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Vote-By-Mail Duplication Observer Affidavit

VOTE-BY-MAIL Duplication Observer Affidavit

Sections 101.5614(4)(a) and (8), Florida Statute (2022)

Note: A physically present candidate or their authorized designee, and one authorized representative of a political party and a political committee, respectively, may observe the duplication of vote-by-mail ballots after signing this affidavit and submitting it to the Broward County Supervisor of Elections.  

I hereby swear or affirm that:

Required
A candidate in the current elections;
A candidate in the current elections;
 Not Required
Authorized representative designated by the following candidate:
Authorized representative designated by the following candidate:
 Not Required
Not Required
Authorized representative designated by the following political Party:
Authorized representative designated by the following political Party:
 Not Required
Not Required
Authorized representative designated by the following political committee:
Authorized representative designated by the following political committee:
 Not Required
Not Required
Under penalties of perjury, I declare that I have read the foregoing affidavit and that the facts stated in it are true.
Under penalties of perjury, I declare that I have read the foregoing affidavit and that the facts stated in it are true.
 Required
Required
Required
Submit 


Disclaimer

I understand that any person who willfully affirms falsely to any affirmation in connection with elections, any person who perpetrates any fraud in connection with any vote to be cast in any election, and any person who releases any information about votes cast for or against any candidate or ballot measure or any results of any election before the closing of the polls in Broward County on election day in violation of Sections 101.5614(4)(a) and (8), Florida Statutes, can be convicted of a felony of the third degree and fined up to $5,000 and imprisoned for up to 5 years. I understand that my failure to sign this affidavit means that I may not observe the duplication of vote-by-mail ballots.

By signing your name electronically on the last field in the form, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form.

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Monday - Friday
8:30 a.m. - 5:00 p.m.
(Excluding Holidays)

General Contact Information
Phone: 954-357-VOTE (8683)
Fax: 954-357-7070
elections@browardvotes.gov

Main Office
Broward County Governmental Center
115 S. Andrews Ave. Room #102
Fort Lauderdale, FL 33301

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1501 NW 40th Avenue
Lauderhill, FL, 33313
(Entrance In the back of the Lauderhill Mall)