Fillable STATE OF ARIZONA Application for Serial Number Initiative (Arizona Secretary of State)

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STATE OF ARIZONA Application for Serial Number Initiative (Arizona Secretary of State)

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The STATE OF ARIZONA Application for Serial Number Initiative (Arizona Secretary of State) form is 1 page long and contains:

  • 1 signature
  • 2 check-boxes
  • 25 other fields

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File type: PDF

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BROWSE ARIZONA SECRETARY OF STATE (AZ) FORMS

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STATE OF ARIZONA
Application for Serial Number
Initiative Petition
A.R.S. § 19-111
FOR OFFICE USE ONLY
The undersigned intends to circulate and file an initiative
petition and hereby makes application for the issuance of an
official serial number to be printed in the lower right-hand
corner of each side of each signature sheet of such petition.
Attached hereto is the full title and text, in no less than
eight point type, of the measure or constitutional amendment
intended to be initiated at the next general election.
Date of Application
Signatures Required
Deadline for Filing
Serial Number
Issued
By submitting this Application for Serial Number and checking all boxes below, I acknowledge the following:
That I have received and will review the accompanying Instructions for Statewide
Initiatives
, including the Secretary of State's recommended best practices for printing copies of the
Statewide Initiative Petition to be circulated.
That at the time of filing, I was provided instructions regarding accurate completion of the S
tatewide
Initiative Petition form.
Applicant Signature Date
Name of Applicant
Committee Name
Address Committee ID No.
City State Zip
Chairperson
Telephone Number Treasurer
E-mail Address
Committee Address
City
State Zip
Committee Telephone Number
Committee E-mail Address
Office of the Secretary of State
1700 W. Washington Street
Phoenix, Arizona 85007
Rev. 03/04/2019
Statutory
Measure
Constitutional
Amendment
Enter a description of no more than one hundred words of the principal provisions
of the proposed measure or constitutional amendment that will appear in no less
than eight point type on the face of each petition signature sheet to be circulated.
click to sign
signature
click to edit
Office of the Secretary of State
1700 W. Washington Street
Phoenix, Arizona 85007
Rev. 03/04/2019
Instructions for Statewide Initiatives
Statement of Organization
At the time of submitting an Application for Serial Number, the individual or organization wishing to place
an initiative on the ballot must either file a Statement of Organization using the Secretary of State’s
Campaign Finance Filing System or designate an existing (non-candidate) committee to act as the initiative's
sponsor. The Secretary of State will not accept an Application without an accompanying statement or
designation.
Application for Serial Number
All individuals or organizations wishing to place an initiative on the ballot must submit an Application for
Serial Number stating their intent to circulate a statewide initiative petition.
Please complete all required fields including:
• The appropriate check box indicating whether the applicant intends to circulate a statutory measure or
constitutional amendment
• A no more than 100-word description of the principal provisions of the initiative, which will be printed on
the face of each petition sheet.
• All information required to identify the initiative applicant and sponsoring committee.
Application Procedure
Upon receipt of Application, the Secretary of State will complete the remainder of the form and issue a unique
petition serial number to be printed on the front and back of each petition sheet. The Secretary of State will also
provide instructions regarding proper completion of the Statewide Initiative Petition form.
Please note:
• An Application for Serial Number will not be accepted unless the applicant has checked both disclaimer
boxes and provided a signature as an acknowledgment of the recommended printing and
circulating procedures.
• At the time of submission, an Application for Serial Number must include the accompanying title and text
of the initiative.
• The minimum number of signatures required for a constitutional amendment to be placed on the
ballot is equal to 15% of the number of votes cast at the last gubernatorial election, and the number of
signatures for a statutory measure is equal to 10%.
• The deadline to file initiative petition signatures is at least 4 months plus 1 day prior to the next
general election.
• Any revision to the title and text or 100-word description requires a new Application for Serial Number to
be filed, and all previous versions will be considered invalid.
Application for Serial Number and Best Practices
for Printing and Circulating Petitions
Office of the Secretary of State
1700 W. Washington Street
Phoenix, Arizona 85007
Rev. 03/04/2019
Recommended Best Practices for Printing and Circulating Petitions
The Statewide Initiative Petition form is designed to be compatible with electronic petition review technology and
verification procedures. The Secretary of State’s Office recommends the following best practices for printing and
circulating petitions to ensure optimal verification and processing. Failure to adhere to these practices may result in
reduced document integrity, which may inhibit the Secretary of State’s ability to efficiently and accurately process
the petitions.
1. Print using a resolution of 600dpi or higher
The Secretary of State's Office recommends that petitions be printed at a resolution of 600dpi or higher to preserve
print integrity and assist in the digital scanning and review process. This will ensure that the form field lines on the
petition remain intact, and that information provided by the committee (such as the initiative description and
petition serial number) is clearly printed for inspection by petitioners.
2. Print from digital file only – Do not photocopy
It is recommended that petitions be duplicated only by means of digital printing and should not be photocopied.
Photocopied petitions may result in a degraded image, including the loss of information capture boxes, pixelated text,
or irregularities that may obstruct scanning capability. To avoid document degradation, please print petitions from a
digital file only.
3. Instructions to signers
Circulators should instruct petition signers to write in the center of (and within) the information capture boxes to
ensure that signature and identifying information is easily discernible by the petition processing software. Signers
should avoid letting information bleed over to adjacent rows, and should sign with blue or black ink.
4. Registered Circulator ID Number
Paid and out-of-state circulators are strongly encouraged to print their Registered Circulator ID Number on the front
and back side of each petition sheet. Failure to include the Registered Circulator ID Number will not (by itself)
invalidate the petition sheet, but greatly inhibits the Secretary of State’s ability to efficiently and accurately process the
petition.
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STATE OF ARIZONA Application for Serial Number Initiative (Arizona Secretary of State)

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Completed 20 July 2020

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