NON-BINDING REFERENDUM PETITION FORM
Note:
• All information on this form, including your signature, becomes a public record upon
receipt by the Supervisor of Elections.
• Under Florida law, it is a first degree misdemeanor, punishable as provided in s. 775.082
or s. 775.08, Florida Statutes, to knowingly sign more than one petition for an issue.
[Section 104.185, Florida Statutes]
• If all requested information on this form is not completed and accurate, the form will not be
valid.
Your name: _____________________________________________________________________
Please Print Name as it appears on your Voter Information Card

Your address: _____________________________________________________________
City ___________________________________ Zip_____________ County__________________
Precinct: ____ Voter Registration Number __________________ or Date of Birth _____________
I am a registered voter of Santa Rosa County, Florida and hereby petition the Supervisor of Elections to place the
following proposed non-binding referendum on the August 25th, 2020 ballot in the primary election:

BALLOT TITLE: Non-Binding Referendum on the Potential Municipal Incorporation of Navarre, FL
BALLOT SUMMARY: A non-partisan, non-binding referendum to be placed on the August 25th, 2020
primary election ballot exclusively in Navarre area voting precincts 10, 26, 29, 35 and 38, addressing the
pursuit of the municipal incorporation Navarre. This vote is non-binding and only serves as a barometer
of support, 60% plus 1 or greater authorizing Navarre’s State Representative to initiate the legislative
incorporation process.
FULL TEXT OF THE PROPOSED CONSTITUTIONAL AMENDMENT:
“Shall proposed legislation, a sample city charter and a feasibility study be presented to the Florida
Legislature, seeking the municipal incorporation of Navarre, FL? Yes or No?”

________________________
DATE OF SIGNATURE

X___________________________________

SIGNATURE OF REGISTERED VOTER

“Initiative petition sponsored by Navarre Area United Political Action Committee”
For Official Use Only:
Serial Number: ______________________
Date Approved: _____________________