“State of Arkansas County of I, (print name of canvasser), being duly sworn, state that each of the foregoing persons signed his or her own name to this sheet of the petition in my presence. To the best of my knowledge and belief, each signature is genuine and each signer is a registered voter of the State of Arkansas, County, or City or Incorporated Town of . At all times during the circulation of this signature sheet, an exact copy of the popular name, ballot title, and text was attached to the signature sheet. My current residence address is correctly stated below
Signature Current residence Indicate one: Subscribed and sworn to before me this Signature Paid Canvasser Seal ”
Volunteer/Unpaid Canvasser day of , 20 Clerk, Notary, Judge, or J.P
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