I am a United States citizen, at least eighteen years of age or, for purposes of voting in a primary election, I will be at least eighteen years of age on the date of the respective general election or city election. I believe I am a registered voter of this county and I am eligible to vote in this election.
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(signature of voter) (date)
Reason for casting provisional ballot:
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(signature of precinct election official)
Iowa Code § 49.81
Referred to in §48A.7A, 48A.8, 49.77, 49.78, 49.79, 49.80, 50.20, 50.21, 53.19