Elec. Code, § 6768

The declaration of a candidate for delegate shall be in substantially the following form:

Declaration of Candidate for Delegate

State of California County of ______ ⎱ ⎰ ss.

I, ______, reside and am a registered voter at

______(street address)______ ,

in the (city or town) of ______ ,

in the County of _______, State of California.

I desire to be a candidate, at the presidential primary to be held on the ____ day of ____, 20_, for delegate to the next national convention of the ____ Party with which the Peace and Freedom Party of California is affiliated on the national level and I will qualify as a delegate if elected.

I personally prefer ____ as the nominee of the Peace and Freedom Party for President of the United States, and hereby declare to the voters of the Peace and Freedom Party in the State of California that if elected as delegate to the national party convention, I shall to the best of my judgment and ability, support ____ as the nominee of the Peace and Freedom Party for President of the United States. (This statement of preference shall be omitted where the candidate for delegate is part of a group not expressing a preference for a particular presidential candidate.)

I declare under penalty of perjury that the foregoing is true and correct.

Executed at ______, California, this ____ day of ____, 20_.

______(Signed) ______