Form 10-Y "Declaration of Intent to Change Political Party Affiliation" - Ohio

What Is Form 10-Y?

This is a legal form that was released by the Ohio Secretary of State - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2017;
  • The latest edition provided by the Ohio Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 10-Y by clicking the link below or browse more documents and templates provided by the Ohio Secretary of State.

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Download Form 10-Y "Declaration of Intent to Change Political Party Affiliation" - Ohio

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Form No. 10-Y Prescribed by Secretary of State (08-17)
Declaration of Intent to Change Political Party Affiliation
print clearly
R.C. 3513.05, 3513.191(C)
To be used by current holders of elective offices for which candidates are nominated in a party primary election, who
voted in a primary election within the preceding two calendar years, and who desire to seek nomination to elected office
in a different political party's primary election.
No person filing this form shall be, during the calendar year in which this form is filed or the during the next calendar
year, a candidate in a primary election of a party other than the party specified herein.
No person filing this form shall file another such declaration for a period of 10 (ten) years after this declaration is filed.
To be filed with the Secretary of State or County Board of Elections, wherever the declaration of candidacy is filed, not
later than 4 p.m. of the 30th day before the deadline for filing a declaration of candidacy.
Exception: Candidates for party nomination of a newly formed political party are exempted from the requirements of
R.C. 3513.191 for a period of four calendar years after the date of the party formation. R.C. 3517.013.
I,
the undersigned, hereby declare that my voting residence is
(Printed Name of Office Holder)
(Street and Number, if any, or Rural Route and Number)
Ohio
,
,
.
(City, Village)
(Zip Code)
(State)
I hold the office of
, for which candidates are nominated in a primary election. I hereby
(Current Office)
declare that I desire to be a candidate for nomination to the office of
(Office Sought)
Party at the next primary election.
as a member of the
(Political Party)
Dated this
day of
,
.
(Day)
(Year)
(Month)
(Signature of Candidate)
Form No. 10-Y Prescribed by Secretary of State (08-17)
Declaration of Intent to Change Political Party Affiliation
print clearly
R.C. 3513.05, 3513.191(C)
To be used by current holders of elective offices for which candidates are nominated in a party primary election, who
voted in a primary election within the preceding two calendar years, and who desire to seek nomination to elected office
in a different political party's primary election.
No person filing this form shall be, during the calendar year in which this form is filed or the during the next calendar
year, a candidate in a primary election of a party other than the party specified herein.
No person filing this form shall file another such declaration for a period of 10 (ten) years after this declaration is filed.
To be filed with the Secretary of State or County Board of Elections, wherever the declaration of candidacy is filed, not
later than 4 p.m. of the 30th day before the deadline for filing a declaration of candidacy.
Exception: Candidates for party nomination of a newly formed political party are exempted from the requirements of
R.C. 3513.191 for a period of four calendar years after the date of the party formation. R.C. 3517.013.
I,
the undersigned, hereby declare that my voting residence is
(Printed Name of Office Holder)
(Street and Number, if any, or Rural Route and Number)
Ohio
,
,
.
(City, Village)
(Zip Code)
(State)
I hold the office of
, for which candidates are nominated in a primary election. I hereby
(Current Office)
declare that I desire to be a candidate for nomination to the office of
(Office Sought)
Party at the next primary election.
as a member of the
(Political Party)
Dated this
day of
,
.
(Day)
(Year)
(Month)
(Signature of Candidate)