Amendment SSA1-SB6

SB6-SSA1,2,14 An Act to repeal 6.56 (5) and 12.13 (3) (v); to renumber 6.79 (3) and 343.50 (1); to renumber and amend 6.87 (4) and 6.97 (3); to amend 5.35 (6) (a) 2., 5.35 (6) (a) 4a., 6.02 (1), 6.02 (2), 6.10 (3), 6.10 (4), 6.15 (1), 6.15 (2) (a), 6.15 (2) (d) 1r., 6.15 (3), 6.18, 6.22 (7), 6.29 (1), 6.29 (2) (a), 6.33 (1), 6.33 (2) (b), 6.34 (2), 6.36 (2) (a), 6.36 (5), 6.40 (1) (a) 1., 6.55 (2) (a) 1., 6.55 (2) (b), 6.55 (2) (c) 1., 6.55 (2) (c) 2., 6.79 (1m), 6.79 (2) (a), 6.79 (2) (d), 6.79 (3) (title), 6.79 (4), 6.79 (6), 6.82 (1) (a), 6.85, 6.86 (1) (ac), 6.86 (1) (ar), 6.86 (3) (a) 1., 6.86 (3) (a) 2., 6.86 (3) (c), 6.869, 6.87 (1), 6.87 (2), 6.87 (3) (a), 6.87 (3) (d), 6.875 (title), 6.875 (2) (a), 6.875 (3) and (4), 6.875 (6) (a) and (b), 6.875 (6) (c) 1., 6.875 (6) (c) 2., 6.875 (6) (e), 6.875 (7), 6.88 (3) (a), 6.92 (1), 6.94, 6.97 (title), 6.97 (1), 6.97 (2), 7.08 (8) (title), 7.52 (3) (a), 7.52 (6) (b), 10.02 (3) (form) (a), 12.03 (2) (b) 3., 12.13 (2) (b) 6m., 343.06 (1) (L), 343.10 (7) (d), 343.11 (1), 343.11 (3), 343.11 (3), 343.14 (3), 343.165 (1) (intro.), 343.165 (2), 343.165 (3) (a), 343.165 (4) (a), 343.165 (4) (c), 343.165 (4) (d), 343.165 (5), 343.17 (3) (a) 2., 343.17 (5), 343.50 (3), 343.50 (4), 343.50 (5) (a) 1., 343.50 (5m) and 343.50 (6); to repeal and recreate 343.17 (5), 343.50 (1), 343.50 (3), 343.50 (4), 343.50 (4g), 343.50 (5) (a) and 343.50 (6); and to create 5.02 (6m), 5.02 (16c), 6.15 (2) (bm), 6.79 (2) (am), 6.79 (3) (b), 6.79 (7), 6.87 (4) (a), 6.87 (4) (b) 2., 6.87 (4) (b) 3., 6.87 (4) (b) 4., 6.87 (4) (b) 5., 6.875 (1) (ap) and (asm), 6.875 (2) (d), 6.965, 6.97 (3) (a), 6.97 (3) (c), 7.08 (12), 343.03 (3r), 343.14 (3m), 343.165 (7), 343.17 (3) (a) 14., 343.50 (1) (c), 343.50 (4g) and 343.50 (5) (a) 3. of the statutes; relating to: requiring certain identification in order to vote at a polling place or obtain an absentee ballot; absentee voting procedure in certain residential care apartment complexes and adult family homes; a requirement for electors to provide a signature when voting in person at an election; the duration of residency for voting purposes; and issuance of operator's licenses and identification cards by the Department of Transportation.

Analysis by the Legislative Reference Bureau

Identification required for voting

Under current law, any person who is a U.S. citizen, who is at least 18 years of age, and who has resided in a ward or election district in this state for at least ten days before the election at which the person is voting may vote in that ward or election district at that election unless the person is disqualified from voting, in certain cases specified by law, as the result of a felony conviction or an adjudication of incompetency. With limited exceptions, a person must register before voting and in certain cases must provide proof of residence. With certain limited exceptions, before being permitted to vote at any polling place, an eligible elector currently must provide his or her name and address. If the elector is not registered, the elector must provide a specified form of proof of residence in order to register. If an elector is not able to present any required proof of residence, as an alternative, current law permits an elector's registration information to be corroborated by another qualified elector who resides in the same municipality. In addition, an elector other than a military elector or an overseas elector, as defined by federal law, who registers by mail and who has not voted in an election in this state must provide one of the forms of identification specified by federal law, or a copy thereof if voting by absentee ballot, in order to be permitted to vote. Corroboration may not be substituted for this identification requirement, but an elector who cannot provide the required identification may cast a provisional ballot. The municipal clerk or board of election commissioners must determine whether electors casting provisional ballots are qualified to vote by 4 p.m. on the day after an election.

