The precinct election board's receipt for the official ballots shall be in the following form:

1. (Herelisttheofficialballotsreceived) ______________________________ ______________________________

   ______________________________ ______________________________

   ______________________________ ______________________________

   ______________________________ ______________________________

   ______________________________ ______________________________

   for the use of the voters at the election.

   Dated this ____ day of ____________, 20____.

   _____________________________________ Precinct Superintendent

   _____________________________________ Precinct Deputy

   _____________________________________ Precinct Deputy

   _____________________________________ Precinct Deputy

   _____________________________________ Precinct Deputy

STATE OF SOUTH DAKOTA

____________ COUNTY

____________ PRECINCT

We, the Precinct Election Board Members, do hereby certify that on Tuesday the ____ day of _______________, 20____, at the opening of the polls for the election held on that day, we received from ____________________ a sealed package containing the following official ballots:

Source: 4 SDR 85, effective June 14, 1978; 25 SDR 167, effective July 6, 1999.

General Authority: SDCL 12-1-9(4) , 12-17B-17(2).

Law Implemented: SDCL 12-16-20.