"State of Alabama, Jefferson County.
"I, the undersigned, being first duly sworn, depose and say that I am a citizen of Jefferson County in Alabama, residing at _________, and in the county, that I desire to become a candidate for the office ________ at the election for the office to be held on the ______ day of ________, and that I am duly qualified to hold the office if elected thereto; I hereby request that my name be printed on the official ballot at the election.
"Signed
"Subscribed and sworn to before me, the undersigned (probate judge or notary public, as the case may be) on this the ______ day of _______, 20__.
"_____________________________________
"(Judge of probate or notary public, as the case may be)"
"We, the undersigned, duly qualified electors of Jefferson County, and residing at the places set opposite our respective names, do hereby request that the name of ______ be placed upon the official ballot as a candidate for the office of ______ at the election for the office to be held in the county on the ______ day of ______. We further state that we know that ______ possesses the qualifications necessary for the office, and is in our judgment a fit and proper person to hold the office. Witness our hands on this the day of ______, 20__."
Ala. Code § 45-37-72.27 (1975)