Minnesota Administrative Rules
Agency 133 - Secretary of State
Chapter 8210 - ABSENTEE BALLOTS
ABSENTEE BALLOT MATERIALS; INSTRUCTIONS
Part 8210.0800 - ABSENTEE BALLOT SIGNATURE ENVELOPE AS PROVIDED BY MINNESOTA STATUTES, SECTIONS 203B16 AND 203B17
Current through Register Vol. 49, No. 13, September 23, 2024
Subpart 1. [Repealed, 34 SR 1561 40 SR 1553]
Subp. 2. [Repealed, 34 SR 1561 40 SR 1553]
Subp. 3. Certificate of eligibility.
On the back of the absentee signature envelope provided for in Minnesota Statutes, section 203B.21, a certificate of eligibility must be printed on the envelope in the form shown in subpart 3a. The county auditor must provide the Certificate of Eligibility as an electronic document to voters who requested electronic delivery of absentee ballots.
Subp. 3a. Form of certificate of eligibility.
| Signature Envelope | |
| Voter must complete this section | please print clearly |
Voter name _____
Voter MN address (present or last) _____
_____ MN
ID number
(MN driver's license #,
MN ID card #,
U. S. passport #,
or last four digits of SSN)_____
Email _____
Phone (optional) _____
I swear or affirm, under penalty of perjury, that I am (check one):
| () a member of the uniformed services or merchant marine on active duty or an eligible spouse or dependent of such a member; | |
| () a United States citizen temporarily residing outside the United States; | |
| () other United States citizen residing outside the United States; | |
| and | |
| . | I am a United States citizen, |
| . | at least 18 years of age (or will be by the date of the election), and |
| . | I am eligible to vote in the requested jurisdiction; |
| . | I have not been convicted of a felony, or other disqualifying offense, or been adjudicated mentally incompetent, or, if so, my voting rights have been reinstated; and |
| . | I am not registering, requesting a ballot, or voting in any other jurisdiction in the United States except the jurisdiction cited in this voting form. |
| . | In voting, I have marked and sealed my ballot in private and have not allowed any person to observe the marking of the ballot, except for those authorized to assist voters under state or federal law. I have not been influenced. |
The information on this form is true, accurate, and complete to the best of my knowledge. I understand that a material misstatement of fact in completion of this document may constitute grounds for a conviction for perjury.
| Voter Signature X _____ |
Subp. 4. Sample envelope layout.
The secretary of state shall provide samples of the layout of the front and the back of the envelope.
Statutory Authority: MS s 201.061; 201.221; 203B.04; 203B.08; 203B.09; 203B.125; 204B.45
