Appendix E

Presidential Candidate Written Affirmation
Pursuant to Article VI of the Call for the 2020 Democratic National Convention, I hereby affirm that,
upon publicly announcing my candidacy for the Democratic nomination for President of the United
States in the 2020 election, I am a member of the Democratic Party. I will run as a Democrat, accept
the nomination of my Party, and I will serve as a Democrat if elected. 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.
Further, I acknowledge that the National 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 fide Democrat whose record of public service, accomplishments, public writings and/or
public statements affirmatively 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.
__________________________________________________________
Print or Type Candidate’s name

__________________________________________________________
Candidate’s signature

Campaign Point of Contact:
Name

_______________________________
Date

Phone

Email

NOTARY AFFIDAVIT
STATE OF ______________
COUNTY OF _______________
I, ____________________________________, a Notary Public, do hereby certify that on this ____day of ___________________,
20____, personally appeared before me ______________________________, known to me to be the person whose name
is subscribed to the foregoing instrument, and swore and acknowledged to me that they executed the same
for the purpose and in the capacity therein expressed, and that the statements contained therein are true and
correct.
_______________________________________________
Notary Public, State of __________________
Name, Typed or Printed: __________________________________________
My Commission Expires: ___________________________