La. Stat. tit. 45 § 1164.3
Any qualified elector desiring a referendum election shall sign a petition addressed to the governing authority of the municipality or other political subdivision in which he resides, or of which he is a customer, and in substantially the following form:
PETITION
TO: [Name of governing authority and name of municipality or other political subdivision]
The undersigned qualified electors respectfully request that you call an election to submit, in the manner provided by law, to the qualified electors of [name of municipality or other political subdivision], . . . and other electors who are customers of the public utility, wherever they may reside, the following proposition:
Shall the Public Service Commission regulate [name of public utility] owned by [name of political subdivision]?
Signature Address Date
Where signatures are made on more than one sheet, each sheet of the petition shall reproduce above the signatures the same matter as is on the first sheet. Each petitioner shall sign his name in his own handwriting and shall write his address and the date on which he signed, otherwise his signature shall be null and void. If an elector cannot sign his name because of age or physical condition, he may have his name and address and the date written by another and shall affix his ordinary "X" mark in the presence of two competent electors, who shall sign their names as witnesses to the mark.
La. R.S. § 45:1164.3