Form 32 "Statement of Circulator or Agent in Charge of Initiative or Referendum Petition (County or Municipal)" - Ohio

What Is Form 32?

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 32 by clicking the link below or browse more documents and templates provided by the Ohio Secretary of State.

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Download Form 32 "Statement of Circulator or Agent in Charge of Initiative or Referendum Petition (County or Municipal)" - Ohio

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Form No. 32 Prescribed by Secretary of State (09-17)
Statement of Circulator or Agent in Charge of
print clearly
Initiative or Referendum Petition (county or municipal)
To be filed with the County Auditor, City Auditor or Village Clerk within 5 days after local petition papers are filed.
R.C. 305.36, 731.35
Statement of
of
Circulator or Agent
Name of Committee
Dated this
day of
,
.
Day
Month
Year
The undersigned states that he/she is the
of
Initiative or Referendum
Circulator or Circulator's Agent
Petition(s), and that the following itemized statement shows in detail (1) All money or things of value paid, given, or promised for
circulating such petition; (2) Full names and addresses of all persons to whom such payments or promises were made;
(3) Full names and addresses of all persons who contributed anything of value to be used in circulating such petition; (4) Time
spent and salaries earned while circulating or soliciting signatures to such petition by persons who were regular salaried
employees of some person who authorized them to solicit signatures for or circulate the petition as part of their regular duties.
Full name and address of all persons to whom money or things of value were paid, given or promised.
WHAT PAID, GIVEN, OR
DATE
NAME
ADDRESS
AMOUNT
PROMISED
Form No. 32 Prescribed by Secretary of State (09-17)
Statement of Circulator or Agent in Charge of
print clearly
Initiative or Referendum Petition (county or municipal)
To be filed with the County Auditor, City Auditor or Village Clerk within 5 days after local petition papers are filed.
R.C. 305.36, 731.35
Statement of
of
Circulator or Agent
Name of Committee
Dated this
day of
,
.
Day
Month
Year
The undersigned states that he/she is the
of
Initiative or Referendum
Circulator or Circulator's Agent
Petition(s), and that the following itemized statement shows in detail (1) All money or things of value paid, given, or promised for
circulating such petition; (2) Full names and addresses of all persons to whom such payments or promises were made;
(3) Full names and addresses of all persons who contributed anything of value to be used in circulating such petition; (4) Time
spent and salaries earned while circulating or soliciting signatures to such petition by persons who were regular salaried
employees of some person who authorized them to solicit signatures for or circulate the petition as part of their regular duties.
Full name and address of all persons to whom money or things of value were paid, given or promised.
WHAT PAID, GIVEN, OR
DATE
NAME
ADDRESS
AMOUNT
PROMISED
Full name and address of all persons who contributed anything of value to be used in circulating petition.
DATE
NAME
ADDRESS
WHAT CONTRIBUTED
AMOUNT
Full name and address of all persons who were regular salaried employees of some person or who authorized
them to solicit signatures for or circulate the petition as part of their regular duties, together with time spent
and salaries earned while so doing.
TIME SPENT
NAME
ADDRESS
SALARY EARNED
(Total Hours)
I,
, declare under penalty of election falsification that I am a(n)
Printed Name of Circulator
for the
Committee,
Circulator or Agent
Name of Committee
and that the foregoing is a full, true and itemized statement of the full names and addresses of all persons to whom money or
things of value were paid, given, or promised for circulating such petition as a consideration for work done in circulating such
petition; full names and addresses of all persons who contributed anything of value to be used in circulating such petition; and the
time spent and salaries earned while soliciting signatures to such petition by persons who were regular salaried employees of
some person who authorized them to solicit for or circulate the petition as part of their regular duties
Signature of Circulator or Agent
WHOEVER COMMITS ELECTION
Street and Number or Rural Route
FALSIFICATION IS GUILTY OF
A FELONY OF THE FIFTH DEGREE
City or Village and Zip Code
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