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AB1045,5,1010 ....(County)
AB1045,5,1111 My Commission expires
AB1045,5,1212 MAIL BALLOT TO:
AB1045,5,1313 NAME ....
AB1045,5,1414 ADDRESS ....
AB1045,5,1515 CITY .... STATE .... ZIP CODE ....
AB1045,5,20 16Penalties for Violations. Whoever swears falsely to any absent elector affidavit
17under this section may be fined not more than $1,000 or imprisoned for not more than
186 months or both. Whoever intentionally votes more than once in an election may
19be fined not more than $10,000 or imprisoned for not more than 3 years and 6 months
20or both.
AB1045,5,2121 ....(Municipal Clerk)
AB1045,5,2222 ....(Municipality)
AB1045,8 23Section 8. 6.22 (7) of the statutes is amended to read:
AB1045,6,3
16.22 (7) Extension of privilege. This section applies to all military electors for
228 10 days after the date of discharge from a uniformed service or termination of
3services or employment of individuals specified in sub. (1) (b) 1. to 4.
AB1045,9 4Section 9. 6.29 (2) (a) of the statutes is amended to read:
AB1045,6,165 6.29 (2) (a) Any qualified elector of a municipality who has not previously filed
6a registration form or whose name does not appear on the registration list of the
7municipality may register after the close of registration but not later than 5 p.m. or
8the close of business, whichever is later, on the Friday before an election at the office
9of the municipal clerk and at the office of the clerk's agent if the clerk delegates
10responsibility for electronic maintenance of the registration list to an agent under
11s. 6.33 (5) (b). The elector shall complete, in the manner provided under s. 6.33 (2),
12a registration form containing all information required under s. 6.33 (1). The
13registration form shall also contain the following certification: “I, ...., hereby certify
14that, to the best of my knowledge, I am a qualified elector, having resided at ... for
15at least 28 10 consecutive days immediately preceding this election, and I have not
16voted at this election". The elector shall also provide proof of residence under s. 6.34.
AB1045,10 17Section 10. 6.55 (2) (a) (form) of the statutes is amended to read:
AB1045,6,2018 6.55 (2) (a) (form) “I, ...., hereby certify that, to the best of my knowledge, I am
19a qualified elector, having resided at .... for at least 28 10 consecutive days
20immediately preceding this election, and I have not voted at this election."
AB1045,11 21Section 11. 6.85 (2) of the statutes is amended to read:
AB1045,6,2522 6.85 (2) Any otherwise qualified elector who changes residence within this
23state by moving to a different ward or municipality later than 28 10 days prior to an
24election may vote an absentee ballot in the ward or municipality where he or she was
25qualified to vote before moving.
AB1045,12
1Section 12. 6.87 (2) (form) of the statutes is amended to read:
AB1045,7,22 6.87 (2) (form)
AB1045,7,33 [STATE OF ....
AB1045,7,44 County of ....]
AB1045,7,66 [(name of foreign country and city or other jurisdictional unit)]
AB1045,7,197 I, ...., certify subject to the penalties of s. 12.60 (1) (b), Wis. Stats., for false
8statements, that I am a resident of the [.... ward of the] (town) (village) of ...., or of
9the .... aldermanic district in the city of ...., residing at ....* in said city, the county
10of ...., state of Wisconsin, and am entitled to vote in the (ward) (election district) at
11the election to be held on ....; that I am not voting at any other location in this election;
12that I am unable or unwilling to appear at the polling place in the (ward) (election
13district) on election day or have changed my residence within the state from one ward
14or election district to another later than 28 10 days before the election. I certify that
15I exhibited the enclosed ballot unmarked to the witness, that I then in (his) (her)
16presence and in the presence of no other person marked the ballot and enclosed and
17sealed the same in this envelope in such a manner that no one but myself and any
18person rendering assistance under s. 6.87 (5), Wis. Stats., if I requested assistance,
19could know how I voted.
AB1045,7,2020 Signed ....
AB1045,7,2121 Identification serial number, if any: ....
AB1045,7,2222 The witness shall execute the following:
AB1045,8,323 I, the undersigned witness, subject to the penalties of s. 12.60 (1) (b), Wis.
24Stats., for false statements, certify that I am an adult U.S. citizen** and that the
25above statements are true and the voting procedure was executed as there stated.

