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Content
Petition to [Action Petitioned For]
Petition summary and
background:
Action petitioned for:
Printed name
[Enter the background of and reasons for this petition]
We, the undersigned, are concerned citizens who urge our leaders to act now to [Enter action item(s) for which you are
petitioning]
Signature
Address
Comment
Date
Printed name
Signature
Address
Comment
Date