Initiative Referendum Petition for City Code AmendmentCITY 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 Commission 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
(include City and State)
Date of Birth OR
Voter
Registration No.
Date
signed
(include
day,
month and
year)
Sign:________________________
Print:
Sign:________________________
Print:
Sign:_________________________
Print:
Sign:_________________________
Print:
FORM EFFECTIVE 5/06/17
F:\CLER\CLER\000_ELECTION\aaFORMS\Initiative Referendum Petition for City Code Amendment.docx