From:
To:
Cc:
Subject:
Date:

Betsy Schonhoff
Dustin Matocha
Elections Internet
RE: Voter Registration Data Availability
Saturday, October 15, 2016 10:12:19 AM

DustinThank you for contacting us regarding this. If you are asking about individual applications in
order to submit a Public Information Request, then it will depend on how quickly counties are
able to input their information. Typically we pull the numbers for our website
(http://www.sos.state.tx.us/elections/historical/vrfig.shtml) about a week after the voter
registration deadline. We should have updated numbers available on our website for the
November Election by the end of next week.
Should you have any questions or concerns regarding this information or need additional
information, please do not hesitate to contact our office. Thank you.
Sincerely,
Elections Division Staff
Texas Secretary of State
1-800-252-8683
Elections@sos.state.tx.us
From: Dustin Matocha [mailto:
Sent: Thursday, October 13, 2016 1:40 PM
To: Elections Internet <Elections@sos.texas.gov>
Subject: Voter Registration Data Availability

When do you expect to have everyone’s voter registration information available for everyone
who registered to vote for this upcoming general election?
----------------------------------------Dustin Matocha

Executive Director, Empower Texans
1-888-410-1836 ext. 701
@DustinMatocha   @EmpowerTexans
www.empowertexans.com

-----------------------------------------

TX-SOS-19-1113-C-000001

 dth Ingram
From:

Sent:
To:

Subject:

Keith Ingram
Tuesday, August 14, 2018 9:32 AM
Lindsey Aston; Betsy Schonhoff; Christina Adkins
FW: Complaint vs. Harris County Voter Registrar

From: Alan Vera [mailto

Sent: Tuesday, August 14, 2018 9:16 AM
To: Keith Ingram <Klngram@sos.texas.gov>
Subject: RE: Complaint vs. Harris County Voter Registrar
CAUTION: This email originated from outside of the organization. Do not click links or open attachme nts unless you

recognize the sender and know the content is safe.
I called the voter registrar's office and asked to speak to Ms. Sheena Tate. She was the person with whom I spoke when I
delivered the challenge personally .
She told me that they were just getting started on my challenge and transferred me to Ms. Sue Hastings, who was
actually working my challenge.
Sue Hastings confirmed that she had received my challenge on July 30. She confirmed that no notices have yet been sent
out. She said that the first notices might be going out today. She gave me the email to which I can submit additional
inquiries for more specific information.
I notified Ed Johnson of the above and he said he'd run another inquiry later this afternoon to see if any notices are
actually sent today .
Regards,
Alan D. Vera
Chairman, HCRPBallot Security Committee
President/CEO
Quest Business Agency, Inc
18130 Cadbury Dr.
Houston, TX 77084
713-253-6569
From: Keith Ingram <Kin ram sos.te xas. ov>
Sent: Tuesday, August 14, 2018 8:55 AM
To: Alan Vera

Subject: RE: Complaint vs. Harris County Voter Registrar
A direct inquiry is probably a good idea. Just following up on the status of your challenges etc.
From: Alan Vera ~
Sent: Tuesday, August 14, 2018 8:53 AM
l

TX-SOS-19-1113-C-000002

 To: Keith Ingram <Klngram@sos .texas .gov>
Subject: RE: Complaint vs. Harris County Voter Registrar

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you

recognize the sender and know the content is safe.
In preparing the poll books for each election, Ed Johnson and others at the county clerk's office have access to the voter
registrar's system. This allows them to get early notice of voters whose registrations may not be "active" on election
day. The goal is to ensure that the poll books used by the election workers are up to date.
This includes access to any notices sent by the registrar to any voter whose registration is in question or has been
challenged. The county clerk has checked that system 3 times since I filed that challenge on July 30. There have been no
notices of any kind sent to voters during that time.
Would you like me to make a direct inquiry? Please advise.
Regards,
Alan D. Vera
Chairman, HCRPBallot Security Committee
President/CEO
Quest Business Agency, Inc
18130 Cadbury Dr.

713-253-6569
ov>
To: Alan Vera<
Subject: RE: Complaint vs. Harris County Voter Registrar

Thanks Alan. There is no crime to refer to the OAG for investigation, but we are looking into what we can do under
18.064 perhaps. How do you know that there has been no action taken on your challenges?
From: Alan Vera ~
Sent: Monday, August 13, 2018 10:45 AM
To: Keith Ingram <Kin . ram sos.tex s. ov>
Subject: Complaint vs. Harris County Voter Registrar

CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you

recognize the sender and know the content is safe.
Keith, last night I submitted a formal complaint form to your office. My complaint is that as of August 10th the Harris
County Voter Registrar has taken NO action _on the voter registration challenge I submitted on July 30.
My complaint requests that your office: 1) contact the voter registrar and advise her of the TEC section that requires her
to take prompt action; and 2) refer the situation to the Texas OAG if she doesn't comply after contact with your office.
I'd love to hear your thoughts on this situation as well as any additional advice you'd care to give .
Regards,
2

TX-SOS-19-1113-C-000003

 Alan D. Vera
Chairman, HCRPBallot Security Committee
President/CEO
Quest Business Agency, Inc
18130 Cadbury Dr.
Houston, TX 77084

..

3

TX-SOS-19-1113-C-000004

 .1th Ingram
From:

Sent:
To:

Subject:

Keith Ingram
Tuesday, August 14, 2018 8:25 AM
'Alan Vera'
RE:Complaint vs. Harris County Voter Registrar

Thanks Alan . There is no crime to refer to the OAG for investigation, but we are looking into what we can do under
18.064 perhaps. How do you know that there has been no action taken on your challenges?
From: Alan Vera [mailto:

Sent: Monday, August 13, 2018 10:45 AM
To: Keith Ingram <Klngram@sos.texas.gov>

Subject: Complaint vs. Harris County Voter Registrar
CAUTION: This email originated from outside of the organization. Do not click links or ope·n attachments unless you

recognize the sender and know the content is safe.
Keith, last night I submitted a formal complaint form to your office. My complaint is that as of August 10th the Harris
County Voter Registrar has taken NO action on the voter registrat ion challenge I submitted on July 30.
My complaint requests that your office: 1) contact the voter registrar and advise her of the TECsection that requires her
to take prompt action; and 2) refer the situation to the Texas OAG if she doesn't comply after contact with your office.
I'd love to hear your thoughts on this situation as well as any additional advice you'd care to give.
Regards,
Alan D. Vera
Chairman, HCRPBallot Security Committee
President/CEO
Quest Business Agency, Inc
18130 Cadbury Dr.
Houston, TX 77084
713-253-6569

1

TX-SOS-19-1113-C-000005

 From:
To:
Subject:
Date:
Attachments:
Importance:

Shannon O"Leary
Keith Ingram
"Who Question" on Requesting 25,000 Voter Applications
Thursday, July 25, 2019 1:00:29 PM
image002.jpg
High

CAUTION: This email originated from OUTSIDE of the SOS organization. Do not click on links or open
attachments unless you are expecting the email and know that the content is safe. If you believe this to
be a malicious or phishing email, please send this email as an attachment to
Informationsecurity@sos.texas.gov.

Hi Keith~
Thank you again for your assistance with the voter application mailer and PDF files.  The print ready
files made such a glorious difference in the look and feel of the final product!!
I am seeking your guidance one again b/c we would like to pick up printed voter applications from
your office.  These would be the standard "generic," non-county specific mail-in applications.  We
would like to pick up 25,000 applications to begin with as soon as possible.  25,000 may seem like a
lot but please understand that right now we are implementing field workers across Texas. Just to
explain the scope of the effort, our budget for field workers registering voters is about $1 million and
the budget is already funded. 
Considering the Chapter 19 fund implications, to say the least, I left a voicemail for you yesterday b/c
I wanted to get your insights on how best to proceed from an "SOS-logistics perspective" as well as
from our org perspective.  I will try you again today but if you get free today before I do, I would
appreciate it if you could give me a call.  202-615-2353.  If I miss your call for any reason, before
you move on to your next to-do, if you could give me 10 minutes, I will call you right back.  
Or if you could at least email back and give me the answer to the "Who Question" being: Who
should I be reaching out to if not you to coordinate?  Also, as a heads up, I expect that we will have
another ask for 50K-75K applications by Fall 2019.  And, at this point, our anticipated distribution of
this specific form I am seeking from your office is estimated at 300K in total before the Nov 2020
election.
FYI - As you know for our mailer program, we paid for the printing of the voter applications and the
mailing cost to get the application to the voters.  For our field teams, we are, of course, using the
voter applications available from the counties but in many cases (most cases) the county folks refuse
to give us more than 20 or so applications at a time - I am sure you can imagine this is like dying by a
1,000 papercuts considering our scope.
Changing subjects slightly, I had one other question for you regarding the time and place for
distribution of voter applications:
I am looking for a specific law, rule or AO-like that sets the regulations.  In a surprising
number of towns, our field teams are getting some push back when distributing voter

TX-SOS-19-1113-D-000001

applications (not any electioneering materials) on the public spaces/sidewalks near certain
government buildings.  The source of the push back is not the same in every case but I
wanted cut through the details and simply end any further strife by providing field workers a
laminated copy of the legal do's and don'ts on time and place using that law, rule or AO-like
resource.  Thoughts?
 
Many thanks again for your kind assistance!
 
Thanks,
Shannon
 
Shannon O'Leary
Of Counsel | The Gober Group
3595 RR 620 S, Suite 200 | Austin TX 78738
| 202.615.2353

 
cid:image001.jpg@01D1F31A.7CB71E90

 
Confidentiality Notice: This e-mail message is for the sole use of the intended recipient(s) and may contain confidential and
privileged information. Any unauthorized review, use, disclosure or distribution is strictly prohibited. If you are not the
intended recipient, please contact the sender by reply e-mail. Please virus check all attachments to prevent widespread
contamination and corruption of files and operating systems. Unless otherwise expressly provided in the e-mail message
above, nothing contained in this message or in any attachment shall constitute a contract or electronic signature under the
Electronic Signatures in Global and National Commerce Act, any version of the Uniform Electronic Transactions Act, or any
other statute governing electronic transactions.
IRS Circular 230 Notice: To ensure compliance with requirements imposed by the Internal Revenue Service, we hereby
inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to
be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code of 1986 (as amended)
or (ii) promoting, marketing, or recommending to another party any transaction or matter addressed herein.

TX-SOS-19-1113-D-000002

From:
To:
Subject:
Date:
Attachments:

Alan Vera
Keith Ingram
FW: list of 4000
Friday, August 3, 2018 11:32:50 AM
Resolution_Agreement_signed_by_LV_102309.txt.zip

CAUTION: This email originated from outside of the organization. Do not click links or open attachments
unless you recognize the sender and know the content is safe.

Keith, I submitted my residency challenge to the Harris County Voter Registrar on Monday, July 30,
2018.
 
A source inside that office has told me that NO notices have been mailed as of this morning to any
voters on my challenge list.
 
Attached for your information is the consent decree signed by the former Harris County Voter
Registrar and the Texas Democratic Party in October of 2009. I see nothing in that consent decree
that would prevent the voter registrar from complying with TEC for handling my challenge.
 
Can you have somebody on you staff advise me of my options for addressing the lack of action by
the registrar? Can you consider this note a formal complaint that no action has been taken as
required by TEC?
 
Are you allowed to contact the registrar, state that a concern has been raised about their
compliance, and inquire as to what actions they've taken?
 
Please help me get the process moving.
 
Regards,
 
Alan D. Vera
Chairman, HCRP Ballot Security Committee
President/CEO
Quest Business Agency, Inc
18130 Cadbury Dr.
Houston, TX 77084
713-253-6569
 

TX-SOS-19-1113-D-000003

Resolution Agreement

1.

The parties hereto agree to resolve all claims and controversies between them,
asserted or which could be asserted in this case, including dismissal of the instant
lawsuit.

2.

The parties agree to release and discharge each other from any and all claims,
demands or suits, known or unknown, fixed or contingent, liquidated or
unliquidated, whether or not asserted in the above case, as of this date, arising
from or related to the events and transactions which are the subject matter to this
case. This mutual release runs to the benefit of all attorneys, agents, employees,
officers, directors, shareholders, partners, affiliates, successors arid assigns of the
party. "Party" as used in the release includes all named parties to this case.

3.

Intentionally Omitted

4.

Each signatory hereto warrants and represents that he or she has the authority to
bind the parties for whom that signatory acts and that the claims, suits, right
and/or interests which are the subject matter hereto are owned by the party
asse1ting same, have not been assigned, transferred or sold and are free of
encumbrance, except that this Agreement is subject to the approval of the Harris
County Commissioner's Court, provided the said Court also approves at the same
meeting, a collateral Agreement dated and signed this same date.

5.

The Harris County Attorney's Office shall deliver drafts of any further settlement
documents to the other party by December 1, 2009. The parties agree to
cooperate with each other in the drafting and execution of such documents as are
reasonably . requested or required to implement the terms and spirit . of this
agreement. The fact that fmther settlement documents are contemplated does not
in any way affect the binding nature -ofthis agreement between the parties.

6.

If a dispute arises with regard to the interpretation and/or performance of this
agreement or any of its provisions, the parties agree to attempt to resolve same by
meet and confer, then by phone conference with the Mediator who facilitated this
settlement.
If the parties cannot resolve their differences by telephone
conference, then each agrees to schedule a day of mediation with the Mediator
within thirty (30) days to resolve the disputes and to share the costs of the same
equally. If a party refuses to mediate, then that party may not recover attorney's
fees or costs in any litigation brought to construe or enforce this agreement.
Otherwise, if mediation is unsuccessful, the prevailing parties shall be entitled to
recover reasonable attorney's fees and expenses, including the cost of the
unsuccessful mediation. Nothing in this paragraph prevents Plaintiffs from
seeking emergency relief from any court or agency. In the event emergency relief

1
TX-SOS-19-1113-D-000004

is granted, and the law so provides, the proscription against award of attorneys
fees is void.
7.

Other terms of this resolution:
If any person submits a signed release using a fonn authorized by the
(a)
Voter Registrar and agreed to by Plaintiffs, the inclividual's voter registration files
will be released to the requesting party or his/her designee in un-r~dacted form.

(b)
No less than monthly, the Voter Registrar's Office will post a list of voter
pending registration applications received since the last posting. This list will
include the name and address of the voter and, insofar as the law allows, a reason
code for the rejection or notice of incomplete.
(c)
The Voter Registrar's Office will not fail to register a voter for the sole
reason that the alleged residential address of an applicant may be a commercial
address. However, if the Voter Registrar's Office deems the given address to be
commercial, a fonnal challenge may be made under the provisions of the Texas
Election Code. The Voter Registrar's Office is not authorized to conduct an
investigation of eligibility that is based solely on residence except as is necessary
to prosecute a challenge.
(d)
The following language will be added to the notice of incomplete
informing applicants that they have been rejected because their name cannot be
located in the driver's license or social security databases: "It is possible that there
was an error in the transcription of your name. Please contact the Voter
Registrar's Office at the following number to resolve the discrepancy.:'
(e)
The Voter Registrar's Office is in the process of updating their employee
manual. This process will be concluded within six months and will include
disclosure and prohibitions on employees or contractors working for the Tax
Office voter department and having other employment or financial interests in any
outside company providing voter information to any candidate, political party, or
other person or entity.
8.

The Voter Registrar's Office claims, represents, and warrants the following
policies and procedures are and have been in effect. Plaintiffs dispute these
policies and procedures have been in effect. Nevertheless, the parties agree the
following policies and procedures will be in effect and will be complied with by
the Registrar's Office:
(a)
The Voter Registrar's Office will comply with all election deadlines
pursuant to the Texas Election Code, incluiling the processing of voter registration
applications, incompls;te notifications and provisional affidavits. In regard to
provisional ballot affidavits, the parties recognize that the Voter Registration

2

TX-SOS-19-1113-D-000005

employees cannot begin processing the affidavits until they are received from the
County Clerk's Office.
(b)
Voter registration employees will be available in the Voter Registration
Office on Election Day until advised by election judges that the last voter has cast
a ballot.
(c)
The Voter Registrar's Office will submit to the Secretary of State for
registration any applicant who legibly provides on the application, or other
acceptable document, their name, residence, date of birth, signature and U.S.
citizenship. The application must also have a Texas Driver's License number or
Personal Identification Nun1ber, or the last 4 digits of their Social Security
number, or a statement that the applicant has not been issued any one of these
three forms of identification. The Office will not reject or send notices of
incomplete for any other omission on the application.
(d)
Any voter registration application, notice of incompletion, rejection letter,
or any other correspondence sent to the voter by the Voter Registrar's Office will
be available in English, Spanish and Vietnamese. If any other languages are
required following the results of the 2010 census, those languages will also be
provided.
(e)
The Voter Registrar's Office will appoint as a deputy registrar any
qualified resident of the county who requests such an appoinlnlent. The
appointment is not conditioned upon completion or attendance of any training
classes, although such training is strongly encouraged. The Voter Registrar's
Office will issue Deputy Voter Registration Certificates to qualified persons
applying to be deputy registrars within ten days of the date the person applies.
The Voter Registration Applications obtained by a deputy registrar may be turned
in at any location throughout the county where the Voter Registrar maintains an
office; however, it is requested that if the Deputy Voter Registrar is submitting in
excess of 60 applications and a receipt is requested, that the applications be
submitted to either the downtown office or the distribution center. Each deputy
registrar will be permitted to have up to four registration books. at a time. If the
deputy registrar will be attending a special event or voter registration drive they
may request an additional amount. The Voter Registrar's Office will also
continue its outreach with Houston Independent School District to encourage and
enable teachers to become deputy voter registrars. Any substantive changes to the
deputy voter registration program will be submitted to the Department of Justice
for preclearance.

(f)
Within three (3) business days of a request by a chairman of a political
party, the Voter Registrar's Office will provide reports of all applications
received, the number rejected, the number of incomplete notifications sent, and
the number of voters registere_d. These reports will include the nanies and
addresses of those affected. The Voter Registrar's Office. is working towards

3

TX-SOS-19-1113-D-000006

maldng this infonnation available on its website to the extent allowed by law. A
business day is any day voter registration personnel are performing an official
function under the Election Code.
(g)
The Voter Registrar's Office will update its website with the list of
registered voters on a daily basis.
The Voter Registrar's Office will provide and distribute the latest fo1m of
(h)
Voter Registration Application prepared by the Secretary of State. All outdated
forms will be destroyed.
(i)
.Letters seeking confirmation of a person's current address shall be sent to
the most recent address in the possession of the voter registrar. Notices of
incomplete or rejection shall be sent to the address on the application.

G)
A registration certificate shall not be cancelled pursuant to Texas Election
Code Section 16.031(3) more than two (2) years after the date of final conviction
unless the Voter Registrar's Office shall have conducted an investigation and
determined the sentence not to have been fully discharged.
(k)
An employee of the Voter Registrar's Office will be physically present
while the Early Voting Ballot Board is reviewing ballots. The employee will be
equipped with a computer that will allow viewing of provisional ba[]ot affidavit
scans upon request by either a member of the Early Voting Ballot Board.

(!)
A formal training session will be held for voter department of the Voter
Registrar's Office to review and confirm all new and continuing policies,
including as as set forth in this resolution.
9.

This resolution will be submitted to the Department of Justice for preclearance as
required under Section 5. If approved, the terms herein shall constitute the
baseline for Voting Rights Act purposes.

I 0.

This agreement is made and performable in Harris County, Texas, and shall be
construed in accordance with the laws of the United States and the State of Texas.

