Section 6586.

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 American Independent 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 intending to affiliate with the American Independent Party. I hereby nominate ____________ for the presidential preference portion of the American Independent 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, or for any group of delegates, to the national convention of the party, and I further declare that I intend to support the candidate named herein.

Number _____ Signature _____ Printed name _____ Residence

 1.

 2.

 3.

etc. 

CIRCULATOR'S AFFIDAVIT

I, ______, solemnly swear (or affirm) that I secured
signatures in the County of ____ to the nomination paper of a
candidate in the presidential preference primary of the American
Independent 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.

(Signed) _____ Circulator _____

(Amended by Stats. 1999, Ch. 790, Sec. 14. Effective January 1, 2000.)