With certain limited exceptions, this substitute amendment requires each eligible elector who attempts to register or to vote at the polls on election day to present "proof of identification." Under the substitute amendment, "proof of identification" means an identification document that contains the name of the individual to whom the document was issued, which name conforms to the individual's voter registration, if the individual is required to register to vote, and that contains a photograph of the individual, except as otherwise permitted by the substitute amendment (see below). "Identification" means a) one of the following documents issued to the individual that is unexpired or if expired has expired after the date of the most recent general election: an operator's license issued by the Wisconsin Department of Transportation (DOT), an identification card issued by DOT, an identification card issued by a U.S. uniformed service, or a U.S. passport; b) a certificate of U.S. naturalization that was issued not earlier than two years before the date of an election at which it is presented; c) an unexpired driving receipt issued by DOT (see below); d) an unexpired identification card receipt issued by DOT; or e) an identification card issued by a federally recognized Indian tribe in this state. A person whose address is confidential as a result of domestic abuse, sexual assault, or stalking or in certain cases a person who has been required by a law enforcement officer to surrender his or her license (see below) is exempted from the requirement. If a person has applied to DOT for a driver's license or identification card, the person may also present the unexpired driving receipt or identification card receipt (DOT receipt) that DOT issues to the person while the application is processed. Under the substitute amendment, any person who applies for an absentee ballot, except a military or overseas elector, as defined by federal law, or a person whose address is confidential as a result of domestic abuse, sexual assault, or stalking, must also provide proof of identification or a copy thereof unless: 1) the person has already provided a copy of his or her proof of identification in connection with an absentee ballot cast at a previous election and has not changed his or her name or address since that election; 2) the person has been required by a law enforcement officer to surrender his or her license (see below); 3) the person is indefinitely confined, in which case the person may submit a statement signed by the person who witnesses his or her absentee ballot verifying his or her identity; or 4) the person is an occupant of any nursing home, or is an occupant of a community-based residential facility, retirement home, adult family home, or residential care apartment complex where a municipality sends special voting deputies, in which case the person may submit a statement signed by the deputies verifying his or her identity. The substitute amendment continues current requirements for certain electors to provide proof of residence in order to register or to vote, but discontinues the use of corroborating electors to verify residence. Under the substitute amendment, if a person who votes at a polling place fails to provide proof of identification, the person may vote provisionally. If a person votes by absentee ballot and fails to provide proof of identification or a copy thereof, unless exempted from the requirement, the ballot is treated as a provisional ballot. A provisional ballot is marked by the poll workers, who immediately contact the municipal clerk or board of election commissioners. The person may then provide the required proof of identification either at the polling place before the closing hour or at the office of the clerk or board. If the person does not provide the required identification to the clerk or board by 4 p.m. on the Friday following the election, the person's vote is not counted. If a person receives a citation from a law enforcement officer in any jurisdiction that is dated within 60 days of the date of an election and is required to surrender his or her Wisconsin driver's license at the time the citation is issued, the elector may present an original copy of the citation or notice of intent to revoke or suspend the elector's driver's license in lieu of his or her driver's license or, if the elector is voting an absentee ballot by mail, may enclose a copy of the citation or notice in lieu of a copy of his or her driver's license. In this case, the substitute amendment provides that the elector's ballot is received and counted if otherwise valid, but the ballot is marked so it can be identified during the canvassing and recount process if the validity of the ballot is questioned.

The substitute amendment also directs the Government Accountability Board, in conjunction with the first regularly scheduled primary and election at which the voter identification requirements created by the substitute amendment initially apply, to conduct a public informational campaign for the purpose of informing prospective voters of the voter identification requirements created by the substitute amendment. In addition, the substitute amendment directs the board to conduct an ongoing outreach effort to identify and contact groups of electors who may need assistance in obtaining or renewing documents that constitute proof of identification for voting purposes and to provide assistance in obtaining or renewing those documents.