11.

Each signatory to this settlement has entered into same freely without duress after
having consulted with professionals of his/her choice. Each signatory expressly
warrants and represents that no promise or agreement which is not herein
expressed has been made to him/her in executing this Agreement and that no one
who is a party hereto is relying upon any statement or representation of any agent
of the parties being released hereby. Additionally, each party hereto is relying on
his/her own judgment and each has been represented by legal counsel in this
matter. The parties represent that their respective counsel has read and explained
to him/her the entire contents of this agreement as well as its legal consequences.

4

TX-SOS-19-1113-D-000007

Each party hereto has been advised by the mediator that the mediator is not the
attorney for any party.

12.

NOTWITHSTANDING ANYTHING ELSE CONTAINED IN THIS
AGREEMENT, THE PARTIES HERETO INTEND TO BE BOUND BY THIS
AGREEMENTAND IT IS BINDINGUPON ALL OF THEM.

13.

THE PARTIES AGREE THAT THIS AGREEMENT IS MADE PURSUANT
TO SECTION 154.071 OF THE CIVIL PRACTICE AND REMEDIES CODE
AND IS NOT SUBJECTTO REVOCATION.

AGRE D on this 23 rd day of October 2009:
__,,-

BoydRi 1ie, Chairman, Texas Democratic Party

~~::~is

CourtlyDemocraticParty

Leo Vasquez, Harris County Tax Assessor Collector.

5
TX-SOS-19-1113-D-000008

12/23/2019

Mail - AO Records - Outlook

RE: Public Records Request (TX-SOS-19-1113)
GeneralCounsel <GeneralCounsel@sos.texas.gov>

Sat 12/21/2019 12 44 AM
To: AO Records <records@americanoversight.org>; FOIA <foia@americanoversight.org>
Cc: GeneralCounsel <GeneralCounsel@sos.texas.gov>
1 attachments (207 KB)
OR2019-32866.pdf;
Good afternoon,
On November 20, 2019, the Office of the Attorney General's Open Records Division issued the attached Open Records Letter No. 2019-32866. Pursuant to that ruling, the Office of the Secretary of State will be
producing additional documents in response to your September 4, 2019 request under Chapter 552 of the Texas Government Code. Due to the volume of materials that we are providing you, the documents will be
transmitted to you via separate, encrypted message.
Please note that some of the released documents are being produced in redacted form. These redactions comprise two categories. First, the responsive information contains public citizens' dates of birth. In the
attached letter ruling, the OAG concluded that such information could be withheld from public disclosure. As a result, we have redacted dates of birth from our document production.
Second, the responsive documents contain email addresses of members of the public, which are confidential under Section 552.137 of the Texas Government Code. The attorney general has authorized all
governmental bodies to withhold an email address of a member of the public without first requesting an attorney general opinion. See Open Records Decision No. 684 (2009). As such, this information has been
redacted from the enclosed materials.
Please let us know if you have any issues receiving or opening the files enclosed with the encrypted messages.
Sincerely,

Adam Bitter
General Counsel
Office of the Texas Secretary of State

From: GeneralCounsel <GeneralCounsel@sos.texas.gov>
Sent: Wednesday, September 25, 2019 4:26 PM
To: American Oversight Records <records@americanoversight.org>; American Oversight FOIA <foia@americanoversight.org>
Cc: GeneralCounsel <GeneralCounsel@sos.texas.gov>
Subject: RE: Public Records Request (TX-SOS-19-1113)
Good afternoon,
Please see the attached letter, with enclosure, in response to your request for information under Chapter 552 of the Texas Government Code.

Jennifer Williams
Legal Assistant to the General Counsel
Office of the Texas Secretary of State

From: American Oversight Records <records@americanoversight.org>
Sent: Wednesday, September 4, 2019 2:56 PM
To: GeneralCounsel <GeneralCounsel@sos.texas.gov>
Subject: Public Records Request (TX-SOS-19-1113)
CAUTION: This email originated from OUTSIDE of the SOS organization. Do not click on links or open attachments unless you are expecting the email and know that the content is safe. If you believe this to be a malicious
or phishing email, please send this email as an attachment to Informationsecurity@sos.texas.gov.
Dear Public Records Officer:
Please find attached a request for records under Texas's public records laws.
Sincerely, 
Vibha Kannan
Paralegal
American Oversight
foia@americanoversight.org 
www.americanoversight.org | @weareoversight
Public Records Request: TX-SOS-19-1113

https://outlook.office365.com/mail/records@americanoversight.org/inbox/id/AAQkADdjNzkxMmYzLWVjNDAtNDViOC04MGExLWZlNTkyZGU3MGY2ZgAQA...

1/1

12/23/2019 Mail A0 Records Outlook

RE: Pubic Rem Request (TX-SOS-19-1113)

GonomlCounsel <6mmlCansel?sos.texas.gav>


11: A0 Records FOIA 
Cc: man?

Innachnuns (207 KB)
cums-azmwt

Good afternoon,

OnNovembetZO, uedheamdredOpen ReootdsLettel No. 2019-32866. 



nlhe
mahedlemer 







Simely,

Adam Bitter
Genetal Counsel
Ol?ce 01 the Texas Sectetary of State

From GeneralComsel ?enemlCotnselOsosmexasgoo

Sent 

To Ametiean Ovetsiwn l" A org) American Oversight FOAdoiaOmmlsightorp
0c GenevaICoumel <Genera|ComselOsos1ensgav>

smject RE Pmic Recotds Request (TX-806494113)

Gooda?moou.



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From Amman Records WP
Sent Wechesday, Semenbet4, 2019256PM

To GeneralOouIsel 

smjed Pubic Records Requw (TX-808494113)

 

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TXSOS101I13

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1/l

Phone: 512-463-5650
Box 12060 Fax: 512-475-2811
(in, Texas 7871 1-2060 Dial 7-1-1 For Relay Services

(800) 252-VOTE (8683)
Rolando B. Pablos
Secretary of State

.ons Division

 

April 17,2017

Mr. David Maxwell

Director of Law Enforcement
Of?ce of the Attorney General
P.O. Box 12548

Austin, Texas 78711

Dear Mr. Maxwell,

Pursuant to Section 31.006 of the Texas Election Code, I respectfully request your assistance in
reviewing allegations of criminal activity in Dallas County. Please ?nd attached four complaint
packets submitted by Aaron Ham's.

After review of the submitted documentation, we believe the information regarding the offenses
warrants a submission for criminal investigation to the Texas Attorney General, speci?cally the
allegations of unlawful assistance and/or witnessing of Applications for Ballots by Mail
(ABBMs) and Carrier Envelopes, under Texas Election Code Sections 84.003, 84.004,
84.0041, and 86.0051, and tampering with a government record under Texas Penal Code Section
37.10. Please note that the complaints concerning Bakari Irungi, Felicia Pitre, and Jose
Rodriguez clearly warrant a referral to your of?ce. Because it concerns the same or similar
allegations of criminal conduct in Dallas County, we have included a complaint concerning
David Espinosa, but concede that additional information may be necessary before a referral is
truly warranted by that complaint. We will forward any such additional information to you
should it be received by this of?ce.

Unlawful Assistance and/or Witnessing of ABBMs and Carrier Envelopes

Under Election Code Section 84.003, it is a Class A misdemeanor for a non-relative or individual
who is not registered to vote at the same addreSs as the applicant to assist the applicant in
completing or submitting an ABBM or for such an individual to act as a witness for an applicant
without complying with TEC Section 1.011. TEC Section 1.011 requires the assistant or witness
to indicate if the applicant or voter cannot make a mark, print the name of the person who cannot
sign, and provide the witness?s own signature, printed name, and residence address.

Under Section 84.004, it is a Class misdemeanor for certain non-relatives and individuals who
are not election of?cials to witness an ABBM for more than one applicant. Each application
witnessed in violation of this section constitutes a separate offense.

OV I TX-SOS-19-1113-E-000001

Robstown ISD, p.2

Under Section TEC, 84.0041, it is a state jail felony for an individual other than the applicant or
a relative thereof to knowingly provide false information on an ABBM. Indicating that an
individual assisted an applicant while knowingly failing to indicate the individual also witnessed
the ABBM may be an example of such false information.

Under TEC Section 86.005], it is a Class misdemeanor for an individual to sign the certi?cate
on a Carrier Envelope for a voter and fail to comply with TEC Section 1.01 1

Finally, under Texas Penal Code 37.10, a person commits an offense if the person knowingly
makes a false entry in or presents a record with knowledge of its falsity and with intent that it be
taken as a genuine governmental record. Section provides that a ?governmental
record? includes an of?cial ballot or other election record; therefore an ABBM or Carrier
Envelope is a governmental record.

If you have any ?trther questions, please feel free to contact our of?ce toll-free at 1-800-252-


Sincerely,

Keith gram
Director of Elections

OVE RSI HT TX-SOS-19-1113-E-000002

Apr 14 2017 12:42 HP FaxDat 6826265679 page 1

 

 

Texas Secretary of State PO. Box 12060 Austin, Texas 78711-2060 1-800-252-VOTE (8683) 
ELECTION COMPLAINT TO THE TEXAS SECRETARY OF STATE
Docket Number OFFICE USE Date Hand-delivered or Date Postmarked

 

 

ONLY 04 14 /2017

Please read the Important information at the end at this document. The Secretary of State has no authority to
order a new election, chan an election result, or conduct a criminal investigation. A complaint ?led with this
form will not alter the resu ts of an election.

 

This complaint form MUST BE SIGNED before it is submitted to the Secretary of State; therefore, you must print
it out and sign it before mailing or faxing a copy or emailing a scanned, signed copy.

I. IDENTITY OF COMPLAINANT

 

 

 

1 COMPLAINANT nest Ml
I -
NICKNAME LAST surnx
2 00M PLN NANT INCLUDEAPTISUITEMF APPLICABLE) STATE ZIP cooe

PHYSICAL

ADDRESS TX -

[Fullhomo or busineu um, dunno. Indzip code)

3 CO LAI NANT ADDRESS (r0 Aim SUITE a APPJCABLE) cm 511?: ZIP CODE
MAILING
ADDRESS

(chock Innu- above,

 

(Full homo orbu-Ineu nddrul. Including street. city. Ollie. and zip code)

4 AREA cone PHONE NUMBER EXT 5 COMPLAINANTT
TELEPHONE - i


 

 

 

NUMBER ADDRESS

 

 

 

II. IDENTITY OF RESPONDENT

pERsou on ENTITY comm ALLEGED vuoumon(s)

 

6 RESPONDENT MSIMRSIMR FIRST Ml

NAM 
NICKNAME sumx

 

7 RESPONDENT

POSITION 0R 

TITLE

 

 

 

3 RESPONDENT ADDRESS (romcwDEAP?rIsuneaiFArPucnaLEf cm ZIP CODE
PHYSICAL
ADDRESS - - TX -

(Full home or including sketchy, state, and zip code)

 

 

 

9 RESPONDENT ADDRESS (TOINCLUOE CITY STATE ZIPCODE

MAILING
ADDRESS

(check It um. mm)
(Full home or bualnns address. including street. city. In?. and zip code)

i
10 RESPONDENT AREA CODE PHONE NUMBER EXT :11 RESPONDENT

 

 

 

TELEPHONE E-MAIL
NUMBER ADDRESS
. ilF Knowm
i

 

 

 

GO TO PAGE 2
TX-SOS-19-1 1 13-E-000003

NOTICE: THIS COMPLAINT IS PUBLIC RECORD ONCE REVIEW IS COMPLETED BY THE SECRETARY OF STATE ATTORNEY GENERAL.
Revised 2128I2014

 

Apr 14 2017 12:42 HP FaxDat 6826265679 page 2

Texas Secretary of State PO. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 

NATURE OF ALLEGED VIOLATION P3992

If you believe that a criminal violation of the Code has occurred. please state the specific acts committed by the person or
entity named in this com plaint. along with areference to the section of the Code alleged to have been violated, if known. If
you need more space, please attach a separate sheet.

Unlawful Witness per Sec. 84.003 of the Election Code as well as Forgery and Tampering with a Govemm

ent Record under Sec. 32.21 of the Penal Code.

 

Sec. 84.006. SIGNING APPLICATION BY ASSISTING APPLICANT. An early voting ballot
application signed for the applicant by a witness other than the early voting clerk or a deputy must indicate the
witness's relationship to the applicant or, if unrelated. indicate that fact.

A person who acts as a witness for an applicant for an earty voting ballot application commits an offense it
his person knowingly fails to comply with Section 1.011. A person who in the presence of the applicant
otherwise assists an applicant in completing an early voting ballot application commits an offense If the person
knowingly fails to comply with Section 1.011 in the same manner as a witness.

An offense under this section is a Class A misdemeanor.

Sec. 32.21. FORGERY. For purposes of this section:

"Forge" means:

(A) to alter, make, complete, execute, or authenticate any writing so that it purports:

to be the act of another who did not authorize that act;

(it) to have been executed at a time or place or In a numbered sequence other than was in fact the case; or
to be a copy of an original when no such original existed;

(B) to issue, transfer, register the transfer of, pass, publish. or otherwise utter a writing that is forged within the
meaning of Paragraph or

(C) to possess a writing that is forged within the meaning of Paragraph (A) with intent to utter it in a manner
specified in Paragraph (B).

(2) "Writing" Includes:

(A) printing or any other method of recording Information;

(B) money, coins, tokens, stamps, seals, credit cards, badges, and trademarks: and

(C) symbols of value. right, privilege. or identification.

A person commits an offense it he forges a writing with intent to delraud or harm another.

(0) Except as provided by Subsections and an offense under this section is a Class A
misdemeanor.

An offense under this section is a state jail felony ii the writing is or purports to be a will. codicil, deed, deed
of trust, mortgage, security instrument, security agreement, credit card, check, authorization to debit an account
at a ?nancial institution, or similar sight order for payment of money. contract, release, or other commercial
instrument

(9) An offense under this section is a felony of the third degree if the writing is or purports to be:

(1) part of an Issue of money, securities, postage or revenue stamps;

(2) a government record listed in Section 37.01 or

(3) other instruments issued by a state or national government or by a subdivision of either, or part of an issue
of stock, bonds, or other instruments representing interests in or claims against another person.

ATTACH ADDITIONAL PAGESAS NEEDED

 

 

TX-SOS-19-1 1 13-E-000004

M01165: TRIO OOMPLAINY IS PUBLIC RECORD ONCE REVIEW IS COMPLETED BY THE SECRETARY OF STATE ANDIOR GENERAL.
Revnaed 2(2612014

 

Apr 14 2017 12:42 HP FaxDat 6826265679 page 3

Texas Secretary of State PO. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 

IV. STATEMENT OF FACTS Page3

State the facts constituting the alleged violation(s), including the dates on which or the period of time in which the alleged
violation(c) occurred. allegatlonc of fact not personally known to the complainant, but alleged on information and
bellef. Please use simple. conclse. and dlrect statements.

 

 

 

ELECTION OCCURRED

 

2016 Elections on: or [Llonon Various
NAME OF ELECTION 
Dallas County Vanous
COUNTY OR POLITICAL SUBDIVISION PRECINCT

 

 

 

 

We have attached only 2 examples, more are available._ _is clearly ?lling out and signing the ap
plications. The signatures do not match the voter's signatures.

 

 

ATTACH ADDITIONAL PAGES A3 NEEDED
TX-SOS-19-1 1 13-E-000005

-. NOTICE: THIS COMPLAINT IS PUBLIC RECORD ONCE REVIEW I3 COMPLETED BY THE SECRETARY 0' STATE ANDIOR ATTORNEY GENERAL.
Revised 

 

 

 

Apr 14 2017 1242 HP FaxDat 6826265679 page 4

Texas Secretary of State PO. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 
V. LISTING OF DOCUMENTS AND OTHER MATERIALS P8964

List all documents and other materials ?led with this complaint. Additionally. list all other documents and other materials
that are relevantto this complaint and that are within your knowledge. including their location, if known.

 


Attached are 2 Applications tor Ballot By Mail (ABBMs) and then corresponding Garner Envelopes that V1
olate the Election Code.

See Exhibit A



TACH ADDITIONAL PAGES AS NEEDED
TX-SOS-19-1 1 13-E-000006

Tm! COMPLAINT I8 PUBLIC RECORD ONCE REVIEW l8 COMPLEYED BY THE SECRETARY OF STATE ANDIOR AYTORNEY GENERAL.
Rev sod 

 

 

 

Apr 14 2017 12:42 HP FaxDat 6826265679 page 5

Texas Sestetary of State PO Box 12060 Austtn Texas 78711-2060 1-800-252-VOTE {8683) sos.state.tx.us
v1. SIGNED STATEMENT page 5

 

 

 

 

.the 

 

under penalty of pequry do swear or a??rm that the information contameo in this
cemptamt Is true and correct to the beat of my knowledge

I have read and underStand the accompanymg Instrucnons and I am aware that
COMPIBIIOH c! this form cannot and will not alter the outcome of the electron

 

I
SIGNAI owe OF COMPLAINANT

NOTICE: THIS COMPLAINT IS NOT ONCE REVIEWED BY
THE SECRETARY OF STATE. IT WILL BE TREATED AS A PUBLIC RECORD.

 

 

REMINDER: YOU MUST SIGN THIS FORM PRIOR TO SUBMITTING

IF MAILING. PLEASE SEND TO:
Texas Secretary of State
Elections Division
c/o Legal Dept
PO. Box 12063
Austin. TX 78711

IF FAXING, PLEASE SEND TO:
512 475.2811

IF PLEASE SEND TO:
elections@sos.state.tx.us

 

 

 

Tkta COMPLAINT l5 PUOLIC ONCE REVIEW IS COMDLEVED IV IECIKTARV 0! ANDIOI ATTORIIY OIMIRAL.

TX-SOS-19-1 1 

Page 6

Apr 14 2017 1242 HP FaxDat 6826265679

JU IKE-Us: anrunnlcu tuna.

   

tall :nI-y CApvos stun can; ovy .. 

 

 

  

Applicanon for Ballot by Mail 361*33: 

    
   

 

Slur-men Min-s .

 

Lat! ml moi-an

   

 

Sr Ill L-lcl Fits! Nam.

 

 




  

Gav

 

 

sc caudal: Bm'? 

   

loll my ballot Io: ll mailing and-Mess after:

 

 

 

 

I 'thl



  

 

 

Voting by Mail:
rs 0' W7 a! that 

may. 

and abscmu lcom the county 
we to con'plalo Box I.

 

?wmnl lad. 

I If you no ?questing ml; ballot bo mailod to a dilloronl (other than mudonccl.

ladle-Io who" lho ballot will be mailed. Sea reverse lot instructions.

Hmong A'Jme?xs as wed on my remnanon commie [j Addtess ol me 
Norsn} l'oung hing fzululy. or bug [(2171 can hrjl'oly Rwluhwy. 
[j Hoopla! uulscdu mumy (bet: Bu: 

Rellremenl Comm

 

later: 65 You: 0' A9. or or Vol-vs with a Dkability,
II apply'ng (wow: uln- hon, soled Inn

ll mice a. unruly ?.5190, .nu- cum-IL: you. aim] 'Mmal 
Ml.- alum

1 1- limo: Elm-L15 Emmnm
You Inn: dime?; pulngn' [why In ?Av: 
:u Eamon A y'


Mu. mu Hutton anaw

 

"you ?baud ?cwoclod absent. from cot-1y." no ?vane [u 

DE DE WT [ll] 

0310 you can boy'n la roe-iv- mail at addross Date 01 rotum to roddonce nddrus -

 

 

 

 

 

 

 

 

 

 

 

Contact lnlonnolion (Optionalr
Please ?51me "1 (MW mm emai 

 

Please select the amuopmtn no:

mum 
You hm? vhdamgpubod pail, In volt a
May Elldmu 
Nwallnr Beam 0 ?Walt 
-- 

Any Resullw Rum?

