"We, the undersigned, judges of an election held at ______ voting precinct, in _______ County, state of Utah, on __________(month\day\year), having first been sworn according to law, certify that the information in this form is a true statement of the number and names of the individuals voting in the voting precinct at the election, and that the total number of individuals voting at the election was ____.
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Judges of Election".
Utah Code § 20A-5-404