The official canvass sheet used by the governing body of a municipality, school district, or other local jurisdiction to canvass an election shall be in the following form:

OFFICIAL CANVASS SHEET

Date of Election:______________________

Type of Election:______________________

Jurisdiction:__________________________

OFFICE OR QUESTION

Names of Candidates or

"Yes" and "No"

Precincts

Precinct 1

Precinct 2

Precinct 3

Precinct 4

Precinct 5

Precinct 6

Totals

STATE OF SOUTH DAKOTA )

) SS

COUNTY OF _____________ )

We, (listnames) , appointed as the Board of Canvassers because of our positions on the governing board in the jurisdiction of _______________ for the ________________election held on the ______ day of __________, 20____, hereby certify that the foregoing is a true abstract of the votes cast in the jurisdiction of ______________ at the election as shown by the returns certified to the person in charge of the election.

________________________________

________________________________

________________________________

________________________________

________________________________

Sworn to before me this ______ day of ______________, 20____.

________________________________

Person in Charge of the Election

Source: 16 SDR 20, effective August 10, 1989.

General Authority: SDCL 12-1-9.

Law Implemented: SDCL 9-13-24 , 13-7-18.