 

If someone helped you to complete this: term or mails the form lo: you. than that person musl complete the sacllona below.

awkanl ls unable to mark 80! I 0. the witness dull check this boat.

 

Ilsa! fl" - h. quhmu.
- Cl ?(cl-Juan anary
%Rcsuling Rumn
WY Voters kom 9" Jl'l' "l codify that tho intermallon glvoa in (his applicxion is true, and I lmdov?znd tl?ul giving false inlomntnon 
Ym my only nuply for a hallo! lry mat lo: we clu?lrwl. and any lusu'lm? runoll an. application In a crlmo."

 

   
  
    

 



SIGN HERE
I ls unable to sign 0: make a
mark in the presence of a witness. 
witness shall complmo Boxes 81184).

 

 

 

500 back lor Wluuss and Aunlam de?nl?ons.

you ate aci'ng as 3: Witness.
ploaco shoal 0-1; box.

you at: scan; as an 

 

 

 

 

louse chem [ms bozo
*llymare admgaswnnus mg,
Assimm. pleas: chock M.

Wllnoss' to Applicant
(Rafe! lo Instructions on back lat clari?cation)

 

 

 

. 

Page 7

Apr 14 2017 12:43 HP FaxDat 6826265679

.. -..- . - - nut?p. .- in, nu. Maw vc v-Ahv?. I?lcl, puu,? "on '13
envelope unlass the ham has neon manned by you or at your smug! my not be used In mum more than on. voter?s ballot. Rosa-or. man :nu me

carrier .molope may be placed together In anolhor envelope if the additional carrier envaopdsl bolero to a person logic-N to vote at the acne adores: This um: envoope mm be
returned by ma?L by Cowman or contract carrier, or in person by the vol: on election day at the early voting :l-rt's ohm. anstmodonos at Votanlo: Selle est: sob-s. mpuls ?nrw
su nombre en el espado proporcionado abalo. Eslo sobrs debe de ser seilado por el votante antes so one ei mum. to unwrap. No fmo :lsie sob". menu :le q-n lg 
sdo llenado par usled. bale su dlrocciOn. W: mmbaleu do his do on solo mum. sin embargo. ma. :9 .n 395,. arm.
puede ser colocaao dentro do otro sabre in' el morals) oficial malarial le a nil votonre ?strode para votar taro la mama acumen. E53: 335?: c?c?u: dob: say-ado poi
conga, par mule co uh mporlsm new 0 :O'nertral, ser entregado en po'sona par ol vorante cl cu lo ottoman on :3 one?: do wanna do vomit-Al 

I OWN that ballot expresses my wishes imependem of any aeration or undue persuasion by any person. [Cutilico que la oaleta adjunta express this dams
indopend'antumont? dc ningan dlctado mansion indoblda per part0 de cualquier persona.)

 

SEAL ENVELOPE Ano SIGN OVER SEALED FLAP 
EL soaRE FIRMS ENCIMA DE SOLAPA DEL soaks)

Instructions to Assistant/t may only ho assisted with reading or marking the ballot it they have a physical d5sabi|ily that renders :hcm unable to wrzte or see. or
have an lnabillty to read the language in which the ballot is written. It you are assisting the voter. you must read the oath and complete the section below. before
assisting the voter. al Aslstente: Un votanlo puece recibir ayuda para leer llenar la boleta solamenle si e: vclanle liene una docapacidad fisica
la cual le impide escrmir over. si no tiene la habilidad de leer el lenguaje en el cual la boleta esta escrita. Si usled le proporcionara ayuda a un votanie.
usted debe leer el luramenlo llenar la siguie'lle secciOn abaio, antes de al votante.)

 

 

SIGNATURE OR MARK OF VOTER (FIRMA 0 MARCA DEL VOTANTE)

 

Oath of Person Assisting V0167: allirm) that I will not suggest. by word. sign. or gesture. how the voter should vote i will confine my to answering
the voter?s questions to stating promotions co the ballot, and to naming amdioales and. rl Ested. their pomlcal parties; I will prepare the voter?s ballot as the voter olrecis;
and I am no: the voters employer. an agent of lhe voler?s employer. or an of?cer or agent of a labor union to which the voter belongs. (Juramonto de la Persona
Asiatiendo al Votanto: Juro (o alirmo) que no sugerir? con palabras. senales. gestos. la manera en la cual el votanle debe votar; Iimitare mi a responder
las preguntas del votante. leer propuestas en la boleta. nombrar a candidates. 5: es mencionado. su parlloo preparare la boleta del votanze de acuerdo a
sus instrucciones: yo no soy el cmpleador del mtanto. un agente del empleador del volanle. 0 on olio'al 0 agents de un slndicato a! oual el volanle oerlenece.)

Instructions to Witness: You are serving as a witness for (name of voter) You must complete the section below if you
witness the mark of the voter. or it the voter cannot make a mark If the voter cannor make amarlr. check here . (Instrucciones al Testigo: Usted esta? lungiendo

como testlgo para (nombre del votante). Usted de'oe lienar :a sguiente socca'on ano si uslec foe lestigo de Que er votante
lirmo 0 de que el votante no puede ?rmer. 8 el votanle no puede marque sus iniciales aqui .l

 

 

Instructions to Person Depositing Carrier Envelope in Mail orto Common or Contract Carrier. ll you are assisting a voter by depositing the carrier envelope in the
mall a common orcontract carrier. you must complete the section below. (Instrucciones a la Persona Oulen Deposits el Sobre O?clal en el Come 0 Entreguc
al Transportisto P?blico Comercial: Si usted asistir? al mtanle a deposiler el Score olicia: en el correo ocon on transpo'jsta pub?co comerdal. ~:sleo debs "mar
la seccion que aparece abajo.)

ll you are an ass:stant or witness. check the appropriate box below and provide inlormatim: (Si Lrsted es un aslstenre lestigo. marque [a casma correcta proporcione

Su lntormaci?n):

38851313;
?5%le
Witness! Signaluw lF'rma) Primed Name (Nomure impress) SlrePt Add'ess (Domenic reszdenmall
Teszign

 

mum

Signature (Erma) Printed Name (Momma mprasn) Slree'. Acdress :Do'ncilro res?oencian
Tour:

by Early Voting Clerk: Name of Election (Nombro do Eloccion):

 

 

Name 0? Voter (Nombre dd with?): Date or Election {Fecha do Elmanidnlv 

TX-SOS-19-1 1 13-E-000009

page 8

14 2017 12:43 HP FaxDat 6826265679

Apr

I 5 (ll aopucaml

1 

. Application for Ballot by Mail

   

1 on o! [no Son?army .4 3-m- 1am


Fm Ura- 0th
71310 I cum, 2'.ch 1"9
91mm: ml (arm-ma 

 

 

 



Suf?x [Jr 9K.)

 

Hr? 

 

 
  



 

Ilall my ballot lo: ll mama] address madame address please mmplele 801 I: 7

Sm. Zip Code

 

 

 

 
  
  
 

 

'Bk?lh unmuml)



an (0: Voting by Man.
Syeasdawwdder (amalgam)

)lsatnny. W)

absence hum mo county 82mm
89 sun 10 complain 80: 

 

Cm?Ihls tallol b0 mailed lo a leeronl (olhor than residence).
whore lhI ballol be mallod. See raven. lor 

Medina Amwss as ?sled on my vote legisllalion aerurmxe Ageless ul the ;act
Musing home. Iauhtyu lung lerm can: laully
Hosp Lil

Relmmenl Camel

Relam? (elabouslup 

Address uulsudc county (soc Bux 

 

You? 65 You: 0! A9: or Oldov 0t Vomn with a 
I1 b! one eledcon. selecl 2:0me box
ll WW3 me (or all away muons. (he calendar yum. soled 'AvanJlAppucalvon 

%ual 

Animal Slalom Eznm?cwu.
I Eled-on Vm 0min" m; ward luly will 

Novomber Elochon

DOlml 

n?mour. 
Room analy
My Rowing Runoll

ONLY Valor: Mum lrom County 0: Volm Con?ned In Jall:

You may oriyauoly lot a hello! by mail for one demon. and any warning mall.
Please sued lhe appropriate hex.

91mm: mom an; FM
DmyEk?ycl'on :?zwd??nmwk?cdpanyloan
Novm?be' Elecmn lic 3W

DOIhot-

 

Repubhmn Primary
Any Rerdmg Runofl

 

 

ll someone helped you to compum this lorm or malls the form lor you. lhen that parson musl complete the sections below.

ls I 10. tho-Maul shall chick 

la a (lens A misdu'nomor slgnaluw was 

         

bro-e: Adrfess k3! Nombe'

Slain

 

ll you "looted "upoclod absent. ltom the county.? sea rovuu let 



Data you can begin to rocolvv nu! ll address Oct. 0! (alum lo toudoncu address

Conucl lntomu?on (OpComlj?
Phase Ital phone nun-bur ,3ny mail address
?ma can ow cm Ms cucslvoaa

 

 

 

 

 

 

 

 

 

"l unify that tho Infommlon In mu application is two. and I undoutond that lalu Inlocmallon In
ml; la a crlmo."

 



SIGN HERE
"applicant In unable lo o?gn or Me a
math in tho presence of a witness, the

  

 

 

 

 

 

witness shall complelo Boxes ?la-b.

 
 
      
   
   

500 back Ior Mme" and Auburn do?nluom.

if you are aclmg as 8 
NP died this 00L

?1 you any riding at: In Mun-m,
please chad um box.
*Il you are acting as mums .39
Auburn. moase check 11911] D2325

Wunon' lo Applicant
(Ruler lo 



 

 

 

 

iy 

page

1-1.3 Fa xDat 6326265679

44

2017 ?12:

14

Apr

 

 

 

 

 

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Apr 14 2017 13:08 HP FaxDat 6826265679 page 1

Texas Secretary of State PO. Box 12060 IAustin, Texas 78711-2060 1-800-252-VOTE (8683) 
ELECTION COMPLAINT TO THE TEXAS SECRETARY OF STATE
OFFICE USE Date Hand-delivered or Date Postmarked
ONLY 04 14 2017

Please read the Important Information at the end of this document. The Secretary of State has no authority to
order a new election, chan an election result, or conduct a criminal investigation. A complaint filed with this

form will not alter the resu ts of an election.

 

 

Docket Number

 

 

 

This complaint form MUST BE SIGNED before it is submitted to the Secretary of State; therefore. you must print
it out and sign it before mailing or faxing a copy or emailing a scanned, signed copy.

I. IDENTITY OF COMPLAINANT

 

 

1 COMPLAINANT MI
NAME I -

NICKNANE um SUFFIX

2 CITY STATE ZIPCODE

PHYSICAL
Tx -
(Full home or buslnose address. including and zip code)

3 COMPLAINANT ?93605
MAILING
ADDRESS

Knock If some As above)

 

(Full home or huslnou address, city, "ligand 1b com)

4 COMPLAINANT AREA CODE PHONE NUMBER EXT !5 COMPLAIMABHT
. em 
NUMBER I ADDRESS 

ll. IDENTITY OF RESPONDENT

Pam 0R ENTITY Gown-me ALLEED mmh)

 

 

 

 

FRST 

6 RESPONDENT
NAME.

NICKNAME LAST SUFFIX

 

7 RESPONDENT . .
POSITION OR Dallas County District Clerk
TITLE

9 RESPONDENT 51w; z|chDE
Tx 

(Full home or business address. includ n9 strut. city. stats. and zip code)

 

 

 

ADDRESS (TOINCLUDE APPLICABLE 
9 RESPONDENT I STATE com:

MAILING
ADDRESS

(ch-ch ma now)

 

(Full home or business Iddrees. lncludlng elreet, city. state, and 1b code)

 

1? RESPONDENT i AREA CODE PHONE NUMBER '11 RESPONDENT
TELEPHONE E-MAIL
NUMBER . ADDRESS
(IF 

GO TO PAGE 2
TY ens 19

NOTICE: THIS COMPLAINT I8 PUBLIC RECORD ONCE REVIEW IS COMPLETED BY THE SECRETARY OF 

 

 

 

1.1.3 000012
TTORNEY GENERAL.
Revised 2/2812014

 

Apr 14 2017 13:08 HP FaxDat 6826265679 page 2

Texas Secretary of State PO. Box 12060 Austin, Texas 78711-2060 (8683) 

Ill. NATURE OF ALLEGED VIOLATION PageZ

If you believe that acriminalviolation of the Code has occurred. please state the specific acts committed by the person or
entity named in this com plaint. along with a reference to the section of the Code alleged to have been violated. if known. If

you need more space, please attach asepereto sheet.

Unlawful assistance per Sec. 86.010 of the Election Code.

 

Sec. 86.010. VOTER. Avoter casting a ballot by mail who would be eligible under Section
64.031 to receive assistance at a polling place may select a person as provided by Section 64.032(c) to assist
the voter in preparing the ballot.

Assistance rendered under this section is limited to that authorized by this code at a polling place.

(6) The person assisting the voter must sign a written oath prescribed by Section 64.034 that is part of the
certificate on the of?cial carrier envelope.

If a voter is assisted in violation of Subsection or the voter's ballot may not be counted.

(9) A person who assists a voter to prepare a ballot to be voted by mail shall enter the person's signature,
printed name, and residence address on the official carrier envelope oi the voter.

A person commits an offense if the person knowingly fails to provide the information on the official carrier
envelope as required by Subsection 

ATTACH ADDITIONAL PAGESAS NEEDED

 

TX-SOS-19-1 1 1 3-E-000013

COMPLAINT l8 PUBLIC RECORD ONCE REVIEW IS COMPLETED BY THE SECRETARY OF STATE ANDIOR ATTORNEY GENERAL.
Revvsed 2/28f2014

 

 

Apr 14 2017 13108 HP FaxDat 6826265679 page 3

Texas Secretary of State P.O. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 

IV. STATEMENT OF FACTS Page3

State the fact: constituting the alleged violation(e), including the dates on which orthe period of time in which the alleged
violationts) occu rred. Identify allegations of fact not personally known to the com plainant, but alleged on information and
belief. Please use simple, concise, and direct statements.

 

 

 

 

 

 

 

 

 

.
. ELECTION IN WHICH OCCURRED 
2016 Elections our: or ELEc'nou 
NAME 0? ELECTION 
Dallas County Various
COUNTY OR POLITICAL OUBDNISION PRECINCT

 

 

 

 

The ?rst AB BM attached shows an ABBM in her handwriting and with her completed assist portion of the 
arm. The remaining are in her handwriting, but without the completed assist portion. This is only a sample.
There are hundreds, if not thousands in this same handwriting.

 

 

ATTACH ADDITIONAL PAGES AS NE EDED

 

 

TX-SOS-19-1 1 13-E-000014

IS PUBLIC RECORD ONCE REVIEW IS COMPLETED BY SICRITARY OF STATE ANOIOR ATTOINIV GENERAL.


 

Apr 14 2017 13:08 HP FaxDat 6826265679 page 4

Texas Secretary of State PO. Box 12060 Austin. Texas 7871 1?2060 1-800-252-VOTE (8683) 

V. LISTING OF DOCUMENTS AND OTHER MATERIALS Page4

List all documents and other materials filed with this complaint. Additionally, list all othet documents and other materials
that are relevantto this complaint and that are within your knowledge.lncluding their location. if known.

Attached are Applications tor Ballot Mail (anolatc the Election Code.

I. ABBM with assistant portion completed whose handwriting matches ABBMs also atta

ched, where the assistant portion is blank.
2. 2 ABBMs with matching handwriting indicating unlawful assistance as the assistant portion of the appli

cation is blank.

 

See Exhibit A

ATTACHADDITIONAL PAGESAS NEEDED

 

TX-SOS-19-1 1 13-l?00015

NOTIOS: THIS COMPLAINT IS DUILIC RICORD ONCE REVIEW IS COMPLETED IV THE SICRBTARY OF STATE ANDIOR ATTORNEY GENERAL.
Rev 

 

 

Apr 14 2017 13208 HP FaxDat 6826265679

Texas Secretary of State

Box 12060

page 5

Austin. Texas ?8711-2060 1-800-252-VOTE (8683I 505 statetx us

 

VI. SIGNED STATEMENT paw,e 5

 

 

NOTICE: THIS COMPLAINT IS NOT ONCE REVIEWED BY
THE SECRETARY OF STATE, IT WILL BE TREATED AS A PUBLIC RECORD.

 

 

the underSIgned

-

under penalty oi pertury oo swear or af?rm that the unfOrmatron contamed in ms
complaint rs true and correct to the best of my knowtedge

I have read and understand the accompanymg mslructrons. and I am aware that
comptelron of this fonT cannot and Will not alter the Outcome of the alectrorm

 




JHE: OF- COMPLAINANT

 

 

REMINDER: YOU MUST SIGN THIS FORM PRIOR TO SUBMITTING

 

 

IF MAILINQ PLEASE SENDTO:
Texas Secretary of State
Elections Diwswn
c/o Legal Dept
PO. Box 12060
Austin TX 78711

IF FAXING. PLEASE SEND 
512 475.2811

IF EMAILING, PLEASE SEND TO:


 

 

NOTICE THIS COMPLAINT I5 PUBLIC RECORD ONCE REVIEW I8 COMPLITIO .V THE IECRETARY OF STATE AYTORNEY GENERAL



page 6

017 13:08 HP FaxDat 6826265679

4

14



 
  
 
 
  

 

Su?uv'r 5: 1? cm Fiml 

 

 

Cily

    

 

 

City State Zip Code

 

 

 

 

 

:1 Voting by ?all

?i you ale wuueslmu lullol be mallet! lo 3 diners"! address (other than ruidnncu)
us ol at alum (Wkl?pl 3621)

lndmalu whom lha banal ml! an malleu Sac rovn'sc lo! Instructions

 

 

Am .I . Gr van an gmt?-JHL- 
Il/ WW
Mutant: ll? In} Lu ?llI' l?xlu If Grunt"; -
a: album; lug-1 who mum); W)
I) [0 Camden! 801 ?8 an "L'l Amway, ml nix-4,: al? ml]
marl I0 IN (Cle CI ?sz ww-zul Mun-r
65 Yams of Age of Older or Vulela with a Disability: ll you selected "expo-emu ?Damn "om xho cc-mly 5m- reverse lm 

ll awlyuq let one gleam gum! :mwopuak: box

If nnca. l(:l all cum!) Clemons the Linemldr )?jur gum-L; 'f-ItnusolA.5zluuhul 
Appll 

U-ul MM and 1.14135. Plump, Lu?lluh". Duo you can begin In ructme man! a! this .vddves' Dale ol lo roanonm amlrom
Van nu}; emu?: .

ham-Lu ?mu?

[3 November 

yus. .,
Mum .