The voting identification requirement under the substitute amendment initially applies to voting at the 2012 spring primary. The substitute amendment also provides that an elector who votes at a polling place at an election held after the substitute amendment becomes law but before the date of the 2012 spring primary shall be requested to present proof of identification but if the elector fails to do so, his or her ballot will still be counted if the elector is otherwise qualified. The substitute amendment directs election officials to provide information to electors who do not present proof of identification at elections held prior to the date of the 2012 spring primary so that the electors will be prepared to provide proof of identification at future elections.

Issuance of operator's licenses and identification cards

This substitute amendment also permits an elector who is eligible to obtain a Wisconsin identification card to obtain the card from DOT free of charge if the elector is a U.S. citizen who will be at least 18 years of age on the date of the next election and the elector requests that the card be provided without charge for purposes of voting.

Under 2007 Wisconsin Act 20 (the biennial budget act), certain provisions specified in the federal REAL ID Act are incorporated into state law when DOT provides notice that it is ready to implement the federal REAL ID Act. Among these provisions is the requirement that DOT follow certain procedures in processing applications for driver's licenses and identification cards and that each driver's license and identification card include a photograph.

This substitute amendment allows DOT, upon the implementation of the federal REAL ID Act in Wisconsin, to process applications for driver's licenses and identification cards in a manner other than that required by REAL ID if the driver's licenses and identification cards are marked to indicate that they are not REAL ID compliant and DOT processes the applications in compliance with DOT practices and procedures applicable immediately prior to implementation of REAL ID. An applicant for a REAL ID noncompliant driver's license or identification card will still be required to provide to DOT: 1) an identification document that includes either the applicant's photograph or both the applicant's full legal name and date of birth; 2) documentation showing the applicant's date of birth, which may be the same as item 1); 3) proof of the applicant's social security number or verification that the applicant is not eligible for a social security number; 4) documentation showing the applicant's name and address of principal residence; and 5) documentary proof that the applicant is a U.S. citizen or is otherwise lawfully present in the United States. However, in processing an application for a REAL ID noncompliant driver's license or identification card, DOT is not required to meet the standards for document retention and verification that are imposed for REAL ID compliant products.

Current law provides for limited exceptions allowing DOT to issue a driver's license that does not contain a photograph of the license holder, including, by DOT rule, a religious belief exception. There are no similar photograph exceptions under current law for identification cards. Under current law, after the implementation of REAL ID, all REAL ID compliant driver's licenses and identification cards must contain a photograph.

Under this substitute amendment, until the implementation of the federal REAL ID Act, the photograph exception for driver's licenses continues and a new religious belief photograph exception is created for identification cards. After the implementation of REAL ID, this substitute amendment creates a religious belief photograph exception for REAL ID noncompliant driver's licenses and identification cards.

Absentee voting in residential care apartment complexes and adult family homes

Currently, municipalities must send two special voting deputies (one designated by each major political party if the party wishes) to conduct absentee voting in nursing homes. Municipalities may also send the deputies to conduct absentee voting in community-based residential facilities and retirement homes that qualify for the service in accordance with standards prescribed by law. This substitute amendment permits municipal clerks and boards of election commissioners to send two special voting deputies to conduct absentee voting in adult family homes and residential care apartment complexes that qualify for the service in accordance with similar standards prescribed by law.

Currently, with limited exceptions, an elector must be registered in order to vote in an election in this state. In order to register, an elector must provide certain information on a registration form and affirm the correctness of the information with his or her signature. If an elector is unable, due to physical disability, to sign his or her registration form, the elector may have another person sign on his or her behalf. An elector who has not previously registered may register at the polling place serving his or her residence on election day. Currently, when appearing to vote, an elector must provide his or her name and address to the election officials and in some cases must also provide proof of residence. Currently, an absentee elector may vote by mail or at the office of the municipal clerk of the municipality where he or she resides. The names of registered electors are checked against a poll list consisting of the names of registered electors and the names of other electors are entered on a separate list.

Signature requirement for electors voting in person

This substitute amendment provides, with limited exceptions, that an elector must also enter his or her signature on the poll list or other separate list when voting in person at an election. Under the substitute amendment, the election officials or, if an elector votes at the office of the municipal clerk or board of election commissioners, the municipal clerk or a deputy, must require each elector to enter his or her signature on the poll list or other separate list before being permitted to vote. If an elector registers at a polling place on election day, the officials must require the elector to enter the elector's signature on a separate list. The substitute amendment also provides that if an elector, due to physical disability, authorized another elector to sign his or her registration form on his or her behalf, the elector is exempt from the signature requirement. In addition, if an elector signed his or her registration form but claims to be unable, due to physical disability, to enter his or her signature on the poll list or other separate list when voting at a particular election, the substitute amendment permits the election officials or the municipal clerk or board of election commissioners or a deputy to waive the signature requirement if they find that, due to physical disability, the elector is unable to enter his or her signature.

