Cal. Elec. Code § 6768 — Qualification of Group of Candidates for National Convention Delegate Portion of Primary Ballot

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)