PROVISIONAL VOTER NOTICE § 24.2-653, Code of Virginia

The officer of election must give this notice to every voter completing a provisional ballot at the polling place for one of the reasons indicated below. The officer must also check the provisional reason(s) below that correspond to the voter's provisional ballot envelope.

Dear Provisional Voter,

You voted a provisional ballot today for the reason(s) checked below. Your local electoral board will meet to determine which provisional ballots should be counted starting at ______AM/PM on the day after the election, at ______. You have the right to attend the meeting to present any information that might prove you are a qualified registered voter of this precinct; you may bring legal counsel with you. You may also request an extension of the determination of the provisional vote in order to provide such information. The electoral board may adjourn determination for no more than seven (7) days after the election. If the electoral board cannot determine that you are a qualified registered voter of this precinct, then your ballot will not be counted. After the completion of the vote count, you can find out if your ballot was counted by calling the toll-free number: 866-839-2556; ask for locality #______. If you have any questions, you may contact your local general registrar’s office by phone, ______, or email, ______.

 Name not on pollbook (Reasons #1 and #2 on  Voted after normal poll closing (Reason #3) provisional ballot envelope) You were required to vote a provisional ballot because Your name did not appear on the list of persons you voted after the normal poll closing time due to a registered to vote in this precinct and the general court order extending the voting hours established by registrar either could not determine your qualifications state law. to vote or could not be reached. Since you told the If the court order has not been overturned when the election officer that you are qualified and registered to ballots are ready to be counted, and you are otherwise vote in this precinct you have been given a provisional registered and qualified to vote in this precinct, your ballot to vote. ballot will be counted. If another provisional reason also To count your ballot, the electoral board must applies to you, please see that reason. determine that you are or should have been registered for this election and are qualified to vote in this precinct.  Absentee ballot lost or not received (Reason #4) If you applied for registration at a DMV or another You were required to vote a provisional ballot because government agency, please provide the agency name, our records show that you were issued an absentee ballot location and approximate date to the officer of election. but it had not been returned prior to election day, either If you have a registration receipt from an agency, please marked or unmarked. You offered to vote in your provide the information to the officer while you are at regular polling place, indicating that your absentee ballot the polls, or call your local general registrar before the was unavailable. meeting listed above. If it is proven that you attempted If you are otherwise registered and qualified to vote in to register before the close of books at a DMV office or this precinct, your provisional ballot will be counted another National Voter Registration Act designated after the electoral board verifies that your absentee ballot agency (and only at these offices), the registrar will use was not received and counted. the voter registration application you completed and turned in at the polls today to determine your  Shown as having already voted (Reason #5) qualifications to be registered, which may result in your You are required to vote a provisional ballot because the ballot being counted. pollbook shows you have already cast a ballot. If your registration was cancelled and you believe If elections officials are able to determine that you this was in error, you may provide information to this did not actually cast a ballot, or that there is an error effect to the general registrar before the meeting listed within their records, your ballot will be counted. above, or attend to present your information. The general registrar will notify you in writing if  Other (Reason #6) you are not properly registered. ______

ELECT-653N Rev. 7/2017