(a) The affidavit shall be in the following form printed on the reverse side of each signature sheet: "Referendum Affidavit of Circulator".
(b) The words "Tucson, Arizona" and the date of issuance shall appear in the upper right-hand corner.
(c) In the upper left-hand corner include the following:
State of Arizona )
) ss.:
County of )
(Where notarized)
(d) Immediately below the language described in subsection (c) above, the following language shall be included:
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 19-115, 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 City of Tucson and that at all times during circulation of this signature sheet a copy of the title and text was attached to the signature sheet (Ariz. Const. Art. IV, Pt. 1, § 1, ¶ 9, A.R.S. §§ 19-112 (B), (C), (D), 19-114(A), Tucson Charter, Chapter XIX, § 2). The signatures appearing on this petition sheet are the genuine signatures of the persons whose names they bear and each and all of them are residents and duly qualified electors of the City of Tucson (Tucson Charter, Chapter XIX, § 2).
(e) Immediately following the language in subsection (d), the following language shall be included: "The names of the persons procuring this petition and who should be notified of all proceedings and action taken in reference to this petition are (Tucson Charter, Chapter XIX, § 2):".
(f) Immediately below the information required in subsection (e), the following shall be included: the petitioners' printed names, residence addresses, street and number (if no street address, describe residence location).
(g) Immediately below the information required in subsection (f), the following shall be included:
Signature of affiant
Typed or Printed Name of affiant (Circulator)
(Residence address, street and number of affiant, or if no street address, a description of residence location)
(h) Immediately following the circulator signature required in subsection (g), the following shall be included:
Subscribed and sworn to (or affirmed) before me on (date)
Notary Public
(Form shall include a designated location for notary stamp)
(i) The official serial number shall appear in the lower right-hand corner, immediately preceded by the words "Serial Number" on both sides of the signature sheet and the title and text page(s).
(j) The affidavit of circulator shall not be modified. Any petition that contains a partially or incorrectly completed affidavit or any affidavit that has been modified is invalid.
(Ord. No. 11525, § 2, 2-21-18)