California Code, Streets and Highways Code - SHC § 2951

The notice of proposed assessment shall be substantially in the following form (filling in the blanks):

Notice is hereby given that the (name of the legislative body) proposes to adopt a resolution of intention under the (here mention statute under which it proposes to proceed) covering (here state in general terms what acquisitions and/or improvements are to be made).  Your land will be assessed to pay a part of the cost thereof.  This questionnaire is sent to the property owners interested to ascertain whether or not the owners of as much as 15 per cent of the area of the proposed district demand proceeding under the “Special Assessment Investigation, Limitation and Majority Protest Act of 1931.”  Under said investigation act information will be obtained and a report thereon made, open to public inspection, and stating among other things (1) the estimated cost of the proposed project;  (2) the estimated amount of existing assessments upon each parcel of land in the district;  (3) the estimated assessment upon your lands for the proposed project.  In the event that you desire the proceeding under said investigation act, so indicate on the attached card and return the same to the clerk within 30 days from (here set forth the date, not earlier than one day subsequent to the mailing of the cards).  Sign your name legibly and describe or designate the property owned by you.

                    (does)

Instruction:  If you are in favor of the improvement without the investigation report strike out the word “does.”  If you desire the investigation report, whether or not you desire the improvement, strike out the words “does not.”