§216.EXHIBIT C. Voter Registration Application Transmittal

Suggested

July, 1995

SBE No. R-25

 

VOTER  REGISTRATION  APPLICATION

TRANSMITTAL

 

To:        _________________________________                      _____________________

                                  Election Office                                                                                Date

 

From:    _________________________________

                     Agency Office Number or Designation

 

Number of Voter Registration Applications Enclosed:  _________________________

 

Comments:  _____________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

 

 

 

(To be completed by Election Authority)

 

Date Received:  _________________

 

Number of Applications Received:__________________________________________

 

Number of Duplicate Registrations in Group:_________________________________

 

Number of Incomplete Applications:   _______________________________________

 

Problems or Other Comments:   ____________________________________________

 ________________________________________________________________________

 

________________________________________________________________________

 

 

 

White Copy – Election Authority                                        Yellow Copy – Agency

 

TRANSMITTAL FORM SPECIFICATIONS

 

PRINT AS TWO PART SELF DUPLICATING FORM

 

            Bottom of original – "Election Authority Copy"

            Bottom of second sheet – "Agency Copy"

 

SIZE 8-1/2" x 11"