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 my presence; that I believe that each of said signers is a resident at the address written opposite his name; and that I 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 1989, ch 388, § 44.