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 election in 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)
(Amended by Stats. 2002, Ch. 454, Sec. 2.5.)