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Complaint Form
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| In accordance with section 402 (a) of the Help America Vote Act of 2002 (HAVA), this form can be used by any person who believes a violation of HAVA Title III has occurred, is occurring or is about to occur. Requirements defined in Title III include: voting system standards, provisional voting, voting information, computerized statewide voter registration list, and registration by mail. | |||
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Name of voter/complainant: |
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Address:
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Telephone:
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County:
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Date of Complaint:
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Description of
complaint:
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Voter/Complainant
Signature:
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Notary Signature
(Required):
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Commission Expires:
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Return Form to:
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