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 is
and 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)
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