2003-R-12
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RESOLUTION NO. 2003-R-12
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
EDGEWATER, FLORIDA, ESTABLISHING SECURITY
PROCEDURES FOR ABSENTEE BALLOTS; REPEALING
ALL RESOLUTIONS IN CONFLICT HEREWITH AND
ESTABLISHING AN EFFECTIVE DATE.
WHEREAS, the City of Edgewater desires to maintain the highest standards of adherence
to pertinent State election laws and to maintain the highest integrity regarding the administration of
local municipal elections; and
WHEREAS, in 1995 the Legislature applied the election code to municipalities; and
WHEREAS, it behooves the City Council of the City of Edgewater to establish security
procedures regulating the issuance, maintenance and completion of absentee ballots in municipal
elections.
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Edge water,
Florida:
Section 1.
The City of Edge water hereby establishes procedures regarding the issuance,
maintenance and completion of absentee ballots in municipal elections as set forth in Exhibit "A"
which is attached hereto and incorporated by reference.
Section 2.
If any section, sentence, clause or phrase of the established procedures are held
to be invalid or unconstitutional by any court of competent jurisdiction, then said holding shall in
no way affect the validity of the remaining portion of said procedures.
Section 3.
A copy of this Resolution shall be forwarded to the V olusia County
Supervisor of Elections by the City Clerk.
Section 4.
All resolutions or parts of resolutions in conflict herewith be and the same are
2003-R-12
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hereby repealed.
Section 5. This resolution shall take effect immediately upon adoption.
After Motionby Councilman Brown and Secondby Councilwoman Lichter
the vote on this resolution is as follows:
AVE NAY
Mayor Donald A. Schmidt x
Councilman James P. Brown x
Councilman Myron F. Hammond x
Councilwoman Harriet E. Rhodes x
Councilwoman Judy Lichter x
PASSED AND DULY ADOPTED this 7" day of July, 2003.
ier
For the use and reliance only by the City of
Edgewater, Florida. Approved as to form and
legality by: Scott A. Cookson, Esquire
City Attorney
Foley & Lardner
2003-R-12
2
CITY COUNCIL OF THE
CITY OF EDGEWATER, FLORIDA
By: 02�
Donald A. Schmidt
Mayor
Robin L. Matusick
Legal Assistant/Paralegal
Approved by the City Council of the City of
Edgewater at a meeting held on this r
day of July , 2003 under Agenda Item
No. 6
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EXHIBIT" A"
CITY OF EDGEWATER
SECURITY PROCEDURES REGARDING ABSENTEE BALLOTS
POLICY: ISSUANCE OF ABSENTEE BALLOTS
Based upon Section 101.62, Florida Statutes, and the City's intent to maintain the highest
standards of adherence to pertinent State election laws and to maintain the highest integrity in
the administration of local municipal elections, the following policy shall be adhered to by the
City of Edgewater regarding the issuance, maintenance and completion of absentee ballots for
municipal elections.
1. The City Clerk, designated as the Chief Elections Officer of the City, shall be responsible
for all security procedures relating to the issuance, maintenance and completion of
absentee ballots for the City of Edgewater elections. The City Clerk shall be authorized
to delegate any or all of the said responsibilities to the V olusia County Supervisor of
Elections; whereby, security procedures as set forth by the Supervisor of Elections for
Volusia County shall take precedence.
2. In advance of City of Edgewater municipal election dates and in accordance with
prescribed election law, the Chief Elections Officer in conjunction with the Volusia
County Supervisor of Elections shall correspond with registered voters living outside of
V olusia County to provide written notice of a scheduled election in order that the elector
may make a request for an absentee ballot.
3. The Chief Elections Officer shall sign for receipt of ballots on the appropriate form
supplied by the V olusia County Department of Elections, and the ballots shall be inspected
for numerical sequence and completeness. The Chief Elections Officer shall deposit the
absentee ballots and all accompanying pertinent materials in a locked cabinet located
within the City Hall vault. The Chief Elections Officer shall remove the ballot materials
from the locked cabinet for the purpose of issuance, maintenance and completion of
ballots, returning the ballots to the security of the locked cabinet upon execution of
assigned work involving said ballots. The Chief Elections Officer and her designee will
have sole custody of the key to the cabinet.
