State of South Dakota )
) SS
County of ______________ )
I, the undersigned, being first duly sworn, depose and say that I am the circulator of the foregoing petition containing ________ signatures; that each person whose name appears on said petition sheet personally signed said petition in the presence of the affiant; that he believes that each of said signers is an owner or entryman of the land described opposite his signature, to be included within the proposed district, and residing at the address written opposite his name, and that affiant stated to every petitioner before he affixed his signature the legal effect and nature of said petition.
___________________________________
Circulator
Subscribed and sworn to before me this ________ day of ________, 19____.
___________________________________
Notary Public
Source: SL 1984, ch 294, § 4.