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<br />MINNESOTA BALLOT QUESTION PETITION <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />SIGNER’S OATH <br />“I swear (or affirm) that I know the contents and purpose of this petition and that I signed the petition only once and of my own free will.” <br /> <br />ALL INFORMATION ON THIS PETITION IS SUBJECT TO PUBLIC INSPECTION <br />***********ALL INFORMATION MUST BE FILLED IN BY PERSON(S) SIGNING THE PETITION UNLESS DISABILITY PREVENTS THE PERSON(S) FROM DOING SO.*********** <br /> <br /> <br /> <br /> <br /> <br />DATE <br /> <br /> <br /> <br />PRINT FIRST, MIDDLE, AND LAST <br />NAME <br /> <br />YEAR OF <br /> BIRTH <br />(If born in 2003 list <br />month and day) <br /> <br /> <br /> <br /> <br />SIGNATURE <br /> <br /> <br />RESIDENCE ADDRESS <br /> (number and street or route and box number) <br />(Not a P.O. Box) <br /> <br /> <br /> <br />CITY OR <br />TOWNSHIP <br /> <br /> <br /> <br /> <br />COUNTY <br /> <br />1. <br /> <br /> <br /> <br /> <br />2. <br /> <br /> <br /> <br /> <br /> <br /> <br />3. <br /> <br /> <br /> <br /> <br />4. <br /> <br /> <br /> <br /> <br />5. <br /> <br /> <br /> <br /> <br />6. <br /> <br /> <br /> <br /> <br />7. <br /> <br /> <br /> <br /> <br />8. <br /> <br /> <br /> <br /> <br />9. <br /> <br /> <br /> <br /> <br />10. <br /> <br /> <br /> <br /> <br />“Each petition must <br />have a short title <br />describing the <br />purpose of the <br />petition.” M.R. <br />8205.1010, subp. <br />2(C) <br />The language on <br />the petition must be <br />printed in no <br />smaller than at 10 <br />point type. M.R. <br />8205.1010, subp. <br />2(B) <br />The signer’s oath <br />and the signature <br />lines must be on <br />the same side of <br />the paper. M.R. <br />8205.1010, subp. <br />2(A) <br />“Each petition <br />page must have a <br />signer’s oath in no <br />smaller than 12 – <br />point bold type. If <br />the form of the <br />signer’s oath is <br />not specified by <br />statute, the <br />following oath <br />must be used: “I <br />swear (or affirm) <br />that I know the <br />contents and <br />purpose of this <br />petition and that <br />I signed this <br />petition only <br />once and of my <br />own free will.” <br />M.R. 8205.1010, <br />subp. 2(F) <br />“Each petition page must have no more than ten <br />signatures lines. The signature lines must be <br />consecutively numbered. Each signature line must <br />have space for the date of signature; a signature; and <br />each signatory’s year of birth; printed first, middle, <br />and last name; and residence address, municipality, <br />and county.” M.R. 8205.1010, subp. 2(H) <br />“Each petition <br />page must include <br />the following <br />statement <br />immediately <br />above the <br />signature lines: <br />“All information <br />must be filled in <br />by person(s) <br />signing the <br />petition unless <br />disability <br />prevents the <br />person(s) from <br />doing so.” MR. <br />8205.1010, subp. <br />2(G) <br />Each petition page <br />must include the <br />following statement <br />“All information <br />on this petition is <br />subject to public <br />inspection” M.R. <br />8205.1010, subp. <br />2(I) <br />The petition <br />cannot be <br />prepared on paper <br />larger than 8 ½ <br />inches wide by 14 <br />inches long. M.R. <br />8205.1010, subp. <br />2(A) <br />DO NOT USE THIS AS YOUR ACTUAL PETITION. This is only an example to provide guidance in <br />preparing your petition <br />Insert the language of your ballot question here. For specific requirements please refer to the statute or <br />statutes that authorize the question to be placed on the ballot. <br />“Each petition page <br />must have a statement <br />summarizing the <br />purpose of the <br />petition.” M.R. <br />8205.1010, subp. 2(D)