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HomeMy WebLinkAbout159 - 10/05/2004 - AMENDING THE GENERAL FORM FOR PETITIONS FOR INITIATIVE, REFERENDUM, AND RECALL ORDINANCE NO. 159, 2004 OF THE COUNCIL OF THE CITY OF FORT COLLINS AMENDING THE GENERAL FORM FOR PETITIONS FOR INITIATIVE, REFERENDUM, AND RECALL WHEREAS,the Charter of the City of Fort Collins states that the City Council is to prescribe by ordinance, upon recommendation of the City Clerk, a general form of petition for recalls, initiatives and referendums; and WHEREAS, on May 16, 1987, the Council did prescribe a general form of petition for circulation and filing by petitioners for each measure sought to be initiated or referred to the vote of the electors and for recall of elected officials,which form was subsequently amended on November 1, 1988 to remove language from the Affidavit of Circulator relating to the prohibition of payment of circulators; and WHEREAS, the general form of petition for initiative, referendum and recall was again amended on May 16, 2000 to comply to a U.S. Supreme Court ruling which held that it is impermissible to require that petition circulators be registered electors; and WHEREAS,the Council has asked the City Clerk to recommend addition modifications to the general form of petition to better ensure that potential signers of a petition are familiar with the purpose and content of a petition before signing the same; and WHEREAS, the City Clerk has recommended Council approval of the following amended general forms of petition for recall, initiative, and referendum. NOW, THEREFORE, BE IT ORDAINED BY THE COUNCIL OF THE CITY OF FORT COLLINS as follows: Section1. Thatthe general form ofpctition for recall petitions,attachedhereto as Exhibit "A", is hereby approved by the Council. Section 2. That the general fonn of petition for initiative petitions, attached hereto as Exhibit`B", is hereby approved by the Council. Section 3. That the general form of petition for referendum petitions, attached hereto as Exhibit"C", is hereby approved by the Council. Section 4. That the City Clerk be, and hereby is, directed to have a sufficient quantity of petition forms printed for distribution,upon request,to any individual or group that has filed with the City Clerk an affidavit commencing recall proceedings,a notice of intent to circulate an initiative petition, or a notice of protest against the going into effect of an ordinance. Section 5. That the general forms ofpetition approved herein shall be used for any recall, initiative, or referendum proceedings commenced after the effective date of this ordinance. Introduced and considered favorable on first reading and ordered published this 21 st day of September,A.D. 2004, and to be presented for final passage on the 5th day of October, A.D. 2004. Mayor ATTEST: City Clerk Passed and adopted on final reading this 5th day �offOctober, A.D. 2004. M ycr ATTEST: City Clerk EXHIBIT "A" Petition Section No. PETITION FOR RECALL TO: The City Council of the City of Fort Collins GENERAL STATEMENT OF PURPOSE WARNING: IT IS AGAINST THE LAW For anyone to sign any recall petition with any name other than his or her own or to knowingly sign his or her name more than once for the same measure or to knowingly sign such petition when not a registered elector. DO NOT SIGNTHIS PETITION UNLESSYOU ARE A REGISTERED ELECTOR. TO BE A REGISTERED ELECTOR,YOU MUST BE A CITIZEN OFTHE STATE OF COLORADO AND A RESIDENT OF THE CITY OF FORT COLLINS AND REGISTERED TO VOTE IN FORT COLLINS MUNICIPAL ELECTIONS. Do not sign this petition unless you have read or had read to you the "Statement of Charges" and "Statement of Defense" in its entirety and understand its meaning. PETITION REPRESENTATIVES (not less than 3, no more than 5) Name Address 1. 2. 3. 4. 5. NOTE., Throughout its circulation, each petition section shall contain and have attached immediately following this page a copy of the charges, and if requested by the person sought to be recalled, a copy of the statement of defense. This page must be replaced by a copy of: AN AFFIDAVIT STATING THE REASONS FOR THE RECALL OF THE OFFICER SOUGHT TO BE REMOVED (STATEMENT OF CHARGES) (limited to 200 words) If requested by the affected officer, this page must be replaced by a copy of: AFFECTED OFFICER'S SWORN STATEMENT OF DEFENSE OF CHARGES (limited to 300 words) DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 1 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 1 Printed Name City Signature Residence Address(Street and Number) Date Signed 2 Printed Name City Signature Residence Address(Street and Number) Date Signed 3 Printed Name City Signature Residence Address(Street and Number) Date Signed 4 Printed Name City Signature Residence Address(Street and Number) Date Signed 5 Printed Name City Signature Residence Address(Street and Number) Date Signed 6 Printed Name City Signature Residence Address(Street and Number) Date Signed 7 Printed Name City Signature Residence Address(Street and Number) Date Signed 8 Printed Name City Signature Residence Address(Street