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Ballot Designation Worksheet

  1. Ballot Designation Worksheet

    Congratulations on deciding to run for your local elected office! All candidates must complete all six (6) forms to receive a response from the City Clerk's office. The six required forms are: Declaration of Candidacy, Ballot Designation Form, Candidate Statement Form, Code of Fair Campaign Practices, Mass Mailing Demo, and Statement of Responsibility Form. Candidates that do not complete all forms will not receive a response from our office.

  2. Name of Candidate

  3. Office Sought

  4. Include the District

  5. Term*

  6. Current Residence Address

  7. Mailing Address (if different)

  8. Contact Information

  9. Email

  10. Authorized Contact

  11. (i.e. Spouse, Campaign Manager, etc.)

  12. Authorized Contact - Phone Number

  13. Authorized Contact - Email

  14. A ballot designation appears under the candidate's name on the ballot and describes that candidate's principal profession, vocation or occupation. The Ballot Designation Worksheet is a form that candidates use to requset a ballot designation and to justify the reason for requesting that designation. There are specific rules regarding selecting a ballot designation, and these rules are outlined in Cal. Admin. Code 20710-20719 and Cal. Elec. Code. 13107. Ballot designation requirements include but are not limited to the following:

    1) A ballot designation represents a candidate’s true principal profession, vocation or occupation 2) A ballot designation may not be more than three words 3) An elected official may use “Incumbent” or his/her full official title as the ballot designation. Official elected titles are not subject to the three word limit 4) An appointed official may use “Appointed Incumbent” or his/her full official title, accompanied with the word “appointed,” as the ballot designation. Official titles are not subject to the three word limit 5) A ballot designation is limited to approximately 48 characters including spaces and punctuation

  15. Please review the rules for ballot designation listed above before filling out this section.

  16. Ballot Designation Example
    Ballot Designation Example

  17. Alternatives required in case proposed ballot designation is denied

  18. Alternatives required in case proposed ballot designation is denied

  19. If occupation is "Retired", input N/A

  20. Dates in Position:

  21. Person who can verify this information

  22. If occupation is "Retired", input N/A

  23. If occupation is "Retired", input N/A

  24. If occupation is "Retired", input N/A

  25. If occupation is "Retired", input N/A

  26. If occupation is "Retired", input N/A

  27. If occupation is "Retired", input N/A

  28. Attach supporting documents for your proposed ballot designation.

  29. Supporting Documentation Provided:

  30. To the best of my knowledge and belief, the above-requested ballot designation(s) represent my true principal profession(s), vocations(s), or occupation(s). Furthermore, I understand that the Elections Office will not accept any ballot designation that violates any rules outlined in either the Cal. Admin. Code 20710-20719 or the Cal. Elec. Code 13107

  31. Date (i.e. 19th)

  32. Month (i.e. August)

  33. Signature of Candidate

  34. Leave This Blank:

  35. This field is not part of the form submission.