Suggested

July, 1995

SBE No. R-25

VOTER REGISTRATION APPLICATION

TRANSMITTAL

To: _________________________________ _____________________

Election Office Date

From: _________________________________

Agency Office Number or Designation

Number of Voter Registration Applications Enclosed: _________________________

Comments: _____________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

(To be completed by Election Authority)

Date Received: _________________

Number of Applications Received:__________________________________________

Number of Duplicate Registrations in Group:_________________________________

Number of Incomplete Applications: _______________________________________

Problems or Other Comments: ____________________________________________

________________________________________________________________________

________________________________________________________________________

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