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The format of the petition for gathering of signatures shall be substantially as follows:

(Ballot Title)

TO: The Honorable ___________________, Clallam County Auditor,

We, the undersigned citizens and legal voters of Clallam County respectfully demand that the proposed ordinance, a copy of which is attached to this petition, be presented to the Board of Clallam County Commissioners for approval and adoption, and if rejected, be submitted to the legal voters of Clallam County for their approval or rejection at the next regular or special election; and, each says that he has personally signed this petition, that he is a legal voter of Clallam County, and that his residence address is correctly written after his name.

Warning: It is a crime in the State of Washington for anyone to sign an initiative petition with a name other than his own, or knowingly to sign his name more than once for the same measure, or knowingly to sign such petition when he is not a legal voter.

    Petitioner’s Petitioner’s Name Residence Address. City

    Signature (print) street and number, or

     (if any) Town

1.

(continuous numbered lines through 20)