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 adopted ordinance, a copy of which is attached to this petition, be presented to the voters of Clallam County for their adoption 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 a referendum 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)