Form 15 "Statement of Receiving or Providing Compensation for Circulating a Statewide Issue Petition" - Ohio

What Is Form 15?

This is a legal form that was released by the Ohio Secretary of State - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2017;
  • The latest edition provided by the Ohio Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 15 by clicking the link below or browse more documents and templates provided by the Ohio Secretary of State.

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Download Form 15 "Statement of Receiving or Providing Compensation for Circulating a Statewide Issue Petition" - Ohio

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Form No. 15 Prescribed by Secretary of State (09-17)
Statement of Receiving or Providing Compensation
print clearly
For Circulating a Statewide Issue Petition
R.C. 3501.381
will:
Printed name of individual or entity
(Check ONE)
receive compensation
compensate an individual or entity
for supervising, managing, or otherwise organizing an effort to obtain signatures for a
(Check and describe one):
A statewide initiative to amend the Ohio Constitution
(describe the purpose):
Date of Attorney General’s summary
certification (MM/DD/YYYY)
A statewide initiative to amend Ohio law
(describe the purpose):
Date of Attorney General’s summary
certification (MM/DD/YYYY)
A statewide referendum on
Entire Bill
Selected Sections
Bill Number
The petition will be circulated for the with the expectation that the issue will be submitted to the electors at the election
to be held on
day of
,
.
Year
Month
I declare under penalty of election falsification that the statements above are true and accurate.
Printed name of individual or authorized signer for an entity
MM/DD/YYYY
Signature of individual or authorized signer for an entity
Date
Address
City, State, and Zip Code
Telephone Number
Email
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE
Whoever fails to file this statement as required by section 3501.381 of the Ohio Revised Code is guilty of a misdemeanor of the
first degree, and the petition for which a person was compensated for supervising, managing, or otherwise organizing the effort to
obtain signatures shall be deemed invalid.
Form No. 15 Prescribed by Secretary of State (09-17)
Statement of Receiving or Providing Compensation
print clearly
For Circulating a Statewide Issue Petition
R.C. 3501.381
will:
Printed name of individual or entity
(Check ONE)
receive compensation
compensate an individual or entity
for supervising, managing, or otherwise organizing an effort to obtain signatures for a
(Check and describe one):
A statewide initiative to amend the Ohio Constitution
(describe the purpose):
Date of Attorney General’s summary
certification (MM/DD/YYYY)
A statewide initiative to amend Ohio law
(describe the purpose):
Date of Attorney General’s summary
certification (MM/DD/YYYY)
A statewide referendum on
Entire Bill
Selected Sections
Bill Number
The petition will be circulated for the with the expectation that the issue will be submitted to the electors at the election
to be held on
day of
,
.
Year
Month
I declare under penalty of election falsification that the statements above are true and accurate.
Printed name of individual or authorized signer for an entity
MM/DD/YYYY
Signature of individual or authorized signer for an entity
Date
Address
City, State, and Zip Code
Telephone Number
Email
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE
Whoever fails to file this statement as required by section 3501.381 of the Ohio Revised Code is guilty of a misdemeanor of the
first degree, and the petition for which a person was compensated for supervising, managing, or otherwise organizing the effort to
obtain signatures shall be deemed invalid.