§ 6786 — California Elections Code

The nomination paper for a candidate for the presidential preference portion of the ballot shall be in substantially the following form:

SECTION OF NOMINATION PAPER SIGNED BY VOTER ON BEHALF OF PRESIDENTIAL PREFERENCE PRIMARY CANDIDATE
		Section ______ Page ______ County of _________.
Nomination paper of a presidential preference candidate for the Peace and Freedom Party presidential primary ballot.
State of CaliforniaCounty 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 Peace and Freedom Party. I hereby nominate ________ for the presidential preference portion of the Peace and Freedom Party’s presidential primary ballot, to be voted for at the presidential primary to be held on the ______ day of June, 20. I have not signed the nomination paper of any other candidate for the same office, or for any group of delegates to the national convention of the ______ Party, with which the Peace and Freedom Party of California is affiliated on the national level.

Number	Signature	Printedname	Residencestreet address/city
1.
2.
3.
etc.

CIRCULATOR’S AFFIDAVIT
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.
	(Signed) Circulator(Printed name)

CIRCULATOR’S AFFIDAVIT

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.

(Signed) Circulator(Printed name)

(Amended by Stats. 2013, Ch. 278, Sec. 11. (SB 213) Effective January 1, 2014.)