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Special District Election Forms and Sample Documents

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Forms and Sample Documents

Important Note:
2008 Manual forms have been revised. See list of forms below.

Listed Alphabetically
Listed by Form Number

The division of local government created and collected these forms and sample documents as a convenience to special districts to meet their statutory election requirements. These forms were written using relevant statutory citations and secretary of state rules that govern elections and campaign and political finance. Many of the election documents and samples enclosed were created, in part, with assistance from other special district governments. Special districts are not required to use all of these specific forms. However, a district wishing to develop its own documents may want to consult with legal counsel for guidance.

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

Abstract of Votes - Judge’s Unofficial - REVISED

B-63

Acceptance of Appointment & Certification of Qualification
of Election Judge - REVISED

B-33

Affidavit of Intent to be a Write-In Candidate - REVISED

B-76

Application for Mail-in Ballot - REVISED

B-2



Ballot Log

B-61

Bond - Sample

B-74

Budget Worksheet

B-1


Call for Nominations - REVISED

B-6

Campaign & Political Finance Memo for Candidates - REVISED

B-8

Canvassers Certificate of Abstract Votes Cast/
Certificate of Results - Replaces B-70 and B-72 - REVISED

B-70
Certification of Appointment of Election Judges - REVISED

Certificate of Election - Initial Notice to Winning Candidates - REVISED

B-79

Certificate of Election - Formal Notice After Oath &
Bond Complete - REVISED

B-80



Designated Election Official Appointment - REVISED

B-5

District Contact Data and Director’s List - REVISED

B-75



Election Resolution - Sample - REVISED
Election Resolution - Sample - REVISED

Emergency Mail-In Ballot Application

B-77




Judge’s Pay Sheet - Expense Bill

B-67



Letter - Request to Assessor for Property Owner’s List - REVISED

B-31

Letter - Request to Clerk & Recorder for Voter Registration - REVISED

B-32

Letter - Request to SOS for Mail Ballot Plan Extension - REVISED

B-10



Mail Ballot - Certificate of Election Returns and
Statement of Ballots - REVISED

B-66

Mail Ballot Plan - Including Mail-In Envelope- REREVISED

B-11 Thru B-26

Mail Ballot Pollbook -NEW
Mail Ballot Log -NEW
Mail Ballot Record and Reconciliation -NEW
Mail-In Elector Affirmation at Polling Place - NEW
Mail-In (Formerly Absentee) Record of Applications
Cover Page - REVISED
Mail-In (Formerly Absentee) Record of Applications and
Ballot Log - REVISED

Master List of Election Judges for Polling Place

B-34



Notice - Mail Ballot Election - REVISED

B-41

Notice - Polling Place Election - REVISED

B-45

Notice of Cancellation & Certified Statement of Results - REVISED

B-27

Notice to Elector Who Casts Provisional Ballot - NEW


Oath Of Canvasser

B-43

Oath of Election Judge - REVISED

B-35

Oath of Office - Board of Directors - REVISED

B-73



Polling Place - Assistance for Electors with Disabilities Sign - REVISED

B-52

Polling Place - Certificate of Election Returns and
Statement of Ballots - REVISED

B-64

Polling Place - Disabled Voter Assistance Form - REVISED

B-57

Polling Place - Instructions To Voters (Instruction Card) - REVISED

B-51

Polling Place - Items/Signs to be Posted at Polling Place

B-49

Polling Place - No Electioneering Sign - REVISED

B-50

Polling Place - Non-English Voter Assistance Form - REVISED

B-58

Polling Place - Oath of Challenged Voter -REVISED

B-60

Polling Place - Poll Book - REVISED

B-53

Polling Place - Provisional Ballot - Affidavit Side - REVISED

B-55.1

Polling Place - Provisional Ballot Envelope -
Voter Information Side - NEW

Polling Place - Receipt for Return of Election Materials

B-68

Polling Place - Self Affirming Oath or Affirmation of Elector - REVISED

B-54

Polling Place - Sign - REVISED

B-44

Polling Place - Voter Challenge - Property Owner - REREVISED

B-59

Polling Place Set Up - Diagram

B-48

Provisional Ballot Log - REVISED

B-69



Recounts - Scenarios and Equation for Calculating Need

B-71

Request for Replacement Mail-in Ballot - REVISED

B-40.1

Request for Mail Ballot - NEW
Resolution of Cancellation of Election by DEO - REVISED
Resolution of Cancellation by Board of Directors - NEW


Sample Ballot for Polling Place Election - REVISED

B-28.1
Sample Ballot for Mail Ballot Election - REVISED

Self Nomination and Acceptance Form - REVISED

B-9



Tally Sheet - Counting Form - REVISED

B-62



Watcher - Certificate of Appointment & Oath - REVISED

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Forms and Sample Documents

The division of local government created and collected these forms and sample documents as a convenience to special districts to meet their statutory election requirements. These forms were written using relevant statutory citations and secretary of state rules that govern elections and campaign and political finance. Many of the election documents and samples enclosed were created, in part, with assistance from other special district governments. Special districts are not required to use all of these specific forms. However, a district wishing to develop its own documents may want to consult with legal counsel for guidance.

