House Journal: Page 794: Tuesday, March 25, 2003
15 by section 53.20 for purposes of the postelection
16 canvass.
17 2. Each person who casts a special provisional
18 ballot under this section shall receive a printed
19 statement in substantially the following form:
20 Your qualifications as a registered voter have been
21 challenged for the following reasons:
22 I. .................................................
23 II. .................................................
24 III. .................................................
25 Your right to vote will be reviewed by the special
26 precinct counting board on ...... You have the right
27 and are encouraged to make a written statement and
28 submit additional written evidence to this board
29 supporting your qualifications as a registered voter.
30 This written statement and evidence may be given to an
31 election official of this precinct on election day or
32 mailed or delivered to the county commissioner of
33 elections, but must be received before .... a.m./p.m.
34 on ...... at ...... If your ballot is not counted you
35 will receive, by mail, notification of this fact and
36 the reason that the ballot was not counted.
37 3. Any elector may present written statements or
38 documents, supporting or opposing the counting of any
39 special provisional ballot, to the precinct election
40 officials on election day, until the hour for closing
41 the polls. Any statements or documents so presented
42 shall be delivered to the commissioner when the
43 election supplies are returned.
44 4. The individual envelopes used for each paper
45 provisional ballot cast pursuant to subsection 1 shall
46 have printed on them the format of the face of the
47 registration form under section 48A.8 and the
48 following:
49 I believe I am a registered voter of this precinct
50 county and I am eligible to vote in this election. I
Page 8
1 registered to vote in ...... county on or about ......
2 at ....... My name at that time was ....... I have not
3 moved to a different county since that time. I am a
4 United States citizen, at least eighteen years of age.
5 ............................
6 (signature of voter) (date)
7 The following information is to be provided by the
8 precinct election official:
9 Reason for challenge:
10 ..................................
11 ..................................
12 ............................
13 (signature of precinct

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League of Women Voters of Iowa
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