Request to Review
Ballot Materials

 

Town of Orchid Special Election 
The deadline to submit this form to the Elections Office is 48 business 
hours prior to the start of the viewing access.

For access to review or inspect ballot materials from the Supervisor of Elections, check the applicable authorization category and submit the completed form. 

		 Candidate (Name of Candidate) _____________________
		 Political Party official chair (Name of Political Party) _____________________
		 Political Committee official chair (Name of Political Committee) __________________

Please complete the following statement(s) as applicable: I hereby swear or affirm that I am a person authorized by F.S. 101.572(2) to review or inspect this information.

Name: 		Position:		
Address:		
City, State, Zip:		
Phone:		

Signature:		Date:		

I also designate the representative listed below to act on my behalf to review or inspect this information.

Designated Representative(s): ONLY ONE PERSON on behalf of a given Candidate, Political Party, or Political Committee is permitted to review or inspect ballot materials at each viewing.

Name (of designee):		
Signature (of designee):		Date:		

Access to mail ballots under F.S. 101.572 (2) shall be provided on (Select which date(s) you are requesting to attend): 

	February 5th from 4:00 p.m. to 4:30 p.m. for which access must be requested by February 3rd at 4:00 p.m.	

F.S. 101.572(2): “A candidate, a political party official, or a political committee official, or an authorized designee thereof, shall be granted reasonable access upon request to review or inspect ballot materials before canvassing or tabulation, including voter certificates on vote-by-mail envelopes, cure affidavits, corresponding comparison signatures, duplicate ballots, and corresponding originals. Before the supervisor begins comparing signatures on vote-by-mail voter certificates, the supervisor must publish notice of the access to be provided under this section, which may be access to the documents or images thereof, and the method of requesting such access. During such review, no person granted access for review may make any copy of a signature.”

4375 43rd Avenue, Vero Beach, FL 32967 I Office: (772) 226-4700 I Fax: (772) 770-5367 I www.voteindianriver.gov
Monday - Friday 8:30 a.m. - 5:00 p.m. excluding holidays