4. Requests for absentee ballots from registered voters in good standing, within the
municipal boundaries of the City of Edge water, or from a person designated by the elector
to make such a request, shall be accepted by the Chief Elections Officer in person, by mail,
by telephone or by facsimile machine. All such requests shall be placed on the Absentee
Ballot Request Form attached hereto as Exhibit 1, by the elector, if in person, or by the
Chief Elections Officer, ifthe request is made by telephone, facsimile machine or through
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written correspondence. All requests made by facsimile machine or through written
correspondence shall be appended to an Absentee Ballot Request Form which shall be
executed by the Chief Elections Officer.
5. The Chief Elections Officer shall make every effort to determine if a request for an
absentee ballot is, in fact, made by or for a registered voter in good standing within the
municipal boundaries ofthe City of Edge water by ascertaining that the petitioner/elector
is so listed on the current Volusia County Registered Voter's List as compiled by the
Volusia County Department of Elections at the close of the voter registration books in
accordance with prescribed law prior to said election. Said confirmation shall be made
in a timely manner so as not to impede the delivery of the absentee ballots to the
petitioner/elector.
6. The Chief Elections Officer shall provide anyone requesting an Absentee Ballot the
Request Form provided by the V olusia County Department of Elections, but shall only
accept said forms when fully executed and signed by an elector/registered voter whose
name is in good standing with the Volusia County Department of Elections as a registered
voter within the corporate limits of the City of Edgewater, as set forth in paragraph 5.
"In the case of a request being submitted for a voter, by an immediate family member or
legal guardian, it shall not be necessary for the voter to sign the request; however, the
form must be signed by the requestor." In the event said request form is returned without
pertinent information and/or the signature of the elector/registered voter, the Chief
Elections Officer shall make an effort to contact the petitioner concerning these matters.
7. In the event it is determined that the petitioner/elector is not on the current printed
Volusia County Registered Voter's List as set forth in paragraph 5, the Chief Elections
Officer shall, in a timely manner, contact the Volusia County Department of Elections by
telephone to ascertain whether said petitioner/elector is a registered voter in good standing
within the corporate limits of the City of Edgewater and shall proceed according to the
information supplied by the Volusia County Department of Elections as to whether an
absentee ballot shall be mailed or provided in person to the petitioner.
8. In the event the Chief Elections Officer determines the petitioner is not a registered voter
in good standing as set forth in paragraph 7, the Chief Elections Officer shall make every
effort via telephone or by mail to notify the petitioner that an absentee ballot will not be
forwarded and that the petitioner should contact the Volusia County Department of
Elections concerning the status of their voter registration.
9. If the Chief Elections Officer determines that a request for an absentee ballot is being
made by a petitioner who has moved outside the corporate limits ofthe City of Edge water,
and said petitioner has not changed his or her voter registration to the new precinct, the
Chief Elections Officer shall notify the petitioner, verbally or in writing, that said
petitioner must contact the Volusia County Department of Elections and vote in
accordance with prescribed election law. The Chief Elections Officer shall not knowingly
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provide an absentee ballot to any registered voter who no longer resides within the
corporate limits of the City of Edgewater and has failed to notify the V olusia County
Department of Elections that he or she is residing in a new precinct.
10. Upon the production of satisfactory personal identification, including signature and photo
I.D. by the petitioner the Chief Election Officer shall issue an absentee ballot to the
petitioner if the petitioner/elector's name is found to be in good standing with the Volusia
County Department of Elections as set forth in paragraph 5. Should the elector fail to
have acceptable photo and/or signature I.D. the voter will be supplied with an affirmation
form (see attachment) then he/she must complete prior to being issued an absentee ballot.
All such actions shall be listed by the Chief Elections Officer within the comment section
of an absentee ballot log.
11. The Absentee Ballot Log, attached hereto as Exhibit 2, shall be maintained by the Chief
Elections Officer for the purpose of tracking the request, distribution and return of all
absentee ballots, and shall include a comment section for notations as to the reason for any
request to receive an absentee ballot made by an individual other than the elector or the
petitioner/elector's immediate family or to note any irregularities ascertained in
determining an elector's standing with the Volusia County Department of Elections as
set forth in paragraph 5. Ballots picked up by the elector or hislher designee shall be so
noted within the comment section of the absentee ballot log. Said ballots may not be
picked up and taken from the office prior ro four days before the election.
12. Requests for absentee ballots to be picked up by a person designated by the elector and
delivered by that designee to the elector shall be accepted under the following conditions:
A) The designee must provide written authorization from the elector, naming the
designee and specifying for which election the absentee ballot is being requested.
