1002. PETITION FORM

1002 PETITION FORM 1002.1 Once the adopted language for the measure has been certified, the Board shall prepare and provide to the proposer at a public meeting an original petition form which shall contain the following: (a) Numbered lines designed so that each signer may personally affix the date signed and his or her signature, printed name, residence address (giving street and number) and election ward; (b) A statement requesting that the Board hold an election on the initiative or referendum measure contained in the petition, stating the measure’s serial number and short title; (c) The text of the official summary and short title of the measure printed on the front of the petition sheet; (d) A warning statement declaring that only duly registered qualified electors of the District of Columbia may sign the petition; (e) Instructions advising signatories of the proper method of signing the petition as follows: EVERYONE WHO SIGNS THIS PETITION MUST SIGN THEIR OWN NAME. UNDER NO CIRCUMSTANCES IS ANY PERSON PERMITTED TO SIGN ANOTHER PERSON’S NAME OR SIGN MORE THAN ONCE. IN ORDER TO ENSURE THAT YOUR SIGNATURE WILL BE COUNTED, PRINT YOUR FULL NAME (AS IT APPEARS ON YOUR VOTER REGISTRATION RECORD), YOUR RESIDENCE ADDRESS, THE DATE OF SIGNING, AND YOUR WARD IN THE SPACES PROVIDED. IF YOU NEED ASSISTANCE WITH PROVIDING YOUR INFORMATION ON THIS PETITION, YOU MUST MAKE THAT REQUEST BEFORE SIGNING. (f) The words "PAID FOR BY" followed by the name and address of the payer or the committee or other person, and its treasurer on whose behalf the material appears, in the right-hand corner of the front page; and (g) A circulator’s affidavit, providing space for the circulator of a petition to record their name and address and the dates between which the signatures on the sheet were obtained. By signing the affidavit, the circulator swears under oath or affirms that: They are a qualified petition circulator; They were in the presence of each person who signed the petition at the time the petition was signed; According to the best information available to the circulator, each signature is the genuine signature of the person whose name it purports to be; and They have not written, altered, corrected, clarified, or obscured information on the petition about the signer of the petition after the signer affixed their signature to the petition. SOURCE: Final Rulemaking published at 43 DCR 103 (January 12, 1996); as amended by Final Rulemaking published at 61 DCR 625 (January 24, 2014); as amended by Final Rulemaking published at 65 DCR 5644 (May 18, 2018); as amended by Final Rulemaking published at 68 DCR 6164 (June 11, 2021); as amended by Final Rulemaking published at 69 DCR 001132 (February 11, 2022); as amended by Final Rulemaking published at 69 DCR 005226 (May 13, 2022); as amended by Final Rulemaking published at 73 DCR 008498 (June 12, 2026). District of Columbia Municipal Regulations Elections and Ethics 3 DCMR § 1002