Referendum/Initiative Cover Sheet
Election: ____________________
Term/Year
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
(Typed question)
This signature verifies that I collceted all of the following signatures, that each signature reflects a distinct
individual, and that no threats or coercive statements were made to induce a person to sign this petition.
______________________________
Printed Name
___________________________
Signature
______________________________
Email
___________________________
Phone
To be filled out by Student Government staff only
Received this __________ day of _______________________, __________ at __________ AM/PM by
___________________________________
Printed Name
____________________________________
Signature
Format for petition with signatures:
773.1
All petitions filed with the Supreme Court as provided in Section 773.0 shall satisfy all of the
following requirements:
(a) All names must be or must be accompanied by the signature of the individual who allegedly
signed the petition;
(b) All signatures must be in non-erasable ink;
(c) All names must be signed exactly as the person's name is recorded with the Registrar's Office;
(d) All names must be followed by student number.
(e) Each page containing signatures shall have the proposed initiative statement of intent or
referendum question stated in full at the top of the page;
(f) Each page containing signatures shall include the identity and signature of the person responsible
for securing signatures for that page and that person shall certify all of the following:
(1) All signatures were made by different individuals;
(2) No threats or coercive statements were made to induce a person to sign the petition;
(3) The signature of the person responsible for securing the signatures may only be counted
once.
(g) Each page containing signatures shall include the statement: “Upon request, the full text of the
amendment shall be made immediately available to any signatories.”
773.2
The full text of the amendment shall be available to all signatories at the time of signing.
Example below. Template available at sg.ufl.edu/elections for your use.
By signing below you are asking that the following question appear on the ballot for the Student Government
election to be held during the (Fall/Spring) semester of (Year):
Should the University of Florida designate areas for student-only tailgating on game days? (Sample question)
Printed Name
UF ID
Signature
Sample
SAMPLE
1234-5678
1.
2.
3.
4.
Etc…
“Upon request, the full text of the amendment shall be made available to any signatories.”
I, _____________________________, certify that all signatures were made by different individuals; no threats
or coercive statements were made to induce a person to sign the petition; and the signature of the person
responsible for securing the signatures may only be counted once.
_____________ _________ ___________________________
Printed Name UF ID
Signature