etc.
CIRCULATOR’S AFFIDAVIT
I, ______, affirm all of the following:
1.That I am 18 years of age or older.
2.That my residence address, including street and 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 the group of candidates named in the signer’s statement above as candidates for nomination and election by the Peace and Freedom Party as delegates to represent the Peace and Freedom Party of California in the ____ Party’s next national convention, 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)
(Amended by Stats. 2013, Ch. 278, Sec. 12. (SB 213) Effective January 1, 2014.)