§ 10511 — California Elections Code

The declaration of candidacy shall be in substantially the following form:

I, _________________, do hereby declare myself as a candidate for election to the office of _________________. ( Initial here if the office for which you are running is for the balance of an unexpired term.) I am a registered voter. If elected, I will qualify and accept the office of __________________ and serve to the best of my ability. I request my name be placed on the official ballot of the district for the election to be held on the ___ day of _____, 20, and that my name appear on the ballot as follows:(Print name above)My current residence address isand my telephone number is .
I desire the following occupational designation to appear on the ballot under my name:(Print desired designation, if any, above)
This occupational designation is true and in conformance with Section 13107 of the Elections Code.
I am aware that any person who files or submits for filing a declaration of candidacy knowing that it or any part of it has been made falsely is punishable by a fine or imprisonment, or both, as set forth in Section 18203 of the Elections Code. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on , 20__, at (Place)
(Signature of Candidate)

(Amended by Stats. 2003, Ch. 296, Sec. 2. Effective January 1, 2004.)