§ Ind. Code § 3-6-12-7Petition carrier affirmation; required information

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(a) The petition carrier must sign and date the following statement at the bottom
of each signature page: "I affirm under the penalties for perjury that I have no reason to
believe that any individual whose signature appears on this page is ineligible to sign this
petition or did not properly complete and sign this page.".
(b) The petition carrier must also print the following information below the affirmation
stated in subsection (a):
(1) The petition carrier's name.
(2) The petition carrier's full address, including the ZIP code.

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