Form No. 2-E Prescribed by Secretary of State (06-10)
DECLARATION OF CANDIDACY
PARTY PRIMARY ELECTION FOR DISTRICT OFFICE
Representative to Congress
To be filed with the Board of Elections of the most populous county or part county of the district
not later than 4 p.m. of the 90
day before the day of the primary election.
Revised Code 3513.05, .07, .08, .09, .10, .191, 3501.38
NOTE – THE CANDIDATE MUST FILL IN, SIGN AND DATE THIS DECLARATION
BEFORE PETITIONS ARE CIRCULATED.
I, ______________________________________, the undersigned, hereby declare under penalty
(Name of Candidate)
of election falsification that my residence address is ______________________________________,
(Street and Number, if any, or Rural Route Number)
_____________________________________, Ohio ______________.
(City or Village)
I hereby declare that I desire to be a candidate for nomination to the office of Representative to
Congress as a member of the _____________________________ Party from the ________________.
(Number of District)
District for the:
full term, or
unexpired term ending ______________________,
(check one box)
(Fill in the appropriate date)
at the primary election to be held on the _________day of ___________________, ____________.
I hereby declare that, if elected to this office or position, I will qualify therefor.
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.
CITY, VILLAGE, OR
ADDRESS STREET AND