§ 911Statement of Candidates for Delegates to National Conventions

Each candidate for election as delegate
or alternate delegate to a National party convention may
include, with his affidavit, the statement hereinafter set forth
in this section; but his failure to include such statement shall
not be a valid ground, on the part of the Secretary of the
Commonwealth, for refusal to receive and file his nomination
petition. Such statement, if signed, shall be signed on all the
sheets of said petition, together with the date of signing and
shall be in substantially the following form:
                      Delegate's Statement
   I hereby declare to the voters of my political party in the
(here insert "State of Pennsylvania," if a delegate or alternate
delegate at large; otherwise, insert "..........District") that,
if elected and in attendance as a delegate to the National
convention of the party, I shall, with all fidelity, to the
best of my judgment and ability, in all matters coming before
the convention, support (here insert name of presidential
candidate) for President of the United States and shall use all
honorable means within my power to aid in securing the
nomination for such candidate for President.

................................................................
(Signature of candidate for delegate or alternate delegate, and
date of signing.)
   On the ballots or ballot labels used at a primary, after or
under the name of each candidate for delegate or alternate
delegate to a National party convention, shall appear the words
"committed to (here insert name of presidential candidate)" or
"uncommitted" according to whether the candidate included, or
failed to include, the above statement with his affidavit.
   (911 amended Dec. 22, 1971, P.L.613, No.165)