INSTRUCTIONS AND FORM FOR VOTE-BY-MAIL BALLOT CURE AFFIDAVIT
is adavit is for a voter who returns a vote-by-mail ballot that does not include the
voter’s signature or whose signature does not match the voter’s signature on le.
A. INSTRUCTIONS - READ CAREFULLY TO HAVE YOUR VOTE-BY-MAIL BALLOT COUNT
In order to ensure that your vote-by-mail ballot will be counted, your adavit should be completed and returned
as soon as possible so that it can reach the supervisor of elections of the county in which your precinct is located
no later than 5 p.m. on the second day aer the election. You must:
❒ Complete and sign the adavit below - sign on the line above (Signature of Voter); AND
❒ Include a copy of one of the following forms of identication (ID):
Tier 1 Ident
ication - Current and valid ID that includes your name and photograph: Florida driver license;
Florida id
entication card issued by the Department of Highway Safety and Motor Vehicles; United States
passport; d
ebit or credit card; military, student, retirement center, neighborhood association, or public
assistan
ce ID; veteran health ID card issued by U.S. Department of Veterans Aairs; Florida license to carry
a concealed weapon or rearm; or employee ID card issued by any branch, department, agency, or entity of
the Federal G
overnment, the state, a county, or a municipality; or if you do not have one of the above forms
of ID, use one of t
hese instead:
Tier 2 Ident
ication - ID that shows your name and current residence address: current utility bill, bank
statemen
t, government check, paycheck, or government document (excluding voter ID card).
❒ Return the comp
leted adavit and the copy of your ID to your county supervisor of elections by one of
the followin
g means:
• Deliver in per
son or by someone else; or
• Mail, if time p
ermits[Insert the completed adavit and ID into a mailing envelope and address to the supervisor.
Be sure there i
s sucient postage and the supervisor’s address is correct]; or
• Fax or email [At
tach the completed adavit and copy of the ID].
BY MAIL - Broward Supervisor of Elections, PO BOX 029026, Ft. Lauderdale, FL 33302-9026
FAX
IN PERSON - You may hand deliver these documents to the Broward County Supervisor of Elections
Voting Equipment Center at: 1501 NW 40th Ave, Lauderhill, FL 33313 (Phone No. 954-357-7055)
WEBSITE - www.browardvotes.gov
Remember, your information MUST reach your county supervisor of elections no later than 5 PM on the second
day after the election, or your ballot will not count.
B. FORM
VOTE-BY-MAIL BALLOT CURE AFFIDAVIT
I, , am a qualied voter in this election and registered voter of
County, Florida. I do solemnly swear or affirm that
I requested and returned the vote-by-mail ballot and that I have not and will not vote more than one ballot in this election.
I understand that if I commit or attempt any fraud in connection with voting, vote a fraudulent ballot, or vote more than
once in an election, I may be convicted of a felony of the third degree and ned up to $5,000 and imprisoned for up to 5
years. I understand that my failure to sign this adavit means that my vote-by-mail ballot will be invalidated.
(Print Voter’s Name)
(Print Name of County)
(Signature of Voter)
(Address of Voter)
Form DS-DE 139 (e. 07-2019)
