READ THESE INSTRUCTIONS CAREFULLY BEFORE COMPLETING THE AFFIDAVIT.
FAILURE TO DO SO MAY CAUSE YOUR BALLOT NOT TO COUNT.
1. In order to cure a missing signature or a signature discrepancy on your Provisional Ballot Voter’s Certificate and Affirmation, your affidavit should be completed and returned as soon as possible so that it can reach the supervisor of elections of the county in which your precinct is located no later than 5 p.m. on the 2nd day after the election.
2. You must sign your name on the line above (Voter’s Signature).
3. Make a COPY of ONE of the following forms of identification:
TIER 1 IDENTIFICATION – Current and valid identification that includes your name and photograph:
· Current and valid Florida driver’s license
· Florida identification card from Department of Highway Safety and Motor Vehicles
· United States passport
· Debit or credit card
· Military identification
· Student identification
· Retirement center identification
· Neighborhood association identification
· Public assistance identification
· Veteran health card issued by U.S. Department of Veterans Affairs
· License to carry a concealed weapon or firearm issued pursuant to section 790.06, F.S.
· Employee ID card issued by any branch, department, agency, or entity of the Federal Government, state, county, or municipality OR
TIER 2 IDENTIFICATION - Identification that shows your name and current residence address (ONLY IF YOU DO NOT HAVE A TIER 1 FORM OF IDENTIFICATION):
· Current utility bill
· Bank statement
· Government check
· Government document (excluding voter information card)
4. Place the envelope bearing the affidavit into a mailing envelope addressed to the supervisor. Insert a copy of your identification in the mailing envelope. Mail (if time permits), deliver, or have delivered the completed affidavit along with the copy of your identification to your county supervisor of elections. Be sure there is sufficient postage if mailed and that the supervisor’s address is correct. Remember, your information MUST reach your county supervisor of elections no later than 5 p.m. on the 2nd day following the election or your ballot will not count.
5. Alternatively, you may fax or e-mail your completed affidavit and a copy of your identification to the supervisor of elections. If e-mailing, please provide these documents as attachments.
6. Submitting a provisional ballot affidavit does not establish your eligibility to vote in this election or guarantee that your ballot will be counted. The county canvassing board determines your eligibility to vote through information provided on the Provisional Ballot Voter’s Certificate and Affirmation, written evidence provided by you, including information in your cure affidavit along with any supporting identification, and any other evidence presented by the supervisor of elections or a challenger. You may still be required to present additional written evidence to support your eligibility to vote.
Bring your signed affidavit and the COPY of your identification to any of the offices of the Supervisor of Elections below.
Or you may fax your affidavit and copy of your identification to 727-464-7636 or email them to Elections@VotePinellas.com. If emailing, include the documents as attachments.
YOUR AFFIDAVIT AND COPY OF YOUR IDENTIFICATION MUST BE RECEIVED NO LATER THAN 5:00 P.M., ON THE 2ND DAY AFTER THE ELECTION AT ONE OF THE ELECTION OFFICES:
- 315 Court St, Room 117, Clearwater, FL 33756
- 13001 Starkey Rd, Largo, FL 33773
- 501 1st Ave N, (5th St N Entrance), St Petersburg, FL 33701
Offices hours are Monday-Friday, 8:00 a.m. - 5:00 p.m.
If you have any questions, call (727) 464-VOTE (8683)
PROVISIONAL BALLOT SIGNATURE AFFIDAVIT