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 19-115, 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 state of Arizona (or in the case of a city, town or county measure, of the city, town or county affected by the measure proposed to be initiated or referred to the people) and that at all times during circulation of this signature sheet a copy of the title and text was attached 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)
A.R.S. § 19-112