A copy of the authorization shall be sent by facsimile machine to the Supervisor
of Elections for verification of the voter's signature. Such written permission shall
be appended to the City's approved absentee ballot request form.
B) A designee is limited to pick up and deliver a total of two absentee ballots per
election, other than the designee's own ballot, except that said designee may pick
up additional ballots for members of the designee's immediately family as set forth
in Section 101.62(4)(b), Florida Statutes. A primary and a general election shall
be considered as separate elections.
C) Said designee shall provide personal picture identification in the form ofa driver's
license, or other similar identification deemed sufficient by the Chief Elections
Officer and shall complete the Absentee Ballot Designee Affidavit prior to
picking up any absentee ballot as set forth above. The Absentee Ballot Designee
Affidavit is attached hereto as Exhibit 3.
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D) In addition to listing on the Absentee Ballot Log the name of the elector to whom
the absentee ballot is being issued, a log listing said designee, shall be maintained.
This log attached hereto as Exhibit 4, which shall also include the name and voter
identification number of those electors for whom the petitioner has picked up
absentee ballots to assure that no petitioner picks up more than two ballots as set
forth in paragraph 12(B).
13. The Chief Elections Officer shall only provide an absentee ballot to a candidate for use by
the candidate personally or for a member of said candidate's immediate family after the
conditions in paragraph 12 have been met.
14. The Chief Elections Officer shall not determine the identity of any petitioner who claims
to be a registered voter within the corporate limits of the City of Edgewater except
through petitioner's production of personal identification. The Chief Elections Officer
shall determine if the petitioner is a registered voter as prescribed in paragraph 7, prior
to issuing an absentee ballot in person to a petitioner.
15. The Chief Elections Officer shall provide by facsimile, copies of all requests for all
absentee ballots to the Volusia County Department of Elections daily for all voters within
the City's boundaries to the Chief Elections Officer. When there is a County and City
election held the same year, the Chief Elections Officer shall compare such requests with
the Absentee Ballot Log to assure that duplicate ballots are not mailed to the
petitioner/elector.
16. The Chief Elections Officer shall compare signatures on all fully executed, returned
absentee ballots with the registered voters' signatures on file in the Volusia County
Department of Elections prior to the counting of the absentee ballots. Any returned
absentee ballots which come under question by the Chief Elections Officer as a result of
missing or questionable information on the absentee ballot, including signatures, shall be
presented to the canvassing board, consisting of the Chief Election Officer or her designee
and the City Attorney or her designee, for a final decision concerning the acceptance or
denial of the absentee ballots.
17. After the returned absentee ballots are received by the Chief Elections Officer and prior
to transport to the Volusia County Department of Elections, the ballots will be reconciled
against the Absentee Ballot Log. The Chief Elections Officer shall also reconcile the
number of absentee ballots originally received from the Volusia County Department of
Elections with the number of absentee ballots provided to electors and the number of
absentee ballots remaining to be returned to the Volusia County Department of Elections,
using the Ballot Report Form supplied by the Volusia County Department of Elections
and attached hereto as Exhibit 5.
18. Absentee ballots will be accepted by the Chief Elections Officer at the Edgewater City Hall
until 7:00 p.m. on the night the election is held. The Chief Elections Officer or her
4
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designee, and the City Attorney or her designee shall hand carry returned absentee
ballots, as well as any relevant materials as required by the Volusia County Department
of Elections, to the Volusia County Department of Elections as soon as possible after 7
p.m. on the night of the election. The names ofthe persons transporting ballots and their
time of departure and arrival shall also be recorded with the Edgewater Police
Department. As an alternative, the Chief Elections Officer may contract with the V olusia
County Department of Elections to transport absentee ballots that have come in by 5:00
p.m.
19. Upon the arrival at the Volusia County Department of Elections, the Chief Elections
Officer or her designee and City Attorney or her designee, shall tabulate absentee ballots.
If there is any discrepancy, all steps necessary to correct any imbalance will be taken,
including but not limited to: hand counting absentee ballot envelopes and double checking
each envelope to ensure that all ballots have been removed. The Chief Elections Officer
shall return all unvoted and voted ballots to the Volusia County Department of Elections
for their custody for the required retention period and shall return all other related
election supplies, secrecy envelopes, mailing envelopes, etc. to the Volusia County
Department of Elections and provide a xerox copy of the absentee ballot log to the Volusia
County Department of Elections at the time of the absentee ballot canvassing.
