DECLARATION TO SECURE ASSISTANCE
State of Florida
County of
Date
Precinct
I, (Print name) , swear or affirm that I am a registered elector and request assistance from (Print names) in voting at the (name of election) held on (date of election) .
(Signature of voter)
Sworn and subscribed to before me this day of, (year) .
(Signature of Official Administering Oath)
DECLARATION TO PROVIDE ASSISTANCE
State of Florida
County of
Date
Precinct
I, (Print name) , have been requested by (print name of elector needing assistance) to provide him or her with assistance to vote. I swear or affirm that I am not the employer, an agent of the employer, or an officer or agent of the union of the voter and that I have not solicited this voter at the polling place, secure ballot intake station location, or early voting site or within 150 feet of such locations in an effort to provide assistance.
(Signature of assistor)
Sworn and subscribed to before me this day of, (year) .
(Signature of Official Administering Oath)
Fla. Stat. § 101.051
Former s. 100.36.