<html> <head> <title>Rule 05:02:10:01.03 Combined absentee ballot application/return envelope.</title> <META NAME="Keywords" Content="Administrative Rules 05:02:10:01.03"> <META NAME="Description" Content="Administrative Rules 05:02:10:01.03 Combined absentee ballot application/return envelope."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 15 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:Wingdings; panose-1:5 0 0 0 0 0 0 0 0 0;} @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; font-size:12.0pt; font-family:"Times New Roman",serif; color:black;} a:link, span.MsoHyperlink {color:blue; text-decoration:underline;} a:visited, span.MsoHyperlinkFollowed {color:#954F72; text-decoration:underline;} .MsoChpDefault {font-size:10.0pt; color:black;} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} /* List Definitions */ ol {margin-bottom:0in;} ul {margin-bottom:0in;} --> </style> </head> <body lang=EN-US link=blue vlink="#954F72"> <div class=WordSection1> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>5:02:10:01.03.&nbsp;&nbsp;Combined absentee ballot application/return envelope.</b> The application for an in-office absentee ballot shall be printed in the following form on an envelope used for sealing the voted ballot:</p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal align=center style='text-align:center'><b>APPLICATION FOR IN-OFFICE ABSENTEE BALLOT</b></p> <p class=MsoNormal align=center style='text-align:center'><b>___________________ COUNTY, SOUTH DAKOTA</b></p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'>My printed name as it appears on the voter registration list is:____________________________</p> <p class=MsoNormal style='text-align:justify'>My voter registration residence address is: ___________________________________________</p> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (address)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (city)</p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'>Check the election for which you are requesting an absentee ballot:</p> <p class=MsoNormal style='margin-left:1.0in;text-align:justify;text-indent: -1.0in'><span style='font-size:16.0pt'>&#9633;</span>&nbsp;&nbsp;Primary&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; If you are registered as an independent and are requesting a primary ballot, you may have a choice of ballots. Please check one of the following:&nbsp; <span style='font-size:16.0pt'>&#9633;</span> Non-political ballot or <span style='font-size:16.0pt'>&#9633;</span> Democratic Party ballot</p> <p class=MsoNormal style='text-align:justify'><span style='font-size:16.0pt'>&#9633;</span>&nbsp;&nbsp;General</p> <p class=MsoNormal style='text-align:justify'><span style='font-size:16.0pt'>&#9633;</span>&nbsp;&nbsp;Municipal</p> <p class=MsoNormal style='text-align:justify'><span style='font-size:16.0pt'>&#9633;</span>&nbsp;&nbsp;School</p> <p class=MsoNormal style='text-align:justify'><span style='font-size:16.0pt'>&#9633;</span>&nbsp;&nbsp;Special ___________________(specify jurisdiction)</p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'>If request is for a municipal or school election:</p> <p class=MsoNormal style='text-align:justify'>I have lived in that jurisdiction at least 30 days in the last year.&nbsp;&nbsp;&nbsp;&nbsp; Yes&nbsp; <span style='font-size:16.0pt'>&#9633;</span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; No&nbsp; <span style='font-size:16.0pt'>&#9633;</span></p> <p class=MsoNormal style='margin-left:.4in;text-align:justify;text-indent:-.4in'>I am a full-time postsecondary student who resided in that jurisdiction immediately prior to leaving for postsecondary education.&nbsp;&nbsp;&nbsp;&nbsp; Yes&nbsp; <span style='font-size:16.0pt'>&#9633;</span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; No&nbsp; <span style='font-size:16.0pt'>&#9633;</span></p> <p class=MsoNormal style='margin-left:.4in;text-align:justify;text-indent:-.4in'>I am on active duty military and my home of record is in that jurisdiction.&nbsp;&nbsp;&nbsp;&nbsp; Yes&nbsp; <span style='font-size:16.0pt'>&#9633;</span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; No&nbsp; <span style='font-size:16.0pt'>&#9633;</span></p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'>I, under penalty of impersonating a registered voter (5 years imprisonment and $10,000 fine), state that I am the person named above, these statements made by me are true and correct, and that I will vote the ballot which will be enclosed in this envelope.</p> <p class=MsoNormal style='text-align:justify'>______________________________________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ___________________</p> <p class=MsoNormal style='text-align:justify'>Voter Signature&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date</p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'><b>INSTRUCTIONS TO THE VOTER</b></p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='margin-left:64.5pt;text-align:justify;text-indent: -.25in'><span style='font-family:Wingdings'>&#167;<span style='font:7.0pt "Times New Roman"'>&nbsp; </span></span>Mark your ballot privately.</p> <p class=MsoNormal style='margin-left:64.5pt;text-align:justify;text-indent: -.25in'><span style='font-family:Wingdings'>&#167;<span style='font:7.0pt "Times New Roman"'>&nbsp; </span></span>Do not fold your ballot.</p> <p class=MsoNormal style='margin-left:64.5pt;text-align:justify;text-indent: -.25in'><span style='font-family:Wingdings'>&#167;<span style='font:7.0pt "Times New Roman"'>&nbsp; </span></span>Place your ballot in this envelope and seal it securely.</p> <p class=MsoNormal style='margin-left:64.5pt;text-align:justify;text-indent: -.25in'><span style='font-family:Wingdings'>&#167;<span style='font:7.0pt "Times New Roman"'>&nbsp; </span></span>Return the envelope immediately to the person in charge of the election.</p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'><b>Auditor Office Use Only:</b></p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'>Voter Precinct: ________</p> <p class=MsoNormal style='text-align:justify'>Type of ID: _________</p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'>Printers Note: When this form is printed for primary, general, or other county elections, reference to municipal and school elections may be omitted. The instruction to &quot;not fold your ballot&quot; may be changed if the ballot is to be folded.</p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 32 SDR 225, effective July 3, 2006; 33 SDR 230, effective July 1, 2007; 36 SDR 112, effective January 11, 2010.</p> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=12-1-9">12-1-9(8)</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=12-19-2.5">12-19-2.5.</A></p> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=12-19-2">12-19-2</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=12-19-2.1">12-19-2.1</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=12-19-9.1">12-19-9.1</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=12-19-2.5">12-19-2.5</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=12-26-7">12-26-7</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=22-6-1">22-6-1.</A></p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> </div> </body> </html>