20. The City Council, shall, in accordance with the City Charter, be the judge of the election
and shall within 3 days after said election, canvass the election returns and declare the
results. When the City is riding with the County in a County wide election the County
canvassing board shall canvass the election returns and the City shall ratify the results.
21. The Chief Elections Officer may delegate various aspects of work relating to the issuance
of absentee ballots to support staff in her absence; however, it is the goal of the City
Clerk/Chief Elections Officer to limit the handling of absentee ballots and pertinent
materials relating to said work to as few individuals as possible in order to maintain
integrity in the absentee balloting system and eliminate any possibility for miss
communication or error.
Election-b:exhiblt.2003
5
Exhibit 1
ABS SWTEE BALLOT REQUEST FORM - F. S.. dI.62
SECTION I- ELECTOR INFORMATION
Voter ID: Party: Precinct:
Name: (last) (first) (middle)
Date of Birth: 1 I Phone Number - -
Residence Address:
Street Addreee, A,drientp City Zip Cade
Permanent Mailing Address:
are ,ft—Bowl Street Ad ,Apertaenf#
City: State: _ _Zip Code'. _ _ _ _ _
Signature of Elector:
(lfresmN rotreaen over Nealepiwne)
SECTION S. IWUNO INFORMATION
MAIL BALLOTS TO:
SECTION S • ELECTION INFORMATION
THIS REQuEsr is MR:
Daytona Beach Shores 2/11/03 ❑ Primary Election 10/07/03 ❑ General Election I IM/03 ❑
All of the elections an elector is eligible to vote in during the 2003 calendar year ❑ Other
SECTION 4. REOUESTOR INFORMATION
THE PiHsoN MAKING THE REQUEST FOR THE ELECTOR IS:
A member of Elector's immediate family ❑ Elector's legal guardian ❑
If someone other than Elector is nuking the request, has Elector given instructions to request an absentee ballot? _
Please provide the following information if someone other than the Elector is making the request.
Requester's Name:
Requester's Address:
Requester's Driver License # u..+..n. Relationship m the Elector:
Requester's Signature:
Ifm uee� nauekon wort nc� tcic Iwne)
A 6POR OPFmE U86OM.
C rsc. A .T ADDRESS: ❑ CHANGE OF lil w ADDRESS: ❑
IN PERGE ❑ STATUS: UC ❑ UM ❑ OM❑ OC QA
BsasSlMade Request takM*:_ Dace: Daterequcslgiveuto RegistmHon:
Office In ❑ Request 1" proofed by: Date: Request given to:
❑
By TelephoTelephoneRisI.stkeyedby:_ Dde: -
❑PerWing Action:
By Mail
Request 2n° proofed by: _ Due:
❑
By &Mail
By FAX ❑ Request Filed under Date: Date request retained by Regiswum
Delivered by P Parry ❑ Reason for not filling regresu
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VOLUSIA COUNTY DI FAK1ML' N 1 Ur
136 N. FLORIDA AVENUE, DELAND, FL 32720
MUNICIPAL IN -OFFICE VOTER CERTIFICATE
VOTER OATH -F S.101.64
I , a n a qualified elector in this election and registered voter of Volusia County,
Florida. I do solemnly swear or affirm that I am the person so listed on the voter registration rolls of Volusia
County and that I reside at the address listed below. I understand that if I commit or attempt to commit fraud in
connection with voting, vote a fraudulent ballot, or vote more than once in an election I could be convicted of a
felony of the third degree and both fined up to $5,000 and imprisoned for up to five (5) years. I understand that my
failure to sign this certificate and have my signature witnessed invalidates my ballot.
VO SSIGNATVaE DALE SIGNED
N�.ne: Qau) (6nt)
(Plu,a P�
S.FL tipcMd:____..
se complete this section if this is a replacement ballot by checking -off the appropriate box.
