AB966,1,5 5OFFICIAL .... BALLOT
AB966,1,66 (date of election)
AB966,1,77 FOR
AB966,2,1
1.... Ward (Wards) (if any)
AB966,2,22 .... Aldermanic district (if any)
AB966,2,33 City (Village or Town) of ....
AB966,2,44 .... 19.. .... (year)
AB966,2,66 Ballot issued by
AB966,2,77 ....
AB966,2,88 ....
AB966,2,99 (Initials of inspectors)
AB966,2,1111 Absent Elector's Ballot issued by
AB966,2,1212 ....
AB966,2,1313 (Initials of municipal clerk or deputy clerk)
AB966,2,1515 Certification of Elector Assistance
AB966,2,1816 I certify that this ballot was marked or punched by me for an elector who is
17authorized under the law to have assistance, upon request and as directed by the
18elector.
AB966,2,1919 ....
AB966,2,2020 (Signature of assisting individual)
AB966, s. 2 22Section 2. 6.15 (2) (a) (form) of the statutes is amended to read:
AB966,2,2323 6.15 (2) (a) (form)
AB966,2,2424 STATE OF WISCONSIN
AB966,2,2525 County of ....
AB966,3,11
1I, ...., do solemnly swear that I am a citizen of the United States; that prior to
2establishing Wisconsin residence, my legal residence was in the .... (town) (village)
3(city) of ...., state of ...., residing at .... (street address); that on the day of the next
4presidential election, I shall be at least 18 years of age and that I have been a legal
5resident of the state of Wisconsin since ...., 19.. .... (year), residing at .... (street
6address), in the [.... ward of the .... aldermanic district of] the (town) (village) (city)
7of ...., county of ....; that I have resided in the state less than 10 days, that I am
8qualified to vote for president and vice president at the election to be held November
9...., 19.. .... (year), that I am not voting at any other place in this election and that I
10hereby make application for an official presidential ballot, in accordance with section
116.15 of the Wisconsin statutes.
AB966,3,1212 Signed ....
AB966,3,1313 P.O. Address ....
AB966,3,1414 Subscribed and sworn to before me this .... day of ...., 19.. .... (year)
AB966,3,1515 ....(Name)
AB966,3,1616 ....(Title)
AB966, s. 3 17Section 3. 6.18 (form) of the statutes is amended to read:
AB966,3,2118 6.18 (form) This blank shall be returned to the municipal clerk's office.
19Application must be received in sufficient time for ballots to be mailed and returned
20prior to any presidential election at which applicant wishes to vote. Complete all
21statements in full.
AB966,3,2222 APPLICATION FOR PRESIDENTIAL
AB966,3,2323 ELECTOR'S ABSENT BALLOT.
AB966,3,2424 (To be voted at the Presidential Election
AB966,3,2525 on November ...., 19.. .... (year)
AB966,4,9
1I, .... hereby swear or affirm that I am a citizen of the United States, formerly
2residing at .... in the .... ward .... aldermanic district (city, town, village) of ...., County
3of .... for 10 days prior to leaving the State of Wisconsin. I, .... do solemnly swear or
4affirm that I do not qualify to register or vote under the laws of the State of ....(State
5you now reside in) where I am presently residing. A citizen must be a resident of:
6State ....(Insert time) County ....(Insert time) City, Town or Village ....(Insert time),
7in order to be eligible to register or vote therein. I further swear or affirm that my
8legal residence was established in the State of ....(the State where you now reside)
9on .... Month .... Day .... Year.
AB966,4,1010 Signed ....
AB966,4,1111 Address ....(Present address)
AB966,4,1212 ....(City) ....(State)
AB966,4,1313 Subscribed and sworn to before me this .... day of .... 19..,.... (year).
AB966,4,1414 ....(Notary Public, or other officer authorized to administer oaths.)
AB966,4,1515 ....(County)
AB966,4,1616 My Commission expires
AB966,4,1717 MAIL BALLOT TO:
AB966,4,1818 NAME ....
AB966,4,1919 ADDRESS ....
AB966,4,2020 CITY .... STATE .... ZIP CODE ....
