Request for Assistance Form

This is an example of a Request for Assistance form, which you will use for voters needing assistance at the voting booth with reading, translating, or marking their ballot.

In total, 3 people must mark this form:

  • An election officer should write the precinct number & name and the date at the top of the form.
  • The voter must print and sign their name in Section A.
  • The assistant must print and sign their name and address in Section B.

If an election officer is asked to translate the ballot as the assistant, and an Authorized Representative wants to observe, they should fill out section C.