REFERENDUM [INITIATIVE] PETITION TO THE SECRETARY OF STATE, STATE OF NORTH DAKOTA
We, the undersigned, being qualified electors request [House (Senate) Bill __________ passed by the __________ Legislative Assembly] [the following initiated law] be placed on the ballot as provided by law.
SPONSORING COMMITTEE
The following are the names and addresses of the qualified electors of the state of North Dakota who, as the sponsoring committee for the petitioners, represent and act for the petitioners in accordance with law:
Name Address
_____________________(Chairperson) __________________________
_____________________ _____________________
PETITION TITLE
(To be drafted by the secretary of state, approved by the attorney general, and attached to the petition before circulation.)
FULL TEXT OF THE MEASURE
IF MATERIAL IS UNDERSCORED, IT IS NEW MATERIAL WHICH IS BEING ADDED. IF MATERIAL IS OVERSTRUCK BY DASHES, THE MATERIAL IS BEING DELETED. IF MATERIAL IS NOT UNDERSCORED OR OVERSTRUCK, THE MATERIAL IS EXISTING LAW THAT IS NOT BEING CHANGED.
[The full text of the measure must be inserted here.]
INSTRUCTIONS TO PETITION SIGNERS
You are being asked to sign a petition. You must be a qualified elector. This means you are eighteen years old, you have lived in North Dakota thirty days, and you are a United States citizen. All signers shall also legibly print their name, complete residential address or rural route or general delivery address, and the date of signing on the petition. Every qualified elector signing a petition must do so in the presence of the individual circulating the petition.
QUALIFIED ELECTORS
Month, Day, Year | Signed Name of Qualified Elector | Printed Name of Qualified Elector | Residential Address or Complete Rural Route or General Delivery Address | City State, Zip Code | |
1. | _____________________________________________________________ | ||||
2. | _____________________________________________________________ | ||||
3. | _____________________________________________________________ | ||||
4. | _____________________________________________________________ | ||||
5. | _____________________________________________________________ | ||||
6. | _____________________________________________________________ | ||||
7. | _____________________________________________________________ | ||||
8. | ____________________________________________________________ |
The number of signature lines on each page of a printed petition may vary if necessary to accommodate other required textual matter. In this section for referral petitions "full text of the measure" means the bill as passed by the legislative assembly excluding the session and sponsor identification. In this section for initiative petitions "full text of the measure" means an enacting clause which must be: "BE IT ENACTED BY THE PEOPLE OF THE STATE OF NORTH DAKOTA" and the body of the bill. If the measure amends the law, all new statutory material must be underscored and all statutory material to be deleted must be overstruck by dashes. When repealing portions of the law, the measure must contain a repealer clause and, in brackets, the text of the law being repealed.
State of North Dakota | ) | |
) | ss. | |
County of __________________ | ) |
(county where signed)
I, ________________, being sworn, say that I am a qualified elector; that I
(circulator)
reside at ____________________________;
(address)
that each signature contained on the attached petition was executed in my presence; and that to the best of my knowledge and belief each individual whose signature appears on the attached petition is a qualified elector; and that each signature contained on the attached petition is the genuine signature of the individual whose name it purports to be.
_____________________
(signature of circulator)
Subscribed and sworn to before me on ______________, _____, at
____________, North Dakota.
(city)
(Notary Seal) ______________________________________________
(signature of notary) Notary Public My commission expires_________________
N.D.C.C. § 16.1-01-09