UT Code § 20A-7-603 (2021)
2021 Utah Code|Title 20A - Election Code|Chapter 7 - Issues Submitted to the Voters|Part 6 - Local Referenda - Procedures|Section 603 - Form of referendum petition and signature sheets.

 Effective 5/5/2021  20A-7-603. Form of referendum petition and signature sheets.    (1)   (a) Each proposed referendum petition shall be printed in substantially the following form: "REFERENDUM PETITION To the Honorable ____, County Clerk/City Recorder/Town Clerk: We, the undersigned citizens of Utah, respectfully order that (description of local law or portion of local law being challenged), passed by the ____ be referred to the voters for their approval or rejection at the regular/municipal general election to be held on __________(month\day\year); Each signer says: I have personally signed this petition; The date next to my signature correctly reflects the date that I actually signed the petition; I have personally reviewed the entire statement included with this packet; I am registered to vote in Utah or intend to become registered to vote in Utah before the certification of the petition names by the county clerk; and My residence and post office address are written correctly after my name."     (b) The sponsors of a referendum or an agent of the sponsors shall attach a copy of the law that is the subject of the referendum to each referendum petition.       (2) Each signature sheet shall:   (a) be printed on sheets of paper 8-1/2 inches long and 11 inches wide;     (b) be ruled with a horizontal line three-fourths inch from the top, with the space above that line blank for the purpose of binding;     (c) include the title of the referendum printed below the horizontal line, in at least 14-point type;     (d) include a table immediately below the title of the referendum, and beginning .5 inch from the left side of the paper, as follows:   (i) the first column shall be .5 inch wide and include three rows;     (ii) the first row of the first column shall be .85 inch tall and contain the words "For Office Use Only" in 10-point type;     (iii) the second row of the first column shall be .35 inch tall;     (iv) the third row of the first column shall be .5 inch tall;     (v) the second column shall be 2.75 inches wide;     (vi) the first row of the second column shall be .35 inch tall and contain the words "Registered Voter's Printed Name (must be legible to be counted)" in 10-point type;     (vii) the second row of the second column shall be .5 inch tall;     (viii) the third row of the second column shall be .35 inch tall and contain the words "Street Address, City, Zip Code" in 10-point type;     (ix) the fourth row of the second column shall be .5 inch tall;     (x) the third column shall be 2.75 inches wide;     (xi) the first row of the third column shall be .35 inch tall and contain the words "Signature of Registered Voter" in 10-point type;     (xii) the second row of the third column shall be .5 inch tall;     (xiii) the third row of the third column shall be .35 inch tall and contain the words "Email Address (optional, to receive additional information)" in 10-point type;     (xiv) the fourth row of the third column shall be .5 inch tall;     (xv) the fourth column shall be one inch wide;     (xvi) the first row of the fourth column shall be .35 inch tall and contain the words "Date Signed" in 10-point type;     (xvii) the second row of the fourth column shall be .5 inch tall;     (xviii) the third row of the fourth column shall be .35 inch tall and contain the words "Birth Date or Age (optional)" in 10-point type;     (xix) the fourth row of the third column shall be .5 inch tall; and     (xx) the fifth row of the entire table shall be the width of the entire table, .4 inch tall, and contain the following words, "By signing this petition, you are stating that you have read and understand the law that this petition seeks to overturn." in 12-point type;       (e) the table described in Subsection (2)(d) shall be repeated, leaving sufficient room at the bottom of the sheet or the information described in Subsection (2)(f); and     (f) at the bottom of the sheet, include 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 for an individual to sign a referendum petition with a name other than the individual's own name, or to knowingly sign the individual's name more than once for the same measure, or to sign a referendum petition when the individual knows that the individual is not a registered voter and knows that the individual does not intend to become registered to vote before the certification of the petition names by the county clerk. Birth date or age information is not required, but it may be used to verify your identity with voter registration records. If you choose not to provide it, your signature may not be verified as a valid signature if you change your address before petition signatures are verified or if the information you provide does not match your voter registration records."       (3) The final page of each referendum packet shall contain the following printed or typed statement: Verification of signature collector State of Utah, County of ____ I, _______________, of ____, hereby state, under penalty of perjury, that: I am a resident of Utah and am at least 18 years old; All the names that appear in this packet were signed by individuals who professed to be the individuals whose names appear in it, and each of the individuals signed the individual's name on it in my presence; I did not knowingly make a misrepresentation of fact concerning the law this petition seeks to overturn; I believe that each individual has printed and signed the individual's name and written the individual's post office address and residence correctly, that each signer has read and understands the law that the referendum seeks to overturn, and that each signer is registered to vote in Utah or intends to become registered to vote before the certification of the petition names by the county clerk. ________________________________________________________________________ (Name) (Residence Address) (Date)  Each individual who signed the packet wrote the correct date of signature next to the individual's name. I have not paid or given anything of value to any individual who signed this petition to encourage that individual to sign it. _____________________________________________________________________ (Name) (Residence Address) (Date)".     (4) If the forms described in this section are substantially followed, the referendum petitions are sufficient, notwithstanding clerical and merely technical errors.     (5) An individual's status as a resident, under Subsection (3), is determined in accordance with Section 20A-2-105.    Amended by Chapter 140, 2021 General SessionAmended by Chapter 418, 2021 General Session, (Coordination Clause)Amended by Chapter 418, 2021 General Session