Section 171.16. Form of affidavit for absentee ballot registration

Latest version.

The following form of affidavit for absentee ballot registration due to illness or permanent physical disability is attached hereto and made a part of this section:

Physician’s Certificate of Permanent Disability
I hereby certify that the above named voter is permanently disabled, and either physically unable to attend the polls or physically unable to operate a voting machine (or mark the ballot) and to orally request assistance to do so.

(Date) (Signature of Physician)

SHOULD YOU LOSE YOUR DISABILITY, YOU MUST INFORM THE COUNTY BOARD OF ELECTIONS OF THE COUNTY WHEREIN YOU RESIDE.

The provisions of this § 171.16 adopted August 17, 1973, 3 Pa.B. 1721.

                    
                        var val = document.getElementById('citecontent').innerHTML;
                        art.dialog.defaults.title = window.location.href;
                        art.dialog.data('cite', val);
                        art.dialog.data('homeDemoPath', '/Scripts/plus/artDialog/');
                        art.dialog.open('/Scripts/plus/artDialog/citeiframe.html');


(Date)	(Signature of Physician)