notice of denial of request to cancel application for a ballot by mail

AW5-18
Prescribed by Secretary of State
Section 84.034, Texas Election Code
05/2012
NOTICE OF DENIAL OF REQUEST TO CANCEL
APPLICATION FOR A BALLOT BY MAIL
Name of Applicant:
_______________________________________________________
Notice is hereby given that your request to cancel your application for a ballot by mail has been denied on
the following ground(s):
(Check one)
_____ 1.
Your request was not signed.
_____ 2.
The election for which the request was made was not specified.
_____ 3.
Your request was not timely received.*
_____ 4.
Your marked ballot was received by me prior to your request.
____________________________________
Early Voting Clerk/Presiding Election Judge
___________________________
Date
*A request to cancel an application for ballot by mail is timely if (1) received by the early voting clerk in
person, by mail, or by other delivery means before the 3rd day before the election; (2) received by the early
voting clerk on or after the 3rd day before election day and accompanied (i) by the ballot to be voted by mail
or (ii) by an executed affidavit that the applicant has not received the ballot to be voted by mail; or (3)
received by the presiding election judge on election day at the applicant’s precinct polling place and
accompanied (i) by the ballot to be voted by mail or (ii) by a notice under Section 86.006(h), that mail ballot
returned in violation of the section and will not be counted.
AVISO DE REHUSAR LA SÚPLICA PARA CANCELAR LA SOLICITUD
PARA UNA BOLETA QUE SE VOTARÁ POR CORREO
Nombre del Solicitante:
_______________________________________________________
Por lo presente se da aviso que se ha rehusado su súplica para cancelar su solicitud para una boleta que se
votará por correo por la(s) siguiente(s) razón(es):
(Indique una)
_____ 1.
La súplica no estaba firmada.
_____ 2.
No mencionó específicamente en qué elección se hizo la súplica.
_____ 3.
No recibimos su súplica a tiempo.*
_____ 4.
Recibí su boleta marcada antes de recibir su súplica.
____________________________________
Secretario(a) para la Votación Adelantada/
Juez Electoral que preside
_______________________
Fecha
*Una súplica para cancelar la solicitud para una boleta por correo se considera haberse recibido a tiempo
(1) si la recibe el Secretario de Votación Adelantada en persona, por correo, u otro método de entrega antes
del tercer día antes de la elección; (2) si la recibe el Secretario de Votación Adelantada durante o después
del tercer día antes de la elección y se adjunta o (i) la boleta que se votará por correo o (ii) una declaración
jurada que diga que el solicitante no recibió la boleta por correo; ó (3) si la recibe el Juez Electoral que
preside el día de elección en el sitio electoral del precinto del votante y se adjunta o (i) la boleta que se
votará por correo o (ii) un aviso bajo la Sección 86.006(h), que la boleta por correo se regresó en violación
de la sección y no será contada.