executed at ____, California, this ____ day of ____, 20_.
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