and Number) Date Signed 9 Printed Name City Signature Residence Address(Street and Number) Date Signed 10 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 2 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 11 Printed Name City Signature Residence Address(Street and Number) Date Signed 12 Printed Name City Signature Residence Address(Street and Number) Date Signed 13 Printed Name City Signature Residence Address(Street and Number) Date Signed 14 Printed Name City Signature Residence Address(Street and Number) Date Signed 15 Printed Name City Signature Residence Address(Street and Number) Date Signed 16 Printed Name City Signature Residence Address(Street and Number) Date Signed 17 Printed Name City Signature Residence Address(Street and Number) Date Signed 18 Printed Name City Signature Residence Address(Street and Number) Date Signed 19 Printed Name City Signature Residence Address(Street and Number) Date Signed 20 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 3 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 21 Printed Name City Signature Residence Address(Street and Number) Date Signed 22 Printed Name City Signature Residence Address(Street and Number) Date Signed 23 Printed Name City Signature Residence Address(Street and Number) Date Signed 24 Printed Name City Signature Residence Address(Street and Number) Date Signed 25 Printed Name City Signature Residence Address(Street and Number) Date Signed 26 Printed Name City Signature Residence Address(Street and Number) Date Signed 27 Printed Name City Signature Residence Address(Street and Number) Date Signed 28 Printed Name City Signature Residence Address(Street and Number) Date Signed 29 Printed Name City Signature Residence Address(Street and Number) Date Signed 30 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 4 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 31 Printed Name City Signature Residence Address(Street and Number) Date Signed 32 Printed Name City Signature Residence Address(Street and Number) Date Signed 33 Printed Name City Signature Residence Address(Street and Number) Date Signed 34 Printed Name City Signature Residence Address(Street and Number) Date Signed 3.5 Printed Name City Signature Residence Address(Street and Number) Date Signed 36 Printed Name City Signature Residence Address(Street and Number) Date Signed 37 Printed Name City Signature Residence Address(Street and Number) Date Signed 38 Printed Name City Signature Residence Address(Street and Number) Date Signed 3.9 Printed Name City Signature Residence Address(Street and Number) Date Signed 40 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 5 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) 41 Printed Name City Date Signed Signature Residence Address(Street and Number) 42 Date Signed Pooled Name City Signature Residence Address(Street and Number) 43 Printed Name City Date Signed Signature Residence Address(Street and Number) 44 Printed Name City Date Signed Signature Residence Address(Street and Number) 45 Printed Name City Date Signed Signature Residence Address(Street and Number) 46 Printed Name City Date Signed Signature Residence Address(Street and Number) 47 Printed Name City Date Signed Signature Residence Address(Street and Number) 48 Printed Name City Date Signed Signature Residence Address(Street and Number) 49 Printed Name City Date Signed Signature Residence Address(Street and Number) 50 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 6 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 51 Printed Name City Signature Residence Address(Street and Number) Date Signed 52 Printed Name City Signature Residence Address(Street and Number) Date Signed 53 Printed Name City Signature Residence Address(Street and Number) Date Signed 54 Printed Name City Signature Residence Address(Street and Number) Date Signed 55 Printed Name City Signature Residence Address(Street and Number) Date Signed 56 Printed Name City Signature Residence Address(Street and Number) Date Signed 57 Printed Name City Signature Residence Address(Street and Number) Date Signed 58 Printed Name City Signature Residence Address(Street and Number) Date Signed 59 Printed Name City Signature Residence Address(Street and Number) Date Signed 60 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 7 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 61 Printed Name City Signature Residence Address(Street and Number) Date Signed 62 Printed Name City Signature Residence Address(Street and Number) Date Signed 63 Printed Name City Signature Residence Address(Street and Number) Date Signed 64 Printed Name City Signature Residence Address(Street and Number) Date Signed 65 Printed Name City Signature Residence Address(Street and Number) Date Signed 66 Printed Name City Signature Residence Address(Street and Number) Date Signed 67 Printed Name City Signature Residence Address(Street and Number) Date Signed 68 Printed Name City Signature Residence Address(Street and Number) Date Signed 69 Printed Name City Signature Residence Address(Street and Number) Date