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Form No. 2-K Prescribed by Secretary of State (06-10)

DECLARATION OF CANDIDACY

FOR MEMBER OF STATE CENTRAL COMMITTEE TO BE ELECTED

PARTY PRIMARY ELECTION

(Intermediate or Minor Party)

To be filed with the Board of Elections of the most populous county or part county in the district

not later than 4 p.m. of the 90

day before the day of the primary election.

Revised Code 3513.05, .07, .09, .10, .191, 3501.38, 3517.03, 3513.262

The candidate must fill in and sign the declaration of candidacy before obtaining signatures on the petition. No

less than 5 nor more than 15 signatures must be obtained. Each signer must be a member of the same political

party as the candidate and must be a qualified elector of the district the candidate wishes to represent on the

committee.

NOTE – THE CANDIDATE MUST FILL IN, SIGN AND DATE THIS DECLARATION

BEFORE PETITIONS ARE CIRCULATED.

I, ________________________________________, the undersigned, hereby declare under penalty of

(Name of Candidate)

election falsification that my voting residence address is ____________________________________,

(Street and Number, if any, or Rural Route Number)

of ________________________________, Ohio ____________, and I am a qualified elector.

(City, Village or Post Office)

(Zip Code)

I hereby declare that I desire to be a candidate for election to the office of Member of the State Central

Committee as a member of the ______________________ Party from the _____________________

(Number of District)

__________________________________________ District, at the primary election to be held on the

(Name of District)

________ day of _______________, ____________.

(Month)

(Year)

I further declare that, if elected to this office or position, I will qualify therefor, and I will support and

abide by the principles enunciated by the ________________________ Party.

Dated this ______ day of _______________________, _____________.

________________________________________

(Signature of Candidate)

WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE

PETITION FOR CANDIDATE

(This petition shall be circulated only by a member of the same political party as stated above by the candidate)

We, the undersigned qualified electors of the State of Ohio, whose voting residence is in the county,

city, village, or township, set opposite our names, and members of the ____________________ Party,

hereby certify that ___________________________________, whose declaration of candidacy is filed

(Name of Candidate)

herewith, is in our opinion, well qualified to perform the duties of the office or position to which the

person desires to be elected.

Signatures on this petition should be from only one county and must be written in ink. Signatures on this

petition shall be of persons who are of the same political party as stated above by the candidate.

VOTING RESIDENCE

CITY, VILLAGE,

DATE OF

SIGNATURE

ADDRESS STREET AND

COUNTY

OR TOWNSHIP

SIGNING

NUMBER

Form 2-K - Declaration Of Candidacy - For Member Of State Central Committee To Be Elected - 2010

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