25-1122d. Advance voting; application for ballot, form; identification, form of.
25-1122d
25-1122d. Advance voting; application for ballot,form; identification, form of.(a) The application for an advance voting ballot to be transmitted bymail shall be accompanied by an affirmation in substance as follows:
Affirmation of an Elector of the County of ______________ andState of Kansas Desiring to Vote an Advance Voting Ballot
State of ______________, County of ______________, ss:
I,
,
do solemnly affirm under penalty of perjury that I am a qualifiedelector of the ______________precinct of the ______________ ward, residing at number _______________on __________________ street, city of _________, or in the township of__________, county of __________, and state of Kansas. My date of birth is______________________(month/day/year).
I understand that if I have not previously voted in any electionin this county and I have not previously submitted valid identification, I mustprovide one of the following forms ofidentification with this application in order to receive a ballot:
(1) A current and valid Kansas driver's license number ornondriver's identification card number; or
(2) the last four digits of my social security number; or
(3) a copy of a current and valid Kansas driver's license ornondriver's identification card, utility bill, bank statement,paycheck, government check, or other government document thatshows my name and address.
I am entitled to vote anadvance voting ballot and I have not voted and will not otherwisevote at the election to be held on __________ (date). Mypolitical party is ________ (to be filled inonly when requesting primary election ballots). I desire my ballots tobe sent to the following address
_______________________________________
_______________________________________ Signature of voter.
Note: False statement on this affirmation is aseverity level 9, nonperson felony.
(b) The application for an advance voting ballot to betransmitted in person shall be accompanied by an affirmation insubstance as follows:
Affirmation of an Elector of the County of ______________and State of Kansas Desiring to Vote an Advance Voting Ballot
State of ______________, County of ______________, ss:
I,
,
do solemnly affirm under penalty of perjury that I am a qualifiedelector of the ______________ precinct of the ______________ward, residing at number _______________ on__________________ street, city of _________, or in thetownship of __________, county of __________, and state ofKansas. My date of birth is ______________________(month/day/year).
I understand that if I have not previously voted in any electionin this county and I have not previously submitted valid identification, I mustprovide one of the following forms of identification with this application inorder to receive a ballot: a current and valid Kansas driver's license ornondriver's identification card, utility bill, bank statement, paycheck,government check or other government document that shows my name and address.
I am entitled to vote an advance voting ballot and I have notvoted and will not otherwise vote at the election to be held on__________ (date). My political party is ________ (to be filled inonly when requesting primary election ballots).
_______________________________________
_______________________________________ Signature of voter.
Note: False statement on this affirmation is a severity level 9, nonpersonfelony.
(c) An application for permanent advance voting status shall be on aform prescribed by the secretary of state for this purpose. Suchapplication shall contain an affirmation concerning substantially the sameinformation required in subsection (a) and in addition thereto a statementregarding the permanent character of such illness or disability.
(d) Any application by a former precinct resident shallstate both theformer and present residence, address, precinct and county of such formerprecinct resident and the date of change of residence.
History: L. 1978, ch. 140, § 5; L. 1980, ch. 109, § 2; L. 1984,ch. 140, § 2;L. 1995, ch. 192, § 21;L. 1996, ch. 187, § 26;L. 2000, ch. 49, § 2;L. 2004, ch. 93, § 2; July 1.