Guam Election Commission
Kumision Ileksion Guåhan
2nd Floor, Suite 202 Oka Building, 241 Farenholt Avenue, Tamuning, Guam 96913
Tel: (671) 477-9791 ∙ Fax: (671) 477-1895 ∙ E-Mail: vote@gec.guam.gov ∙ Website: http://gec.guam.gov
CERTIFICATION OF QUALIFICATION
SENATOR

I, CLIFFORD HACKERTT, do solemnly swear that I am a qualified candidate for the office of SENATOR for the Primary Election to be held on the date set by law for this year, and have met the following qualifications as set forth in the Organic Act of Guam, Title 48 Chapter 8A § 1423(f) of the United States Code:

I am submitting with this statement a Nominating Petition in the form and manner as prescribed by the Election Code of Guam. I make the foregoing Affidavit under oath, knowing that any false statement herein constitutes a violation under the laws of Guam.

Declarant Signature
NOTARY ACKNOWLEDGMENT
SUBSCRIBED AND SWORN to before me on this _____ day of ____________________, 20______.
NOTARY PUBLIC in and for the Island of Guam
My Commission expires: _________________________________