Recall Petition
We, the qualified electors of the electoral district from which ________________________ (name and title of office) was elected, demand the elected official's recall
The grounds of this demand for recall are as follows:
(State in two hundred words or less the grounds of the demand)
"It is unlawful to sign this petition before it has a serial number."
"___________ paid circulator" "______________ volunteer".
Signature Name Post Address City or Date
(first and office & zip town signed
last name actual code (if any)
printed) address
(street &
no. and if
no street
address,
describe
residence
location)
The validity of signatures on this sheet must be sworn to by the circulator before a notary public on the form appearing on the back of the sheet.
Number ________________
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 19-206, 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 office, of the city, town or county for which the officer subject to the proposed recall serves) and that at all times during circulation of this signature sheet a copy of the time-and-date-marked petition was stapled 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. § 19-204