Statement of National Affiliation and Number of National
Convention Delegates for the
Peace and Freedom Party of California

To the Secretary of State:
Sacramento, California

You are hereby notified that the Peace and Freedom Party of
California, by vote of its state central committee, has affiliated on
the national level with the ____ Party. The address of the
____ Party's principal office is ____, and its telephone
number is ____.
You are further notified that the number of delegates to repre­sent the Peace and Freedom Party of California in the next na­tional convention of the ____ Party is ____

Dated this ____ day of ____, 19_.

Chairperson of the State Central
Committee of the Peace and Freedom
Party of California