Fillable 5-42f Form (Texas Secretary of State)

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5-42f Form (Texas Secretary of State)

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________
________ 2) It was determined that the signature on the application for ballot by mail
and carrier envelope w as not signed by the same person.
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_______________________________________
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AW5-42
Prescribed by Secretary of State
Sec. 87.0431, Texas Election Code
2/2020
NOTICE OF REJECTED BALLOT
This is to serve as notice that your ballot for the ________________________Election was
rejected by the early voting ballot board and was not counted. If you believe that your mail
ballot was rejected in error, please contact your early voting clerk to determine what
remedies may be available to you.
Name of Voter ____________________________________________________
VUID Number___________________________
Reason for Rejection: (Check As Appropriate)
1)
3) Application for ballot by mail did not state a legal ground for voting by
mail.
4) Voter registration records indicated you did not have an ef fective
registration for this election.
5) Address to which ballot was mailed was not outside the county. Voting
early by mail due to expected absence from the county requires
balloting materials be mailed to an address outside the county.
Certificate on carrier envelope was not properly executed.
_____ You failed to sign your signature or make your mark.
_____ The witness failed to indicate on the envelope that you could
not make a mark.
_____ The assistant or witness failed to print their name.
_____ The assistant or witness failed to sign their name.
_____ The residence address of the assistant or witness was not given.
6) The residence address on the statement of residence is not located in
the political subdivision conducting the election.
7) The mailing address on the application for ballot by mail did not match
your voter registration address nor did the mailing address match any
addresses provided on your statement of residence. Since you did not
indicate on your application for a ballot by mail that you were having
your ballot mailed to a hospital, retirement center, long term care
facility, nursing home, jail, or a relative, your ballot was rejected.
8) The statement of residence was not included in the carrier envelope.
9) No identification was included with your mail ballot.
10) Other:__________________________________________________
Signature of Early Voting Ballot Board Judge
Date
Print
Reset
___________________________________________
__________________
AW5-42
Requerido por la Secretaría de Estado
Sección 87.0431, Código Electoral de Texas
2/2020
AVISO DE BOLETA RECHAZADA
Esto sirve como aviso de que su boleta para la Elección _______________________ fue
rechazada por la Junta de Votación Anticipada y no fue contada. Si cree que su boleta
por correo fue rechazada por error, comuníquese con su secretario de votación
anticipada para determinar qué remedios pueden estar disponibles para usted.
Nombre del votante _____________________________________________
VUID (número único de identificación de votante) ______________________
La razón del rechazo fue (a continuación indique las razones):
_____ 1) La constancia que aparece en el sobre de envío no se ejecutó en
forma apropiada.
_____ Le falta su firma o marca.
_____ El testigo no anotó en el sobre que Ud. no podía hacer su marca.
_____ El asistente o testigo no imprimió su nombre.
_____ El asistente o testigo no firmó su nombre.
_____ No se dio la dirección de residencia del asistente o testigo.
_____ 2) Se determinó que la firma en la solicitud de boleta postal y el sobre
de envío no estaba firmada por la misma persona.
_____ 3) La solicitud de boleta postal no estableció un fundamento legal para
votar por correo.
_____ 4) Las actas del registro electoral indican que en la fecha en que
celebraron estas elecciones, usted no estaba inscrito como votante.
_____ 5) La dirección a la cual se envió la boleta no está ubicada fuera de
este condado. Votar por anticipado por correo debido a la ausencia
esperada del condado requiere que los materiales de votación sean
enviados por correo a una dirección fuera del condado.
_____ 6) La dirección de residencia indicada en la declaración de residencia
no se encuentra en la subdivisión política que lleva a cabo la
elección.
_____ 7) La dirección postal indicada en la solicitud de boleta postal no
coincidía con su dirección de registro de votante ni con la dirección
postal incluida en su declaración de residencia. Dado que no indicó
en su solicitud de boleta postal que estaba teniendo su boleta
enviada por correo a un hospital, centro de jubilación, centro de
cuidado a largo plazo, hogar de ancianos, cárcel o un pariente, su
boleta fue rechazada.
_____ 8) La declaración de residencia no vino incluida en el sobre de envío.
_____ 9) No incluyó ninguna identificación con su boleta por correo.
_____ 10) Otra: ________________________________________________
Firma del Juez de la Junta de Votación Anticipada
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5-42f Form (Texas Secretary of State)

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Completed 29 July 2020

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