C ONSTITUTIONAL AMENDMENT INITIATIVE ... - Regulate …

CONSTITUTIONAL AMENDMENT INITIATIVE PETITION FORM ? VOLUNTEER

Amendment Information Ballot Title: Regulate Marijuana in a Manner Similar to Alcohol to Establish Age, Licensing, and Other Restrictions

Ballot Summary: Regulates marijuana (hereinafter "cannabis") for limited use and growing by persons twenty-one years of age or older. State shall adopt regulations to issue, renew, suspend, and revoke licenses for cannabis cultivation, product manufacturing, testing and retail facilities. Local governments may regulate facilities' time, place and manner and, if state fails to timely act, may license facilities. Does not affect compassionate use of low-THC cannabis, nor immunize federal law violations.

See separate document for the full text of the proposed constitutional amendment.

Date Approved__3_/1_7_/2_0_1_6________

Serial Number_____1_60_2________

Sponsor's Information

Sponsor Name: Sensible Florida, Inc.

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Sponsor Address: Post Office Box 550193 Fort Lauderdale, FL 3335.5

Voter's Information

I am a registered voter of Florida and hereby petition the Secretary of State to place the above proposed amendment to the Florida Constitution on the ballot in the general election.

Name - Last__________________________ First_______________________ Middle________________

Address_________________________________________________________________________________

City__________________________________ Zip_______________ County_________________________

Change the address on my voter registration record to the above address (check box, if applicable)

Voter Registration Number

or Date of Birth

Voter's Signature_________________________________________ Date Petition Circulator's Information

This petition form is only to be collected by a volunteer or directly by the voter him or herself.

A paid petition circulator must use the DS-DE 155B version of the form. Forms for paid petition circulators can be obtained from the Division's Paid Petition Circulator website.

Visit for more information.

Attention x This form becomes a public record upon its filing with the Supervisor of Elections. x It is a first degree misdemeanor to knowingly sign the same petition more than once. [?104.185, F.S.]

x Failure to complete the form as required may invalidate the form.

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