California Elections Code Section 7152

The state central committee shall enclose with the notice required by Section 7151 one copy of the following statement for appointment of members of the state central committee, which shall be in substantially the following form: APPOINTMENT OF MEMBERS OF THE STATE CENTRAL COMMITTEE OF THE DEMOCRATIC PARTY MEETING AT ____, IN THE YEAR 19_ I, ____, duly qualified as a member of the state central committee of the Democratic Party at ____ in the year 19_ by virtue of my (appointment by the ____ central committee) (nomination) (election to the office of ____) (strike out parts inapplicable) on the ____ day of ____, 19_ upon the Democratic ticket, do hereby appoint the following voters, who shall be members of the state central committee: __________________________________________________________________ Name Senatorial, Post office Congressional, address Assembly district __________________________________________________________________ Name Senatorial, Post office Congressional, address Assembly district __________________________________________________________________ Name Senatorial, Post office Congressional, address Assembly district