721—21.801 (422B) Form of ballot for local option tax elections. If questions pertaining to more than one of the authorized local option taxes are submitted at a single election, all of the public measures shall be printed on the same ballot. The form of ballots to be used throughout the state of Iowa for the purpose of submitting questions pertaining to local option taxes shall be as follows:
	 21.801(1) Local sales and services tax propositions. Sales and services tax propositions shall be submitted to the voters of an entire county. If the election is being held for the voters to decide whether to impose the tax in a county where a local option sales and services tax has previously been approved for part of the county, the question of imposition shall be voted upon in all parts of the county where the tax has not been approved. If the election is being held for the voters to decide whether to repeal the tax in a county where a local option sales and services tax has previously been approved for part of the county, the question of repeal shall be voted upon in all parts of the county where the tax was previously imposed. If the election is being held for the voters to decide whether to change the rate or use of the tax in a county where a local option sales and services tax has previously been approved for part of the county, the question of rate or use change shall be voted upon in all parts of the county where the tax was previously imposed.
The ballot submitted to the voters of each incorporated area and the unincorporated area of the county shall show the intended uses for that jurisdiction. The ballot submitted to the voters in contiguous cities within a county shall show the intended uses and repeal dates, if not uniform, for each of the contiguous cities. The ballots shall be in substantially the following form:
	  a.   	 Imposition question for voters in a single city or the unincorporated area of the county:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize imposition of a local sales and services tax in the [city of ________________] [unincorporated area of the county of _____________], at the rate of _____ percent ( _____ %) to be effective on _______________ (month and day), _____ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
A local sales and services tax shall be imposed in the [city of _____________] [unincorporated area of the county of _______________] at the rate of _____ percent ( _____ %) to be effective on _______________ (month and day), _____ (year).
Revenues from the sales and services tax shall be allocated as follows:
(Choose one or more of the following:)
[______________ for property tax relief (insert percentage or dollar amount)]
[______________ for property tax relief (insert percentage or dollar amount) in the unincorporated area of the county of ________________]
[______________ for property tax relief (insert percentage or dollar amount) in the county of ________________]
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
	  b.   	 Imposition question for voters in contiguous cities:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize imposition of a local sales and services tax in the cities of ___________, ____________, ____________, (list additional cities, if applicable) at the rate of _____ percent ( _____%) to be effective on ____________ (month and day), _____ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
A local sales and services tax shall be imposed in the cities of ____________, ____________, ____________, (list additional cities, if applicable) at the rate of _____ percent ( _____%) to be effective on ____________ (month and day), _____ (year).
Revenues from the sales and services tax are to be allocated as follows:
FOR THE CITY OF  	 :
____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
	  c.   	 Imposition question with an automatic repeal date for voters in a single city or the unincorporated area of the county:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize imposition of a local sales and services tax in the [city of ________________] [unincorporated area of the county of _____________], at the rate of _____ percent ( _____%) to be effective from ____________ (month and day), _____ (year), until ____________ (month and day), _____ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
A local sales and services tax shall be imposed in the [city of ____________] [unincorporated area of the county of ____________] at the rate of _____ percent ( _____%) to be effective from ____________ (month and day), _____ (year), until ____________ (month and day), _____ (year).
Revenues from the sales and services tax shall be allocated as follows:
(Choose one or more of the following:)
[____________ for property tax relief (insert percentage or dollar amount)]
[____________ for property tax relief (insert percentage or dollar amount) in the unincorporated area of the county of ___________________]
[____________ for property tax relief (insert percentage or dollar amount) in the county of ___________________]
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
	  d.   	 Imposition question with an automatic repeal date for voters in contiguous cities:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize imposition of a local sales and services tax in the cities of ____________, ____________, ____________, (list additional cities, if applicable) at the rate of ____ percent ( ____%) to be effective from ______________ (month and day), _____ (year), until _____________ (month and day), _____ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
A local sales and services tax shall be imposed in the cities of ___________, ____________, ___________, (list additional cities, if applicable) at the rate of _____ percent ( _____%) to be effective from ______________ (month and day), _____ (year), until ______________ (month and day), _____ (year).
Revenues from the sales and services tax are to be allocated as follows:
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
	  e.   	 Repeal question for voters in a single city or the unincorporated area of the county:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize repeal of the ____ percent ( _____%) local sales and services tax in the [city of ___________________] [unincorporated area of the county of _____________] effective ______________ (month and day), _____ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
The _____ percent ( _____%) local sales and services tax shall be repealed in the [city of ______________________] [unincorporated area of the county of _____________________] effective ____________ (month and day), _____ (year).
Revenues from the sales and services tax have been allocated as follows:
(Choose one or more of the following:)
[____________ for property tax relief (insert percentage or dollar amount)]
[____________ for property tax relief (insert percentage or dollar amount) in the unincorporated area of the county of __________________]
[____________ for property tax relief (insert percentage or dollar amount) in the county of ___________________]
The specific purpose (or purposes) for which the revenues were otherwise expended was (were):
(List specific purpose or purposes)
	  f.   	 Repeal question for voters in contiguous cities:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize repeal of the ____ percent ( _____%) local sales and services tax in the cities of ____________, ____________, ____________, (list additional cities, if applicable) effective ______________ (month and day), _____ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
The _____ percent ( _____%) local sales and services tax shall be repealed in the cities of ___________, ____________, ___________, (list additional cities, if applicable) effective ______________ (month and day), ______ (year).
