Absentee Ballot Certification Form

MAIL BALLOT CERTIFICATION FORM

Email the completed form to [email protected] no later than 18 days before each primary or election.

Instructions: 1. Download and save form. 2. Enter county name, election date, and type (special, primary, or general). Number of ballots issued 3. Check applicable boxes to certify ballot mailing according to RCW 29A.40.070. 4. Enter all information requested for delayed mailings. 5. Email completed certification to Elections Division by the 18th day prior to the election or primary.

County: ______, 20______Election

I hereby certify:

All regular voters were issued ballots at least 18 days before the date of the election. Number issued ______

A total of ______regular ballots did not meet the deadline. (If you checked this box, please fill out the information below.)

Reason(s) for delay: ______

Date of projected mailing: ______

Steps taken to remedy the delay: ______Certified by: Phone:

Title: Email: