2011 Utah Code
Title 20A Election Code
Chapter 7 Issues Submitted to the Voters
Section 303 Form of referendum petition and signature sheets.

20A-7-303. Form of referendum petition and signature sheets.
(1) (a) Each proposed referendum petition shall be printed in substantially the following form:
"REFERENDUM PETITION To the Honorable ____, Lieutenant Governor:
We, the undersigned citizens of Utah, respectfully order that Senate (or House) Bill No. ____, entitled (title of act, and, if the petition is against less than the whole act, set forth here the part or parts on which the referendum is sought), passed by the ____ Session of the Legislature of the state of Utah, be referred to the people of Utah for their approval or rejection at a regular general election or a statewide special election;
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."
(b) The sponsors of a referendum shall attach a copy of the law that is the subject of the referendum to each referendum 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 3/4 inch from the top, with the space above that line blank for the purpose of binding;
(c) contain the title of the referendum printed below the horizontal line;
(d) contain the word "Warning" printed or typed at the top of each signature sheet under the title of the referendum;
(e) 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 referendum petition with any other name than his own, or knowingly to sign his name more than once for the same measure, or to sign a referendum 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." ;
(f) contain horizontally ruled lines, 3/8 inch apart under the "Warning" statement required by this section; and
(g) be vertically divided into columns as follows:
(i) the first column shall appear at the extreme left of the sheet, be 5/8 inch wide, be headed with "For Office Use Only," and be subdivided with a light vertical line down the middle;
(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 referendum packet shall contain the following printed or typed statement:
"Verification
State of Utah, County of ____
I, _______________, of ____, hereby state that:
I am a Utah resident 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.
________________________________________________________________________
(Name) (Residence Address) (Date)"
(4) The forms prescribed in this section are not mandatory, and, if substantially followed, the referendum petitions are sufficient, notwithstanding clerical and merely technical errors.