Utah Code § 20A-7-203

Manual initiative process -- Form of initiative petition and signature sheets
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(1) This section applies only to the manual initiative process.
(2)
(a) Each proposed initiative petition shall be printed in substantially the following form:
 "INITIATIVE PETITION To the Honorable ____, Lieutenant Governor:
 We, the undersigned citizens of Utah, respectfully demand that the proposed law
described in this initiative petition be submitted to the legal voters/Legislature of Utah for
their/its approval or rejection at the regular general election/session to be held/ beginning on
_________(month\day\year);
 Each signer says:
 I have personally signed this initiative petition or, if I am an individual with a qualifying
disability, I have signed this initiative petition by directing the signature gatherer to enter the
initials "AV" as my signature;
 The date next to my signature correctly reflects the date that I actually signed the
initiative petition;
 I personally had an opportunity to read the entire statement included with this initiative
packet;
 I am registered to vote in Utah; and
 My residence and post office address are written correctly after my name.
WARNING TO SIGNERS WITH PRIVATE VOTER REGISTRATION RECORDS
If you sign this petition, your voter identification number and the date you signed may be
publicly disclosed. This disclosure may occur even if you are an at-risk voter with a voter
registration record that has been classified as a private record.
 NOTICE TO SIGNERS:
 Public hearings to discuss this initiative were held at: (list dates and locations of public
hearings).".

(b) The following statement shall appear, in at least 14-point, bold type, immediately following the
information described in Subsection (2)(a), if the initiative proposes a tax increase:
 "This initiative seeks to increase the current (insert name of tax) rate by (insert the tax
percentage difference) percent, resulting in a(n) (insert the tax percentage increase) percent
increase in the current tax rate."
(c) The following statement shall appear, in at least 14-point, bold type, immediately following the
information described in Subsection (2)(a), if:
(i) the initiative proposes a law other than a tax increase; and
(ii) the initiative petition is part of a condensed initiative packet:
"This initiative seeks to (the sponsors shall provide a brief, plain-language description of the
principal provisions of the proposed law, not to exceed 50 words, that is understandable to
the average reader).".
(3) Each initiative signature sheet shall:
(a) be printed on sheets of paper 8.5 inches long and 11 inches wide;
(b) be ruled with a horizontal line .75 inches from the top, with the space above that line blank for
the purpose of binding;
(c) include the title of the initiative printed below the horizontal line, in at least 14-point, bold type;
(d) if the signature sheet is part of a condensed initiative packet:
(i) contain a printed QR code at the top of the signature sheet, in a location above the columns
described in Subsection (3)(e);
(ii) ensure that the QR code links directly to the web page on the lieutenant governor's website
described in Section 20A-7-202.7; and
(iii) include the following statement adjacent to the QR code in not less than 8-point, bold type:
"This QR code provides access to a website that includes the full text of the law proposed
by this initiative petition.";
(e) be vertically divided into columns immediately below the title of the initiative, as follows:
(i) the first column shall begin .5 inch from the left side of the paper, be .25 inch wide, and be
headed, together with the second column, "For Office Use Only";
(ii) the second column shall be .25 inch wide;
(iii) the third column shall be 2.5 inches wide, headed "Registered Voter's Printed Name (must
be legible to be counted)";
(iv) the fourth column shall be 2.5 inches wide, headed "Signature of Registered Voter";
(v) the fifth column shall be .75 inch wide, headed "Date Signed";
(vi) the sixth column shall be three inches wide, headed "Street Address, City, Zip Code"; and
(vii) the seventh column shall be .75 inch wide, headed "Birth Date or Age (Optional)"; and
(f) be horizontally divided into rows as follows:
(i) the first row shall be .5 inch high for purposes of a registered voter's entry of the information
described in Subsection (3)(e); and
(ii) the second row shall span the width of each column described in Subsection (3)(e) and
contain the following statement in 12-point type: "By signing this initiative petition, you
are stating that you had an opportunity to read and understand the law proposed by this
initiative petition.".
(4) The columns and rows described in Subsections (3)(e) and (f) shall be repeated, leaving
sufficient room at the bottom of the sheet for the information described in Subsection (5).
(5) The bottom of the signature sheet shall include, in the following order:
(a) the words "Fiscal Impact of" followed by the title of the initiative, in at least 12-point, bold type;

(b) except as provided in Subsection (6), the initial fiscal impact statement issued by the Office of
the Legislative Fiscal Analyst in accordance with Subsection 20A-7-202.5(2)(a), including any
update in accordance with Subsection 20A-7-204.1(5), in not less than 12-point type;
(c) if the initiative proposes a tax increase, the following statement in 12-point, bold type:
 "This initiative seeks to increase the current (insert name of tax) rate by (insert the tax
percentage difference) percent, resulting in a(n) (insert the tax percentage increase) percent
increase in the current tax rate.";
(d) if the signature sheet is part of a condensed initiative packet, the following statement in 12-
point, bold type:
"This initiative seeks to (the sponsors shall provide a brief, plain-language description of the
principal provisions of the proposed law, not to exceed 50 words, that is understandable to
the average reader)."; and
(e) the word "Warning," in 12-point, bold type, followed by the following statement in not less than
eight-point type:
 "It is a class A misdemeanor to sign an initiative petition using a name other than your
own name, to sign more than once, or to sign if you are not a registered voter.
Providing your birth date or age is optional, but it may be used to verify your identity. If you
do not provide it, your signature may not be validated if your address changes or if the
information you provide does not match your voter registration record."
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(6) The final page of each initiative packet shall contain the circulator verification sheet described in
Subsection 20A-1-1004(1).
(7) If the initial fiscal impact statement described in Subsection (5)(b), as updated in accordance
with Subsection 20A-7-204.1(5), exceeds 200 words, the Office of the Legislative Fiscal
Analyst shall prepare a shorter summary statement, for the purpose of inclusion on an initiative
signature sheet, that does not exceed 200 words.
(8) If the forms described in this section are substantially followed, the initiative petitions are
sufficient, notwithstanding clerical and merely technical errors.

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