The municipal clerk shall provide ballots for each voter at such election, to be printed upon plain, substantial white paper, in substantially the following form:

“To vote upon the public question printed below, if in favor thereof mark a cross (X) or plus (+) in the square at the left of the word YES, and if opposed thereto mark a cross (X) or plus (+) in the square at the left of the word NO.

“Shall chapters 70 to 76 of the title

[ ] YES Municipalities and Counties of the Revised

Statutes (s. 40:70-1 et seq.), providing

[ ] NO for the commission form of government,

be adopted in ……………….. (here

insert name of municipality)?”