| E.__The referendum to be voted on must be worded |
| substantially as follows: "As an owner of property in the |
| proposed capital improvement district described on the |
| reverse side of this ballot or in the attachment to this |
| ballot, are you in favor of authorizing the municipality |
| of _______ to apply a special assessment against the |
| property you own in the proposed capital improvement |
| district for a period of ____ years, for the purpose of |
| (description of improvements), with the total assessment |
| to all property owners within the capital improvement |
| district not to exceed $___________, plus a contingency of |
| no more than 25% of that assessment, all of which are |
| subject to the property tax collection and lien procedures |
| established by state law, and with said authorization |
| contingent on the voters of the municipality of _________ |
| accepting the public costs for the capital improvement |
| district improvements before any work is done, |
| specifically described as (description of public |
| elements)?" |