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OPTICAL SCAN
PROVISIONAL BALLOT PROCESSING PROCEDURES
Procedures for Election Official to Follow:
1. Check reason(s) for provisional ballot in box below.
2. Have the voter complete the Provisional Ballot Voter’s Certificate and
Affirmation.
3. Witness the voter’s signature and complete the “Election Official” section of the
Certificate.
4. Issue the voter the Notice for Provisional Ballot Voter.
5. Issue the voter a provisional ballot, secrecy envelope, and this Certificate
envelope.
6. Instruct voter to place provisional ballot envelope in ballot box after voting.
Reason for Provisional Ballot (Check all that apply)
Voter’s name does not appear on the precinct register and voter’s eligibility
cannot be verified.
Voter refutes the supervisor’s office confirmation that he or she is not
registered/eligible.
There is an indication on the precinct register that the voter has requested an
absentee ballot and the voter does not have a ballot to surrender. Poll worker
cannot verify that the voter has not voted.
There is an indication on the precinct register that the voter has returned the
absentee ballot or has voted in the office or at an early voting site, but the voter
maintains that he or she has not voted, even after a call to the office.
Voter did not provide picture/signature identification.
There is an indication on the precinct register that the voter has been
challenged in this election.
Voter is challenged at the precinct (Attach copy of challenge).
Voter’s ID signature and signature given do not match. Voter refused affidavit.
Indication on precinct register that voter’s Fl DL #, Fl ID card # or SSN is not
yet verified by the Department of State in conjunction with DHSMV.
Other (provide comment) ______________________________________
Extended Hours Only:
Vote cast after 7 p.m. due to extended hours at polls by:
Qualified voter
Eligibility undetermined
DS-DE #49 OS (eff. 01/06) (back)
Information Verified At Supervisor’s Office
Registered? Yes______ No______ Status ____________
FVRS Voter ID Number ____________________
Address (if different )___________________________________
Voted in Correct Precinct? Yes______ No______
Voter Cast Absentee Ballot? Yes______No______
Voted During Early Voting? Yes______No______
Signature Match? Yes______No______ (Attach copy)
Investigative Findings:
Procedures for Canvassing Board to Follow:
1. Review information provided in the Voter’s Certificate and Affirmation.
2. Determine if voter is registered in state FVRS.
3. Determine if voter voted in the correct precinct.
4. Match voter’s signature with signature on file.
5. Determine whether voter cast an absentee ballot or voted during early
voting.
6. Review all information provided by supervisor’s office, evidence provided
by voter, if any, and any evidence provided by challenger, if applicable.
7. Accept or reject provisional ballot based on preponderance of the
evidence.
FOR SUPERVISOR OF ELECTIONS
AND CANVASSING BOARD USE ONLY
CANVASSING BOARD ACTION STATE REASON IF REJECTED
COUNTED
NOT COUNTED
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