1I am not a candidate for any office on the enclosed ballot (except in the case of an
2incumbent municipal clerk). I did not solicit or advise the elector to vote for or against
3any candidate or measure.
AB1045,8,44 ....(Printed name)
AB1045,8,55 ....(Address)***
AB1045,8,66 Signed ....
AB1045,8,87 * — An elector who provides an identification serial number issued under s.
86.47 (3), Wis. Stats., need not provide a street address.
AB1045,8,129 ** — An individual who serves as a witness for a military elector or an overseas
10elector voting absentee, regardless of whether the elector qualifies as a resident of
11Wisconsin under s. 6.10, Wis. Stats., need not be a U.S. citizen but must be 18 years
12of age or older.
AB1045,8,1413 *** — If this form is executed before 2 special voting deputies under s. 6.875 (6),
14Wis. Stats., both deputies shall witness and sign.
AB1045,13 15Section 13. 6.94 of the statutes is amended to read:
AB1045,9,6 166.94 Challenged elector oath. If the person challenged refuses to answer
17fully any relevant questions put to him or her by the inspector under s. 6.92, the
18inspectors shall reject the elector's vote. If the challenge is not withdrawn after the
19person offering to vote has answered the questions, one of the inspectors shall
20administer to the person the following oath or affirmation: “You do solemnly swear
21(or affirm) that: you are 18 years of age; you are a citizen of the United States; you
22are now and for 28 10 consecutive days have been a resident of this ward except under
23s. 6.02 (2); you have not voted at this election; you have not made any bet or wager
24or become directly or indirectly interested in any bet or wager depending upon the
25result of this election; you are not on any other ground disqualified to vote at this

1election". If the person challenged refuses to take the oath or affirmation, the
2person's vote shall be rejected. If the person challenged answers fully all relevant
3questions put to the elector by the inspector under s. 6.92, takes the oath or
4affirmation, and fulfills the applicable registration requirements, and if the answers
5to the questions given by the person indicate that the person meets the voting
6qualification requirements, the person's vote shall be received.
AB1045,14 7Section 14. 7.52 (5) (b) of the statutes is amended to read:
AB1045,9,258 7.52 (5) (b) For the purpose of deciding upon ballots that are challenged for any
9reason, the board of absentee ballot canvassers may call before it any person whose
10absentee ballot is challenged if the person is available to be called. If the person
11challenged refuses to answer fully any relevant questions put to him or her by the
12board of absentee ballot canvassers under s. 6.92, the board of absentee ballot
13canvassers shall reject the person's vote. If the challenge is not withdrawn after the
14person offering to vote has answered the questions, one of the members of the board
15of absentee ballot canvassers shall administer to the person the following oath or
16affirmation: “You do solemnly swear (or affirm) that: you are 18 years of age; you are
17a citizen of the United States; you are now and for 28 10 consecutive days have been
18a resident of this ward except under s. 6.02 (2), stats.; you have not voted at this
19election; you have not made any bet or wager or become directly or indirectly
20interested in any bet or wager depending upon the result of this election; you are not
21on any other ground disqualified to vote at this election." If the person challenged
22refuses to take the oath or affirmation, the person's vote shall be rejected. If the
23person challenged answers fully all relevant questions put to the elector by the board
24of absentee ballot canvassers under s. 6.92, takes the oath or affirmation, and fulfills
25the applicable registration requirements, and if the answers to the questions given

1by the person indicate that the person meets the voting qualification requirements,
2the person's vote shall be received.
AB1045,10,33 (End)
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