Arizona Revised Statutes
Title 19 - Initiative, Referendum and Recall
§ 19-204 - Form of petition

19-204. Form of petition
A. The caption and body of a recall petition shall be substantially as follows:
Recall Petition
We, the qualified electors of the electoral district from which ________________________ (name and title of office) was elected, demand the elected official's recall
The grounds of this demand for recall are as follows:
(State in two hundred words or less the grounds of the demand)
B. Each petition sheet shall have printed on the top of each sheet the following:
" It is unlawful to sign this petition before it has a serial number."
C. The following shall be printed on each petition sheet in capital letters in at least twelve point bold-faced type in the upper right-hand corner of the face of the petition sheet and below the statement prescribed in subsection B of this section:
" ___________ paid circulator" " ______________ volunteer" .
D. A circulator of a recall petition shall state whether the circulator is a paid circulator or volunteer by checking the appropriate line on the petition form before circulating the petition for signatures.
E. Signatures obtained on recall petitions in violation of subsection D of this section are void and shall not be counted in determining the legal sufficiency of the petition. The presence of signatures that are invalidated under this subsection on a petition does not invalidate other signatures on the petition that were obtained as prescribed by this section.
F. Each petition shall contain ten numbered lines for signatures. The lines shall be headed as follows:
Signature Name Post Address City or Date
(first and office & zip town signed
last name actual code (if any)
printed) address
(street &
no. and if
no street
address,
describe
residence
location)
The validity of signatures on this sheet must be sworn to by the circulator before a notary public on the form appearing on the back of the sheet.
Number ________________
G. The affidavit shall be in the following form printed on the reverse side of each signature sheet:
Affidavit of Circulator
State of Arizona )
) ss.:
County of ___________)
(Where notarized)
I, (print name) , a person who is not required to be a resident of this state but who is otherwise qualified to register to vote in the county of _______, in the state of Arizona at all times during my circulation of this petition sheet, and under the penalty of a class 1 misdemeanor, depose and say that subject to section 19-206, Arizona Revised Statutes, each individual printed the individual's own name and address and signed this sheet of the foregoing petition in my presence on the date indicated and I believe that each signer's name and residence address or post office address are correctly stated and that each signer is a qualified elector of the state of Arizona (or in the case of a city, town or county office, of the city, town or county for which the officer subject to the proposed recall serves) and that at all times during circulation of this signature sheet a copy of the time-and-date-marked petition was stapled to the signature sheet.
(Signature of affiant) _______________________
(Residence address, street
and number of affiant, or
if no street address, a
description of residence
location) ___________________________
Subscribed and sworn to before me on _________________________
(date)
__________________________________
Notary Public
(Form shall include a designated location for notary stamp)
H. The form of the affidavit shall not be modified. Any petition that contains a partially completed affidavit or an affidavit that has been modified is invalid.

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