Page:Election Integrity Act of 2021 (U.S. state of Georgia).pdf/54

21 ________________________ Signature or Mark of Elector

________________________ Printed Name of Elector


 * Oath of Person Assisting Elector (if any):
 * I, the undersigned, do swear (or affirm) that I assisted the above-named elector in marking such elector's absentee ballot as such elector personally communicated such elector's preference to me; and that such elector is entitled to receive assistance in voting under provisions of subsection (a) of Code Section 21-2-409.
 * This, the ______ day of _________, _________.

___________________________

____________________________


 * Reason for assistance (Check appropriate square):
 * Blancovinkjeemptysmall.png Elector is unable to read the English language.
 * Blancovinkjeemptysmall.png Elector requires assistance due to physical disability.
 * The forms upon which such oaths are printed shall contain the following information:
 * Georgia law provides that any person who knowingly falsifies information so as to vote illegally by absentee ballot or who illegally gives or receives assistance in voting, as specified in Code Section 21-2-568 or 21-2-573, shall be guilty of a felony.

S. B. 202 - 54 -