I previously requested an Absentee Ballot and the ballot was (please check one):
Destroyed ❑ Spoiled ❑ Lost ❑ Not Received ❑
VOTER INFORMATION
VOTERID# PARTY PItECINCI'
T OF[ E RCATION PBONDw IDEMIFlGTION M
r r • ELECTION BALLOT INFORMATION
NM OFInEEI CN BA SIYLE
DATEOF.11.N BALLOTSNBSEBIALp
• P • P MUNICIPAL WITNESS INFORMATION
a'ITNESS SIGNAIVRE (SNNIGPAL OFFlGAy
Flt'NICIPAL ADO ccc (mmpine.wr,9`
Tg vik pynsU�iukgyvisVv-0Eluvar C,niBtre.CYrwY bwnirnadx
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Florida Statute 101.657
Voting absentee ballots in person. — 2(a) The elector must provide picture
identification and must complete an In -Office Voter Certificate ...
The-Munidpalln-Ofea Voter Certificate must be issued to each voter who desires to
vote an absentee ballot in person in accordance with F.S. 101.657-2(a). Give the
form to the voter and instinct them to read the oath. Ask them to print, sign,
and date it where indicated. Have the voter fill in their complete residence
address where indicated on the form.
Ask the Voter to provide one of the accepted forms of ID as listed on the `Please
Present Photo And Signatua Identification"sign. In the "Voter Information" section,
fill in the type of ID provided by the voter and write the ID number in the space
provided.
Fill in the "Election / Ballot Information" section, indicating the name and date
of the election. Complete the 'Ballot Style" and `Ballot Stab Serial #" as the
ballot is issued.
Complete the "Municipal Witness Information" section by signing your name
and writing (or using your city address stamp) the address at which you are
located
Attach the stub to the certificate with a paper clip for return to the elections
office. Return all certificates with the corresponding stubs to the Elections
Office on Election Day.
I
l
E.h E,it 3 AFFIDAVIT
FOR A DESIGNEE
TO OBTAIN AN ABSENTEE BALLOT
Florida Statute §101.62(4)(b) TODAY'S DATE
Month Day Year
Voter's Last Name First Name Middle NameAnitial
I HAVE BEEN AUTHORIZED BY
WHOSE VOTER IDENTIFICATION NUMBER IS
Election
TO OBTAIN AN ABSENTEE BALLOT FOR THE
1 HEREBY CERTIFY THAT
❑ I AM NOT A MEMBER OF THE ABOVE VOTER'S IMMEDIATE FAMILY.
❑ I AMA MEMBER OF THE ABOVE VOTER'S IMMEDIATE FAMILY AND MY RELATIONSHIP TO
THE VOTER IS
1 UNDERSTAND THAT ANY PERSON WHO PERPETRATES ANY FRAUD IN CONNECTION WITH ANY VOTE TO BE
CAST VIOLATES FLORIDA STATUTES AND CAN BE CONVICTED OF A FELONY OF THE THIRD DEGREE AND
FINED UP TO $5,000 AND/OR IMPRISONED FOR UP TO FIVE (5) YEARS.
UNDER PENALTIES OF PERJURY, 1 DECLARE THAT I HAVE READ THE FOREGOING AFFIDAVIT AND THAT THE
FACTS STATED IN IT ARE TRUE.
DESIGNEE'S NAME PRINTED DATE OF BIRTH
LAST NAME FIRST NAME MONTH DAY YEAR
VOTER IDENTIFICATION # STATE DRIVER'S LICENSE NUMBER
m
Exhibit 4
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Absen ve Ballots - Designer Pickup
101.62 Request for absentee ballots.--
4. By delivery to a designee on election day or up to 4 days prior to the day of an election. Any
elector may designate In writing a person to pick up the ballot for the elector; however the
person designated may not pick up more than two absentee ballots per election, other than the
designee's own ballo4 except that additional ballots may be picked up for members of the
designee's Immediate family. For purposes of this section, "Immediate family" means the
designee's spouse or the parent, child, grandparent, or sibling of the designee or of the designee's
spouse. The designee shall provide to the supervisor the written authorization by the elector and a
picture Identification of the designee and must complete an affidavit. The designee shall state in
the affidavit that the designee Is authorized by the elector to pick up that ballot and shall Indicate
If the elector Is a member of the designee's Immediate family and, If so, the relationship. The
department shall prescribe the form of the affidavit. If the supervisor Is satisfied that the designee
Is authorized to pick up the ballot and that the signature of the elector on the written
authorization matches the signature of the elector on file, the supervisor shall give the ballot to
that designee for delivery to the elector.
OVERVIEW
1.) No Ballot may be taken out of the designated Elections Office prior to 4 days before an elation
(the Friday before the Election Day).
2.) A person may NOT take out a ballot for the purpose of voting it him or herself
(See F.S. 101.657(1).
