Initiative petition City Code Amendme--2017F:\CLER\CLER\000_ELECTION\INITIATIVE PETITIONS AS OF 2013\Initiative petition City Code Amendment Oct 2014.docx
CITY CODE AMENDMENT
INITIATIVE/REFERENDUM PETITION
We, the undersigned qualified electors of the City of Miami Beach, Florida, do hereby petition the City of Miami Beach Commis sion to adopt the
following measure as an amendment to the City of Miami Beach Code, or to submit said proposed City Code amendment to the qualified electors of
Miami Beach, Florida, in accordance with Article VII of the City Charter of Miami Beach, Florida:
(INSERT TEXT OF PROPOSED CITY CODE AMENDMENT)
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Sign and print name
Street Address, including
City and State
Date of Birth OR
Voter
Registration No.
Date
signed
Sign:________________________
Print:
Sign:________________________
Print:
Sign:_________________________
Print:
Sign:_________________________
Print:
I hereby certify that I witnessed each person whose signature appears above personally sign this Petition on each of the respective dates set forth
above.
Name of person circulating petition (sign and print name): _________________________________________/______________ (date signed)