Unsigned Ballot Statement


IMPORTANT: Read these instructions carefully before completing the statement.
Failure to follow these instructions may cause your ballot not to count.

1. In order to ensure that your vote-by-mail ballot will be counted, your statement should be completed and returned as soon as possible so that it can reach the elections official of the county in which your precinct is located no later than 5:00 p.m. on the eighth day after the election.

2. You must sign your name on the line above (Voter’s Signature).

3. Place the statement into a mailing envelope addressed to the Registrar of Voters, 1300 South Grand Avenue, Building C, Santa Ana, CA 92705. Be sure there is sufficient postage if mailed and that the address of the elections official is correct.

4. Alternatively, you may submit your completed statement by facsimile transmission to the Registrar of Voters at 714-567-7556, or submit your completed statement to a polling place within Orange County before the close of the polls on Election Day.

5. If you have any questions, call the Registrar of Voters’ office at (714) 567-7600.

Full name:
Residential address:
City:
Zip code: