Case 206-cv-00896-ALM-TPK Doc # 348-1 Filed 110212 Page 1 of 13 PAGEID # 12616 - moritzlaw osu 2025

1. Click ‘Get Form’ to open the document in the editor.
2. Begin by clearly printing your full name in the designated area. Ensure that you include your first name, middle name/initial, last name, and suffix if applicable.
3. Provide one form of identification. You can either write the last four digits of your Social Security number, your full Ohio driver’s license number, or indicate another acceptable form of ID shown to the precinct election official.
4. Sign the affirmation statement confirming that you are a registered voter in the precinct where you are casting your provisional ballot. Make sure your signature matches what is on file with the Board of Elections.
5. If applicable, complete any additional forms for change of address or name as required by federal and state law. Ensure all information is accurate and legible.

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