Signed 70 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 8 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 71 Printed Name City Signature Residence Address(Street and Number) Date Signed 72 Printed Name City Signature Residence Address(Street and Number) Date Signed 73 Printed Name City Signature Residence Address(Street and Number) Date Signed 74 Printed Name City Signature Residence Address(Street and Number) Date Signed 75 Printed Name City Signature Residence Address(Street and Number) Date Signed 76 Printed Name City Signature Residence Address(Street and Number) Date Signed 77 Printed Name City Signature Residence Address(Street and Number) Date Signed 78 Printed Name City Signature Residence Address(Street and Number) Date Signed 79 Printed Name City Signature Residence Address(Street and Number) Date Signed 80 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 9 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 81 Printed Name City Signature Residence Address(Street and Number) Date Signed 82 Printed Name City Signature Residence Address(Street and Number) Date Signed 83 Printed Name City Signature Residence Address(Street and Number) Date Signed 84 Printed Name City Signature Residence Address(Street and Number) Date Signed 85 Printed Name City Signature Residence Address(Street and Number) Date Signed 86 Printed Name City Signature Residence Address(Street and Number) Date Signed 87 Printed Name City Signature Residence Address(Street and Number) Date Signed 88 Printed Name City Signature Residence Address(Street and Number) Date Signed 89 Printed Name City Signature Residence Address(Street and Number) Date Signed 90 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, Page 10 or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 91 Printed Name City Signature Residence Address(Street and Number) Date Signed 92 Printed Name City Signature Residence Address(Street and Number) Date Signed 93 Printed Name City Signature Residence Address(Street and Number) Date Signed 94 Printed Name City Signature Residence Address(Street and Number) Date Signed 95 Printed Name City Signature Residence Address(Street and Number) Date Signed 96 Printed Name City Signature Residence Address(Street and Number) Date Signed 97 Printed Name City Signature Residence Address(Street and Number) Date Signed 98 Printed Name City Signature Residence Address(Street and Number) Date Signed 99 Printed Name City Signature Residence Address(Street and Number) Date Signed 100 Printed Name City Petition Section No. STATE OF COLORADO ) COUNTY OF LARIMER ) SS. AFFIDAVIT OF PETITION CIRCULATOR CITY OF FORT COLLINS ) The undersigned petition circulator, being first duly sworn and upon oath, states that he or she is eighteen(18)years of age or older, that he or she personally circulated the attached petition;that each signature thereon was affixed in the presence of the petition circulator; that each signature thereon is the signature of the person whose name it purports to be;that to the best of the knowledge and belief of the affiant each of the persons signing said petition was, at the time of signing, a registered elector in the City of Fort Collins;that each signer had an opportunity before signing to read the full text of the petition; and that the petition circulator has not paid or will not in the future pay, directly or indirectly, any money or other thing of value to any signer for the purpose of inducing or causing such signer to affix his or her signature to such petition. AFFIANT: Signature of Petition Circulator Printed Name of Circulator Street Address of Petition Circulator City/State Date Subscribed and sworn to before me this day of Notary Public Address of Notary Public EXHIBIT "B" Petition Section No. PETITION FOR INITIATIVE TO: The City Council of the City of Fort Collins GENERAL STATEMENT OF PURPOSE WARNING : IT IS AGAINST THE LAW For anyone to sign any initiative petition with any name other than his or her own or to knowingly sign his or her name more than once for the same measure or to knowingly sign such petition when not a registered elector. DO NOT SIGN THIS PETITION UNLESS YOU ARE A REGISTERED ELECTOR. TO BE A REGISTERED ELECTOR, YOU MUST BE A CITIZEN OF THE STATE OF COLO- RADO AND A RESIDENT OF THE CITY OF FORT COLLINS AND REGISTERED TO VOTE IN FORT COLLINS MUNICIPAL ELECTIONS. Do not sign this petition unless you have read or had read to you the proposed initiative or the summary of the initiated measure in its entirety and understand its meaning. PETITION REPRESENTATIVES Name (not less than 3,no more than 5) Address 1. 2. 3. 4. 