2011 Utah Code
Title 20A Election Code
Chapter 7 Issues Submitted to the Voters
Section 203 Form of initiative petition and signature sheets.

20A-7-203. Form of initiative petition and signature sheets.
(1) (a) Each proposed initiative petition shall be printed in substantially the following form:
"INITIATIVE PETITION To the Honorable ____, Lieutenant Governor:
We, the undersigned citizens of Utah, respectfully demand that the following proposed law be submitted to the legal voters/Legislature of Utah for their/its approval or rejection at the regular general election/session to be held/ beginning on _________(month\day\year);
Each signer says:
I have personally signed this petition;
I am registered to vote in Utah or intend to become registered to vote in Utah before the certification of the petition names by the county clerk; and
My residence and post office address are written correctly after my name.
NOTICE TO SIGNERS:
Public hearings to discuss this petition were held at: (list dates and locations of public hearings.)"
(b) The sponsors of an initiative shall attach a copy of the proposed law to each initiative petition.
(2) Each signature sheet shall:
(a) be printed on sheets of paper 8-1/2 inches long and 11 inches wide;
(b) be ruled with a horizontal line three-fourths inch from the top, with the space above that line blank for the purpose of binding;
(c) contain the title of the initiative printed below the horizontal line;
(d) contain the initial fiscal impact estimate's summary statement issued by the Governor's Office of Planning and Budget according to Subsection 20A-7-202.5(2)(b), including any update according to Subsection 20A-7-204.1(4), and the cost estimate for printing and distributing information related to the initiative petition according to Subsection 20A-7-202.5(3), printed or typed in not less than 12 point, bold type, at the top of each signature sheet under the title of the initiative;
(e) contain the word "Warning" printed or typed at the top of each signature sheet under the initial fiscal impact estimate's summary statement;
(f) contain, to the right of the word "Warning," the following statement printed or typed in not less than eight point, single leaded type:
"It is a class A misdemeanor for anyone to sign any initiative petition with any other name than his own, or knowingly to sign his name more than once for the same measure, or to sign an initiative petition when he knows he is not a registered voter and knows that he does not intend to become registered to vote before the certification of the petition names by the county clerk." ; and
(g) be vertically divided into columns as follows:
(i) the first column shall appear at the extreme left of the sheet, be five-eighths inch wide, be headed with "For Office Use Only," and be subdivided with a light vertical line down the middle with the left subdivision entitled "Registered" and the right subdivision left untitled;
(ii) the next column shall be 2-1/2 inches wide, headed "Registered Voter's Printed Name (must be legible to be counted)";
(iii) the next column shall be 2-1/2 inches wide, headed "Signature of Registered Voter";
(iv) the next column shall be one inch wide, headed "Birth Date or Age (Optional)";

(v) the final column shall be 4-3/8 inches wide, headed "Street Address, City, Zip Code"; and
(vi) at the bottom of the sheet, contain the following statement: "Birth date or age information is not required, but it may be used to verify your identity with voter registration records. If you choose not to provide it, your signature may not be verified as a valid signature if you change your address before petition signatures are verified or if the information you provide does not match your voter registration records."
(3) The final page of each initiative packet shall contain the following printed or typed statement:
"Verification
State of Utah, County of ____
I, _______________, of ____, hereby state that:
I am a resident of Utah and am at least 18 years old;
All the names that appear in this packet were signed by persons who professed to be the persons whose names appear in it, and each of them signed his name on it in my presence;
I believe that each has printed and signed his name and written his post office address and residence correctly, and that each signer is registered to vote in Utah or intends to become registered to vote before the certification of the petition names by the county clerk.
I have not paid or given anything of value to any person who signed this petition to encourage that person to sign it.
________________________________________________________________________
(Name) (Residence Address) (Date)"
(4) The forms prescribed in this section are not mandatory, and, if substantially followed, the initiative petitions are sufficient, notwithstanding clerical and merely technical errors.