Use this form only if you are registering to vote with a voucher as your proof of residence.
I,_(Name of Voucher) swear or affirm that (Check one): | |
( ) I am pre-registered to vote in this precinct | |
Voter ID # _ | |
(to be completed by the election judge) | |
( ) I registered in this precinct today and did not have another person vouch for me | |
( ) I am an employee of a residential facility | |
_ | |
(Name of residential facility) | |
Residential Address of Voucher or Address of Residential Facility | |
_ | |
Street Address | City |
Telephone number _ | |
Email address (optional) _ | |
I personally know that _ | |
(Name of person registering) | |
is a resident of this precinct. | |
_ | |
Signature of Voucher |
Election Judge Official Use Only: | ||
Subscribed and sworn to before me | ||
__/__/____ | _ | |
Date | Signature of Election Judge |
The above oath shall be attached to the voter registration card and retained for at least 22 months.
20 SR 2787; 32 SR 2055; 40 SR 1553; 43 SR 437
The following portion of this part was vetoed by the governor at 32 SR 2060:
"( ) I am an employee of a residential facility | |
_ | |
(Name of residential facility) | |
Residential Address of Voucher or Address of Residential Facility | |
_ | |
Street Address | City |
Telephone number _ | |
Email address (optional) _ " |
January 30, 2024
Official Publication of the State of Minnesota
Revisor of Statutes