25 C.F.R. § 81.55
(a) Each page of the petition must contain:
(3) The following declaration at the bottom of each page to confirm the collector was present when each signature was collected:
“I, (Collector's Printed Name) , hereby declare that each individual whose name appears above signed and dated the petition. To the best of my knowledge, the individual signing the petition is a member of the tribe and is 18 years or older. (Signature of Collector) (Notary Certification)”,