Revenues from the sales and services tax have been allocated as follows:
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues were otherwise expended was (were):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues were otherwise expended was (were):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues were otherwise expended was (were):
(List specific purpose or purposes)
	  g.   	 Rate change question for voters in a single city or the unincorporated area of the county:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize an increase (or decrease) in the rate of the local sales and services tax to _____ percent ( _____%) in the [city of _______________] [unincorporated area of the county of _____________________] effective ______________ (month and day), _____ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
The rate of the local sales and services tax shall be increased (or decreased) to ____ percent ( _____%) in the [city of __________________] [unincorporated area of the county of _____________] effective ______________ (month and day), _____ (year). The current rate is ____ percent ( _____%).
Revenues from the sales and services tax are allocated as follows:
(Choose one or more of the following:)
[_____________ for property tax relief (insert percentage or dollar amount)]
[_____________ for property tax relief (insert percentage or dollar amount) in the unincorporated area of the county of ___________________]
[_____________ for property tax relief (insert percentage or dollar amount) in the county of ____________________]
The specific purpose (or purposes) for which the revenues are otherwise expended is (are):
(List specific purpose or purposes)
	  h.   	 Rate change question for voters in contiguous cities:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize an increase (or decrease) in the rate of the local sales and services tax to _____ percent ( _____%) in the cities of ____________, ____________, ____________, (list additional cities, if applicable) effective ______________ (month and day), _____ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
The rate of the local sales and services tax shall be increased (or decreased) to _____ percent ( _____%) in the cities of ___________, ____________, ___________, (list additional cities, if applicable) effective _____________ (month and day), _____ (year).
Revenues from the sales and services tax are allocated as follows:
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues are otherwise expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues are otherwise expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_____________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues are otherwise expended is (are):
(List specific purpose or purposes)
	  i.   	 Use change question for voters in a single city or the unincorporated area of the county:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize a change in the use of the ______ percent (_____%) local sales and services tax in the [city of _______________] [unincorporated area of the county of ______________] effective _______________ (month and day), _______ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
The use of the _____ percent ( _____%) local sales and services tax shall be changed in the [city of ____________________] [unincorporated area of the county of _____________] effective ______________ (month and day), _____ (year).
PROPOSED USES OF THE TAX:
If the change is approved, revenues from the sales and services tax shall be allocated as follows:
(Choose one or more of the following:)
[_____________ for property tax relief (insert percentage or dollar amount)]
[_____________ for property tax relief (insert percentage or dollar amount) in the unincorporated area of the county of __________________]
[_____________ for property tax relief (insert percentage or dollar amount) in the county of ____________________]
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
CURRENT USES OF THE TAX:
Revenues from the sales and services tax are currently allocated as follows:
(Choose one or more of the following:)
[_____________ for property tax relief (insert percentage or dollar amount)]
[_____________ for property tax relief (insert percentage or dollar amount) in the unincorporated area of the county of ___________________]
[_____________ for property tax relief (insert percentage or dollar amount) in the county of ____________________]
The specific purpose (or purposes) for which the revenues are otherwise expended is (are):
(List specific purpose or purposes)
	  j.   	 Use change question for voters in contiguous cities:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize a change in the use of the ______ percent (_____%) local sales and services tax in the cities of __________, ___________, __________, (list additional cities, if applicable) effective _______________ (month and day), _______ (year).
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25. Counties using special paper ballots which are read by computerized tabulating equipment may summarize the question on the ballot and post the complete text as provided in Iowa Code section 52.25.)
The use of the _____ percent ( _____%) local sales and services tax shall be changed in the cities of ___________, ____________, ___________, (list additional cities, if applicable) effective _____________ (month and day), _____ (year).
PROPOSED USES OF THE TAX:
If the change is approved, revenues from the sales and services tax are to be allocated as follows:
FOR THE CITY OF  	 :
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
(List specific purpose or purposes)
CURRENT USES OF THE TAX:
FOR THE CITY OF  	 :
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues are otherwise expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues are otherwise expended is (are):
(List specific purpose or purposes)
FOR THE CITY OF  	 :
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues are otherwise expended is (are):
(List specific purpose or purposes)
	  k.   	 Imposition question with differing automatic repeal dates for voters in contiguous cities:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize imposition of a local sales and services tax in the cities of __________, ___________, __________, (list additional cities, if applicable) at the rate of _____ percent ( _____%) to be effective from _______________ (month/day/year) until automatic repeal date specified.
A local sales and services tax shall be imposed in the following cities at the rate of _____ percent ( _____%) to be effective from _____________ (month/day/year) until the date specified below and the revenues from the sales and services tax are to be allocated as follows:
FOR THE CITY OF  	 :
The tax shall be repealed on _____________ (month/day/year).
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
FOR THE CITY OF  	 :
The tax shall be repealed on _____________ (month/day/year).
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
FOR THE CITY OF  	 :
The tax shall be repealed on _____________ (month/day/year).
_______________ for property tax relief (insert percentage or dollar amount)
The specific purpose (or purposes) for which the revenues shall otherwise be expended is (are):
	 21.801(2) For a local vehicle tax:
(Insert letter to be assigned by the commissioner)
SHALL THE FOLLOWING PUBLIC MEASURE BE ADOPTED?  	 YES □
NO □
Summary: To authorize the county of (insert name of county) to impose a local vehicle tax at the rate of _____ dollars ($_____) per vehicle and to exempt the following classes from the tax:
	 .
The revenues are to be expended as set forth in the text of the public measure.
(Insert in substantially the following form the entire text of the proposed public measure immediately below the summary on all paper ballots as provided in Iowa Code section 49.45, or place on the left-hand side inside the curtain of each voting machine as provided in Iowa Code section 52.25.)
The county of _______________, Iowa shall be authorized to impose a local vehicle tax at the rate of _________ dollars ($______) per vehicle and to exempt the following classes of vehicles from the tax:
	
____________ (insert percentage or dollar amount) of the revenues is/are to be used for property tax relief.
The balance of the revenues is to be expended for:
(List purposes for which remaining revenues will be used)