5. NOTE: Throughout its circulation, each petition section shall contain or have attached immediately following this page the full text of the proposed ordinance or resolution. DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 1 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 1 Printed Name City Signature Residence Address(Street and Number) Date Signed 2 Printed Name City Signature Residence Address(Street and Number) Date Signed 3 Printed Name City Signature Residence Address(Street and Number) Date Signed 4 Printed Name City Signature Residence Address(Street and Number) Date Signed 5 Printed Name City JSignature Residence Address(Street and Number) Date Signed 6 Printed Name City Signature Residence Address(Street and Number) Date Signed 7 Printed Name City Signature Residence Address(Street and Number) Date Signed 8 Printed Name City Signature Residence Address(Street and Number) Date Signed 9 Printed Name City Signatu ce re Residen Address(Street and Number) Date Signed 10 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 2 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 11 Printed Name City Signature Residence Address(Street and Number) Date Signed 12 Printed Name City Signature Residence Address(Street and Number) Date Signed 13 Printed Name City Signature Residence Address(Street and Number) Date Signed 14 Printed Name City Signature Residence Address(Street and Number) Date Signed 15 Printed Name City Signature Residence Address(Street and Number) Date Signed 16 P nted Name City Signature Residence Address(Street and Number) Date Signed 17 Printed Name City Signature Residence Address(Street and Number) Date Signed 18 Printed Name City Signature Residence Address(Street and Number) Date Signed 19 Printed Name City Signature Residence Address(Street and Number) Date Signed 20 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 3 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 21 Printed Name City Signature Residence Address(Street and Number) Date Signed 22 Printed Name pity Signature Residence Address(Street and Number) Date Signed 23 Panted Name City Signature Residence Address(Street and Number) Date Signed 24 Printed Name City Signature Residence Address(Street and Number) Dale Signed 25 Printed Name City Signature Residence Address(Street and Number) Date Signed 2ti Printed Name City Signature Residence Address(Street and Number) Date Signed 27 Printed Name City Signature Residence Address(Street and Number) Date Signed 28 Printed Name City Signature Residence Address(Street and Number) Date Signed 29 Prnted Name City Signature Residence Address(Street and Number) Date Signed 30 Footed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 4 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 31 Printed Name City Signature Residence Address(Street and Number) Date Signed 32 Printed Name City Signature Residence Address(Street and Number) Date Signed 33 Printed Name City Signature Residence Address(Street and Number) Date Signed 34 Printed Name City Signature Residence Address(Street and Number) Date Signed 355 Printed Name City Signature Residence Address(Street and Number) Date Signed 36 Printed Name City Signature Residence Address(Street and Number) Date Signed 37 Printed Name City Signature Residence Address(Street and Number) Date Signed 38 Printed Name City Signature Residence Address(Street and Number) Date Signed 39 Printed Name City Signature Residence Address(Street and Number) Date Signed 40 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 5 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) 41 Printed Name City Date Signed Signature Residence Address(Street and Number) 42 Date Signed Printed Name City Signature Residence Address(Street and Number) 43 Printed Name City Date Signed Signature Residence Address(Street and Number) 44 Printed Name City Date Signed Signature Residence Address(Street and Number) 45 Printed Name City Date Signed Signature Residence Address(Street and Number) 46 Printed Name City Date Signed Signature Residence Address(Street and Number) 47 Printed Name City Date Signed Signature Residence Address(Street and Number) 48 Printed Name City Date Signed Signature Residence Address(Street and Number) 49 Printed Name City Date Signed Signature Residence Address(Street and Number) 50 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 6 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 51 Primed Name City Signature Residence Address(Street and Number) Date Signed 52 Primed Name City Signature Residence Address(Street and Number) Date Signed 53 Printed Name City Signature Residence Address(Street and Number) Dale Signed 54 Printed Name City Signature Residence Address(Street and Number) Date Signed 55 Printed Name City Signature Residence Address(Street and Number) Date Signed 56 Printed Name City Signature Residence Address(Street and Number) Date Signed 57 Printed Name City Signature Residence Address(Street and Number) Date Signed 58 Printed Name City Signature Residence Address(Street and Number) Date Signed 59 Printed Name City Signature Residence Address(Street and Number) Dale Signed 60 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 7 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 61 Printed Name City Signature Residence Address(Street and Number) Date Signed 62 Printed Name City Signature Residence Address(Street and Number) Date Signed 63 Printed Name City Signature Residence Address(Street and Number) Date Signed 64 Printed Name City