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Appendix it; a? i,
?Haiti!

Presidential Candidate Written Af? rmation
Fursuant to article oi the Lao for the with Democratic National Lonvention, i hereby af?rm that,
upon publicly announcing thy-candidacy for the Democratic nomination for President ofthe United
States in the 2020 election, I am a member of the Democratic Party. I will run as a Democrat, accept
the nomination ofmy Party, and 1 will serve as a Democrat ifelected. I understand that signing this
form does not supplant any legal or Party requirement by any state or territory to qualify for ballot

placement in that jurisdiction.

Ferment that the Netienei Chairperson of the Democratic National. Committee is
authorized to determine whether a presidential candidate has established substantial support for
their nomination as the Democratic candidate for the Office of the President of the United States, is
a bona ?de Democrat whose record of public service, accomplishments, public writings and/or

public statements af?rmatively demonstrate that the candidate is faithful to the interests, welfare
and success of the Democratic Party of the United States, and will participate in the Convention in

good faith.

Chief/e 

Print or Type Candidate's name

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Candidate?s signature Date

Name Phone Email
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nornav AFFIDAVIT
smite} ?tment
coomr or 

1, mm, a Notary Public, do hereby certify that on this iday of malt 

zo?, personally appeared before me . known to me to be the person whose name
is subsc?hed to Ithe foregoing imminent, and swore and aclmowledge-d to me that they executed the same
for the purpose and in the capacity therein expressedand that the statements contained therein are true and

CUE 9 g: 

Notary lJuinc, State of mmgi 5+ 

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