UT Code § 20A-7-203 (2021)
2021 Utah Code|Title 20A - Election Code|Chapter 7 - Issues Submitted to the Voters|Part 2 - Statewide Initiatives|Section 203 - Form of initiative petition and signature sheets.

 Effective 5/5/2021  20A-7-203. Form of initiative petition and signature sheets.    (1)   (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 following proposed law 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 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. NOTICE TO SIGNERS: Public hearings to discuss this petition were held at: (list dates and locations of public hearings.)".     (b) If the initiative petition proposes a tax increase, the following statement shall appear, in at least 14-point, bold type, immediately following the information described in Subsection (1)(a): "This initiative petition 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 sponsors of an initiative or an agent of the sponsors shall attach a copy of the proposed law to each initiative 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 initiative printed below the horizontal line, in at least 14-point, bold type;     (d) include a table immediately below the title of the initiative, 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 statement, "By signing this petition, you are stating that you have read and understand the law proposed by this petition." in 12-point type;       (e) the table described in Subsection (2)(d) shall be repeated, leaving sufficient room at the bottom of the sheet for the information described in Subsection (2)(f); and     (f) at the bottom of the sheet, include in the following order:   (i) the words "Fiscal Impact of" followed by the title of the initiative, in at least 12-point, bold type;     (ii) except as provided in Subsection (4), the initial fiscal impact estimate's summary 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;     (iii) if the initiative petition proposes a tax increase, the following statement in 12-point, bold type: "This initiative petition 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."; and     (iv) 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 an initiative 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 an initiative 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 initiative 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 proposed by the initiative; 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 proposed by the initiative, 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. 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 initial fiscal impact estimate described in Subsection (2)(i), 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 a signature sheet, that does not exceed 200 words.     (5) If the forms described in this section are substantially followed, the initiative petitions are sufficient, notwithstanding clerical and merely technical errors.     (6) 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 SessionAmended by Chapter 418, 2021 General Session, (Coordination Clause)