D.C. Mun. Regs. tit. 3, § 1101
1101
PETITION FORMAT AND APPROVAL
1101.1
Each petition sheet shall be printed on white paper of good writing quality of the same size as the original petition form approved by the Board and shall be double sided.
1101.2
Each petition sheet shall contain the following:
(a) Numbered lines for twenty (20) names, designed so that each signer can personally affix his or her signature; the date signed; and the signer's printed name, residence address (giving street and number), and election ward;
(b) A statement requesting that the Board hold a recall election in the manner prescribed in Charter Amendment No. 2 to Title IV of the District of Columbia Self-Government and Governmental Reorganization Act;
(c) The name of the elected officer sought to be recalled and the office held by that elected official;
(d) The name and address of the proposer or proposers of the recall;
(e) The statement of grounds for the recall and the response of the officer sought to be recalled, if any. If the officer sought to be recalled has not responded, the petition shall so state;
(f) A warning statement declaring that only duly registered electors of the District of Columbia may sign the petition;
(g) Instructions, advising signatories of the proper method of signing the petition, as follows: EVERY PETITIONER MUST SIGN HIS OR HER OWN NAME. UNDER NO CIRCUMSTANCES IS ANY PERSON PERMITTED TO SIGN ANOTHER PERSON'S NAME. PRINT YOUR NAME AND RESIDENCE ADDRESS IN FULL.
(h) The words "PAID FOR BY" in the right hand corner of the front page, followed by the name and address of the payer or the committee or other person and its treasurer on whose behalf the material appears.
1101.3
The back page of each petition sheet shall bear an affidavit, to be signed by the person circulating the sheet and made under penalties of perjury, which contains the following information:
(a) The printed name of the circulator;
(b) The residence address of the circulator, including the street number;
(c) A statement that the circulator of the petition sheet was in the presence of each signatory when the petition was signed;
(d) A statement that, according to the best information available to the circulator, each signature is the signature of the person whose name it purports to be;
(e) A statement that the circulator of the recall petition sheet(s) meets the petition circulator requirements set forth in § 1103.1;
(f) The dates between which the signatures to the petition were obtained;
(g) A statement that the proposer of the recall informed the circulator of the petition sheet of the law set forth in D.C. Official Code § 1-1001.14 (2011 Repl.);
(h) A statement that the circulator has not tendered any form of compensation to anyone as consideration for his or her signature;
(i) A statement that the circulator has not made any false statements to the Board of Elections regarding the recall;
(j) A statement that the circulator has not made any false statements regarding the recall to anyone who signed the petition.
1101.4 Upon filing with the Board the notice of intention to recall and the elected officer's response, the Board shall prepare and provide to the proponent an original petition form which the proposer shall formally adopt as his or her own form, and which shall be reproduced by the proponent.
1101.5 The proponent shall reproduce, in accordance with § 1101.1, at his or her own expense, copies of the original petition form approved by the Board for use in circulating the petition.
1101.6 No petition pages may be circulated prior to the Board's approval of the original petition form.
SOURCE: Final Rulemaking published at 42 DCR 4419, 4421-23 (August 18, 1995); as amended by Final Rulemaking published at 60 DCR 5582 (April 12, 2013).