3.) The maximum number of ballots per election that maybe picked up
a; For Immediate Family Members —No limit 1
b'. For Non -Family Members-2 -
4) Requirements for picking up a ballot
a. Designee must have written permission from the voter
b. Written permission must state the person by name.
c. Written permission must be signed by the voter & signature must be verified
d. Person designated to pick up the ballot must have a SIGNED PICTURE ID
e. The Designee must complete an affidavit stating that they arc authorized by the elector to
pick up a ballot, what relationship (if any) the am to the voter and must present a signed
picture ID.
MUNICIPAL INSTRUCTIONS
1) Confirm that the Designee has written permission it= the voter containing the required infomation
2) Ask to see the Designee's signed picture ID and check the 'Ust of Absentee Ballot Pickup Designee &
Voters" form to verify that the voter has not exceeded the pickup limit
3) Give the Designee the "Affidavit For Designee To Obtain An Absentee Ballot" form w complete
4) While the Designee is completing the form, call the Elections Office to tiler that you will be fang them a
copy of the written permission so that they may verify the signature. Please include the "tees M number on
the fax. (Elections Office FAXJ86-7408850)
5) Once the Elections Office has verified the votees signatuse, issue the ballot to the Designee
6) Before putting the ballot, secrecy envelope and affidavit envelope into the outer envelope, explain to. the
Designee how the voter is to fill out the affidavit envelope and that the ballot most be retumed so that the.
Elections Office receives it by 7:00pm on Election Day.
7) Complete the "List of Absentee Ballot Pickup Designee & Voters" form
8) Attach the permission note to the completed "Affidavit For Designee To Obtain M Absentee Ballot" form.
9) Complete the "Record of Absentee Voters" form, indicating the weds name to which the ballot was issued.
10) At the end of the day, note all ballots issued that day for pickup in column #5 on the "Absentee Ballot
_. _ Da0y_Repnr_'_fnrm._.
Exhibit 5
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INSTRUCTIONS
•
Request for absentee ballots. (3) For each request for
an absentee ballot received, the supervisor shall record
the date the request' was made, the date the absentee
ballot was delivered or mailed, the date the ballot was
'received by the supervisor, and such other Information
he or she may deem necessary.
The "Record Of Absentee Voters — Municipalities" must be completed and
faxed to the Elections Office at the end of each day during which a ballot
was issued in compliance with F.S. 101.62. It is not necessary, however, to
start a new form for each day. Just continue to add names to the list of those
residents of your city who come into your office and vote by absentee ballot
This includes those ballots that are picked up by a third party for someone
else. When a ballot is picked up for another person, make sure that you list
the name of the person for whom the ballot is for on this form, not that of
the person picking up the ballot
So that we may keep an accurate record of those voters who have been
issued an absentee ballot, it is necessary that you fax a copy of the form to
the elections office at the end of every day during which ballots have been
issued. If the ballot was voted in your office, note the same date in the
"Ballot Issued" and 'Ballot Retumed" columns. If someone picked up a
ballot for another person, write the persons name and address for which the
ballot is for in the "Voter Name" and "Voter Residence" columns and
complete the "Date Ballot Issued" column. However, do not complete the
"Date Ballot Returned" column until the voted ballot has been returned to
your office.
Before faxing the form, note the date in the "Date Faxed To Elections
Office column. Use the Elections Division FAX number (386-740-8850)
and not the main office FAX number when sending this form
K:\Abm,.\Kato Hum\Word rde\Bk k Fonm\bfurvop•Gdn\RecoA of Ab,.w V.h1widp4,W vA Imuucuau.doc
INSTRUCTIONS
FOR
ABSENTER BAT.T Q DATT Y RFPORT - M NTLIP T ITTFS
The purpose of this form is account for all ballots that are used during any given day. At the
beginning of each day, you will note the "Beginning Ballot Serial Number' in Column 8 of the form.
At the end of the day, list all of the ways ballots were issued during the day (Voted, Provisional,
Spoiled and Picked -Up) in the appropriate Columns. Then add these numbers together and write
the total number in Colurnn 7. Now note the "Ending Ballot Serial Number" in Column 9.
Subtract the number in Column 8 from the number in Column 9. Write the number in Column 10.
This number should be the same as the number in Column 7. Repeat this process every day, for all
ballot styles you have been issued, even if you have not issued any ballots so as to ensure that no
ballots are unaccounted for on a daily basis.