Durational residency requirement for voting

Under current law, with certain limited exceptions, an individual must be a resident of this state and of the municipality and ward, if any, where the elector is voting for ten days before an election to be eligible to vote in the election. This substitute amendment increases this durational residency requirement to 28 days. Under the substitute amendment, if an elector who does not meet this residency requirement formerly resided at another location in this state within the 27-day period preceding an election, the elector may vote at that location if the elector is otherwise qualified to vote at that location.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB6-SSA1, s. 1 Section 1. 5.02 (6m) of the statutes is created to read:

SB6-SSA1,7,3 5.02 (6m) "Identification" means any of the following documents issued to an individual:

SB6-SSA1,7,5 (a) One of the following documents that is unexpired or if expired has expired after the date of the most recent general election:

SB6-SSA1,7,6 1. An operator's license issued under ch. 343.

SB6-SSA1,7,7 2. An identification card issued under s. 343.50.

SB6-SSA1,7,8 3. An identification card issued by a U.S. uniformed service.

SB6-SSA1,7,9 4. A U.S. passport.

SB6-SSA1,7,11 (b) A certificate of U.S. naturalization that was issued not earlier than 2 years before the date of an election at which it is presented.

SB6-SSA1,7,12 (c) An unexpired driving receipt under s. 343.11.

SB6-SSA1,7,13 (d) An unexpired identification card receipt issued under s. 343.50.

SB6-SSA1,7,15 (e) An identification card issued by a federally recognized Indian tribe in this state.

SB6-SSA1, s. 2 Section 2. 5.02 (16c) of the statutes is created to read:

SB6-SSA1,7,21 5.02 (16c) "Proof of identification" means identification that contains the name of the individual to whom the document was issued, which name conforms to the individual's voter registration form, if the individual is required to register to vote, and that contains a photograph of the individual, except as authorized in s. 343.14 (3m) or 343.50 (4g).

SB6-SSA1, s. 3 Section 3. 5.35 (6) (a) 2. of the statutes is amended to read:

SB6-SSA1,7,25 5.35 (6) (a) 2. A copy of the election fraud laws provided in s. 12.13 (1) and (3) (intro), (d), (f), (g), (k), (L), (o), (q), (r), (u), (v) and (x), together with the applicable penalties provided in s. 12.60 (1).

SB6-SSA1, s. 4 Section 4 . 5.35 (6) (a) 4a. of the statutes is amended to read:

SB6-SSA1,8,4 5.35 (6) (a) 4a. Instructions prescribed by the board for electors for whom proof of identification is required under s. 6.79 (2) or for whom proof of residence under s. 6.34 is required under s. 6.55 (2).

SB6-SSA1, s. 5 Section 5. 6.02 (1) of the statutes is amended to read:

SB6-SSA1,8,8 6.02 (1) Every U.S. citizen age 18 or older who has resided in an election district or ward for 10 28 days before any election where the citizen offers to vote is an eligible elector.

SB6-SSA1, s. 6 Section 6. 6.02 (2) of the statutes is amended to read:

SB6-SSA1,8,14 6.02 (2) Any U.S. citizen age 18 or older who moves within this state later than 10 28 days before an election shall vote at his or her previous ward or election district if the person is otherwise qualified. If the elector can comply with the 10-day 28-day residence requirement at the new address and is otherwise qualified, he or she may vote in the new ward or election district.

SB6-SSA1, s. 7 Section 7. 6.10 (3) of the statutes is amended to read:

SB6-SSA1,8,24 6.10 (3) When an elector moves from one ward to another or his or her residence from one ward or municipality to another ward or municipality within the state after the last registration day but at least 10 28 days before the election, the elector may vote in and be considered a resident of the new ward or municipality where residing upon transferring registration under s. 6.40 (1) or upon registering at the proper polling place or other registration location in the new ward or municipality under s. 6.55 (2) or 6.86 (3) (a) 2. If the elector moves within 10 his or her residence later than 28 days of before an election, the elector shall vote in the elector's old former ward or municipality if otherwise qualified to vote there.

