Print as many copies as you need.
The removal petition shall be in substantially
 the following form.
 All petition pages must have the following:
 
 

   
 REMOVAL PETITION

    (WARNING. - It is a misdemeanor, punishable by fine and imprisonment, for any person to sign any removal petition with any name other than his own, or knowingly to sign his name more than once to such petition, or knowingly to sign such petition when he is not a qualified elector.)

   
      Date: ________

   
TO THE GOVERNOR OF THE STATE OF MISSISSIPPI:

    We, the undersigned qualified electors of ________ County, State of Mississippi, respectfully demand that ________, holding the office of ________ in said county, be removed from office by the governor for the following reasons, to wit: (Setting out the reasons for removal in not more than two hundred words); that a special election, after lawful notice, be called to permit the qualified electors of said county to vote on the question of whether or not the said officer shall be removed;

    That we each for himself say that: I am a qualified elector of said county, and my voting precinct is correctly written after my name, and that it was stated to me prior to the signing of said petition that after signing the same I would not be permitted to remove my name from said petition.


    NAME                                VOTING PRECINCT


    1. ______________                    ______________


    2. ______________                    ______________


    3. ______________                    ______________


    4. ______________                    ______________

The last page of every copy of the petition must have the following:

STATE OF MISSISSIPPI

   
County of ________

    I, ________, a qualified elector of said county do now state under oath that every person who signed the foregoing petition signed his or her name thereto in my presence, and that before the signing of said petition the signator was told that after signing the same his or her name could not be removed from said petition; that I believe that each has stated his or her name and precinct correctly, and that so far as I know each signer is a qualified elector of this county, and I further certify that the date appearing on the foregoing petition is the correct date on which the first signature was affixed to said petition or any section thereof.

   
      (Signature) ______________

    Sworn to and subscribed before me, this ________ day of ________, 20____.

   
      ______________

   
      ______________

For the full state code for a recall see here. We thank the author of the site for permission to link to it.