Democratic Party of Georgia

2015 Congressional District Chair of the Democratic Party of Georgia

Notice of Intent to Run

I, ______________________________, intend to run for the ____ Congressional District Chair of the
Democratic Party of Georgia. I affirm that I am/am not a current State Committee Member.
I have made an X under the statement that is true for me.
_________ As a current State Committee Member, I serve under __________________ County or I am
an At-large member.
_________Conversely, I am not a current State Committee Member and therefore the 30 signatures of
current State Committee Members supporting my candidacy are attached as Exhibit A.

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Signature

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Date