Signature Residence Address(Street and Number) Date Signed 65 Printed Name City Signature Residence Address(Street and Number) Date Signed 66 Printed Name City Signature Residence Address(Street and Number) Date Signed 67 Printed Name City Signature Residence Address(Street and Number) Date Signed 68 Printed Name City Signature Residence Address(Street and Number) Date Signed 69 Printed Name City Signature Residence Address(Street and Number) Date Signed 70 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 8 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 71 Printed Name City Signature Residence Address(Street and Number) Date Signed 72 Printed Name City Signature Residence Address(Street and Number) Dale Signed 73 Printed Name City Signature Residence Address(Street and Number) Date Signed 74 Printed Name City Signature Residence Address(Street and Number) Date Signed 75 Printed Name City Signature Residence Address(Street and Number) Date Signed 76 Printed Name City Signature Residence Address(Street and Number) Date Signed 77 Printed Name City Signature Residence Address(Street and Number) Date Signed 78 Printed Name City Signature Residence Address(Street and Number) Date Signed 79 Printed Name city Signature Residence Address(Street and Number) Date Signed 80 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 9 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 81 Printed Name City Signature Residence Address(Street and Number) Date Signed 82 Printed Name City Signature Residence Address(Street and Number) Date Signed 83 Printed Name City Signature Residence Address(Street and Number) Date Signed 84 Printed Name City Signature Residence Address(Street and Number) Date Signed 85 Printed Name City Signature Residence Address(Street and Number) Date Signed 86 Printed Name City Signature Residence Address(Street and Number) Date Signed 87 Printed Name City Signature Residence Address(Street and Number) Date Signed 88 Printed Name City Signature Residence Address(Street and Number) Date Signed 89 Printed Name City Signature Residence Address(Street and Number) Dale Signed 90 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, Page 10 or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Dale Signed 91 Printed Name City Signature Residence Address(Street and Number) Date Signed 92 Printed Name City Signature Residence Address(Street and Number) Date Signed 93 Printed Name City Signature Residence Address(Street and Number) Date Signed 94 Printed Name City Signature Residence Address(Street and Number) Date Signed 95 Printed Name City Signature Residence Address(Street and Number) Date Signed 96 Primed Name City Signature Residence Address(Street and Number) Date Signed 97 Printed Name City Signature Residence Address(Street and Number) Date Signed 98 Printed Name City Signature Residence Address(Street and Number) Date Signed 99 Printed Name City Signature Residence Address(Street and Number) Date Signed 100 Printed Name City Petition Section No. STATE OF COLORADO ) COUNTY OF LARIMER ) SS. AFFIDAVIT OF PETITION CIRCULATOR CITY OF FORT COLLINS ) The undersigned petition circulator,being first duly sworn and upon oath,states that he or she is eighteen (18)years of age or older, that he or she personally circulated the attached petition;that each signature thereon was affixed in the presence of the petition circulator; that each signature thereon is the signature of the person whose name it purports to be;that to the best of the knowledge and belief of the affiant each of the persons signing said petition was,at the time of signing, a registered elector in the City of Fort Collins;that each signer had an opportunity before signing to read the full text of the petition; and that the petition circulator has not paid or will not in the future pay, directly or indirectly, any money or other thing of value to any signer for the purpose of inducing or causing such signer to affix his or her signature to such petition. AFFIANT: Signature of Petition Circulator Printed Name of Circulator Street Address of Petition Circulator City/State Date Subscribed and sworn to before me this day of Notary Public Address of Notary Public EXHIBIT ASCII Petition Section No. PETITION FOR REFERENDUM TO: The City Council of the City of Fort Collins GENERAL STATEMENT OF PURPOSE WARNING: IT IS AGAINST THE LAW For anyone to sign any referendum petition with any name other than his or her own or to knowingly sign his or her name more than once for the same measure or to knowingly sign such petition when not a registered elector. DO NOT SIGN THIS PETITION UNLESS YOU AREA REGISTERED ELECTOR. TO BE A REGISTERED ELECTOR,YOU MUST BE A CITIZEN OFTHE STATE OF COLORADO AND A RESIDENT OF THE CITY OF FORT COLLINS AND REGISTERED TO VOTE IN FORT COLLINS MUNICIPAL ELECTIONS. Do not sign this petition unless you have read or had read to you the proposed referred measure or the summary of the referred measure in its entirety and understand its meaning. PETITION REPRESENTATIVES (not less than 3, no more than 5) Name Address 1. 2. 3. 