application for absentee voter ballot solicitude para la balota de

application for absentee voter ballot solicitude para la balota de

MRGCD ELECTION DIRECTOR
PO BOX 44607
RIO RANCHO NM 87174
APPLICATION FOR ABSENTEE VOTER BALLOT
SOLICITUDE PARA LA BALOTA DE VOTANTE AUSENTE
M
I D D L E
D
2013
ELECTION
R
I O
I S T R I T O
C
G
R A N D E
C
O N S E R V A N C I A
O N S E RVA N C Y
D
E L
M
E D I O
R
I O
D
G
I S T R I C T
R A N D E
APPLICATION FOR ABSENTEE VOTER BALLOT
SOLICITUDE PARA LA BALOTA DE VOTANTE AUSENTE
COUNTY / CONDADO
I hereby declare that I am a qualified elector as defined by state law, I am at least 18 years of age, and I am qualified to vote in the election
for Board of Directors of the Middle Rio Grande Conservancy District. I declare that I am casting only one vote in said county, even though
I may be a qualified elector in more than one county within the benefited area of the Conservancy District.
Declaro que soy electór calificado segun la ley estatal, que tengo por lo menos 18 años de edad, y que soy calificado para votar en la
elección de Directores del Distrito Conservancia del Medio Rio Grande. Declaro que lanzo sólo un voto en dijo condado, aunque yo
pudiera ser electór calificado en mas de un condado del area beneficiado del Distrito Conservancia del Medio Rio Grande.
Print or type qualified elector’s name/
Nombre del elector calificado - escrito a maquina o imprimido
Street Address of qualified elector
La dirección de la calle de elector calificado
City - State - Zip
Ciudad - Estado - Zona Postal
OFFICIAL MRGCD ELECTION MATERIAL - DO NOT DUPLICATE
Description of qualifying property
Descripcion de la propriedad de que es dueno:
X___________________________________
Signature of Voter
MRGCD-ABS-001 (Rev. 2/2013)
Affix Standard
FIRST CLASS
postage here
MRGCD ELECTION DIRECTOR
PO BOX 44607
RIO RANCHO NM 87174
Fold on this line, close with tape (DO NOT STAPLE), place postage and mail.
FOR MRGCD ELECTION DIRECTOR USE ONLY
Date Received
/
/ 20
Time:
:
m
ACCEPTED AS QUALIFIED ELECTOR
Qualified Elector List Control #
Ballot sent:
/
/ 20
REJECTED
Individual Name not on Qualified Elector List
Other reason (specify)
Rejected by (printed name):
Rejection notice sent
Election Board Signature:
/
/ 20
Date
/
/ 20