B-1 through B-9 | B-10 through B-29 | B-30 through B-39 | B-40 through B-49

B-50 through B-59 | B-60 through B-69 | B-70 through B-79 | B-80 through B-81

Budget Worksheet
Application for Mail-In Ballot - REVISED
Application for Permanent Mail-In Voter Status - REVISED
Election Resolution - Sample - REVISED
Election Resolution - Sample - REVISED
Designated Election Official Appointment - REVISED
Call for Nominations - REVISED
Campaign & Political Finance Memo for Candidates - REVISED
Self Nomination and Acceptance Form - REVISED


Letter - Request to SOS for Mail Ballot Plan Extension - REVISED
Mail Ballot Plan - including Mail-In Envelope- REREVISED
Notice of Cancellation & Certified Statement of Results - REVISED
Sample Ballot for Polling Place Election- REVISED
Sample Ballot for Mail Ballot Election - - REVISED


Letter - Request to Assessor for Property Owner’s List - REVISED
Letter - Request to Clerk & Recorder for Voter Registration - REVISED
Acceptance of Appointment & Certification of Qualification of
Election Judge - REVISED
Master List of Election Judges for Polling Place
Certification of Appointment of Election Judges - REVISED
Oath of Election Judge - REVISED
Mail-In (Formerly Absentee) Record of Applications
Cover Page - REVISED
Mail-In (Formerly Absentee) Record of Applications and
Ballot Log - REVISED


Request for Replacement Mail-in Ballot - REVISED
Request for Mail Ballot - NEW
Notice - Mail Ballot Election - REVISED
Oath Of Canvasser
Polling Place - Sign - REVISED
Notice - Polling Place Election - REVISED
Watcher - Certificate of Appointment and Oath - REVISED
Polling Place Set Up - Diagram
Polling Place - Items/Signs to be Posted at Polling Place


Polling Place - No Electioneering Sign - REVISED
Polling Place - Instructions To Voters (Instruction Card) - REVISED
Polling Place - Assistance for Electors with Disabilities Sign - REVISED
Polling Place - Poll Book - REVISED
Polling Place - Self Affirming Oath or Affirmation of Elector - REVISED
Polling Place - Provisional Ballot - Affidavit Side - - REVISED
Polling Place - Provisional Ballot Envelope -
Voter Information Side - NEW
Notice to Elector Who Casts Provisional Ballot - NEW
Mail-In Elector Affirmation at Polling Place - NEW
Polling Place - Disabled Voter Assistance Form - REVISED
Polling Place - Non-English Voter Assistance Form - REVISED
Polling Place - Voter Challenge - Property Owner - REREVISED


Polling Place - Oath of Challenged Voter -REVISED
Mail Ballot Pollbook -NEW
Mail Ballot Log -NEW
Mail Ballot Record and Reconciliation -NEW
Tally Sheet - Counting Form - REVISED
Abstract of Votes - Judge’s Unofficial - REVISED
Polling Place - Certificate of Election Returns and
Statement of Ballots - REVISED
Mail Ballot - Certificate of Election Returns and
Statement of Ballots - REVISED
Judge’s Pay Sheet - Expense Bill
Polling Place - Receipt for Return of Election Materials
Provisional Ballot Log - REVISED


Canvassers Certificate of Abstract Votes Cast/
Certificate of Results - Replaces B-70 and B-72 - REVISED
Recounts - Scenarios and Equation for Calculating Need
Oath of Office - Board of Directors - REVISED
Bond - Sample
District Contact Data and Director’s List - REVISED
Affidavit of Intent to be a Write-In Candidate - REVISED
Emergency Mail-In Ballot Application
Certificate of Election - Initial Notice to Winning Candidates - REVISED


Certificate of Election - Formal Notice After Oath &
Bond Complete - REVISED
Resolution of Cancellation of Election by DEO - REVISED
Resolution of Cancellation by Board of Directors - NEW

 

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