4. 5. NOTE. Throughout its circulation, each petition section shall contain or have attached immediately following this page the full text of the proposed ordinance or resolution. DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 1 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 1 Printed Name City Signature Residence Address(Street and Number) Date Signed 2 Printed Name City Signature Residence Address(Street and Number) Date Signed 3 Printed Name City Signature Residence Address(Street and Number) Date Signed 4 Printed Name City Signature Residence Address(Street and Number) Date Signed 5 Printed Name City Signature Residence Address(Street and Number) Date Signed 6 Printed Name City Signature Residence Address(Street and Number) Date Signed 7 Printed Name City Signature Residence Address(Street and Number) Date Signed Printed Name City Signature Residence Address(Street and Number) Date Signed 9 Printed Name City Signature Residence Address(Street and Number) Date Signed 10 Pdnted Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 2 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the rase of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 11 Printed Name City Signature Residence Address(Street and Number) Date Signed 12 Printed Name City Signature Residence Address(Street and Number) Date Signed 13 Printed Name City Signature Residence Address(Street and Number) Date Signed 14 Printed Name City Signature Residence Address(Street and Number) Date Signed 15 Printed Name City Signature Residence Address(Street and Number) Date Signed 16 Printed Name City Signature Residence Address(Street and Number) Date Signed 17 Printed Name City Signature Residence Address(Street and Number) Date Signed 18 Printed Name City Signature Residence Address(Street and Number) Date Signed 19 Printed Name City Signature Residence Address(Street and Number) Date Signed 20 Primed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 3 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 21 Printed Name City Signature Residence Address(Street and Number) Date Signed 22 Printed Name City Signature Residence Address(Street and Number) Date Signed 23 Printed Name City Signature Residence Address(Street and Number) Date Signed 24 Printed Name City Signature Residence Address(Street and Number) Dale Signed 25 Printed Name City Signature Residence Address(Street and Number) Date Signed 26 Printed Name City Signature Residence Address(Street and Number) Date Signed 27 Printed Name City Signature Residence Address(Street and Number) Date Signed 28 Printed Name City Signature Residence Address(Street and Number) Date Signed L9 Printed Name City Signature Residence Address(Street and Number) Date Signed 30 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 4 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 31 Printed Name City Signature Residence Address(Street and Number) Date Signed 32 Printed Name City Signature Residence Address(Street and Number) Date Signed 33 Printed Name City Signature Residence Address(Street and Number) Date Signed 34 Printed Name City Signature Residence Address(Street and Number) Date Signed 35 Printed Name City Signature Residence Address(Street and Number) Date Signed 36 Printed Name City Signature Residence Address(Street and Number) Dale Signed 37 Printed Name City Signature Residence Address(Street and Number) Date Signed 38 Panted Name City Signature Residence Address(Street and Number) Date Signed 39 Printed Name City Signature Residence Address(Street and Number) Date Signed 40 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 5 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) 41 Printed Name City Date Signed Signature Residence Address(Street and Number) 42 Date Signed Printed Name City Signature Residence Address(Street and Number) 43 Printed Name City Date Signed Signature Residence Address(Street and Number) 44 Printed Name City Date Signed Signature Residence Address(Street and Number) 45 Printed Name City Date Signed Signature Residence Address(Street and Number) 46 Printed Name City Dale Signed Signature Residence Address(Street and Number) 47 Printed Name City Date Signed Signature Residence Address(Street and Number) 48 Printed Name City Date Signed Signature Residence Address(Street and Number) 49 Prnted Name City Date Signed Signature Residence Address(Street and Number) 50 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 6 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 51 Printed Name City Signature Residence Address(Street and Number) Date Signed 52 Printed Name City Signature Residence Address(Street and Number) Date Signed 53 Printed Name City Signature Residence Address(Street and Number) Date Signed 54 Printed Name City Signature Residence Address(Street and Number) Date Signed 55 Printed Name City Signature Residence Address(Street and Number) Date Signed 56 Printed Name City Signature Residence Address(Street and Number) Date Signed 57 Printed Name City Signature Residence Address(Street and Number) Date Signed 58 Printed Name