Hava Complaint Form printable pdf download

Hava Complaint Form

HAVA Complaint Form

Any person who believes that a violation of Title III of the federal Help America Vote

Act has occurred, is occurring, or is about to occur may file a complaint with the Office

of the Secretary of State. Title III of the Help America Vote Act includes:

• Standards and requirements for voting equipment;

• Requirements to offer provisional voting;

• Requirements for posting voting information on election day;

• Requirements for a statewide voter registration system; and

• Requirements for voters who register by mail

If your complaint falls under one of the above categories, you may use this form to file

a complaint with the Office of the Secretary of State. A letter containing the same

information is also acceptable. All complaints must be notarized and filed with the

Office of the Secretary of State no later than 30 days after certification of the election.

Send complaint to:

Secretary of State, Elections Division

Post Office Box 40229

Olympia, WA 98504-0229

The Secretary of State must make a final determination within 90 days of receiving

the complaint. Thank you for taking the time to make this complaint.

Person Making Complaint

Last Name

First

Middle Initial

Street address

City

County

State

Zip Code

Home Telephone

Work Telephone

Email Address (optional)

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)

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Description of the Alleged Violation

Please identify:

HAVA Complaint Form

3/2015

Hava Complaint Form