Fillable REQUEST FOR APPOINTMENT AS A VOLUNTEER DEPUTY REGISTRAR (Texas Secretary of State)

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REQUEST FOR APPOINTMENT AS A VOLUNTEER DEPUTY REGISTRAR (Texas Secretary of State)

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BW2-1
Prescribed by Secretary of State
Section 13.033, Texas Election Code
7/2012
For Election Official Use only
Date ______________________ Volunteer Deputy Number ________________________
THIS DEPUTIZATION IS VALID IN AND FOR __________________________________COUNTY ONLY.
REQUEST FOR APPOINTMENT AS A VOLUNTEER DEPUTY REGISTRAR
IN ______________________________ COUNTY
Please Print
NAME
________________________________________________________________________________________
Last First Middle
RESIDENCE ADDRESS
________________________________________________________________________________________
Street City Zip
DATE OF BIRTH (MM/DD/YYYY)
_________________________
EMAIL ADDRESS
_________________________________________
TELEPHONE NUMBER WHERE YOU CAN BE REACHED
FROM 8:00 A.M. TO 5:00 P.M. MONDAY THROUGH FRIDAY
__________________________________________
VUID NUMBER (Optional)
_____________________________
I understand that under Section 13.031 of the Texas Election Code, a Volunteer Deputy Registrar must (1) be 18 years of
age or older; (2) not have been finally convicted of a felony, or, if so convicted, must have (i) fully discharged the person’s
sentence, including any term of incarceration, parole, or supervision, or completed a period of probation ordered by any
court, or (ii) been pardoned or otherwise released from the resulting disability to vote; (3) not have been finally convicted
of an offense under Section 32.51 of the Texas Penal Code (identity theft); (4) be a United States citizen; (5) not have
been determined by a final court judgment to be (i) totally mentally incapacitated, or (ii) partially mentally incapacitated
without the right to vote; and (6) a resident of the State of Texas. I affirm that I meet all the qualifications to be a
Volunteer Deputy Registrar.
I further understand that I may not accept any completed voter registration applications unless and until I complete the
training program mandated under Section 13.047 of the Texas Election Code.
I further understand that if I have been terminated as a volunteer deputy registrar because of a final conviction under
Section 13.008 of the Texas Election Code (prohibition against performance-based compensation for registering voters)
or Section 13.043 of the Texas Election Code (failure to deliver a voter registration application), I may not be reappointed
as a Volunteer Deputy Registrar.
_________________________________________
SIGNATURE OF APPLICANT
__________________
DATE
BW2-1
Prescribed by Secretary of State
Section 13.033, Texas Election Code
7/2012
For Election Official Use only
Date ______________________ Volunteer Deputy Number ________________________
THIS DEPUTIZATION IS VALID IN AND FOR __________________________________COUNTY ONLY.
SOLICITUD PARA NOMBRAMIENTO COMO SUBREGISTRADOR VOLUNTARIO
EN EL CONDADO DE ___________________________
Favor de escribir en letra de molde
NOMBRE
________________________________________________________________________________
Apellido Primer Nombre Segundo Nombre
DIRECCIÓN RESIDENCIAL
________________________________________________________________________________
Número y Calle Ciudad Código Postal
FECHA DE NACIMIENTO (MM/DD/AAAA)
_________________________
CORREO ELECTRÓNICO
_________________________________________
NÚMERO TELEFÓNICO DONDE PODEMOS HABLARLE
DE 8:00 A.M. A 5:00 P.M. DE LUNES A VIERNES
____________________________________
NÚMERO VUID (Optativo)
_______________________________
Entiendo que bajo la Fracción 13.031 del Código Electoral de Texas, un Registrador Adjunto Voluntario deberá (1) tener
por lo menos 18 años de edad; (2) nunca haber sido encontrado condenado por un delito grave, o en caso de ser
delincuente, haber (i) purgado la pena por completo, incluyendo cualquier plazo de encarcelamiento, libertad condicional,
supervisión o periodo de prueba ordenada por cualquier corte, o (ii) recibido un indulto o de otra manera haber sido
liberado de la resultante inhabilidad de poder votar; (3) no haber sido encontrado culpable de una ofensa bajo la Fracción
32.51 del Código Penal de Texas (robo de identidad); (4) ser un ciudadano de los Estados Unidos; (5) no haber sido
declarado (i) total ni (ii) parcialmente como discapacitado mental sin el derecho al voto, por el fallo final de un juzgado de
sucesiones; y (6) ser residente del estado de Texas. Afirmo que reúno todos los requisitos para ser Registrador Adjunto
Voluntario.
Además entiendo que no podré aceptar ninguna solicitud de registración de votante hasta que yo haya completado el
programa de capacitación conforme a la Fracción 13.047 del Código Electoral de Texas.
Además entiendo que si me dan de baja como registrador adjunto voluntario por razón de ser encontrado culpable bajo la
Fracción 13.008 del Código Electoral de Texas (prohibición de compensación basado en el rendimiento de inscribir a
votantes) o la Fracción 13.043 del Código Electoral de Texas (fallar en la entrega de una solicitud de votante), no volveré
ser designado Registrador Adjunto Voluntario.
_________________________________________
FIRMA DEL SOLICITANTE
__________________
FECHA
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REQUEST FOR APPOINTMENT AS A VOLUNTEER DEPUTY REGISTRAR (Texas Secretary of State)

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Completed 29 July 2020

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