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Form 1

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“INITIATIVE PETITION To the Honorable Secretary of State of the State of Arkansas, or County Clerk, or City Clerk We, the undersigned registered voters of the State of Arkansas, or , or Incorporated Town of County, Arkansas, or City of , Arkansas (as the case may be), respectfully propose the following amendment to the Constitution of the State or act or ordinance (as the case may be), and by this, our petition, order that the same be submitted to the people of said state, or county, or municipality (as the case may be), to the end that the same may be adopted, enacted, or rejected by the vote of the registered voters of said (state, county, or municipality) at the regular general election to be held on the , and each of us for himself or herself says: day of , 20 I have personally signed this petition; I am a registered voter of the State of Arkansas, or County, Arkansas, or City of , Arkansas (as the case may be), and my printed name, date of birth, residence, city or town of residence, and date of signing this petition are correctly written after my signature

, or Incorporated Town of (Here insert popular name and ballot title of initiated measure.) (In the case of a proposed initiated act or ordinance, insert the following: BE IT ENACTED BY THE PEOPLE OF THE STATE OF ARKANSAS, OR COUNTY, ARKANSAS, OR CITY OF OR INCORPORATED TOWN OF (Here insert full text of initiated measure.)”

, ARKANSAS (as the case may be)):

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Form 1