AB966,4,24 21Penalties for Violations. Whoever swears falsely to any absent elector affidavit
22under this section may be fined not more than $1,000 or imprisoned not more than
236 months, or both. Whoever intentionally votes more than once in an election may
24be fined not more than $10,000 or imprisoned not more than 3 years, or both.
AB966,4,2525 ....(Municipal Clerk)
AB966,5,1
1....(Municipality)
AB966, s. 4 2Section 4. 10.02 (3) (form) (intro.) of the statutes is amended to read:
AB966,5,33 10.02 (3) (form) (intro.)
AB966,5,44 FACSIMILE BALLOT NOTICE
AB966,5,55 OF .... ELECTION
AB966,5,66 Office of .... [County] [Municipal] Clerk.
AB966,5,77 To the Electors of .... [County] [Municipality]:
AB966,5,148 Notice is hereby given of a .... election to be held in the several wards in the
9[county] [municipality] of ...., on the .... day of ...., 19.. .... (year), at which the officers
10named below shall be chosen. The names of the candidates for each office to be voted
11for, whose nominations have been certified to or filed in this office, are given under
12the title of the office and under the appropriate party or other designation, each in
13its proper column, together with the questions submitted to a vote, in the sample
14ballot below.
AB966,5,1515 INFORMATION TO ELECTORS
AB966,5,1816 Except where a different statement is prescribed by the board for use in whole
17or in part by municipalities using electronic voting systems under s. 5.95, the voting
18instructions shall be given substantially as follows:
AB966, s. 5 19Section 5. 19.01 (1) (form) of the statutes is amended to read:
AB966,5,2020 19.01 (1) (form)
AB966,5,21 21State of Wisconsin,
AB966,5,2222 County of ....
AB966,6,223 I, the undersigned, who have been elected (or appointed) to the office of ...., but
24have not yet entered upon the duties thereof, swear (or affirm) that I will support the
25constitution of the United States and the constitution of the state of Wisconsin, and

1will faithfully discharge the duties of said office to the best of my ability. So help me
2God.
AB966,6,33 .... ....,
AB966,6,44 Subscribed and sworn to before me this .... day of ...., 19.. .... (year)
AB966,6,55 ....(Signature)....,
AB966, s. 6 6Section 6. 19.01 (2) (a) (form) of the statutes is amended to read:
AB966,6,127 19.01 (2) (a) (form) We, the undersigned, jointly and severally, undertake and
8agree that ...., who has been elected (or appointed) to the office of ...., will faithfully
9discharge the duties of the office according to law, and will pay to the parties entitled
10to receive the same, such damages, not exceeding in the aggregate .... dollars, as may
11be suffered by them in consequence of the failure of .... to discharge the duties of the
12office.
AB966,6,1313 Dated ...., 19.. .... (year)
AB966,6,1414 ....(Principal)....,
AB966,6,1515 ....(Surety)....,
AB966, s. 7 16Section 7. 23.10 (4) (form) of the statutes is amended to read:
AB966,6,1717 23.10 (4) (form)
AB966,6,18 18state of Wisconsin
AB966,6,19 19department of natural resources.
AB966,6,2020 To all to whom these presents shall come, greeting:
AB966,7,221 Know ye, that reposing special trust and confidence in the integrity and ability
22of ...., of the county of ...., we do hereby appoint and constitute .... a conservation
23warden (or county, or special conservation warden) for the (county of ....), state of
24Wisconsin, and do authorize and empower .... to execute and fulfill the duties of that

1office according to law, during good behavior and the faithful performance of the
2duties of that office.
AB966,7,53 In testimony whereof, the secretary has hereunto affixed the secretary's
4signature and the official seal of the department, at its office in the city of Madison,
5Wisconsin, this .... day of ...., 19.. .... (year).
AB966,7,66 (Seal) state of wisconsin
AB966,7,7 7department of natural resources.
AB966,7,88 By .... ....
AB966, s. 8 9Section 8. 59.64 (1) (d) 1. (form) of the statutes is amended to read:
AB966,7,1010 59.64 (1) (d) 1. (form)
AB966,7,11 11State of Wisconsin
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