Cal. ELEC § 8083

The county elections official’s statement to the Secretary of State of the number of signers shall be in substantially the following form: statement of county elections official of number of signers I, County Elections Official of the County of ____, hereby certify that I have examined the ____ hereto attached filed on behalf of ____, candidate for nomination to the office of ____ at the primary election to be held on the __ day of ____, 20_, and that the total number of signatures which I have not marked “not sufficient” is ____. Dated this __ day of ____, 20_. __County Elections Official (seal) By _________ Deputy