Poll Book, Tally List and Official Returns

Poll Book, Tally List and Official Returns

(ForPublicSchoolDistricts) First,AnnualandSpecialElection

STATEOFNORTHDAKOTA

Countyof

______SchoolDistrict

Atanelectionheldat in PublicSchoolDistrict No. ,Countyof ,StateofNorthDakota,onthe dayof ,20 ,thepollsof saidelectionbeingopenat 11:00a.m.of saiddayandcontinuing openuntil7:00p.m.ofthesameday,thefollowingoathsweretakenbytheJudgesandClerksofElection.

*Idosolemnly**swear(oraffirm)thatIwillperformmydutiesasJudge accordingto lawandthebestof myability.

Idoherebycertifythattheaboveoathwasadministeredbymeto

,JudgeofsaidElection,andbyhimsubscribedinmypresencepreviousto openingthepolls.

OfficeTitle

*Idosolemnly**swear(oraffirm)thatIwillperformmydutiesasJudge accordingto lawandthebestof myability.

Idoherebycertifythattheaboveoathwasadministeredbymeto

,JudgeofsaidElection,andbyhimsubscribedinmypresencepreviousto openingthepolls.

OfficeTitle

*Idosolemnly**swear(oraffirm)thatIwillperformmydutiesasClerkaccordingtolawandthebestof myability.

Idoherebycertifythattheaboveoathwasadministeredbymeto

,ClerkofsaidElection,andbyhimsubscribedinmypresencepreviousto openingthepolls.

OfficeTitle

*Idosolemnly**swear(oraffirm)thatIwillperformmydutiesasClerkaccordingtolawandthebestof myability.

Idoherebycertifythattheaboveoathwasadministeredbymeto

,ClerkofsaidElection,andbyhimsubscribedinmypresencepreviousto openingthepolls.

OfficeTitle

* Suchoathoraffirmationmaybeadministeredbyanyofficerauthorizedtoadministeroaths,orbyeitheroftheJudgesorClerks

**Ifanoath,strikeoutthewords"oraffirm." Ifanaffirmation,strikeoutthewords"Swear,or."

No. / Name / Address
1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
7
8
9
20
1
2
3
4
5
6
7
8
9
30
1
2
3
4
5
6
7
8
9
40
No. / Name / Address
1
2
3
4
5
6
7
8
9
50
1
2
3
4
5
6
7
8
9
60
1
2
3
4
5
6
7
8
9
70
1
2
3
4
5
6
7
8
9
80
No. / Name / Address
1
2
3
4
5
6
7
8
9
90
1
2
3
4
5
6
7
8
9
100
1
2
3
4
5
6
7
8
9
110
1
2
3
4
5
6
7
8
9
120
No. / Name / Address
1
2
3
4
5
6
7
8
9
130
1
2
3
4
5
6
7
8
9
140
1
2
3
4
5
6
7
8
9
150
1
2
3
4
5
6
7
8
9
160

TallyList

FirstandAnnualElection--PublicSchoolDistrict

UseOneorMoreLines,asMaybeRequiredforEachName

NamesofCandidates / 5 / 10 / 15 / 20 / 25 / 30 / 35 / 40 / 45 / 50 / 55 / 60 / 65 / 70 / 75 / 80 / 85 / 90 / 95 / 100 / Total
ForMemberofSchoolBoardfora termof
___ year(s).
ForMemberofSchoolBoardfora termof
___ year(s).
ForMemberofSchoolBoardfora termof
___ year(s).

TallyListforSpecialElection--PublicSchoolDistrict

For
Against
For
Against
For
Against

OfficialReturns

FirstandAnnualElection,PublicSchoolDistrict

GiveNumberofBallotsBothinWordsandFigures

Weherebycertifythatatanelectionheldin PublicSchoolDistrictNo.

Countyof ,StateofNorthDakota,onthe dayof ,20______

therewere votescastforMemberofSchoolBoardin saidPublicSchoolDistrictforthetermof year(s),

ofwhich received votes;

ofwhich received votes; ofwhich received votes; ofwhich received votes;

havingreceivedthehighestnumberof votesis herebydeclaredelectedMemberofSchoolBoardforthetermof year(s).

Therewere votescastfor

MemberofSchoolBoardinsaidPublicSchoolDistrictforthetermof year(s)

ofwhich received votes; ofwhich received votes; ofwhich received votes; ofwhich received votes;

havingreceivedthehighestnumberof votesis herebydeclaredelectedMemberofSchoolBoardforthetermof year(s).

Therewere votescastfor

MemberofSchoolBoardinsaidPublicSchoolDistrictforthetermof years(s).

ofwhich received votes; ofwhich received votes; ofwhich received votes; ofwhich received votes;

havingreceivedthehighestnumberof votesis

herebydeclaredelectedMemberofSchoolBoardforthetermof year(s).

OfficialReturnsforSpecialElection-PublicSchoolDistrict

Weherebycertifythatanelectionofthevotersofthe PublicSchoolDistrictNo.

heldat in PublicSchoolDistrictNo. ,Countyof

,StateofNorthDakota,onthe dayof ,20 , forthepurposeofdeterminingthequestionof

Therewere votescastupon thequestionof ofwhich voteswerefor ofwhich voteswereagainst .Themajorityofallvotescastbeing

(For,etc.,orAgainst ,etc.,statingtheproposition)

Thequestionof isherebydeclaredtobe

(CarriedorLost)

Therewere votescastupon thequestionof ofwhich voteswerefor ofwhich voteswereagainst .Themajorityofallvotescastbeing

(For,etc.,orAgainst ,etc.,statingtheproposition)

Thequestionof isherebydeclaredtobe

(CarriedorLost)

Clerk Judge

Clerk Judge

PollBook,TallyListand OfficialReturnsofElection Heldin

PublicSchool

Dist.No.

Countyof StateofNorthDakota

______20____

STATEOFNORTHDAKOTA

Countyof

Filedinmyofficethis

dayof______20____

BusinessManager

CountySuperintendentorDesignee

Onecopyto befiledwiththeBusinessManager,the otherto bereturnedto theCountySuperintendentor Designee.