Source: Miss. Code Ann. §§ 23-15-637; 23-15-639.
Absentee Cure Form
You are receiving this form because there was a deficiency on your absentee ballot application and/or absentee ballot envelope. For your absentee ballot to be counted, complete and return this cure form as soon as possible. This form must be received by your County Election Commissioners by 12:00 p.m. on _______________________________ (10th day post-election). Please note that this is an actual receipt date and NOT a postmark date.
Once completed, the form can be returned to the officials in charge of the election by you or a person authorized by you. The cure form can be returned by:
* Facsimile (FAX)
* Delivering it in person to the registrar
* Mail or commercial carrier
If this form is not returned by the deadline, your absentee ballot will not be counted.
READ AND COMPLETE THE FOLLOWING:
I am an eligible voter in this election and registered to vote in _____________________ County, Mississippi. I solemnly swear or affirm that I requested, voted, and returned an absentee ballot for the ____________________ (date of the election) general/special/primary/runoff election and that I have not voted more than one ballot in this election.
____________________ __________________________
Voter's Name (Printed) Name of Person Authorized to Return
____________________ __________________________
Voter's Signature Signature of Person Authorized to Return
____________________ __________________________
Voter's Residential Address Relationship to Voter (if any)
____________________ __________________________
Voter's Date of Birth Address of Person Authorized to Return
____________________ __________________________
Voter's Driver's License #, DPS Issued Photo ID #, or Last Four of SSN
____________________
Date
1 Miss. Code. R. 17-4.2