 

Con'acl lnlovmailon (OpUunJil?
PL-ny; Ivbl {may BUrmudulu Primary
l'nmaq

Ann, Piuhul?l

ONLY Volovs ibnnl from Eounly or ?Jotcrs Con?ned ln Jail: culify Ilul the inlommllon givon In [his annlicallnn true .uull ululersla?d lhal giving false Inlonnaliou ?1
You may only apply 10! a ballot by null lu one uchbom and may vuud?l. application is a crime -
plnasv salad Illa app'q halo box

  

 

 

491J5u_?v_ L?Il'v MI ?v 

?lm nius? u? l4 gut :uvum tn 
May Llu 
.l 

[3 Nu?; [[L'Clkn 00.? nUCl?dilC andw

 

 

 

 

 
 

 

6- *1 I, SIGN HERE
mm lfapplicant is unable lo sign 0! make a
AW Flt-tum?) Run ?ll mark in the presence of a whness, the
witness shall cemplete Boxes Mla-b.

   
 
   
  
   
 

See back for Witnes- dot-unions.

a W?Ilness,
pit-nae Ult?k In: box.
If ya; mu aclmq :15 an Assistam.
[mass (mock ll'ns hm.
ll you an! dLIll?g as Witness inn
Ass-Siam monm mom :1me

(I
Wilness? Rol :onglxip to Applicant 
(Relax I l? 

I I

   

  

 

Apt Numtmr
IV I awluwel


 

5w t"

-4

 

 

 

 

 

formulario .515 gispunibh: un Espa?ol. Para conseguir la version en Espar'ml favor dc llamar sin cargo al 1.800.252.8683 a olicina do! dc EsfacL?-ngvelmig lacion pa: WUJlldelantado

mm to voter one: Ins envelope. and non Wt your name to spoon below. this ermine. must no order: by the voter adore it int-cs the voter?s ".3333 0: not sign the
envelope union the bola ha been me by you or st your direction carrier envel . sod to rohrm men than one voter?s ballot. Honour. more than one
:houmeaodress This 
mm by mail. by oommon or oonm carrier. or in person by the voter on ?Indian an at the any voting clerks ot?icc. {lnsbucoiones al Vounte: Selle ate score. i am 'r?me
nu Wendupocioproporoionadcahh osteoalmomome do ouctabokta'uys


Era mm to boloto do this do on ?le mimic. Sin embargo. has do u't solo ooh-e oticiu
sor om do on: sabre sl 

semis) o?olol meson-l to patents: a un votanu pm velar no la mm dbeccidn. Esta sobre otrcial deb: 32-: sound;
canoe. por media do on mm: pool? 0 morbid. serontrogodo on persona por ol votente at on do in deocion on to olitina dol secretam an votation tenrprana.)

out"! "11! M01 0W my wishes Independent at my dictation or more persuasion by any person (Cat?lco one to bolero Mjunta exams ml: new),
ndependlontumrm paranoia 

 

 

SEAL ENVELOPE AND SIGN OVER SEALED 

Instructions to Assistant: A voter may only be assisted with reading or marking the ballot it they have a pinsical disability that renders them unable to write or see. or
have an inability to read the language in which the ballot is written. It you are assisting the voter. you must read the oath and complete the section below. before
assisting the voter. ai Asistento: Un votante puede recibir ayuda para leer llenar la beleta solamente sr el votante tiene una discapacidad lisica
lacual leimpide escribir ver.o si no tiene la habilidad do leer el :enguaie en el cual la boleta esta escrila. Si usted la proporcionara ayuda a un votante.
ustod debe leer ol juramento llenar la sigulente seccion abajo. antes de al votante.)

 

 

 

 

Oath of Person Assisting Voter i swear (or affirm) that I will not suggest. by word. sign or gesture. now the voter should vote; I will my assolanoe to ansmring
the voter's questions. to statlng propositions on the ballot. and to naming candidates and. it isle-d. their political parties; wm prepare the voter?s ballot as the voter directs;
and i am not the voter?s employer. an agent at the voter?s employer. or an o?iicsr or agent ot a labor union to the water belongs (Juramento do to Persona
al Votonu: Jun) (0 aftmo) que no sugen'r? con palabras. se?alas. gestos. la manera en la coal at vctanre daba voter; limtare mi aslstencre a responder
lea preguntas del votante. leer proqu en la boteta. nombrar a los candidatos. sl es mencionado. su partido polnioo: preparare la boleta del volante oe acuerdo a
sus instruociones: yo no soy el empleador del votanta. un agente del empleacor do! votante. 0 un o?clel agente do on sindicato al coat el voter-la porter-coo.)

page 7

Instructions to Witness: You are serving as a witness for (name ol voter) You must complete the section were rt you
witness the mark or the voter. or it the voter cannot make a mark. It the voter cannot make a mark, check hem . al Testigo: Usted esta 'ung endo
oomo testloo para (hombre del votarte). Usted debs ?anar la sculente seccion abajo sl usteo tue tastigo oe qua cl vcrante
llrmo, 0 da Que el votnnte no puede ?rmer. Si el votanta no puede ?rmer. maraue sus initiates aqui 

Instructions to Person Depositing Carrier Envelope in Mali or to Common or ContractCarn?er. it you are ass:st:ng a voter by the corner envelope In th
null or witha common or contract mniar. you must complete the section below. a la Persona Ouien Deposite el Sabre O?cial en el Como Entreguo

at Tmtoportiau Pounce Comerclol: Si usted asistlra' at votante a deposr?or el sobre o?cal an e? correo 0 ton on corn-areal. ustad Gabe l'enar
la seooi?n que aparece abate.)

 

 

 

it you are an assistant or witness. check the appropriate box below and provide inlormation: (Si usted es un asistente testigo. marque Ia casilla correcta proporcione
su lnlormaabn):

Aoisteme
Signature (FItma) Printed Name (Hombre impresol Sheet Address (Domioifio 'eSIcle'tGail
0W Taboo
Auburn;
mm

Wires! Signature (Fume) Primed Name (Nombra impress) Street Address (Domicilio residencial)
Tubeo

 

Completed by Early Voting Cleric Name of Election (Nombra de 812ch

mfg-uh" - 

I TX-SOS-19-1113-E-000018

 

2017 13:08 HP FaxDat 6826265679

page 8

13208 HP FaxDat 6826265679

1 ?1?4
?1 .-

4

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mam t' II: ?gr (.1 Vsn?yn?l. 1:321113 E-000019

 $19" "ma so? law. this omczope most 52 misc :1 the vote: Daron. rt 13.3ch 2?1: voter?s ands. 90 1:t sad ?Ls
your 

Moo-midst? directionmiammulo ominous-atom 
- 929! mummy} ..owevcr.ml
whorl-"dope must be placed logotturln anther envelop. the wow menu-losers) belong to a person reg-stored to vote at the who am This :arror envelope 

Matty 90-11mm"
re on It womb Wanda ohm Est: soon debs do ur saloon por ol volume amen at one or votanro Io ominous No Mn- csto sabre a mono: Eu: to boo-ea 
30M. mm?mwswu?n?ogun mmhbohudomasdcm woman?. amt-largo mason unsouaobnohcm
one cobra s: sebum o?cut adlctonll lo a an vomit: Mo pm vow halo la rots-n: dirocolon Esta soot: ohm] ear swede W,
com par media do no We publioo corn-raid. cor mood on persons por el vowno or din on I: elocotdn en I: alone dot ammo :22 vomcion 



 

due I: hoia.J adjust: express ms donors

  
 
   

SEAL ENVELOPE AND SIGN overt SEALED FLAP I 
(5m: EL soar: FIRME ENCIMA DE SOLAPA DEL sonar) MARCA DEL 

Instructions to Assistant A \oter may only be assisted with reading or marking me ballot it they have a physical disamlity that renders them unable to write or see or
have an inabilityto read the language in which the ballot is written. It you are assisting the voter, you must read the oath and complete the section'berow helore
assisting the voter. al Asistente: Un votante puede recibir ayuda para leer lienar la boleta solamente SI el votante tiene una discapaCIded lisica
la cual leirnpide esoribir 0 ver. si no tiene la habllidad de leer el Ienguaje en el cual la boleta esl? escrita. Si ustc?d le proporcionar?. ayuda a un vorante
usted debe leer el juramento llenar Ia siguiente secci?n abajo. antes de asistir al votante.) I

 

 

 

 

 

 

Oath 01 Person Assisting Voter: i swear (or af?rm) that I \mlr not suggest by ward, Sign. or gesture. how the voter should vote:| wull confine my assistant? to answering
the voters questions. to stating propositions on the harm. and to naming candidates ans. isted. their political parties. I a ill prepare the vorer's ballot as the voter 
or and am not the voter?s employer. an agent oi the voter's employer. or an of?cer or agent oi a labor union lo which the voter belongs (Juramento de la Persons
Aolstiendo sl Votanlle: Juro (o a?rno) que no sugerir? son paiabres. se?alee. gestos. la manera en la coal at volante deoe volar; hmitsre mi astste'loa a responder
las preguntas del votante. leer meaias en la bolela. nomorar 3 ins candidatos si es menclonado su particle pelitlco preparers ?3 Delete cel totante de acunrdo a
sus instruociones: yo no soy el empleador del votante. un agente del empleadsr del voter-ta 0 Ln eliciai 0 agents do an sindlcato oval el gamma permits?, 1

my

 

Instructions ?0 YOU 3'9 serving 35 a witness (name of voter) Vou must complete the section oelow it we
witness the mark of the voter, or it the voter cannot make a mark. If the voter cannot melee a mark. check here al Testigs' esls tungiendo
oorno teshgo para (hombre del votante). Usrec deoe 'lsnar la sign-ems secddn sr usted foe tesls'wa as 530% at arctanle
time. 0 de que el votante no puede ?rmer. Si el votante no puede firmer marque sus iniciales aqul 8

Instructions to Person Depositing Carrier Envelope in Mail or to Common or ContractCarrler: it you are assming a voter by deposmng the rams - ?ve?ope ,n tre
mall or with a common or contract carrier, you must complete the section below. a la Persona Ouien Deposits el Sobre Oticial en el Correo Entregue

al Transportisla P?blico Comerolst' Si usred asistir? al votanle a deposits: el sobre o?cisl en el correo 0 :on 4r! pumice torrential uslec' debe [lenar
la secoibn que epareoe abaio.) 

 

 

it you are an assistant or witness. check the appropriate box below and provide information; (Si osted es un asistenle lastigo. marque ia casilla

. ccrrecta o'cione
su inlormocon): YD CO .

Assisant/
Anatomy
3W .90 Signature (Firm) Printed Name (Nomom inpreso) Street Address reside-noel)
08
Assistant!
How.
28%? Signature (Fm-m) Printed Name (Norm: :npraso) Srreet Address iDomcrlio residencial)

Completed by Early Voting Cleric Name of Election (Nombre de Elecci?n):

 

Name ofVotorl'Nombro dolvotantoTX-SOS-19-1113-E-000020

2017 13:09 HP FaxDat 6826265679

page 

Apr 14 2017 13:09 HP FaxDat 6826265679

 

 

 
 

Application for Batiot by Mail?

 

?65:09! Mr Ut: 731k: LI 1' .1 thUL-kn ut Ftah 3' 



:1 01!: not it ttm':
cum: 2.1.x 1, .
than m. 5- .

If.?

 

 

1 Last Norm (Please arm

 

Suf?x {.Jr 8r. I t. First Nanm n2
3M1

 

   

Rutdmco
2

 



City

 

 

out my batlot to: math mm? (Him tmm?re?mn

  

attioss. oaas'r: (Jammie Fm. 

City Zip Code

 

 

 

 

-4 qi?h 

   

 

1: Voting by 
0f 896 alw- 
(W)

text absence from the nmmy (W)
re to completa Box a

Iemem in tent 

.or: 65 Your: at A9. or Ohio: or Votms mm a Disability:
tut unu EKI awrourintc box
It .tpuyrng um fur al county In he atom year. setocl 'Annml Awama?mt'


UMlnnu 011th Lls?stvm. mum
You mutt] declxe gm- ;mttr at [nt?y mt? 
0 W7 unruly
Elm" 8 Democratic Ptimary
0014

chubtican Primary
Runoff

 

mu Vol-r! Absent from County or Voters Con?ned in Jail:
You may My apply For .1 Mat by trail lot one Mann and My ?Mum nmolt
Phase soled he appropriate box.

Minimum/1a leliloq?ws;
May [loam
tlouomhct 

Other -

mummy 

Yum out (ted-rt we ,u-o'uu patty to vutn n-
a mm:
Primary
Primary
f-ny Runoll

  

"applicant is unable to martt 801 10, the IKHICS that! chock this box.

was assay: In tho agitation.



Signature ot Witness {Assatunt

 

5 ?tt-d Mid: *5 Apt Number

Mable]

If someone helped you to complete this term or melts the form for you. then that puson must complete the sections below.

Mute to convict: Ih's mimmation tr; 3 Ohms A mi?mtusanm It mgnatwo was w'tnosxml or applicant



?(titted frame at 

It you are requesting thlo ballot be maltod to a diflorcnt address (othet than residuttcc), 
indtcate whore lhu ballot be mailed. See ruorn for Instructions.

Maumg Address as 115.160 on my mtorruglsnalm cen?icalu Address at tat:
Nusmg homc. nm?nlcd living (nudity. long mu.- itmtitty
Hospital

Rutnenmu Cantu

Relative. lblittlo Lh?p

uutswlu the ?unity tau: um

It you mound ?expected Mia (roan the county." Sn raven. tot Instructions

DUDE DEED - DE Ht]

Data you can begin to ?2ch mil at this address Date 0! relum to unidencc address

Contact lntormatton (Optmnatl'
Please tut phone number amt?m onwl 
Used In rme om Omar has 

 

 

 

 

 

 

 

certify that the information given this application is true. and I understand that giving talse lntormatton in
this application is a crlmo."

 



HERE
"applicant is unable to sign or a
mark in the presence at a witness. the
witness shall complete Boxes ?ta-b.

 

 

 

      
   
     

 



300 back for Witness and Autstant de?nitions.

It you are acting as a Witness.
pleaSu check this box.
t! you are acting as an Aulstant.
please chock this box.
It you ate as Witness mg
Assistant. please check homing:

 

City

 

$333? Sif?tf??'?im?lt? 1

 

 

page 11

Apr. 14 2017 13:10 HP FaxDat 6826265679

Wow 0 was .V'mp?i. om: man wit "on- with.? nu. m-vth. .. u. -, -- . --.-- - -, '0 . 
envelope unless the ballot has been manned by you or at your direction. m: carrier WM my not be used to mm men than are aged ballot. data-ever more man one
my .motopo may be placed together in mother envelope 3 the adzs?tioml cantor caseload!) belong to person reg'storld to vote at tho same admin ca-iar mm must be
romeo by mdl. by common or contract cantor. or in person by the voter on election day at me early votng clerk?s ottloc. (Instructions: at Vannte: Seth ests sabre. 7 despite; ?rm:
at: nombra on at epoch proporcbnado unis. Esta sob'u debs do 801' son-m pet or votante ante: do cl votanto lo omngus. No tune care 303': a ruencs 33 one a ooteta new
3150 um por rated. 0 boio su d?nocion. Eat. unbr- o?chl no oer utitzado Earl ?Mr Ia botela an mes on it: saw ?atoms. sin embryo. mas :e a? 5310 more alrcial
anode nor colocndo demo do otro who 6 at scouts) I adidond lo penenece I mum. narnmdo para warm hobo to warn: Gaussian. 55:: some atom can se' E's-m1: ow
cor-mo, por media de un tmsportista public!) 0 comorctal. ser 9n persona por el votanto st dia 60 -a oleccron en la otrorna cet seeretanc do voucron try-trans;

I ?rim that the enclosed ballot expresses my wisnms independent of any dictation or undue persuasion by any person. (Certifico que la bcleta adjunta expresa mis deaeos
lndependientemente de pinyin didudoopommion 

 

 

4


SEAL ENVELOPE AND SIGN OVER SEALED FLAP 

(SELLS El SOBRE FIRME ENCIMA DE SOLAPA DEL SOBREI 

Instructions to Assistant A voter may only be assisted with reading or marking the ballot if they have a physical disability that renders them unable to write or see, or
have an inability to read the language in which the ballot is written. It you are assisting the voter you must read the oath and compete the secuon below. belore
assisting the voter. al Aaistente: Un votante puede recibir ayuda para leer Ilenar la boleta solamente 51' at votants tiene una ciscapacidad fisica
la cual le impide escribir venosi no tiene la habilldad de leer el Ienguale en el cual la boleta esta escrita. Si usted le proporcionara? ayuda a un votanle.
usted debs leer el juramento llenar la siguiente secci?n abato. antes de asistir at votante.)

 
 

 

 

 

sronrnrun; OR MARK or VOTER MARCA DEL VOTANTE)

 

 

 

Oath of Person Assisting Voter I swear (or af?rm) that will not suggest try wo'd. Sign, or gesture how 291 voter Shauid vole. mil con?ne my assistance ?9 answering
the voter's questions. to stating propositions on the ballot. and to naming candidates and. it listed their [30' um! parties: I will prepare the tot-El 5 ballot as 'he ?are: direc's
and I am not the voter's employer, an agent at the voter?s employer. or an ot'iser or agent at a labor union to wrucn tne voter belong: (Juramento de la Persona
Aststiendo al Votanto: Juro (o alirmo) que no sugerire con palabras. senales. gestcs. ?a manena en la CJat el votante debs wtar' 'lmrlare mr as's?enja a responder
ias preguntas del votante. leer propuestas en la boleta. nombrar a los candidates. si es mendonado. su partrdo politico. preparers; la bo-eta del mtants? oe aeoerdo a
sus Instrucciones: yo no soy el empleador del vomnte, un agente del empieador del votante 0 un o?oal 0 agents de un smdcato a! coat a; ?flame certanec'si)

 

Inm?ons to Witness: YOU are serving as a witness tor (name at voter) YOU must ccmp?sle the section below it you
witness the mark at the voter. or it the voter cannot make a mark. It the voter cannot make a mark. check here . al Testlgo. Usted e693 lurgrendo

oomo testigo para (nornbre del votante). Usmd debs Ilenar la s'guiente session absjo sr ustod tue tesago de que el votantg
?rmo. 0 do que el votanta no puede ?rmar. Si el votante no puede ?rmar, marque sus initiates aqui 

Instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier: it you are assisting a voter by s?epositino the camel envempe the
mall or a common or contract carrier. you must complete the section below. a la Persona Quien Deposits el Sobra O?cial en Correo Entregue
at Transportista Comercial: Si usted asistlra al tante a deposltar el sabre oticial en el oorreo ocon un transportista publico oomemial. .rsted debs 'lerar
la seoci?n qua apareca abajo.)

 

It you are an assistant or witness. check the appropriate box below and provide information: (Si usted es un asistente testigo, marque la msiiIa corrects proportione
su inlormacbn): 
Assistant
Asia!?
Witness! Signature (Frrma) Printed Name (Nombre morass) Street AddreSS(Dnmicil vasioonmsil
'resttgo

0 Asia".

Signature (Firms) Printed Name (Nombre impreso) Street Address {Domicilro :esrdencial]
Tostlpa

 

Cornpleted by Early Voting Clerk: Name at Election (Nombro do Eleoci?n):

 

Name 0, ("0'11be votante): ma. -4 elm-u..- m- .. 

TX-SOS-19-1 1 13-E-000022

Apr 14 2017 12:50 HP FaxDat 6826265679 page 1

 

 

Texas Secretary of State PO. Box 12060 Austin, Texas 78711-2060 
ELECTION COMPLAINT TO THE TEXAS SECRETARY OF STATE
Docket Number OFFICE USE Date Hand-delivered or Date Postmarked
ONLY 04 14 2017

 

 

 

Please read the important Information at the end of this document. The Secretary of State has no authority to
order a new election, change an election result. or conduct a criminal investigation. A complaint ?led with this
form will not alter the results of an election.

