FOR THIS PETITION TO BE VALID YOU MUST ENTER YOUR "DIGITAL SIGNATURE" IN THE BOX BELOW, WHICH MEANS TYPING
YOUR NAME IN THE FOLLOWING FORMAT:
TYPE "/s/" BETWEEN TWO FORWARD SLASHES (Without Quotation Marks) FOLLOWED BY YOUR FULL NAME AS IN THE EXAMPLE BELOW=>
/s/ John A. Doe   

ENTER DIGITAL SIGNATURE IN BOX BELOW AS INSTRUCTED ABOVE.
 

Enter Date Below


VERIFICATION AND DECLARATION:
By entering my digital signature above,  unless I indicate otherwise in misc. at bottom of the form that I am a tourist, a minor, or some other concerned individual who wants only to express support, I declare under penalty of law, that I am over 18 years of age, that I am a citizen of the United States and  eligible to vote in the State of Hawai`i, and that I respectfully request that my representatives in the Hawaii State Legistlature pass HB2986 (also known as) the "Malama Aina Act" to eliminate graffiti and illegal dumping of trash throughout the entire State of Hawai`i.

MAKE SURE TO CLICK ON THE "SUBMIT" BUTTON AT THE BOTTOM OF THIS FORM!!

IT IS OPTIONAL TO ENTER THE CONTACT INFORMATION BELOW, BUT WE WOULD APPRECIATE IT IF YOU WOULD, SO THAT OFFICIALS CAN VERIFY THIS AS A LEGITIMATE PETITION.

First Name:

Last Name:

Address Street 1:

Address Street 2:

City:

State:

Zip Code:

Daytime Phone:

Evening Phone:

Cell Phone:

Fax:

Email:

Misc.:

FINAL STEP. PLEASE CLICK
"SUBMIT" BUTTON BELOW.