Minnesota Administrative Rules
Agency 133 - Secretary of State
Chapter 8200 - VOTER REGISTRATION
FORMS
Part 8200.9960 - CHALLENGES TO VOTER REGISTRATION, FORM TO BE USED UNDER MINNESOTA STATUTES, SECTION 204C.12, SUBDIVISION 2

Universal Citation: MN Rules 8200.9960
Current through Register Vol. 49, No. 13, September 23, 2024

I,_____, do hereby state under oath,
Name of person making challenge
I am:
() an election judge.
() a challenger authorized by Minnesota Statutes, section 204C.07.
() a Minnesota voter.
I reside at_____,_____,
Street Address City or Township
Telephone number:_____
E-mail address (optional):_____
I challenge the registration of _____
Name of challenged voter
whose registration lists his or her residence as
_____ _____
Street Address City or Township
This challenge is based on my personal knowledge. The grounds for my challenge are:_____
_____
_____
(attach additional sheets of signed statement if necessary).
I swear or affirm that the information stated here is truthful.
__/__/____ _____
Date Signature of Challenger
Signed and sworn to or affirmed before me
__/__/____ _____
Date Signature of Election Judge
For Election Judge Use Only:
Challenge was administered by Election Judge:_____
Time:_____
() Voter refused to take challenge oath.
() Challenge was dismissed: Voter passed challenge and voted.
() Challenge was sustained: Voter failed challenge and did not vote.
Additional Comments:

Statutory Authority: MS s 201.061; 201.221; 203B.09

Disclaimer: These regulations may not be the most recent version. Minnesota may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.