AFFIDAVIT FOR REPLACEMENT BALLOT

The owner listed below declares and certifies under penalty of perjury under the laws of the State of California as follows:

PROPERTY OWNERS NAME

EMAIL ADDRESS

ASSOCIATION/COMMUNITY NAME

Type of Vote

Please note if you are unaware what type of vote is currently going on for your association, select both from the drop down menu.

Property Address

Please include your full property address.

Mailing Address

Please include your full mailing address. If you property address is the same as your mailing address please put 'same' in the below section.

CHOOSE ONE OF THE FOLLOWING:

Replace Voting Materials

Missing Outer Envelope Signature - I was informed by the inspector that I did not sign my outer envelope.

Date

YYYY

DIGITAL SIGNATURE

Type your Full Legal Name - I, the undersigned, do hereby declare and certify under penalty of perjury under the laws of the State of California that I am the legal owner of the property listed above and that the statements I have submitted are truthful.

***AFFIDAVIT FOR REPLACEMENT BALLOT***

AFFIDAVIT FOR REPLACEMENT BALLOT