This complaint form MUST BE SIGNED before it Is submitted to the Secretary of State; therefore, you must print
it out and sign it before mailing or faxing a copy or emailing a scanned, signed copy.

 

I. IDENTITY OF COMPLAINANT

 

1

 

COMPLAINANT FIRST Ml
NAME
LAST SUFFIX

  

COMPLAINANT ADDRESSCOINCLUDE APPLICABLE) CIIY STATE ?coma

PHYSICAL

(Fullhomo or business address. ind

CO NANT memos IF APPLICABLE) cm STATE ZIP CODE
MAILING
ADDRESS

[ch-ck nm. In ADM)

(Full homo or business addrlu. Inducing street. city. state. and zip code)

 

 

NUMBER ADDRESS

COMPLAINANT c005 NUMBER I5 i

 

 

II. IDENTITY OF RESPONDENT

DERSON on 5mm couumwo ALLEGED 

 

10

6 RESPONDENT

- Ml

 

 

NAME
MCKNAME 
RESPONDENT -
POSITION OR Canvasser
TITLE

 

RESPONDENT I curv STATE 2m cooe
PHYSICAL TX
ADDRESS

(Full home or business addreel. Including street, city, mic, and zip code)

RESPONDENT
MAILING
ADDRESS

(check -f am? In above)

 

 

 

 

ADDRESSUC CITY STATE ZIP CODE:

(Full home or business address. Including street city. slate, and L0 coda]

RE SP 0ND ENT ARFA cone PHONE NUMBER FXT
TELEPHONE
NUMBER

 

 

 

 



GO TO PAGE 2
TV A
NOTICE: Tuna Is PUBLIC RECORD ONCE REVIEW Is COMPLETED BY THE SECRETARY OF 

Rewsec? 2/280014

 

 

Apr 14 2017 12:50 HP FaxDat 6826265679 page 2

Texas Secretary of State P.O. Box 12060 Austin. Texas 78711-2060 1-800252-VOTE (8683) 
Ill. NATURE OF ALLEGED VIOLATION Pagez

If you believe that a criminal violation of the Code has occurred, please state the speci?c acts committed by the person or

entity named in this corn plaint. along with a reference to the section of the Code alleged to have been violated. if known. If
you need more space, please attach a separate sheet.

Unlawful Assistance per Sec. 86.010 of the Election Code.

Sec. 86.010. ASSISTING Avoter casting a ballot by mail who would be eligible under Section
64.031 to receive assistance at a polling place may select a person as provided by Section 64.032(c) to assist
the voter in preparing the ballot.

Assistance rendered under this section is limited to that authorized by this code at a polling place.

The person assisting the voter must sign a written oath prescribed by Section 64.034 that is part of the
certi?cate on the official carrier envelope.

It a voter is assisted in violation of Subsection or the voter's ballot may not be counted.

A person who assists a voter to prepare a ballot to be voted by mail shall enter the person?s signature,
printed name. and residence address on the of?cial carrier envelope ot the voter.

A person commits an offense if the person knowingly fails to provide the information on the of?cial carrier
envelope as required by Subsection 

 

ATTACH ADDITIONAL PAGESAS NEEDED

 

TX-SOS-1 9-1 1 

nova: "as OOMPLAINT :8 PUBLIC Recono once REVIEW :3 COMPLETED BY THE SECRETARY or ANOIOR ATTORNEY GENERAL.
Revised 2128/2014

 

 

Apr 14 2017 12:50 HP FaxDat 6826265679 page 3

Texas Secretary oi State PO. Box 12060 Austin, Texas 78711-2060 1-800-252-VOTE (8683) 

IV. STATEMENT OF FACTS Pago3

State the facts constituting the alleged violationls). including the dates on or the perlod of tlme In the alleged
vlolatlon(a) occurred. allegations of fact not personally known to the complainant. but alleged on information and
belief. Please use simple, concise, and direct statements.

 

 

 

ELECTION IN WHICH Vloumou(s) OCCURRED

 

2015 Elections DAT: or ELECTION Various
NAM: or ELECTION MMIDDIYYW
Dallas County Vanous
on POLITICAL sueomsuou 

 

 

 

 

The first ABBM attached shows an ABBM in his handwriting and with his completed assist portion of the
form. The remaining are in his handwriting, but without the completed assist portion. This is only a sample.
There are hundreds, if not thousands in this same handwriting.

 

 

 

ATTACH ADDITIONAL PAGES AS NEEDED

 

 

 

TV one 
This :5 PUBLIC RECORD once nevnew IS ev me. or 
Rowsed 21280014

 

Apr 14 2017 12:50 HP FaxDat 6826265679 page 4

Texas Secretary of State PO. Box 12060 Austin, Texas 78711-2030 1-800-252-VOTE (8683) 

V. LISTING OF DOCUM ENTS AND OTHER MATERIALS P8964

List all documents and other materials filed with this complaint. Additionally. list all other documents and other materials
that are relevantto this complaint and that are within your knowledge. including their location. if known.

Attached are Applications tor Ballot By Mail (ABBMS) that Violate the Election Code.

I. ABBM with assistant portion completed by whose handwriting matches ABBMS also at

tached. where the assistant portion is blank.
2. 10 ABBMs with matching handwriting indicating unlawful assistance as the assistant portion of the app]

ication is blank.

 

See Exhibit A

ATTACHADDITIONAL PAGES AS NEEDED

TX-SOS-19-1 1 13-E-000026

ls PUBLIC RECORD ONCE REVIEW IS COMPLETED BY THE SECRETARY 0' STATE ANDIOR GENERAL.
Rev-sod 212812014

 

 

 

Apr 14 2017 1250 HP FaxDat 6826265679

Texas Secretary of State PO Box 12060

page 5

Auslln. Texas 73711-2060 1-800-252-VOTE (8683) ww 303 state tx us

 

VI. SIGNED STATEMENT paggs

 

 

 

the urdersgned.

under penalty of do swear or af?rm that the Information contamed thus
as true ano corvea to the nest of my knowledge

I have read and understanc the accomoawymg IOSUUCIIOFIS and I am aware that
completuon of HMS form cannot ano wm not alter the outcome of the e?ectton

 

NOTICE: THIS COMPLAINT IS NOT ONCE REVIEWED BY
THE SECRETARY OF STATE, IT WILL BE TREATED AS A PUBLIC RECORD.

 

REMINDER: YOU MUST SIGN THIS FORM PRIOR TO SUBMITTING

IF MAILING, PLEASE SEND TO:
Texas Secretary of State
Elections Duwsnon
do Legal Dept
PO Box 12060
Austin. TX 78711

IF FAXING. PLEASE SEND TO:
512 475.2811

IF EMAILING. PLEASE SEND TO:
elect:ons@sos statetxus

 

 

NOTICE THIS IIONRLAUNT IS PUCLIC ONCE REVIEW IC COMPLEYED IV THE IICIETARV OF STATE ANDIOR ATTORNIV 

TX-SOS-19-1 1 1335662062?? 

 

Page 6

2017 12:50 HP FaxDat 6826265679

14

Apr

  

?l it ?Pro?1?-
. "n 

.Sr. Ill etc) Fh - -- Mfg} initial
.State le Code

 



 

 

 

 

 

 

 

 

 

 

 

7 It you are requesting this ballot be mailed to a different address (other than residence),
indicate where the ballot will be mailed. See reverse for instructions

 

 

Mailing Address as listed on my voter registration certif?xzte Address of the jail
Disability. W)
Nursing home. assisted living facility. or 'ong term care :aclmy Relative: relationship
Emeded absence from the county- (gamma)
Be sure to complete Box 8! Hospital Address outside the county (see Box 

Con?nement in rail. Re?nement Center
a ONLY Voters SSYears of Age orOlder or Voters with a Disability: lfyou selected 'expected absence from the county," see vevom tor instructions

If applying for one election seled appropriate box

 

 

 

 

lt applying once for all county elections in the miendar year. select ?Annual 
Anmal Ap mutton . 

 

 

 

 

 

 

 

 

 

 

 

 
   

 

ynilomnd 0m [Elm'mi Wm Data you can begin to receive mail at this address Date at return to residence address
gins-y Election Kim" mm? ?m comet Information [Optlonan'
. 3? Please list phone number email address:
November Electron Democratic Primary Used in ace our of?ce has moons. 3?
Other Republican Primary
Rainy Resulting Runotl~

ONLY Voters Abs-rt from Court or Voters Con?ned in Jail: ?1 certify that the information given in this a hca?on is true, and i understand that giving false information in
l! . PP
You may only apply for a halo! by mail for one election. and any resulting mail. this application is a crime."
Please select the mpmp?ate box?

I to vets 
May Election I?mtcedg gm Wm 
Novembe' Election DernO'TaEc Primary
Other . . SIGN HERE
8 Pnrna .
p? "applicant is unable to sign or make a
Any Resulting Runoii mark in the prosence of a witness, the

 

witness shall complete Boxes #11a-b.

   
  

 

someone helped you to complete this four: or mails the form for then that person must complete the sections belowapplicant I9 unable to merit 80x9 10. the witness shall check this box [3 11b See back for Wrtness and Assistant de?nitions

 
  

If you are actan as a Witness
please check this box.

if you are acting as an Assistant.
please check this box.

ll you are acting as Witness and
Assistant, please check 

Failure to complete this himnation is a Class A misdemeanor 1 signature was witnessed or app?cznt

A 


      

 

 

 

 

Street Ad ress Apt Nunber Witness? Relationship to Applicant
(it applicable) (Refer to Instructions on back for clarification)

State In 

 

Esta formulan'o est? disponlble on 55573501. Para consegur'r la version on Espa?o! favor de Homer sin cargo al 1.800. 2528683 a la ofrcina del Secretarlo de Estado la Secretaria do Volacl?n porAdelanmr

     
  

*y

l? .1 l? 1h' VUID lr
St?mwul (J .yu- . . . .
Eumx (Jr, 5: . m. cm *1 

 



.Cily

:39 Box t: 7 City Slae

 

 

 

 

 

 

 

 

 

 

?ail: If you are requesting this ballot be mailed to a ?More!? oodles: (olhu than residence),
5 o! W335i} lnditalo where the be mailed. See reverse for instructions-
Maing Address as ism! on my vole! certi?cate: Moss ol the pi!
hr 
Nurs'ng homa lrv'mg bcilly, long h?m melaniny Rdamm; "elm.?
an absence run the cum. (Emulsi?smmi
om carapace Box 48

?asp? mamas oukade wmly (see Box 
mm .n pa. LWE Cam

ONLY Voinrs 65 Years olAgo or am: or Vb: with a Disability: If you selected ?0102ch abseim from he county." see reverse lor instructions
ll 3W lot one demon :clx! 

I 3:119le me:- lo: ml Matador.

A 1 
talcum yew, scluct 'Annunl Ami-what 
Wm
:gz?nimi mum?m'ozu;

Odom-can addms
?-Irusi rlrxivemc unit-v.1 

    
 

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0?0 0? (alum In rm wuss

 

 

?mm, Comet Inlommlon (Optiomll'

r\ the! Baden . Please l'sl [trend number and!? ?nail amass:
cu WK pm"! 

a Elma: primary

Any Reading Rmo?

ONLY me AmemnCoumymlenJa?:

eel-lily that the information given in this apolicalion a mu. Indl umiaruana um giving [also Hormo?on 
You mayonly and Mbappl'mtlonlsacn'mo.?
Please soled me ammpraie box.

 

 

 

u?mmiomLElgsim ?m?egms;

musirlixiare milk! '0 *0
DMay Eledon my 

3 man
Nmurnbet Elucl'nn
Otter 

 

Den-wrath: Primary 
. . SIGN HERE
mum" "applicant is unab
Any Resting Runol

mark in the presence of a wllness. the
witness shall comploto Boxes #11a-b.

  

 

 

   
 

 

If someone helped you to complete lormor malls tho lorm far you. than that person must camplek the sections below.

Is unabb ta mar): Box to, me witness stun check his box El

See back for Witness and Assisi?: de?nitions.
Failure iu aornp'o?o this. mkvmaiior: a a Class A 11 589mm was massed or applicanl
was Mod vn cmciemg lhe Wanna

ll yuv are \cing as ?Illness,

 

 

 

 

2017 12:51 HP FaxDat 6826265679

 

 

 

 

 

 

please chem Ibis ho:
VQI m9 3(1th .15 Assislam.
plum med: IN: box
- .?Asaistmi P?nled Name 0! Wths. slant
?7 mm? 1' you are #1509 a Witness mu
please ctr-r.) bum mags
"Pl Numbei Cvly Wilnoss' Relationship to Applicant
mix-able) (Relax lu Instruction:- (in Emu Mun; Won}
Slate 2m TX-SOS-19-1 1 13-E-000029 
2? 39:? Immofarlo and disponible on Espar'vol. Para oouseguir la version on Espmiol two: de uamnr sm can)" :1 1 Rm one? . . 

 

page 8

Apr 14 2017 12:51 HP FaxDat 6826265679

 

Application for Ballot by Mail

01in: ll Sta.) ELIN (ll zuu- xi 15'th rut Use 06W
Ak??q 1211.] WHO 1, two, Llama? Funml? ?1
5'4er 0' 

 

 

1

 

Sulfur St. etc}

Fir

 

 

 

   

Addrga; Sec (mot. or um .whcauon lo! "ng5

2

 

City

   
 

 

l" BCB

 

 

187 City

 

 

 

  
   
 

Data 01 Birth mud:

--
?2

(09mm!)

   

 

 

  

- Voting by Mail;
Sycasolugeamlu it

 
  
   

Inseam/Wm

I twulml almanac Imrn the: mmty (W
He sun to complolo lion: '8

1 unhnunml nu Idl' WW

you an requasling this ballot be mailed to a dillerent address (other than rosiduco),
indicata where [he ballol will be mailed. $00 reverse lor instructions.

Mating Mamas as lat-Led on my voxcr regmuabun cemkub: ol 1M 1an
Nursmu home ARQSIM Iwuu; lanky, long lum care Lanny
Humpnal

Re?xcnuanl Center

Rnlatvo; ICDllOl?lShIp 

Address uulsrde the WW (we 80: 381

 

ONLY Vol-rs 65 Years 0! Age or Oloor or Valor- uilha 
ll .1me let one cluclrm- 950d ammo:
l1 lul all amly elermn? . Ul? mum." year soled 'Anmal Minna}! 

Ga

  
 
 

Annual Anpkalu'.


4|nfuly 

hypr??lfmr. F?mnry
Mmc?zm Prim

Wewlm rumor

ovum Elmwl

Don?:

I UH 
Md,?

?Mac "My! push ln 

I you selected 'expecled abs-nu from the county.? sac reverse for instructions

DE 

Dale you can begin to rec-in mil al this address Dale 0? return lo "ammo address

 

 

 

 

 

 

 

 

Contact Information (Opuonalr
Please lust nllorve numhel al-lross.
USN (85? 00! queahnz,

 

 

ONLY Voters Abumfrom County or Voters Con?ned in 
You nay only wply lot a bald by will hr one electron. and any rewkng 
Please safest In: ammonia box

my 32m?" 55am?; Pun II

polka palylo vole In
Eh?l?n A primary
Nuvanher blu?hnn . octah: l?rnury



Republvcon PM
Any Rcsulng Rum?

  
  
   

 

ll awlicant is unable to mark Box i 10. (ha warms: shall check this box.

was ass-5m In the 

IX

ol [Ass?anl

 

311.31g! Address Au! Numbu

ul appleablel

 

but:

 

ll'eomene helped you to complelolhl term or malls the form-lor you, Illerl mus; oomplole mo'sec?cns' below; 

allure l0 complete Ins mlormalon IS .5 Class A mosdmnuamr 4 $49 nalure way. wmtesser: nr awhcall

certify man "In inlormalion 93m in this application is Imo? and undoriland mar givlng Ills. mlormaiion 
lhis applicatlon ls a c?mo.?

   

 

SIGN HERE
"applicant ls unable to sign or make a

mark in the presence ol a witness. the
witness shal complete Boxes Illa-b.

 

      
  
  
 

 

See back lot Wines and Aulsum de?nilians

El

 



   

ll you are aclmg a; a Witnoss,
please char): bux.



Print-9d NZnne ul 

If you ac aclmg as an Assislanl.
please check (no:

ll you are acting as ?lms: and
Mci?anl, please check ?gm mag;

Whnoss? Relalionsm'p to Applicant
{Ruler to ~(uu 

 

 

City

     

 

 

Zip

 

 

 

page 9

Ap" 14 2017 1251 HP FaxDat 6826265679

 
    
    

 

  

 

 

. .- - . . 
Ap p'ication for Banot by .. \l fk?zI-Zt F's-nun h.
?lJm?rvll?pj?MsnSut?x . Sr. In. etc} Hrs! Na

  

 

 

 
 

 

City

 
 

 

 

 

 


r? Magoo (W

?w 

AM absence Eur My (W
.13: to comptao Box 38

?remen! 3? Int 
ONLY Voters 65 Years at A9: or Otdu ?Vows with a Dtsabltity:

It you an.- thit ballot be mail-d to a different addrou (othor than residence].
Indicate when the bo malted. Sec terms: for 

Matting as ?zzled :11 my tcg'stratw oer??mlc o! the 1m!

Nursing home. assisted ?ving tmly. u- long tam mm fadviy Relatrve; 
[3 Hospital

Rcliemonl Center

Md'ess meat?: the tummy Box w)

 

 

rt (a can em. wcdaoclrm

It applying oacc (a all county chants Gaunt-I year. select mlAmtrcatim

   
  

'w

Pnnvuy

Hepuwcan Primary
Resm Rum?

ONLY Votars Absent 6mm County 0! ma Conthed in Jait:

YOU may only amty [or a battol by mail one elm-tn. and any resuming mm?
Please select the agorapmte tnx.

Blou'yatm
May Flodion :11 just (Mtiar: out; Mm gm my 
er Ehdm 003th Prunary
[3 Repuhtu' an mm,

Any RnsuRing Runo'.?

    
   
      

II applicant ls unabte to mark Box i to. the witness shat! chad: mt: box.

was asd-stnd in oomph-fang the opp?cdor?v



nglue of mamas/Assistant

 

Street mamas Am Nunber

apptic?i?e)

 

3319.

If someone helped you to compiete this fom?o? malls tho far'm?foryou. than ttf'at piorbon must bompl?t? th'e ??ec?ons below.

Fattneto compkm information is a Class A mtsdanpmo: signatue was vntnessnd or Room-ant

. I you ?expected absmce trout the county." for Instruction:

- 

Dat- you can begin to waive nail al this 36m: nat- ol to residence 


Contact Information (Op?onnlf
Pteasa fist phone numbcl god/o; uma'n address:
115m mast! out 0181:: has an?qnni

 

 

 

 

 

 

 

'l unity that the Information given in this application ts true, and I that givlng false infomation in
this applicdion is 3 ohm."

 



 
 



 

 

 

SIGN HERE

lpr?catt is unable to sign or make a
mark in the presence of a witness. the
witness shall comptete Boxes M?s-b.

 



See on tor Macs: and As sistant de?nitions.

It y0u are ading as :1 Warm?.
nloasc chadAutmm.
ff VOU are acting as Witness .951
dense died: ?lly-J19?

Witness" Relatio-nship to Applicant






Printed Name at 

 



 

 

 

 An-?fw 121v'nv-v'tl at .. 