BALLOT STYLE --► f '" � �---- SERLA.L NUMBER
ABSENTEE BALLOT DAILY REPORT —MUNICIPALITIES
MUNICIPALITY: Daytona Bach Shorts
ELECTION/DATE: Fe H. 2OD3'
Col—.1
11 Column ]
111 Colutm 3
III Column 4 11M.—M-7111Colutm
6
Column 7
Columm B
Colunm 9
Columm 10
Total No.
No.O[
No.Of
No. Of
No.Of
Of BallotsBallot
Ikeinning
EMing
Day/Date
Style
BallonPmsisicnal
11
Ballots
BalloB
Banat
1,
nil
V.
Ballots
Spoiled
P'cked-Up
Cd.3,
�
Sedal Na
serial No.
IT
o1On
L1
0001
4
0 1
0
5
00048
1 0053
5
0002
1
0 0
0
1
00005
00006
1
Tues
2/40002
0001
0
0 0
0
0
00053
00053
0
1
0 1
0
3
00006
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Exhibit 6
MULTI -PURPOSE AFFIRMATION `FIDAVIT Precinct Number
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SECTION 1 VOTER INFORMATION
Under penalties for false swearing, I swear (or affirm) that I am a qualified voter In Volusla County, FL; that I have not yet
)voted in this election:
That my current name Is
Last First Middle
That 1 now reside at
House # Street Name City Zip Code
That I receive my mall at
(If different from residence address) P.O. Box, etc. City Zip Code
That my date of birth Is
SECTION 2 CHECK ALL THAT APPLY
❑ CHANGE OF ADDRESS — F.S. 101.045(2)(a) My former address in Volusla County' was:
Voter must have been registered in Volusia County at least 29 days prior to this election
❑ CHANGE OF NAME — F.S. 101.045(2)(b) My name has changed by marriage or other legal process. My former name was:
❑ DECLARATION TO SECURE ASSISTANCE— F.S. 101.051(4) My condition is: _temporary _penranent
I request assistance from (print name of persons assisting)
For the following reason:
❑ VOTER WITHOUT PROPER IDENTIFICATION— F.S. 98.4711 am the person I represent myself to be
❑ REQUEST FOR DUPLICATE IDENTIFICATION CARD — F.S. 97.071 1 request a duplicate voter ID card be mailed to me
❑ VOTER WHOSE SIGNATURE IS DIFFERENT— F.S. 101.49 The signature presented on my identification appears different
from the signature on the precinct register. Please update my file signature to the one below.
❑ DECEASED VOTER — (to be completed by a member of the immediate family only):
Name of Deceased Data of BIM Date of Death
Name of Person Giving Information Signature Relationship
SECTION 3 SIGNATURE OF VOTER AND ELECTION OFFICIAL
and I further swear (or affirm) that I am otherwise legally Sworn to and subscribed before me this day
registered and entitled to vote in Volusla County, Florida. of , 20
X x
Signature of Voter Election Official Signature
SECTION 4 MUST BE COMPLETED BY ELECTION OFFICIAL
VOTER'S REGISTRATION #
VOTER'S NEW PRECINCT# (if change of address)
VOTER'S PARTY AFFILIATION (Voter cannot change party affiliation at the polls)
BALLOT STYLE
Information was provided by: _ Phone Bank Operator (give first name)
_ Registration Database / Precinct Map
SECTION 5 FOR VOTER WHOSE PRECINCT HAS CHANGED
NEW POLLING PLACEIADDRESS:
Voter Instructions: Please take this form to the Voter Assistance Table at the polling place listed above.
Exhibit 6
MUNICIPAL GUIDELINLs
AFFIDAVIT ENVELOPE
INSTRUCTIONS
Once a votes has voted their ballot, they most place it in a Secrecy Envelope that is then
Placed inside of an Affidavit Envelope. The Affidavit Envelope is then sealed and signed on
the back of the envelope by the voter. The witness (city clerk) must also sign the back of the
envelope and fill in the complete address (city) where indicated.
Votes Prints Name
AFFIDAVIT ENVELOPE - FRONT
.M. ENVELOPE
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DEANIE LOWE
SUPERVISOR OF ELECTIONS
VOLUSIA COUNTY
136 N FLORIDA AVE
DELAND FLORIDA 32720-4208
AFFIDAVIT ENVELOPE — BACK
Voter Dates
Here
Voter Signs
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