Florida Medical Marijuana Petition Form
Content
CONSTITUTIONAL AMENDMENT PETITION FORM
Note: - All information on this form, including your signature, becomes a public record upon receipt by the Supervisor of Elections. - Under Florida law, it is a first degree misdemeanor, punishable as provided in s. 775.082 or s. 775.083, Florida Statutes, to knowingly sign more than one petition for a candidate, a minor political party, or an issue. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid. Your name _________________________________________________________ Please Print Name as it appears on your Voter Information Card Your residential street address _______________________________________________________________ City ________________________________ Zip _________________ County ______________________ Voter Registration Number ______________________________ or Date of Birth ____________________ I am a registered voter of Florida and hereby petition the Secretary of State to place the following amendment to the Florida Constitution on the ballot in the general election. AMENDMENT TO CREATE ARTICLE I, SECTION 28 (“Right to Marijuana for Treatment Purposes”) OF THE FLORIDA CONSTITUTION BALLOT TITLE – RIGHT TO MARIJUANA FOR TREATMENT OF CERTAIN MEDICAL DISEASES AND CONDITIONS. BALLOT SUMMARY – THIS PROPOSED AMENDMENT IS DESIGNED TO CREATE A NEW ARTICLE I, SECTION 28 (“Right to Marijuana for Treatment Purposes”) OF THE FLORIDA CONSTITUTION SO AS TO PERMIT THE CULTIVATION, PURCHASE, POSSESSION AND USE OF MARIJUANA TO TREAT ALZHEIMER’S, CACHEXIA, CANCER, CHRONIC PAIN, CHRONIC NERVOUS SYSTEM DISORDERS, CROHN’S DISEASE, EPILEPSY AND OTHER SEIZURE DISORDERS, GLAUCOMA, HIV/AIDS, MULTIPLE SCLEROSIS, PARKINSON’S, DISEASES CAUSING MUSCLE SPASTICITY, OR OTHER DISEASES AND CONDITIONS WHEN RECOMMENDED BY A PHYSICIAN. FULL TEXT OF THE PROPOSED AMENDMENT – ARTICLE I, SECTION 28 (“Right to Marijuana for Treatment Purposes”) OF THE FLORIDA CONSTITUTION IS HEREBY CREATED TO READ AS FOLLOWS: “SECTION 28. Right to Marijuana for Treatment Purposes. – “(a) No person shall be deprived of life, liberty or property or otherwise penalized for the cultivation, purchase, use or possession of marijuana in connection with the treatment of Alzheimer’s, cachexia, cancer, chronic pain, chronic nervous system disorders, Crohn’s disease, epilepsy and other seizure disorders, glaucoma, HIV/AIDS, multiple sclerosis, Parkinson’s, diseases causing muscle spasticity, or other diseases and conditions when recommended by a physician. “(b) This section shall be self-executing. The legislature, however, may provide by general law for the voluntary registration of persons intending to exercise their rights hereunder and for the regulation of the distribution and sale [PETITION CONTINUES ON THE OTHER SIDE]
[PETITION BEGINS ON THE OTHER SIDE] of marijuana to persons intending to exercise their rights hereunder. “(c) Nothing herein, however, shall be construed so as to prevent the legislature from enacting laws penalizing the operation of motor vehicles, boats, watercraft or aircraft while under the influence of marijuana or regulating the use of marijuana by minors. Similarly, all laws in effect at the time of adoption of this section penalizing the operation of motor vehicles, boats, watercraft or aircraft while under the influence of marijuana or regulating the use of marijuana by minors shall remain in force.”
X ____________________________________________
DATE OF SIGNATURE SIGNATURE OF REGISTERED VOTER This petition is a paid political advertisement, paid for by People United for Medical Marijuana, a political committee, whose mailing address is P.O. Box 560296, Orlando, Florida 32856.
