Indiana Code § 3-6-12-7

Petition carrier affirmation; required information
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Sec. 7. (a) The petition carrier must sign and date the following statement at the bottom of each signature page: "I affirm under the penalties for perjury that I have no reason to believe that any individual whose signature appears on this page is ineligible to sign this petition or did not properly complete and sign this page.".       (b) The petition carrier must also print the following information below the affirmation stated in subsection (a): (1) The petition carrier's name. (2) The petition carrier's full address, including the ZIP code. (3) The petition carrier's date of birth.

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