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The ballots to be used at a special election hereunder shall be in substantially the following form:

“Shall _______________ (Name of Consolidated

Gravity Drainage District) assume the outstanding

bonded and other indebtedness of (Designation

of district or districts debt or debts to be assumed)

as follows: ________________(Amount)

YES

[  ]

Taxable Valuation: $_______________

NO

[  ]

______________________________________

(Signature of Voter)

Notice to Voters:  To vote in favor of the proposition submitted on this ballot, place a cross (X) mark in the square opposite the word ‘YES’; to vote against it, place a similar mark opposite the word ‘NO.’ “