Paid Petition Circulator’s Name ____________________________ Address ________________________________________________
Serial Number: 09-01 Date Approved: 03/26/2009
Note: - All information on this form, including your signature, becomes a public record upon receipt by the Supervisor of Elections. - Under Florida law, it is a first degree misdemeanor, punishable as provided in s. 775.082 or s. 775.083, Florida Statutes, to knowingly sign more than one petition for a candidate, a minor political party, or an issue. [Section 104.185, Florida Statutes] - If all requested information on this form is not completed, the form will not be valid. Your name _________________________________________________________ Please Print Name as it appears on your Voter Information Card Your residential street address _______________________________________________________________ City ________________________________ Zip _________________ County ______________________ Voter Registration Number ______________________________ or Date of Birth ____________________ I am a registered voter of Florida and hereby petition the Secretary of State to place the following amendment to the Florida Constitution on the ballot in the general election. AMENDMENT TO CREATE ARTICLE I, SECTION 28 (“Right to Marijuana for Treatment Purposes”) OF THE FLORIDA CONSTITUTION BALLOT TITLE – RIGHT TO MARIJUANA FOR TREATMENT OF CERTAIN MEDICAL DISEASES AND CONDITIONS. BALLOT SUMMARY – THIS PROPOSED AMENDMENT IS DESIGNED TO CREATE A NEW ARTICLE I, SECTION 28 (“Right to Marijuana for Treatment Purposes”) OF THE FLORIDA CONSTITUTION SO AS TO PERMIT THE CULTIVATION, PURCHASE, POSSESSION AND USE OF MARIJUANA TO TREAT ALZHEIMER’S, CACHEXIA, CANCER, CHRONIC PAIN, CHRONIC NERVOUS SYSTEM DISORDERS, CROHN’S DISEASE, EPILEPSY AND OTHER SEIZURE DISORDERS, GLAUCOMA, HIV/AIDS, MULTIPLE SCLEROSIS, PARKINSON’S, DISEASES CAUSING MUSCLE SPASTICITY, OR OTHER DISEASES AND CONDITIONS WHEN RECOMMENDED BY A PHYSICIAN. FULL TEXT OF THE PROPOSED AMENDMENT – ARTICLE I, SECTION 28 (“Right to Marijuana for Treatment Purposes”) OF THE FLORIDA CONSTITUTION IS HEREBY CREATED TO READ AS FOLLOWS: “SECTION 28. Right to Marijuana for Treatment Purposes. – “(a) No person shall be deprived of life, liberty or property or otherwise penalized for the cultivation, purchase, use or possession of marijuana in connection with the treatment of Alzheimer’s, cachexia, cancer, chronic pain, chronic nervous system disorders, Crohn’s disease, epilepsy and other seizure disorders, glaucoma, HIV/AIDS, multiple sclerosis, Parkinson’s, diseases causing muscle spasticity, or other diseases and conditions when recommended by a physician. “(b) This section shall be self-executing. The legislature, however, may provide by general law for the voluntary registration of persons intending to exercise their rights hereunder and for the regulation of the distribution and sale [PETITION CONTINUES ON THE OTHER SIDE]
[PETITION BEGINS ON THE OTHER SIDE] of marijuana to persons intending to exercise their rights hereunder. “(c) Nothing herein, however, shall be construed so as to prevent the legislature from enacting laws penalizing the operation of motor vehicles, boats, watercraft or aircraft while under the influence of marijuana or regulating the use of marijuana by minors. Similarly, all laws in effect at the time of adoption of this section penalizing the operation of motor vehicles, boats, watercraft or aircraft while under the influence of marijuana or regulating the use of marijuana by minors shall remain in force.”
X ____________________________________________
DATE OF SIGNATURE SIGNATURE OF REGISTERED VOTER This petition is a paid political advertisement, paid for by People United for Medical Marijuana, a political committee, whose mailing address is P.O. Box 560296, Orlando, Florida 32856.
Paid Petition Circulator’s Name ____________________________ Address ________________________________________________
Serial Number: 09-01 Date Approved: 03/26/2009
