Registration Form For Third Party Voter Registration Page 2
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1
2SUPERVISORS OF ELECTIONS’ ACCOUNTING OF
THIRD-PARTY VOTER REGISTRATION ORGANIZATION’S
VOTER REGISTRATION APPLICATIONS
(S
97.0575, F
S
)
ECTION
LORIDA
TATUTES
3P__________
Third-party organization voter registration organization’s identification number:
a. Number of voter registration applications provided:
State forms: _____________
Federal forms: _________________
b. Number of voter registration applications received:
State forms (blank):
_______
State forms (non-blank):
_________
Federal forms (blank): _______
Federal forms (non-blank): _________
3P__________
Third-party organization voter registration organization’s identification number:
a. Number of voter registration applications provided:
State forms: _____________
Federal forms: _________________
b. Number of voter registration applications received:
State forms (blank):
_______
State forms (non-blank):
_________
Federal forms (blank): _______
Federal forms (non-blank): _________
3P__________
Third-party organization voter registration organization’s identification number:
a. Number of voter registration applications provided:
State forms: _____________
Federal forms: _________________
b. Number of voter registration applications received:
State forms (blank):
_______
State forms (non-blank):
_________
Federal forms (blank): _______
Federal forms (non-blank): _________
3P__________
Third-party organization voter registration organization’s identification number:
a. Number of voter registration applications provided:
State forms: _____________
Federal forms: _________________
b. Number of voter registration applications received:
State forms (blank):
_______
State forms (non-blank):
_________
Federal forms (blank): _______
Federal forms (non-blank): _________
3P__________
Third-party organization voter registration organization’s identification number:
a. Number of voter registration applications provided:
State forms: _____________
Federal forms: _________________
b. Number of voter registration applications received:
State forms (blank):
_______
State forms (non-blank):
_________
Federal forms (blank): _______
Federal forms (non-blank): _________
DS-DE 124 (eff. 06/2011) – continuation page
Rule 1S-2.042, F.A.C.
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