SB6-SSA1, s. 8 Section 8. 6.10 (4) of the statutes is amended to read:

SB6-SSA1,9,11 6.10 (4) The residence of an unmarried person sleeping in one ward and boarding in another is the place where the person sleeps. The residence of an unmarried person in a transient vocation, a teacher or a student who boards at different places for part of the week, month, or year, if one of the places is the residence of the person's parents, is the place of the parents' residence unless through registration or similar act the person elects to establish a residence elsewhere. If the person has no parents and if the person has not registered elsewhere, the person's residence shall be at the place which that the person considered his or her residence in preference to any other for at least 10 28 days before an election. If this place is within the municipality, the person is entitled to all the privileges and subject to all the duties of other citizens having their residence there, including voting.

SB6-SSA1, s. 9 Section 9. 6.15 (1) of the statutes is amended to read:

SB6-SSA1,9,18 6.15 (1) Qualifications. Any person who was or who is a qualified an eligible elector under ss. 6.02 and 6.03, except that he or she has been a resident of this state for less than 10 28 days prior to the date of the presidential election, is entitled to vote for the president and vice president but for no other offices. The fact that the person was not registered to vote in the state from which he or she moved does not prevent voting in this state if the elector is otherwise qualified.

SB6-SSA1, s. 10 Section 10. 6.15 (2) (a) of the statutes is amended to read:

SB6-SSA1,9,25 6.15 (2) (a) The elector's request for the application form may be made in person to the municipal clerk of the municipality where the person resides. Application may be made not sooner than 9 27 days nor later than 5 p.m. on the day before the election, or may be made at the proper polling place in the ward or election district in which the elector resides. If an elector makes application before election day, the application form shall be returned to the municipal clerk after the affidavit has been signed in the presence of the clerk or any officer authorized by law to administer oaths. The affidavit shall be in substantially the following form:

SB6-SSA1,10,3 STATE OF WISCONSIN

SB6-SSA1,10,4 County of ....

SB6-SSA1,10,15 I, ...., do solemnly swear that I am a citizen of the United States; that prior to establishing Wisconsin residence, my legal residence was in the .... (town) (village) (city) of ...., state of ...., residing at .... (street address); that on the day of the next presidential election, I shall be at least 18 years of age and that I have been a legal resident of the state of Wisconsin since ...., .... (year), residing at .... (street address), in the [.... ward of the .... aldermanic district of] the (town) (village) (city) of ...., county of ....; that I have resided in the state less than 10 28 days, that I am qualified to vote for president and vice president at the election to be held November ...., .... (year), that I am not voting at any other place in this election and that I hereby make application for an official presidential ballot, in accordance with section 6.15 of the Wisconsin statutes.

SB6-SSA1,10,16 Signed ....

SB6-SSA1,10,17 P.O. Address ....

SB6-SSA1,10,18 Subscribed and sworn to before me this .... day of ...., .... (year)

SB6-SSA1,10,19 ....(Name)

SB6-SSA1,10,20 ....(Title)

SB6-SSA1, s. 11 Section 11 . 6.15 (2) (bm) of the statutes is created to read:

SB6-SSA1,11,3 6.15 (2) (bm) Except as authorized in s. 6.79 (7), when making application in person at the office of the municipal clerk, each applicant shall present proof of identification. If any document presented by the applicant is not proof of residence under s. 6.34, the applicant shall also present proof of residence under s. 6.34. The clerk shall verify that the name on the proof of presented by the elector conforms to the name on the elector's application and shall verify that any photograph appearing on that document reasonably resembles the elector.

SB6-SSA1, s. 12 Section 12. 6.15 (2) (d) 1r. of the statutes is amended to read:

SB6-SSA1,11,15 6.15 (2) (d) 1r. Upon proper completion of the application and cancellation card, the municipal clerk shall require the elector to provide proof of residence under s. 6.34. If the elector cannot provide proof of residence, the elector may have his or her residence corroborated in a statement that is signed by another elector of the municipality and that contains the current street address of the corroborating elector. If the residence is corroborated by another elector, that elector shall then provide proof of residence under s. 6.34 permit the elector to cast his or her ballot for president and vice president. The elector shall then mark the ballot in the clerk's presence in a manner that will not disclose his or her vote. The elector shall then fold the ballot so as to conceal his or her vote. The clerk or elector shall then place the ballot in an envelope furnished by the clerk.