    

 

Stt??vllJI Sr ull 06:)

 

 

- hc $391.. brim let-ms

 

  
   
 
 
  

Code

Mail my bib! to: marlin: artdtess dl?m mamnce address, pinaso complete Box :3 I
I 2?
Date 0' Birth (Wm) [Oncomil 




 

 

State

 

 

 

 

- 

   
  
  
   

tor Mug by Mail:
5 vearsoiageorddm. 

Mmimq a< km on my vtinr registration certi?cate Amrrm nl nu! pi
811W. 

It you are requesting this ballot be mailed to ditterem addrese (other than 
Indicate when the ballot will be mailed. See reverse lot instructions.

0 Nursmg home. as ststod trving IPrm can: faullty Risimwn 
[Mind absence tram he county. 

 

Ba sun to complete Bout Hospital Marv? nwtsuh- :hn tut-may man no. an,
I Cnn?nmnl inia? WW ?1 Retirement Cenlm
ONLY Voters 65 Years at Age ?Older 9! Voters with a Disability: it you selected 'expeaed abacus. from the county." 52: revetse lo: innructions



ll 29?me Augean 3' county elect the calendar year. select 'Ammi Applicatum 
Apdicmim 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0 516011?. Em; Bum n. om you can begin to receive mail at addtess Date 01 to residence undress
lit-clue ?nal in ?0 v0?-
ay Etedm a? ,7 Contact intonation (optimum
Please list phone nurture 0&9} . mm; a.
3 November moaalvc Pnnrary - U500 We We hm 
I
a Rennbticm Primary
Resmng Rum?

 

ONLY Vnten Absent trout County 0: Voter! Con?ned In Jail:
Ym anymming runoff

 

entity that the infatuation given in this application is true. and mental-1d th;giving lalsc in

 

 

 

     
   

 

this application a 
Pie-m soled In Wt? box.
You trust dt'dzn an: pt?tbml pxty to -. in 
May Election a 
November Elec?ion Dammit; Primaty .
Other . SIGN HERE
can i?nmarv Mapp?cant is unable to sign or make a
Any Result-g Runolt mark in the presence of a witness. the
. witness shall complete Boxes imaob.

 

It somana helped you to complete this tom-I or Malls the 'orm tar you. than that button Must tat-Hale? tho sections Below.

 

 

ls unabIe to mark 801 a 10. the witness shal check this tun. Sec bad to. "We? and Assmm amni'ims
Fatima to complete intonation is a Class Amisocmenm :l Stg?altlfe was ?the-3W 0t aoplicanl It vm are. .uumg as a wanna
was PISSIRM In comotdmg Assistant?
La? ch. .K lh:
Signatrre 0' Wings [Assistant pnmed Name of ?Mmesq'mwmt v: or t\ itox

If you ate :3th as Witness am!
Assistant. please mack 

Witne?s' Relationship to Applicant
Male: to on back lor (lamination)

TX-SOS-19-11 13-E-000032 
State ED

W'sr?n ?Emu-3h," an 0m mum-Ab la . 

 

 

8 item Addams Apt Numbe! City
(If amicable)

 

 

Apr 14 2017 12:52 HP FaxDat 6826265679

 

 

 

 

 

page 11

Apr 14 2017 12:52 HP FaxDat 6826265679

 

Application for Ballot by Mail

I I

 

 

 

firm-Hm. l.

 

 

   

ha: 0! ll-s-lml?lhn H6910 by he 030% SWIM a! S?mv Tr ?nial Us? M. v, . -
- V?Jlill [.?Okld??llv ,k ?1 .
.71 MisSul?nx n: elcl Fits! . 
C'v ,Tx
2: 7 Cty Sun

 

 

 

 

   
 

04!: o! (Quinlan

4 

A

 
 

 

 

  

or May by ?ail:
year: 0! agent mm (W

Dmmh' WW)

 
  
   
  

Enx?fkt? {5030106 hum Ine county 
sum to momma Boa l8

Weight

ll you an ?questing [his bollol be mailed in a ditforani addrus (other than residoncol.
indicate whuo the ballot oill be mailed. Sn vent? instructions. 

Mating/illness as IISICG on any vma regisuahon Moss 0! lpe p-l
.

Mung homo. assa?cvl luv-mg lav-t1, lunq tern core localily

(blame. up

Mimi Address mo mum (see Em 418)

mem?nl (Junta

 

6a ONLY M15 65 Years 0! A90 or Older orVotocs milk a Disability.
ll Jam"; '0 on? Plaim selucl amuwnab box
ll ?mply'rq; lot all manly clcums in the calcium yuan sch-cl 'N?nual Appw?umn 

31mm 

 

Indium lion:- will) it Emails
. Vuumlmweggmudgumu k? NIP .-
My Eirt?won ?mu?
marinated layman 0911?)qu p, 
09'? mey

Rle Kmulcng Rod!

(MY Mel?s Absenl from County at Valet: Con?ned in Jail:
You may only manly 3 Dailil mm luv one dedm. .111 31y vesting mall
Plum sclec.? th?alc? In.

(1333 l? rm?
May I hrmo
Muuwll-j UrJou

DWICI 

Prrmag Elegmtni
Ymmuv Jazz: ung- mum wily wow NI
.1 ?my,

Dt-ululobl.? Pu an
Rumba-?lo mey

Any Rowling Runoff

 

 

        

was 455m in 00?:an (11c applicallon



Sty-mm: ul Illssislam

 

Fame [0 ?01?th mu mlumalm is .1 Cl?ms A ?lowly": mg. ?:qu or ?who.?

F?n?nlul Name ol WIness/Asgsm

. ll you skated 'expoctod abw fro-u th. cowly,? sea "was. tor insuugll'om

DD 

Data you can begin to roam mil at this addless Dale ol Mum in adduss

Contact mammalian (Opicnall' 1
Please is! phone.- number and alarms.
Used in raw nut mice in; ("Minus

1 

may on: the lnlorma?on given In this applicmion is lnn. and I mag-W the: ?via {also Inlormuuon in
this application?s 3 am.?

 

 

 

 

 

 

 

 

 

 

NU

 

 



 

 

 

  
 



 

 

 

SIGN HERE
is 11
mark in lho ptesenco o! a witness, the

 
 

witness shall complete Boxes ?13-h.
- If someone helped you lo complex: {his form or mails mi: {orm loiyota. {hen'lh'alpa?rson "lust cofnplelo lho?ucllons below;
ll applicanl is mama to math 80: I 10, "us shall cited this box. 

San back to: Wimp! and *Ti?am de?nitionsWho".
clear-c checl hs hm} 1|

one 343; as an .A?qusunl.
please d?lrcl?us hm) 

you sweat-'19 as WW5 
Assklat?L um: med muggy;

 

 

 

 

 

 

 

 

 

Estc {omiulan?o c513 alspomolc on Espai?iol. Para consecuir la valwn Esoahol (mm: m:

Sl'uul AM: a? Numhtl Ctly Wilneu' Relationlhip lo Awlican?
(I1 Wm) (Rule! lu inszt on back lot 
I
. 
2w 

llanlar cin ram :Miser.? I 

.lcm'vn "at u'wv - l-fr

 

- in. I. lu1.'.l Suf?xiJ.? . N. 

 

 

 

 

 

 

2 913? cAdrrutSr no dlM?U0Clti lmumimclions 
3 my. . . .. I 

   
   
    

 

 

 

 

Dato of Birth (HI-V611,
I?q

4

    
  
 

  

?ugh-y Nomi ll II you an "queuing this ballot be mailed to a dillcicnl address (0mm than residence).
(1399de

indicate when the hallo! nm be mailed See reverse [or insuuc?ons.
-l

;i Maimg Address as hum on my vol/3r rmimliun nl .m?l 
A ability.

  

Nummg mam. assisled Mung faculty. or mum (me lacihly Relative, velahmsh-p 
waded aim from calm WW)
1 sunk) :Mpbl! a? .3 Address ?plaids: lhv- Lou-11v [in

- mminiail [Comm ReinmimlCenlm

ONLY Voters 65 ans of A3. at Chiba Vow-s with a Disability.
Ilappiying Iorone eledion. *i?dapmeboa

lvapply'ng once in! at court! ebdms in me dandy MN styled 'Anmai 
{am-?lb Miami

 

you selected "expecied absence kom the county." sec reverse lor instructions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

   
  
 
       

 

   

 

j: Em Dal. you can begin lo sail a! this ?dress Dale 0! wtum lo nsldencc address
i '1
a) ?may Eldhi i .01 an dad. Marlow! 71 Contact ?ovulation ?W'O?'lr dd
CD Nth-em - . Please numbcc .3313; mm: .1 Mess
a be? Ewm BWNIC Pf'mfv U596 in case out Dmt'l.? Ix.? ?walnuts.
0 00m! . Rppubllcan Primary
Any Nesu? lirq Runo?
.1 . 
OllY VolenAbum from 0! Wm Con?ned in Jail . cc?ily that Ibo "lion-nation given in this application is true. and understand that giving false iniovmalion in
You abjl?ymailbmeewabn, anon magmas?. is acrlme.?

ab?! 
Wg?i ii 1W5.
. . 

November Election 'l 
WM Primary
Olhcr .1 1 an SIGN HERE
1 "applicant is unable to sign or aim a
raw?; mark in Nu presence ol a witness. the
i wines: shall complete Boxes iris-b.

 

ll someorle helped you to complete this form at mm inform for you. than that when most co?mplelb the spellons below.

 

 

If applicant is unabl- luv-ark B'ox 10,019 witness shall check this box See hack for ??tness and Assistani de?nitions
Fnaurclo compile mid 'n?wnattili is a ?lm A if signaling was or angina! mu am a when
was assisled in oompldir'g (he ajpl'valkn pit-m check (his Dar
I A mu aw awn-(12$ an Assistant.
59mm", oi wmess l?mstanl witnessrAmaiau "md m"



~k ll you are aclng as Witness and
I Assistant. pier? check 99"? 00x95

 

 

 

 

 

Apr 14 2017 12:52 HP FaxDat 6826265679

 

 

 

 

 

 

 

Sheet/ladies: . Apt Number City Witness' Relationship lo Applies!"
applicable) (Rein l0 on back kn clan-?ualinn;
5 TX-SOS-19-1113-E-000034
State I g: 7ip
CA. ..11 J-.. page 13

Apr 14 2017 12:53 HP FaxDat 6826265679

 

x''szk?fu

  

First

. 

City

 

 

 

Data of Barth tr? ay) (Opburat)

City

 

State

 

 

 

 

 

Ff.

 

by Mail:

 



Mt) ME)
hunter! amen-:3 ham coulry. 
8. sun to Box '8
Mm: 

OILY Voters ?5 Yea: ot A9. or 0111:! or Voteg; with a Dtsahi?tyz
I aommg b! me etcd'mn. select 

applying our,? kl comfy cioctims 'the year, soled thlm'


 

Nun! Appttumon
Wag mamas 
999 prim! patty tn mt: In
November Election 6 
-- 1' 
B?Kny Resetting Rum?

 

Con?nedin Jail:

Mailing Atkitess as listml on my Vite: togistraiion mt??cate
Maugham: 3555:4011 mug tnc?y. long; tum rare faculty


[j Reliement Cent?

you soloctod ?expected absmce tram the county." see muse to: 

Bat you can begin to methanol at this actress

Codact Intunutfon (Option?r

Phrase list phone mmbur 3951qu ?has


If you an requesting this battot be mailed to a dittcront addiess [other than residence),
indicate whore lho ballot will be mailed. See nurse for instructions.

[3 Aim-5.: the 
rolgbonship

Address outside the minty {we Box 



Date of mlum to resldance audios:

 

 

 

 

 

 

BUDD-

 

 

 

 

 



 

My Rum?

 

 
 
  
     

 

If applicant is to mark Box 1 10. tha w?nm aha! check this box.

[3

FWC to cmvtete this intmnation IS a Class Amisdutmmr it shinning was witnessed o: npp?umt
was 'n Wig the animation



Signature 3! Wine? 

Sheet AW

'1 entity that the h?umation gm it this application is true. and I understand that giving lalse infatuation in

ml: application is a mime." .
Please stated avpvopn?atc Um. 
mum?emm th?m?qm
Duay?eam :??imcmm?dmty hymen 
Novemba median 080 I 
Dane: CIR In SIGNHERE

?apptimt is unable to sign 0: nan a
mark in the ptcsancc of a witness. the
witness shat] complete Boxes 81124:.

(I sdm?dn? hyped you to cctn?l?t? thi?fom or'm'aills 1?13 (qn?'for'yohftha?n {Flat person must complete the'isectiona bel?w.

Printed Name 0! WimeWMsis butt

 

  

 

 

 

  
 
  
   

 

See back for Witness and Assistant de?nition;
you an: acting as a Witnesa?

"hast: ?iv-rt the bot
1 If acting as an Assistant.

I Jtcc't [ms box

ym are wu?mJ as Witness my
Assistant. named attack gemmxm

 

 

 

Am Number
app-mama)

City

 

5?bit?



{In

Wilness? Relatlonsttip to 

(Rem 

1

 

 

page 14

Apr 14 2017 12:53 HP FaxDat 6826265679

      



I 11'2?" a. yZ-r - ASN.1 .

 

.. . I?_r 4 . 
5.4? :71 4,;1 v1: an.) Y. 2:03.21; all. "um-L: 1.. L: 4215.3. 4:44.41. 




 

 

      

 

r?n nsmuydsu?dkuhu . hum; by. Gan ,1
16' 5: 12:13 flu-(y 97<?n 1311.1?,


 

   

3mm: m? Mi, arc)

 

 



     
    

 

 

 

 

 

 

 

 

 

 

  
     
  

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

      

 

 

  
 

 
  

 

 

:f scmconn named you lc rr- 9 {cm or mans In: (our. for ysrr, :han rm: "ms: to


  

manometer: Wuapplicam
was wad In MUM application.



signage cf .?Asu?stam Primed Name a! 

     
  
   

 

 

 

 

 

Sud mums A01 

:?r?nQI. my,

 

.r'u?el 9. the seeders baton:

  
      
   

 

 

 

  
 
 

"pumacfh gas-am?.


yea are using 3530 Assistant,
p. 'mcheck box



Relationship to Applicam

320 Ind: brillnm and Anhtanl datum?:


12.119350 We am! 7. City State L25: gods

you an "queuing ms Dana: be mailed to a dl?lreul addrc as (other than roswoncol, 
lam-cram. WW Indicate when the halo! win mailed. See venue for Instruction:
Martin; Wm or: Med 0mm mater registralon cantata? Address of the: jal

hmm?ism kw (tumor Iommczelaciit- Relative: relationship 
wmem Mm. mm 
a mud. Eon IO Address outsido the county (see Ber. 86)
in Just mm cm
OlYlohrs Is Venn oug- word-r ?Was an: a omwrr Iwuulocbd "mum horn cum nurmeioc instructions
..I ..
3m cm: b! all (13ch mm: cation! year. wed ?fvmual?gclcafmf I I I ll 
- 
Dab marl anhls mwu 

cilia 
Phase lust phone mmbor an anal mare-3;
PWWY 'uaadlncasa 
- - . 1 . ry -
My Rams Rune?
MYVotornNnom from County orVohrI Con?ned In Jan "lam? mo ln?onnalor- inrhh War Is mu. and I understand that mu mama-on on

Phasesderifro 
Emmy
unlit: hookah
Um Bach" wintry. ?1,me 
g?m MI Wa?cprimuy
- . SIGN HERE
Repudn 
.0 an ?applicant unable to sign a nuke a
Dm?emw 
mm shall corwldo aom??la-b.

 

page 15

Apr 14 2017 12:53 HP FaxDat 6826265679

Hui REMLJUE a 

.. . 

  

I. 

Qumran-d by he 0K1: 2:ng u! my '1 

Rf??fW; ?nigh-

bra}; 3.4 not-tunU3: I),
?1-7 I Cur-11 Hum-?Putin! I.
Add-.7 



 

 

Staff: 331? 5r. II. at} Fl

 

 

Cl

  
  
 

 

 

 

 

 

 

 

 

{Va-?un?t
mdagouow?mnm






UWMLW

If you ave this ballot he mailed to :1 amount wares: (thn than residence)
lndlealo whom Nu hallo! be mailed. Su rovers. fot instructlocn.

rugtsbat'nn ordinate Andcoss (1111pr
Mrsinghoml. assign! "mu m, 0! long lam: care fac?ilr


Rumm Center

Rum; relationship 

 

Yum 011.4708" ?Nahum; My:
tuba

I amp was Put at uni; dod' the ms, 59m 'Anmd 

?35m farm 

Eledon 

Nam Sudan



Dame-Ric mey
Macaw! Primary
~7me



 

OULY Vat": morn! from (211811 VOICES cm In Jdl:
You naymiy 3pm for a bulb! by mi bale MnJ?dmyre-mlhg 
Hem saint: ul- amt? box.

mmwmez?m BMW

Eledun Oemnam: Primary
Daamm
My Resulting Runo?

 

 

Adams waldo he comfy (Mn 80:: 18)
NM ?lulu! ?taped?! ton It. may.? no "verse for Instruction:

- 

Dataolnlumtn ?ml-?Hun
Coma Mot-mun (Oploodr

 

 

 

 

 

 

 

 



in cm atc?a- has amt-ms.

 

an"? In! Ibo Intermauon given this application I: has. and I "00:5!sz that gating Warm: In
?it app?c?bnrf a aha:

 

 

 

 

?appicahl ls unable In ?in at make a
mark In the meme of a witness, the
shall Boxesn?l a-b.

 

 

s~~1ecnz hcfned 10"13 complete ":33 term or 113. [In Item For vcu. thin 'na pula?lr? nus! complum the sccuo 15 be on

"Warmly-In?ow mask 

msasimd i1 omuhlhg hemp?catlm

.X

Squaw: rf?mrnets swam

PM of Wkasl?

 



El

Him-Io cum on domaionh a mamMmagigme was 

Sn back In: Whoa ?As-hunt ?mum.

Rwy? achgma?lhou,
pm? mad: w. box.

If ya: an ?Linc as Assault. 
plus: diedacting at: Nuns? 

 

Mi Wm Oily
{l awlic?el



Wimosr. Relationsth to Applicant

{71.13f VI 9 .. n. I

 

page 16

Apr 14 2017 12:53 HP FaxDat 6826265679

 

. . .. 
-?Wvlr? -

?a 


I-r u-

 

  

 

 



Maul my ballot to: It lr?om reammce maven. picasu Box 1! I

I-vlf?d



Suf?x . Em?? etc.)



 

 

UD

 

 

 

 

 

Voting by Hall:
an n! we 0' We! 
aw? mem

 

waded absence (t?m?m-mem :3 Lame

ONLY Voters 55 Yeas at A9. or Old? 00 Voten with a 

It 3qume to: (he Medan.sahct appr "no box

If men to: (Judy 01nd 010 yum, :?wlo-rx 'l?nzunl Arylx?atnm 


OH


Elam
Other 

     
 

Annual M?lcauon

anal-Jim.
You lust Mire "Aunt {wry I all; 
.5 WAN

Domenic Ptlmary
Republican Primm'y
Any Retailing Runoff

ll you are requesting thin ballot bu mailed to a ditterent addrass (other than residence).
indicate where the ballolwill b0 walled. See reverse to: instructions.

Mal-n9 Addie-33 as Ilsleu on my wits legwra?km mm?mrc des 0? men!