City Signature Residence Address(Street and Number) Date Signed 59 Printed Name City Signature Residence Address(Street and Number) Date Signed 60 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 7 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 61 Printed Name City Signature Residence Address(Street and Number) Date Signed 62 Printed Name City Signature Residence Address(Street and Number) Date Signed 63 Printed Name City Signature Residence Address(Sheet and Number) Date Signed 64 Printed Name City Signature Residence Address(Street and Number) Date Signed 65 Printed Name City Signature Residence Address(Street and Number) Date Signed 66 Printed Name City Signature Residence Address(Street and Number) Date Signed 67 Printed Name City Signature Residence Address(Street and Number) Date Signed 68 Printed Name City Signature Residence Address(Street and Number) Date Signed 69 Printed Name City Signature Residence Address(Street and Number) Date Signed 70 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT C0LLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 8 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 71 Printed Name City Signature Residence Address(Street and Number) Date Signed 72 Printed Name City Signature Residence Address(Street and Number) Date Signed 73 Printed Name City Signature Residence Address(Street and Number) Date Signed 74 Printed Name City Signature Residence Address(Street and Number) Dale Signed 75 Printed Name City Signature Residence Address(Street and Number) Date Signed 76 Printed Name City Signature Residence Address(Street and Number) Date Signed 77 Printed Name City Signature Residence Address(Street and Number) Date Signed 78 Printed Name City Signature Residence Address(Street and Number) Date Signed 79 Printed Name City Signature Residence Address(Street and Number) Date Signed 80 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Page 9 Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 81 Printed Name City Signature Residence Address(Street and Number) Date Signed 82 Printed Name City Signature Residence Address(Street and Number) Date Signed 83 Printed Name City Signature Residence Address(Street and Number) Date Signed 84 Printed Name City Signature Residence Address(Street and Number) Date Signed 85 Printed Name City Signature Residence Address(Street and Number) Date Signed 86 Printed Name City Signature Residence Address(Street and Number) Date Signed 87 Printed Name City Signature Residence Address(Street and Number) Date Signed 88 Printed Name City Signature Residence Address(Street and Number) Date Signed 89 Printed Name City Signature Residence Address(Street and Number) Date Signed 90 Printed Name City DO NOT SIGN THIS PETITION UNLESS YOU ARE A RESIDENT OF Petition FORT COLLINS AND REGISTERED TO VOTE AT YOUR CURRENT ADDRESS Section #: Before signing this petition,you are encouraged to read the full text of the initiated or referred measure, Page 10 or the purpose statement in the case of a recall petition,which immediately precedes these signature pages. Signature Residence Address(Street and Number) Date Signed 91 Printed Name City Signature Residence Address(Street and Number) Date Signed 92 Printed Name City Signature Residence Address(Street and Number) Date Signed 93 Printed Name City Signature Residence Address(Street and Number) Date Signed 94 Printed Name City Signature Residence Address(Street and Number) Date Signed 95 Printed Name City Signature Residence Address(Street and Number) Date Signed 96 Printed Name City Signature Residence Address(Street and Number) Date Signed 97 Printed Name City Signature Residence Address(Street and Number) Date Signed 98 Printed Name City Signature Residence Address(Street and Number) Date Signed 99 Printed Name City Signature Residence Address(Street and Number) Date Signed 100 Printed Name City Petition Section No. STATE OF COLORADO ) COUNTY OF LARIMER ) SS. AFFIDAVIT OF PETITION CIRCULATOR CITY OF FORT COLLINS ) The undersigned petition circulator,being first duly sworn and upon oath,states that he or she is eighteen (18)years of age or older, that he or she personally circulated the attached petition;that each signature thereon was affixed in the presence of the petition circulator; that each signature thereon is the signature of the person whose name it purports to be; that to the best of the knowledge and belief of the affiant each of the persons signing said petition was, at the time of signing,a registered elector in the City of Fort Collins;that each signer had an opportunity before signing to read the full text of the petition; and that the petition circulator has not paid or will not in the future pay, directly or indirectly, any money or other thing of value to any signer for the purpose of inducing or causing such signer to affix his or her signature to such petition. AFFIANT: Signature of Petition Circulator Printed Name of Circulator Street Address of Petition Circulator City/State Date Subscribed and sworn to before me this day of Notary Public Address of Notary Public