2015 Mississippi Code
Title 23 - ELECTIONS
Chapter 15 - MISSISSIPPI ELECTION CODE
Article 19 - ABSENTEE BALLOTS
A. ABSENTEE BALLOTING PROCEDURES LAW
§ 23-15-635 - Form of elector's certificate, attesting witness certification, and voter assistance certificate where county registrar is not attesting witness and voter is not absent voter as defined in the Armed Forces Absentee Voting Law

(1) The form of the elector's certificate, attesting witness certification and certificate of person providing voter assistance on the back of the envelope used by voters who do not use the registrar of their county of residence as an attesting witness and who are not absent voters as defined in Section 23-15-673, shall be as follows:

"ELECTOR'S CERTIFICATE

STATE OF

COUNTY OR PARISH OF

I, , under penalty of perjury do solemnly swear that this envelope

contains the ballot marked by me indicating my choice of the candidates or

propositions to be submitted at the election to be held on the day of

, 2 , and I hereby authorize the registrar to place this envelope in

the ballot box on my behalf, and I further authorize the election managers to

open this envelope and place my ballot among the other ballots cast before

such ballots are counted, and record my name on the poll list as if I were

present in person and voted.

I further swear that I marked the enclosed ballot in secret.

Penalties for vote fraud are up to five (5) years in prison and a

fine of up to Five Thousand Dollars ($ 5,000.00). (Miss. Code.

Ann. Section 23-15-753.) Penalties for voter intimidation are up

to one year in jail and a fine of up to One Thousand Dollars ($

1,000.00). (Miss. Code. Ann. Section 97-13-37.)

(Signature of voter)

CERTIFICATE OF ATTESTING WITNESS

Under penalty of perjury I affirm that the above named voter personally

appeared before me, on this the day of , 2 , and is known by me to

be the person named, and who, after being duly sworn or having affirmed,

subscribed the foregoing oath or affirmation. That the voter exhibited to me

his blank ballot; that the ballot was not marked or voted before the voter

exhibited the ballot to me; that the voter was not solicited or advised by me

to vote for any candidate, question or issue, and that the voter, after

marking his ballot, placed it in the envelope, closed and sealed the envelope

in my presence, and signed and swore or affirmed the above certificate.

(Attesting witness) (Address)

(Official title) (City and State)

CERTIFICATE OF PERSON PROVIDING VOTER ASSISTANCE

(To be completed only if the voter has received assistance in marking the

enclosed ballot.) I, under penalty of perjury, hereby certify that the

above-named voter declared to me that he or she is blind, temporarily or

permanently physically disabled, or cannot read or write, and that the voter

requested that I assist the voter in marking the enclosed absentee ballot. I

hereby certify that the ballot preferences on the enclosed ballot are those

communicated by the voter to me, and that I have marked the enclosed ballot in

accordance with the voter's instructions.

Penalties for vote fraud are up to five (5) years in prison and a

fine of up to Five Thousand Dollars ($ 5,000.00). (Miss. Code.

Ann. Section 23-15-753.) Penalties for voter intimidation are up

to one (1) year in jail and a fine of up to One Thousand Dollars

($ 1,000.00). (Miss. Code. Ann. Section 97-13-37.)

Signature of person providing assistance

Printed name of person providing assistance

Address of person providing assistance

Date and time assistance provided

Family relationship to voter (if any)"

(2) The envelope used pursuant to this section shall not contain the form prescribed pursuant to Section 23-15-719 and shall have printed on the flap on the back of the envelope in bold print and in a distinguishing color, the following: "YOUR VOTE WILL BE REJECTED AND NOT COUNTED IF THIS ENVELOPE IS NOT SIGNED ACROSS THE FLAP OF THIS ENVELOPE BY YOU AND AN ATTESTING WITNESS."