Nursing hon-e. mzuz-tcd living ltu'ilry at long term are laumy
t-loqmtal

Rm" mac:

[3 Relative), relationship

Nike?s tho [sec 80? 

ll yoa selected ?expat!? absenc: Iron in county." see reverie tor 

- 

Dal. you can begin to receive mil at this address Date of return to residence adduss

 

 

 

 

 

 

 

 

 

 

 

 

 

Contact [MormaliOII (Opuonall?

1/
Please list phone runhc: agwor ?nail 
Used In case cutoff? his Wm.

 

ONLY Vour: Abcni trom County or Voters Confined in Jall:

You may ody apply for a ballot by rank to: one etcdizm. and any nsulting mm".
Please select the box

 

  
  

mummOIhaEmem; mmaytmgom,
May em Imzm'??i ?mull-d mtuwu- I1
[3 Momma Elecum Demanm 
Ohm-W [:1qu mm,
Any Resulting Rumor!

an?, that the womauon given in this application ls hue. and I understand that giving mse Eton-mien 'n
um; application is; a crlme.?



SIGN HERE

ls unable to sign 0: make a
mark in the presence 01 a witnesa the

 

 

 

 

tf is unable to mark Box I 10. the witness shall check this box.

was assisted m?clmg the appimb?on



olWitnoss JAssixL-am

somedna halbet? y'all to cowblete'thi's fom?qu?itg the form that?psrson 'must ?omnlet'sft?? sections below.

Cl

Fallow to complete In?: nfcmaalion is a CBS: A mulcmcunor a! signature was 01 applicmn

witness shall complete Boxes #11a-b.

 

 
  
 

See back to: Wllnass and Assistant de?nitions.

Cl

 

  

It you are aoung as a Wllnoss,
please creek this boxAssistant.

 



 

Street NJer-ss

Name. ol Meeso :k bm'

tf you mo ac'ing Witness mg
Assistant, plane mack mtg?:-

 

 

 

 

 

 

 

 

 

Apr Witness' to Applicant
(rt ammue) (Rater In Instructions on back fm dali?callonl
7? Tx-sos-19-1 1 13-E-000038
ste formulaic osta' dispomble en Espa?ol. Para cansoguir la version en Espa?ol {avordc ?amnr sin cargo Apr 14 2017 12:18 HP FaxDat 6826265679

Texas Secretary of State

page 1

PO. Box 12060 Austin, Texas 78711-2060

1-800-252-VOTE (8683)



 


OFFICE USE Date Hand-delivered or Date Postmarked

ONLY 04 14 2017

Please read the Important Inlormation at the end of this document. The Secretary of State has no authority to
order a new election, chan an election result, or conduct a investigation. A complaint ?led with this
form will not alter the resu ts of an election.

 

Docket Number

 

 

 

This complaint form MUST BE SIGNED before it is submitted to the Secretary of State; therefore, you must print
It out and sign it before mailing or faxing a copy or a scanned. signed copy.

I. IDENTITY OF COMPLAINANT

 

 

1

MS I MR RRST

COMPLAI NANT

 

 

 

 

 

NICKNANE SUFFIX
2 COMPLAINANT ADDRESS cn?y STATE upcooh
PHYSICAL I
ADDRESS

adore?u. clty. Nate. and ale cede)
ADDRESS (TO INCLUDE APT I SUITFV APPLICABI F) CITY

       

mom. or us

 

3 COMPLAINANT 
MAILING
ADDRESS

um. as above:

ZIP 

(Full home 0! buslnou add rm. Including street. dry. state. and dpcodo)

 

4 

 

AREA CODE PHONE NUMBER EXT 5 COMPLAI NANT
TELEPHONE 
NUMBER ADDRESS

 


I

II. IDENTITY OF RESPONDENT

pensou on amrv commne ALLEGED 

 

 



FIRST



6 RESPONDENT
NAME

MCKNANE SIJH IX

 

7

8

9

10

RESPON DE 
POSITION OR
TITLE

RESPONDENT

PHYSICAL
ADDRESS

Canvas 

 

 

ADDRESS (TO IF APPLICABLEI

 

(Fill home orbuslness address, Including street, city, state, and zip code)

STATE 2 CODE

 

RESPONDENT
MAILING
ADDRESS

(check am an above)

RESPONDENT
TELEPHONE
NUMBER

 

(TO INCI LDF IF 

(Full home or buelnue addtau. includi rig street, city, stile. and zip code)

11 RESPONDENT

AREA CCDE PHONE NUMBER FXT
E-MAI 
ADDR 3

(IF KNOWN)



STATE CODF

 

 

GO TO PAGE 2

 

10 1111

NOVICE: n-IIs COMPLAINT Is PuaLIc RECORD once REVIEW IS COMPLETED BY me secneuav or 's?f'e?i?or'ova GENERAL.

avised 2128/2014

Apr 14 2017 12:18 HP FaxDat 6826265679 page 2

Texas Secretary of State PO. Box 12060 Austin, Texas 78711-2060 1-800-252-VOTE (8683) 

NATURE OF ALLEGED VIOLATION Pagoz
If you believe that a criminal violation of the Code has occurred. please state the specific acts committed by the person or
entity named In this com plaint, along with a reference to the section of the Code alleged to have been violated, If known. it
you need more space, please attach aseparate sheet.

Uniawtul Witness per Sec. 84.003 of the Election Code as well as forgery and tampering With a Uovemm
ent Record under Sec. 322] of the Penal Code.

 

Sec. 84.003. SIGNING APPLICATION BY ASSISTING APPLICANT. An early voting ballot
application signed for the applicant by a witness other than the early voting clerk or a deputy must indicate the
witness's relationship to the applicant or, if unrelated, indicate that fact.

A person who acts as a witness for an applicant for an early voting ballot application commits an offense If
the person knowingly fails to comply with Section 1.011. A person who in the presence of the applicant
otherwise assists an applicant in completing an early voting ballot application commits an offense it the person
knowingly fails to comply with Section 1.011(d) in the same manner as a witness.

An offense under this section is a Class A misdemeanor.

Sec. 32.21. FORGERY. For purposes of this section:

(1) "Forge" means:

(A) to alter, make, complete, execute, or authenticate any writing so that it purports:

to be the act of another who did not authorize that act;

(ii) to have been executed at a time or place or in a numbered sequence other than was in fact the case; or
(ill) to be a cepy of an original when no such original existed;

(B) to issue, transfer, register the transfer of. pass, publish, or otherwise utter a writing that is forged within the
meaning of Paragraph or

(C) to possess a writing that is forged within the meaning of Paragraph (A) with intent to utter it in a manner
specified in Paragraph (B).

(2) ?Writing" includes:

(A) printing or any other method of recording information;

(B) money, coins, tokens, stamps, seals, credit cards, badges, and trademarks; and

(C) symbols of value, right, privilege. or identification.

A person commits an offense if he forges a writing with intent to defraud or harm another.

(0) Except as provided by Subsections and (9-1 an offense under this section is a Class A
misdemeanor.

An offense under this section Is a state jail felony if the writing is or purports to be a will, codicil, deed, deed
of trust, mortgage, security Instrument, security agreement, credit card, check, authorization to debit an account
at a financial institution, or similar sight order for payment of money, contract, release, or other commercial
instrument.

An offense under this section is a felony of the third degree if the writing is or purports to be:

(1) part of an issue of money, securities, postage or revenue stamps;

(2) a government record listed in Section 37.01 or

(3) other instruments issued by a state or national government or by a subdivision of either. or part of an issue
of stock, bonds, or other instruments representing interests in or claims against another person.

ATTACH ADDITIONAL PAGESAS NEEDED

 

 

- A . TY 
NOTICE: this oonLAiN'r 18 PUBLIC necono one: REVIEW 15 COMPLETED BY THE secneunv or STATE ANDIOR A?r?rormev GENERAL.

Revised 2/28/2014

 

Apr 14 2017 12:18 HP FaxDat 6826265679 page 3

Texas Secretary of State PO. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 

IV. STATEMENT OF FACTS Page3

State the facts constituting the alleged violationls). including the dates on which or the period of time in which the alleged
violationtsl occurred. identify allegations of fact not personally known to the complainant, but alleged on Information and
belief. Please use simple, concise. and direct statements.

 

 

 

ELECTION WHICH OCCURRED

 

2016 Elections one or ELEOTION Various
NAME OF ELECTION mmoomrw
Dallas County Various
COUNTY OR POLITICAL PRECIN01

 

 

 

 

 

Attached are a few samples of ABBMs and Carrier Envelopes where _as clearly signed, or cause
someone else to sign, the ABBMs who is not the voter. The signatures on the ABBMs do not match those on th
a Carrier Envelopes. The handwriting on the ABBMs all match the handwriting of

Voters have called the Dallas County Elections Office and complained About receiving ballots that they did not

WBM oi Alice Washington. shown in the attached WFAA story, has the handwriting of -

 

 

 

ATTACH ADDITIONAL PAGESAS NEEDED

 

 

TX-SOS-19-1 113-E-000041
nor-era: oompumr is PUBLIC necono one: asvnaw is COMPLETED av THE sacaeumr OF STATE ATTORNEY GENERAL.
Rev sod2l2al2014

 

Apr 14 2017 12:18 HP FaxDat 6826265679 page 4

Texas Secretary of aate PO. Box 12060 Austin. Texas 78711-2060 (8683) 
V. LISTING OF DOCUM ENTS AND OTHER MATERIALS Page4

List all documents and other materials ?led with this complaint. Additionally, list all other documents and other materials
that are relevantto this complaint and that are within your knowledge. Including their location, if known.

 

 

Attached are the following:

1.App|ications for Ballot By Mail (ABBMs) and their corresponding Carrier EnveIOpes that
violate the Election Code.

2.An article from WFAA News with a link to a news story that aired on Monday, April 10th,
concerning this same canvasser. evidenced by the application shown during the
news broadcast.

3.A screenshot of the ABBM 0? shown during the broadcast, with the
handwriting of

 

See Exhibit A

l?
ATTACH ADDITIONAL PAGES AS NEEDED

 

TX-SOS-19-1 113-E-000042
none-e nus cokuum IS eueuc necono once nevrew :3 comment) av THE or STATE ATTORNEY GENERAL.
Revlseo 2I28I2014

 

 

Apr 14 2017 12:18 HP FaxDat 6826265679

Texas Secretary of State PO 80): $2060 Austm Texas 78711-2060 I-800-252-VOTE (8683) us
VI. SIGNED STATEMENT pages

 

 

 

the undersigned

    

. at the Informattow contameo in thus
complamt :5 true anc correct to the best of my krowledge

 

I have read and understanc the and I am aware that
completuon of torm cannot ano not alter the Outcome of the eectuon

 

NOTICE: THIS COMPLAINT IS NOT ONCE REVIEWED BY
THE SECRETARY OF STATE, IT WILL BE TREATED AS A PUBLIC RECORD.

 

 

 

 

REMINDER: YOU MUST SIGN THIS FORM PRIOR TO SUBMITTING

IF MAILING, PLEASE SEND TO:
Texas Secretary of State
Elections 
uo Legal Dept
PO Box 12060
Austm. TX 7871.1

IF FAXING PLEASE SEND TO:
512 475.2811

IF EMAILING, PLEASE SEND TO:
electlons@sos statetx us

 

 

 

NOYISK YFIS COMPLAINT l6 PUBLIC RECORD ONCE REVIEW II COMPLETED IV THE UP STATE OINERAL

TX-SOS-19-1 1 13150666213"

page 6

6826265679

Fa xDat

HQ

2017 12:18

44

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. I. 

 




v-m l7:- . 
. I . .

   

  

Lasl Kama :l'vmr- :m 

   
   
 
 

. 

 

Residence Andie-55. 344mg-Iymga mu- hr .mcuuny unions vulv'rlm ybL-r can] ?A-um,1! 
Annual/\pphunlann




 



 

 

 

 

 

 

 

 

 

Stnh, 1; I lyrI fl'Sl Nam MXd3?o 

Mum-.1; [Mal-(ma Datn you can begin to tccniwz mail (hi; address Data mumsContact "Mrs? .Imh; errvr-u "r 
quu Lh-rdrull hum-1W - up." .. ?Hum,? v.1; \i?u .U 
0th . ju?m?wc??J 
Any Hrs? lung Hill)"
ONI Vedas nhsenl [rum Counly or Voters Con?rmd in Jall; ?Tcnn 1y mm mm mloxmation qlvun In um i true, and I nuns-(wand {also 
Yup. may on), :q?mfy .4 ballot by 1i! an? :my nun/n" this applicant)? a cuimnf
I?hmm 504-: :l 

 

Uzl'h?m? and Omar [ladima Flimsy! It nuux
Ym. hr rv . an; a I-un
41:1:111 I I I
Mir-an (Human: 
tithe! - [j Rwullimn Planmy MGM HERE

If applicant is unable to Sign 0: make .1
mad: In the ptnsencc 013 wllness. the
witness sha? complete Box #11.

[3 Ni) Hnsuking Hum"

     

 
 
  
 

 

 

 
  
   


- 

See back {or Witness and Assistant definitions. .
.1 wrung '15 mblo no Hank Box 9 13 and you me 311M135 a Witness lo that fact Nam:- inls box am: Sign below. 

 
 

ll ya: asst-am! hr in mthfing Hus zuxmmfi?m the appfiznnl's 1 1mm {In aw?mb?m (m lr?mu n? Iln apum nl pk: ?st} du-i 15.5 box as Assisiant and 5,9? rx-qu 
at m, ad] ?a Mont-s my mumL [than (M). hohjux?g thun In maxim: u-is: is 0393211 mat-mama wag-rum? was rw-lic?m. was aesim? iv ma, mph} with

Stsu?jilc (?dmz?sr. [N?sql'ml Famed Name uf NXnex': IA sis-Ian!

2?
2?

 

 

   

 

 

 

 

n1?: h?l. "in (H Wilness' Rulallonship to Applicant
1 (More: In lr-srmciicnt: or. 5nd! 
'7 "i 
53?: - 

       
  

Mani my bal'ol to: 1' :mjnj 11.1.1:st (Wen haniruttwr xvlw'I? k? 7 6h?) . ?pt odn 
Unico'hnwm - 
Jting you are H-qll??ling HIM halal he mailed In a addrnu :h?'mgmomifi?mgm Mum, tho mum
will hr: mulled. Sou reverse [or s.
n' wow? (employ; 00L D?aj 1 (rucllon
Ma?mn Amine; . lie?lud nu va vold uynitl-?Jlx In ?(Mn pf lhr? izni.?
lit-mm; 
. La. .: 1.1.11. 1.: 31 .1, 1? ..
mum]. [3m :Gluml?ggyum-m "Wt-Inn {4-1: 
. ml; . [an?ck??o?xj?01""I?n rH 
ml .mxsw' .1 lu?ul It?! Irv M1. on 
55 YCINS 0' OIdc' 0' VOICIS 3 (""n'mity? ?wk-Med hom [ju- ?ounly'l1f-1yml? k-r ,ltll?d hm

 

 

1' 

 

Page 7

Apr-Q 2017 12:19 HP FaxDat 6826265679

man-town um . on use Barnum. gnu war- rum "are spec! now emu-Jpn must 58 531.0 Cy u- vow WW rt mu: cu- vt..cia use? um _re
envelope unless the bust has been Moo by you or at your direction. ml: car-rm mob! mg be used to ram mg an: voter?s ballot However. more that one
corner envelope may be puma together in Inotlm analogs it the edition! carrier belong to a person registered to vote at the some aod'ess his senior envelope wet be
teamed by mail. by some a contract carrier, or in person by tho war on election Guy at the early voting clerk?s of?ce. (Instrucdones el Vanna: Selle este sob-a. deep-ass firms
at hombre on It 89.3?) mom-00840 lib-5?? Em 30hr! Gob. dd ear Marlo po: ct mints anus do que el worms to entmgue. No Mm. 251. asbro a menu: do Que re baht: nave
bows. nisdeun solovotante. Sin embargo. 
pom our cdocado dunno do one soon at at aobretst onset dismal to mm a un volante made para voter bate la mlsma timocitln Esta scare cilia-lat debs sot muscle as:
sorreo. pot media do on twist: sonmcid. so! entrogado on persona por el vorante at do ac in stealth on laoticina dot scenario dc mansion tempt-ans.)

i certify that the enclosed ballot ?prams my walls: independent cl any dictation ar undue mien


   

'son. (Centric: que la boleta auto-?ta express mas dun;

 

SEAL ENVELOPE AND oven SEALED FLAP 
{ssue EL scene it FIRME DE scum DEL SOBRE) SIGNATURE OR MARK 0F VOTER (FIRMA MARCA DEL 

 

 

 

 

 

 

 

Instructions to Assistant: A voter may only be assisted with reading or marking the ballot it they have a physical disability that renders them unable to write or see. or
have an inability to read the language in which the ballot is written. it you are assisting the voter, you must read the oath and complete the section below. before
assisting the voter. at Aeistente: Un votante puede recibir ayuda para leer Ilenar la boleta solamente si el votante tiene una decapacidad lisica
la cual lo lmpide escriblro ver. 0 st no tiene la de leer eI languale en el cual la boleta esta? escrita. Si usted le proporcionara ayuda a un vorante.
usted debe leer el juramento llenar la siguiente seccirin abajo. antes do asistir al votante.)

Oath ot Person Assisting Voter. I swear (or affirm) that I will not suggest. by word. sign. or gesture. how the voter should vote; i will oonline my 355531159 to answering
the voter?s questions. to stating propositions on the ballot. and to namrng candidates and. it listed, their political parties: I will prepare the voter?s ballot as the voter directs;
and i am not the voter?s employer. an agent of the voter's employer. or an of?cer or agent of a labor union to which the voter belongs (Juramgnto de la Persona
Asiatiendo al Votonte: Juro (o alirmo) one no sugerir? con palabras. sel'ieles. gestos. ta menera en la coal et votante debs voter. limiters ml asistencia responder
las preguntes del votante. leer promesxas en la boleta. nombrar a los candidates, si es mencionado. su partldo politioo; p'eparare la hoteta dei vctame de ammo a
sus instruocioneS; yo no soy el empleador del votante. un agents del empleador del votante. 0 un ohcial 0 agents do on sindiceto at coal at votsnte pertenece.)

instructions to Wtuuss: You on serving as a mlness tor (name of voter) You must complete the section below it you
witness the mark of the voter, or lithe valet cannot make a mark. it the voter cannot make a mark. check here . at Testigo: Usteo esta iungienoo

coma testigo pm (hombre del volatile) Usted debs tlenar ta siguiente seccltin abalo st usted lue testrgo de que ol votante
time. 0 de que ct votante no pueoe lirmar. St at votante no puede lirmar. marque sus inidales aqui 

instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier. it you are assisting a voter by depositing the carrier envelope in the
mail or with a common or contract carrier. you must complete the section below. (instruoelones la Persona Quien Deposits at Sabre Oticiel en el Canon 0 Entregue

at Tiansportista Pubrrco Comerclal: Si usted asistira at votante a depositar at sabre o?cial en el correo 0 con un t'ansportisla publico comercial, usted deb: tlenar
Ia que aparece abaio.)

 

 

 

it you are an assistant or witness. check the appropriate box below and provide information: (Si usted es un asistente testigo. marque la casilla correcta proporcione
su inlormaclon):

Assistant!
.

Mussel Signature (Firma) Printed Name (Norrbre impmso)

Street Address (Dornicilio residential)
Tostlgo

Assistant!
0 Asisunte

Signature (Firms) Printed Name (Hombre Impreso) Street Address (Domicile residence?
.