SB6-SSA1, s. 13 Section 13. 6.15 (3) of the statutes is amended to read:

SB6-SSA1,12,9 6.15 (3) Procedure at polling place. An eligible elector may appear at the polling place for the ward or election district where he or she resides and make application for a ballot under sub. (2). Except as otherwise provided in this subsection, an elector who casts a ballot under this subsection shall follow the same procedure required for casting a ballot at the municipal clerk's office under sub. (2). The inspectors shall perform the duties of the municipal clerk, except that the inspectors shall return the cancellation card under sub. (2) (b) to the municipal clerk and the clerk shall forward the card as provided in sub. (2) (c) if required. Upon proper completion of the application and cancellation card and submittal of proof of residence under s. 6.34 or providing corroboration of residence verification of the proof of identification and proof of residence, whenever required, as provided in sub. (2) (bm), the inspectors shall permit the elector to cast his or her ballot for president and vice president. The elector shall mark the ballot and, unless the ballot is utilized with an electronic voting system, the elector shall fold the ballot, and deposit the ballot into the ballot box or give it to the inspector. The inspector shall deposit it directly into the ballot box. Voting machines or ballots utilized with electronic voting systems may only be used by electors voting under this section if they permit voting for president and vice president only.

SB6-SSA1, s. 14 Section 14. 6.18 of the statutes is amended to read:

SB6-SSA1,13,2 6.18 Former residents. If ineligible to qualify as an elector in the state to which the elector has moved, any former qualified Wisconsin elector may vote an absentee ballot in the ward of the elector's prior residence in any presidential election occurring within 24 months after leaving Wisconsin by requesting an application form and returning it, properly executed, to the municipal clerk of the elector's prior Wisconsin residence. When requesting an application form for an absentee ballot, the applicant shall specify the applicant's eligibility for only the presidential ballot. Unless application is made under s. 6.86 (1) (ac), or the applicant is exempted from providing proof of identification under s. 6.87 (4) (b) 2. or 3., or the applicant is a military or overseas elector, the elector shall enclose a copy of his or her proof of identification or any authorized substitute document with his or her application. The municipal clerk shall verify that the name on the proof of identification conforms to the name on the application. The clerk shall not issue a ballot to an elector who is required to enclose a copy of proof of identification or an authorized substitute document with his or her application unless the copy is enclosed and the proof is verified by the clerk. The application form shall require the following information and be in substantially the following form:

SB6-SSA1,13,6 This form shall be returned to the municipal clerk's office. Application must be received in sufficient time for ballots to be mailed and returned prior to any presidential election at which applicant wishes to vote. Complete all statements in full.

SB6-SSA1,13,7 APPLICATION FOR PRESIDENTIAL

SB6-SSA1,13,8 ELECTOR'S ABSENTEE BALLOT.

SB6-SSA1,13,9 (To be voted at the Presidential Election

SB6-SSA1,13,10 on November ...., .... (year)

SB6-SSA1,13,19 I, .... hereby swear or affirm that I am a citizen of the United States, formerly residing at .... in the .... ward .... aldermanic district (city, town, village) of ...., County of .... for 10 28 days prior to leaving the State of Wisconsin. I, .... do solemnly swear or affirm that I do not qualify to register or vote under the laws of the State of ....(State you now reside in) where I am presently residing. A citizen must be a resident of: State ....(Insert time) County ....(Insert time) City, Town or Village ....(Insert time), in order to be eligible to register or vote therein. I further swear or affirm that my legal residence was established in the State of ....(the State where you now reside) on .... Month .... Day .... Year.

SB6-SSA1,13,20 Signed ....

SB6-SSA1,13,21 Address ....(Present address)

SB6-SSA1,13,22 ....(City) ....(State)

SB6-SSA1,13,23 Subscribed and sworn to before me this .... day of .... .... (year)

SB6-SSA1,13,24 ....(Notary Public, or other officer authorized to administer oaths.)

SB6-SSA1,13,25 ....(County)

SB6-SSA1,14,1 My Commission expires

SB6-SSA1,14,2 MAIL BALLOT TO:

SB6-SSA1,14,3 NAME ....

SB6-SSA1,14,4 ADDRESS ....

SB6-SSA1,14,5 CITY .... STATE .... ZIP CODE ....

SB6-SSA1,14,10 Penalties for Violations. Whoever swears falsely to any absent elector affidavit under this section may be fined not more than $1,000 or imprisoned for not more than 6 months or both. Whoever intentionally votes more than once in an election may be fined not more than $10,000 or imprisoned for not more than 3 years and 6 months or both.

SB6-SSA1,14,11 ....(Municipal Clerk)

SB6-SSA1,14,12 ....(Municipality)