Miss. Code Ann. § 25-5-9: Miss. Code Ann. § 25-5-9

The removal petition shall be in substantially the following form:

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.)

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. __________

__________________