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 Green Party 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 preferring the Green Party. I hereby nominate ____________ for the presidential preference portion of the Green Party’s presidential primary ballot, to be voted for at the presidential primary to be held on the____________ day of ____________, 20____. I have not signed the nomination paper of any other candidate for the same office.
Number_________Signature_________Printed
name_________Residence
1.
2.
3.
etc.
CIRCULATOR’S DECLARATION
I, ________, affirm all of the following:
1.That I am 18 years of age or older.
2.That my residence address, including street 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 Green 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] _____________________________