Minn. R. Part 8210.0600
The statement of absentee voter for persons voting under Minnesota Statutes, sections 203B.04 to 203B.15, must be printed in the forms shown in subparts 1a and 1b. The version found in subpart 1a must be provided only to absentee voters who are registered to vote at the time of application. All other absentee voters must be provided the version found in subpart 1b. The statements must be printed to the specifications of subpart 3.
Signature Envelope
| Voter must complete this section | please print clearly |
| Voter name _____ | |
| Voter MN address _____ | |
| _____MN | |
| ID number | |
| (MN driver's license #, | |
| MN ID card #, | |
| or last four digits of SSN) _____ | |
| * I do not have a MN-issued driver's license, MN-issued ID card, or a Social Security Number. |
I certify that on Election Day I will meet all the legal requirements to vote.
| Voter SignatureX _____ |
Witness must complete this section
| Witness name _____ | |
| MN street address | |
| (or title, if an | |
| official or notary) | |
| _____ | |
| Street Address | |
| _____MN | |
| City |
I certify that:
| . | the voter showed me the blank ballots before voting; |
| . | the voter marked the ballots in private or, if physically unable to mark the ballots, the ballots were marked as directed by the voter; |
| . | the voter enclosed and sealed the ballots in the ballot envelope; and |
| . | I am or have been registered to vote in Minnesota, or am a notary, or am authorized to give oaths. |
| Witness Signature X _____ | ||
| If notary, must affix stamp |
Signature Envelope
| Voter must complete this section | please print clearly |
| Voter name_____ | |
| Voter MN address_____ | |
| _____MN | |
| ID number | |
| (MN driver's license #, | |
| MN ID card #, | |
| or last four digits of SSN) _____ | |
| * I do not have a MN-issued driver's license, MN-issued ID card, or a Social Security Number. |
I certify that on Election Day I will meet all the legal requirements to vote.
| Voter SignatureX _____ |
Witness must complete this section
| Witness name _____ | |
| MN street address | |
| (or title, if an | |
| official or notary) | |
| _____ | |
| Street Address | |
| _____MN | |
| City |
Witness MUST CHECK ONE indicating proof of residence provided by voter: (See instructions)
| -9 | MN driver's license, ID card, permit, or receipt |
| -9 | Bill, student fee statement, or residential lease plus photo ID |
| -9 | Registered voter in the precinct who vouched for voter's residence in the precinct (must complete the voucher form on the back of the Voter Registration Application) |
| -9 | Tribal ID card |
| -9 | Notice of late registration |
| -9 | Previous registration in the same precinct |
| -9 | An employee of a residential facility in the precinct who vouched for voter's residence at the facility (must complete the voucher form on the back of the Voter Registration Application) |
I certify that:
| . | the voter showed me the blank ballots before voting; |
| . | the voter marked the ballots in private or, if physically unable to mark the ballots, the ballots were marked as directed by the voter; |
| . | the voter enclosed and sealed the ballots in the ballot envelope; |
| . | the voter registered to vote by filling out and enclosing a voter registration application in this envelope; |
| . | the voter provided proof of residence as indicated above; and |
| . | I am or have been registered to vote in Minnesota, or am a notary, or am authorized to give oaths. |
| Witness SignatureX _____ | ||
| If notary, must affix stamp |
The statement shall be printed on the back of the absentee ballot return envelope. The words "Voter must complete this section" and "Witness must complete this section" shall be printed in no smaller than 12-point bold type. The "X" on the signature lines must be in at least 20-point type. The remainder of the statement shall be printed in no smaller than 10-point medium type. The area for the voter's name and address must be no smaller than 1-1/4 inches by 3-1/4 inches. The voter's certificate must be at least 4-1/8 inches wide. County auditors and municipal clerks may use the existing stock of absentee ballot return envelopes on hand as of January 1, 2014, for absentee voting conducted in-person.
Minn. R. Part 8210.0600
Statutory Authority: MS s 201.061; 201.221; 203B.04; 203B.08; 203B.09; 203B.125; 203B.14; 204B.45