Completed by Early Voting Cleric Name 01 Election (Nombre do accei?n):
Nam of Voter {Hombre del votantnl:

 

SIG woos-1941135000045

8

page

679

Dat 6826265

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12:19 HP

2017

14

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Jm or?xrtl? (Iand/vn

 

    
 

1| you no II I-n mailm! lo .I lotlrr rr- pl wl?I?lr?







ml! lIo mailed. Soo Ior incIIucuons
D?I?Iltvl I II. I, 1'14 
I I'I'lIti, 

I ..I. :l I. .II. I .I 
Iiul II I [Q?M?u'k'fo -1 
Il?l"| Ll 

II -I I. "(1001181 901 

\70 "nu/12!. lla? I'l'v'ltl'Aly

 

ONLY vamq Old: I Ul Vo?r?v'xu-I- II-I 

l- 

II q-[Ilwn (1 I-II 1.7

.q ?II?rrlw I II II-I - 'kil)? l7! I k-I' 
II 12UnIc 0| to Ir?sidv?IIcn 

 

9 Cunlml 

. I: I I'll Il'v'x 
5 . . - -
..I .I.- 3

UnivVowls Alwcm County or VolI?It. Jail; gwon In Ihls and I undomlaml lIuI gIva; (alsc in
If?: :IpplIcnI?l'lIuI'm HIV 

 

 

Ur.|f..nr '"yj I 


I F4 Inn-w,
Ill Lh'l 

 

 

,1 SIGN HERE
I I I
II applicant Is unabte to Sign OI make a
mark in the presence 01.; witness, "In
witness shall complete Box 811?

If Iomoone helped you to complain this Iorm or mail: IoIm luv you. than that man man comm tho section! balm.

Aug Hm 

    

 

Sac back Ior Wuness MC chinm'ons.

Iznal In inn! 7. 115.1 LII I, Hudnr? . I'm a

you gaystmifhe ?Inkluu In mhon In Um pmuum: 0 In! 3' Em?! [Ir-hull w: I wk 11va ..H ngsis1anl and I 

cam: I ham? 'Jv?du I) 1'11
Relationsmp Ia 

I-I bath fur 

   

IS. Il' FICA Inuknw um2,1. . Am rum?? If 

 

 

- 000016 I

 

 

EsIe Immuidno cm disponiblo on Espafml. Pam consegm'r In version en Espafm! favor d9 Homnr sin cargo a! 1.800 252.8583 a 1.3 oficina d9! Socmtan?o d9 FsIado la Secretaria do por AdeL-Inndo

 
      

Page 9

Apr 14 2017 12:19 HP FaxDat 6826265679

lnotmctions to Voter Seal this envelope. no then sign your name in spam below. this envuooc must be sealed :y the voter bdow it leaves the voter?s hands. Do not sign mt;

Modbyyouoralmdirectbn.1his gag one
cutter envelop- lithe sedition! amoromclopetsl belong to a person nqlatored tomuthonmo eddrm?niscamor envelope must be

by mail. by common or contract corner, or in person by the voter on election day or the u'ly voting clerks onion. ol Vatonte: Sell. we ochre. deems time
a: north" on OI mach WMGO dab- Iobna debe no ?r condo por OI vomte anus do we at intent to ontnguo. No fume estc sabre a mono; do out is bolcta hay.
ciao Mad: 90" listed. a beta su cinnamon. Est! toll. o?ciol no dob. our utillzodo . or II bolou de mi: do un solo voturto. Sin embryo. "nu de un solo cobra Olim-
ouodo on: colocado dontro do our: solar! a el mas) ottcrol odicronal la pononcca on votonto pm velar baa aim direction. at. some oliaal deco so: tarmac por
some. per Media on an humanist. Dw?co commit?. 0 SH entree-do on persons por el vow-rte at da de la 6?th en its charm del acetone do votacion tommnn)

that the undead ballot extras?: my Mobs: independent 0' any dictation or undue
hmmammomsmimdawmumwpmi

 

   
 
   

persuasion by any person. (Certi?ed ?gun to boleta adiunta oxoreso rm: dosoos

SEAL AND SIGN OVER SEALED FLAP .
(SELLE EL SOBRE FIRME ENCIMA DE DEL SOBRE)

 

 

 

SIGNATURE MARK VOTER (FIRMA MARCA DEL VOTANTE)

Instructions to Assistant: A voter may only be assisted with reading or marking the ballot it they have a physical disability that renders them unable to write or see. or
have an inability to read the language in which the ballot is written. It you are assisting the voter. you must read the oath and complete the section below. belore
a"55?5"?9 9' Aslstento: ?meme puede rocibir 3M8 para leer Ilenar la boteta solamente si el volante tiene una discapacidad tisica
Ia cual le impido escribir ver, 0 st no tiene Ia habilidad de leer el lenguaje en el cual la boleta esle escrita. Si usted le proporclonara ayuda a un votante,
usted debo leer el iuramonto llenar la siguiente seccion abajo, antes de asistir al votante.)

 

 

 

Oath at Person Assisting Voter. I swear (or af?rm) that I will not suggest. by word. sign, or gesture, how me voter should vote; I Will con?ne my assmtance to answering
the voters questions. to stating propositions on the ballot. and to naming candidates and. it listed. their political parties.l will prepare the voter's ballot as the voter d-rects899'" 0' We? employer, Of an otlloer 0' agent 0! a labor union to witch the voter belongs. (Juramento do In Persona
Asiationdo a! Votente: Juro (o a?rmo) que no sugerire con palabras, senales. gestos. la manera en la cual el volante debe votar: limitare mi asistencia a responder
las preguntas del votante. leer propuestas en la boleza. nombtat a los candidates. si es mencmado. su partido politico: preparare la boleta oel votante de ecuerao a
sus Instruocimos". yo no soy el emaleador del votante. un agente del empleador eel vctanle. 0 on ofclel 0 agents de un sindicato al cual el votante pertenece 

 

"?5me to Was: You are serving as a witness for (name 0! voter) You must complete the section below it you
witness the mark of the voter, or it the voter cannot make a mark. It the voter cannot make a mark. check here at Testigo: Usted esla' lungiendo

oomo testigo para (hombre del votante) Usted debe :lenar la Siguiente secciOn abaio st usted lue de que el votante
lirmo. 0 de Que el votante no puede firmer SI el votante no puede ?rmer. marque sus iniciales equl 

 

 

to Person Depositing Gan-tor Envelope in Moll or to Common or Contract Carrier. It you are a voter by depositing the carrier envelope in the
mail orwilh a common or contract carrier. you must complete the section below. a la Person Ouien Deposits el Sobre Oftcial en el Comm 0 Entreguo

al 1ranoportista Publico Comercial: Si usted asistira? at votante a depositar el sobre oficiai en el cornea 0 con un transportista ptiblico comarcial. usted debe llenar
la seccion que aparece abaio.)

If you are an assistant or witness. check the appropriate box below and provide information (Si usted es un asistente testigo. marque la correcla proporcione
su informaclOn):
Assistant!
Artist-m!
0 Witness! Signature (Erma) Printed Name (Nonbro impress) Street Address (Dom-cilia residencial)
Tosllgo

 

Wm?v


mums; Signature (Firms) Printed Name (Nombra impreso) Street Address (Do-niche resideroiat)
Tattoo

Completed by Early Voting Cleric Nana o! Election (Nombre de Etecoidn):



 

TX-SOS-19-1 1 13-E-000047

10

page

7317 1220 HP FaxDat 6826265679

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bar {2.1.1 or the 

Mart-71y b-l"o! to. 1.141;; 1'95? 2* 

 

Sum! 1Jr

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4. .

 

 

0an ml


    



atinq by um
.H) .Hm no; [rug

in (?51erch 80): 16a)

1. Hr 1152?.? and Box)!?

(1.1 l' n11 tum-J IJ- :41! only

. um -n (Complete BM)

Mann-rm h?r" um 41- only

n: 

.?Ll

..-- 

I1 yuu nra ro-uuerahng fhl?: hullzt be rr.u1r 5 I: .1 autumnl addv-ru 
will f?r: Son h?u 



 

 

 

ONLY 65 Years at Ago 0: Older or Voters with Disah?ity? 
(U UM ..h-xniu bum! Jm wumle um
:zi? 11mg r1? the 'wmlm run Ufa": 1; ".evzu?. 

AnnualAppluan

?mi; L'm?l UP Fanmry fu-?hnnw

?u'n -
Ed?s.- L.: mum 
a 
N-wmrb? F'v *9 

3'11- 1

n,
(l1 Pvimv 1
Any Resmm; Run-3n

 

Absent lrom County or Voters Con?ned In Jail:
onPy mg?y LY a bailot hv mud 10mm: r-I?xur. and 3m ?mull
?In-.a-zr mgr?r approprintn hm:

m" tilt?xa?r [Terri hmtuz;

 

 

 

[you selected ?expected absence ham Um county so?: reverse for 

 

Li DD - 1] U7 

 

 

-2L .lqt .

 

"hid i In? rum-w gnaw 

'?I'll - 'p 

 

- 

 

 

?l umlify Um! lhe information {inch ?his application is (mo, and! that giving
[his application is 21 camein?am?! .F. urnm? :0 mm 5? 1
. mark in lhu of ., ?x-Ein'x 1. {'26
I Fin--. 
31:911r". 1911221065lnMS? Hz?lahun?hlp :3

 

H- (mun. .5
u! . i

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Middlr? mum]

 

l-un. .nn when: Im- [In 

l-fII'-" .1. ,rll
r] g. ,1 . Hal-V": '1 If! r] . Li: 

 

Dale 0! return to rcsidcuca address

 



?150 infon ?Lion in



 

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.3161?31 1. thisLaos-19m 13-E-000048
page 11

Apr 14? 2017 12:21 HP FaxDat 6826265679

 

msbucbonstoVour:Scu l'tll space um.muem-itm ?ma haunted more bane; Do oot:ignthis

carrier covalen- may be mood together In math-r emelam It the new can-r unload? wag to - amen registered to in. same address This can-tor melon: mm 02
married by null. by common or contrast mar, or in person by the voter on elation day at the arty voting clerk?s 996cc. (luminaries at Vow; Selle esto sob-o. canoes (mg
30 mum on at aspaclo proportionate amp. Est. some do!? on set solar? por cl antes de nu. at vowne to W. No ?nno ante sabre a moms cue to beret: ha?
ddo ltooadn oer ustod. a but: so direcolrlm. Est. so oficlal no dobe ur attitude pol-I we I. outer; do rm: no un solo vounto. Sin embargo, on up ?to 50m 0515.31
pinch sat cobcado denim do ctro soon s: or subtotal o?cial :11th lo pertonoce I on vomit. pm your bajo la ohmic" Esta sobr- olicial oobs set enmdo no:
7am. nor meolo :0 un transportista 1:0me 0 comercial. 0 an We on ma porel vomit. at da do is en tooticim del sooretano co vouston me.)

I certify thot the 61610500 ballot expresses my wishes [viscometer-it at any dtcuoon or undue m, as?:
hoop-rimmedenangm diaspoopcmm 

 
 
   

SEAL ENVELOPE AND SIGN OVER SEALED FLAP 
(SELLE El. SOBRE FIRME ENCIMA DE SOLAPA DEL SOBRE)

 

 

SIGNATURE OR MARK 0F VOTER (FIRMA 0 MARCA DEI. VOTANTEL

insuucbon' a to Assistant A voter may only be assisted with reading or marking the ballot it they have a physical disability that renders them unable to write or see. or
have an inability to read the language tn which the ballot is written. It you are assisting the voter, you must read the oath and complete the section below, belOre
assisting the voter. (Instrucclones at Asistenta: Un votanto puede recibir ayuda para leer ltenar la boleta solamente si el votante tlene una discapacioad fisica

la cual loimpide escriblro ver. 0 st no tiene Ia de leer et ienguaje en el cuat la boleta esta escrita. Si usted le proporclonara? ayuda a un votante.
usted debe leer el juramento Ilenar la siguiente seccion abajo. antes de 8515!? at votante.)

 

 

Oath of Person Assisting Voter. I swear (or affirm) that will not Suggest. by word. sign. or gesture. how the voter should vote: I :ontine my assistance to answer no
the waters questions. to stating propositions on the ballot- and to naming candidates and, it listed. their poliLcal parties:l Mil prepare the voter's ballot as the voter directs
and I am not the voter?s employer. an agent of the voter's employer. or an of?cer or agent of a labor union to which the voter belongs. (Juramento do ta Persona
Ads?gmo at Votante: Juro (o a?rmo) qua no sugerir? con palabras. se?ales. gestos ta manera en la coal at votante debe votar. limiters mi assures a responder
las preguntas Ciel votanta. leer propuestas en la botata. nombrar a los candidatos. si es mencionado. su particle politico; preparar? la holeta del votante oe aCJeroo a
sus instruociones; yo no soy el empleador dot votanta, un agents clel emoteador rte volante, 0 un of?crat 0 atomic de un sindtcato at war el votante De?ne?)

Instructions to Witness: You are sewing as a witness for (name of voter) You must complete the section below it you
witness the mark at the voter, or it the voter cannot make a mark It the voter cannot make a mark. check here

195? . at Testigo: Usled es:a? lunglendo
oomo go para

(hombre dot votante). Useo debe lienar la siguiente seccion abate sr usted tue teetigo de que el votanle
?rrno. a de que el volante no puode ?rmar. Si et votame no puede ?rmer. marque sus iniciales aqui 

 

 

 

to Can?t? Envelope in Mali or to Common or Contract Carrier: It you are assisting a voter by depositing the carrier envelope in the

mall or with a common or contract carrier. you must complete the section below. a la Persona Ouien Deposits ol Sabre O?clal on at Canon 0 Entregue

at Transpor?sta Ptiblico Comerclal: Si listed asistlra at volatile a depositar el sobra oictal en at correct 0 con un transposzta ptiblico 0 come rrzial. usted debe llenar
la seoci?n que aparece abate.)

su lntonnacion):
Assistant]

nsidenlo

0 anss/ Signature (Firm) Printed Name (Nombre impraso)
Tastigo 

It you are an assistant or witness. check the appropriate box below and provide information (Si usted es un asistente testigo. marque la casilla correcta proporcione

Street Address (Domicilio residenoial)
Assistanv

Miami:
Wot-5s: Signature (Firms) Printed Name 

. Street Address (Domicillo residencial)
tastlp

Completed by Earty Voting Cleric Nome of Election (Hombre de Eteccion):

 

TX-SOS-19-1 1 13-E-000049

page 12

HP Fa xDat 6826265679

2017 12:71

14

Am

   

 

  
 

 

 

II Ming "rx 
.ngn [mv?pu?nxj?fd

.IIN (Wye 89.5.2911?

my": .. I-wn "In ammv (C-Invpk?tc?on w?hmd?ome)
.J I31 32w ?nut-1 I-LI I-al onIy

II 
. I 'L-p'pl 5. I-II :(In on?Iy

Um] Votms 05 Year: of Age or 0+ch or ancvs .1 ability:
II: yivn?xo'v' Imion polo-:1 811;?: ?It" mx
II I: (In r?f?q?j?'f 14? lmtr.1- Hun

 

Amnm? AppIinIIon


(nu mun! I- It! yr;
.I {Vnunly

I?ra'ury
[j anH-mn I?m my
Any Resurmg Rural

I now L10. .II In

II Iy 

hum- If? (Jinn

[j 

 

 

ONLY Vmocs Absent Irum County 0: Voters Con?ned in 
Ynu nmy app?y Ix?ul hy 51v om.- and any ?i'vIH-nq 
.xI-Ich 1hr: -uxnamatc tux



and 01m Eli: ?rms
May 
[j I?Jccbon

[10:th 

In.- :lu'li'n II. n?

.1 mm - rfy?
Duwcmm 
[40:11? can Pr-Imry

Any Rmulinf) 

599 back for Witness and Assistant do?n'dlons.

*u we .Ictrg n: Win-1?s and paw aha Palm: Ihr-a a: a Class A gamma: var; Mm 'is'o-d . rah-rm! 073:5?er In Lomnlomg 0112 

 

 

Sienna-'42 0' Wm Mien-.13?

 

- . I r' -
Addm "-14 NUFMC .IJZWUUW, (Reler to InsIIucII-ans 0:1 hack for 

-, .??c?ad?ihel??bum3m 'Qf? amaon?m 

II app?um! Is warm to mark 80: a 10 and yOu me adIIo as II Wimoss Io Ihal facL pusrcu- Imx and Gig" ?.4:wa LI 8/
ass?skx] [he appluml in this ?mr in the apduumt?s mum or rnaIIe-Mmlm faxed lIIc amicaum rIv mm! of IN: aIrpInmI. menu: chad b0: 33 Assist: nI and sign IIu'zm



  
   
 

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[h Il?nn umiduncy?.

l3 3"

a 

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whore 1hrI'll? be mailed. Soc [event In 

[j I mm r;

II-?unq II In? IN ild; inn I "aw 

[3 Norm?
URI 

??you ScIccled absmI Ir?om counIy. soc reverse 

IUL- I

Dam you can begin to utl<lrc~s 0: do of fI?tUnI 10 re? idoncc 
I NoJJu-lnvouw .fI' II 
I

 

 

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InkmnaIion (OptionnII'

i'ln?. phone numb? 

lhlu! .: um: Imz. unawnr.

I IIVI 

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I J- I

 

 

canin Ihnt the inlonnation gum. in applicmion is Inm mu] that gIvIng (also 
this Is a crime

 

 

 



 

  

SIGN HERE
If applicant is unable to sign ormake a
mark in the presence of a witness, the
witness shall camplote Box #11

oIVbTI??hbn Wom??bm I591 than ?3-3553. .

b?l.

 

 



. ?Lg??g

. {1&de II

199

 

WIIness' Rala?onship Io Applicant

 

 

 

 

 

Esm- hyr'h. I2 rm qua d'SpUnIlile cu I'spanol. Para conseguir In version on Espm'IoI favor de Ila'nal m; came 3/ 18001518683013 n?r;lna d9! dc Esrarlo 0 la Secretaria d9 Volaclon porAchanIrdo

 mmunwmom spaao our?. 
mu

m.
mapsuntmwonllotmmnutdby mg


mum by mail. by com or contract cantor. or in person by the voter on election any at the only voting etertt?: etneo. mutt-oedema at Vobnto: Selle note soon. despu?s twine
su nornbre on at upsets 9WD etude. Eete sabre debs do at mane por el voted: tutu do quo oi vetante to some. No tinno list: some a mm on so: In beret: boys
side ?@60de ebajo bolote 6e museumsolo votante. Sin street
pout. eeloado d-ntro do one soon st at sublets) 05:21 ??oral l0 Men?! I an vomit answer? para vow hero to ?lm Esta sabre o?clal debs my ?trade pat
publicoocomtal.osor entregadoen cldladoll oluoerencn la attain: dolmmn?ode voracion tempura-u

I certify that the enclosed bold expresses my wishes independent of any ticta?on or undue persuasion by any person. (Gumbo out Ia boteta adrunta express nuts 



utters 
(ssus El. soerts rtnME ENCIMA or scum DEL soon!) 9 WW 0" A 0 DEL VOTANTE)

instructions to Assistant; A voter may only be assisted with reading or marking the ballot if they have a physiml disability that renders them unable to write or see. or
have an inability to read the language in which the ballot is written. it you are assisting the voter, you must read the oath and complete the section below. before
assisting the voter. (tnetru cciones al Asistente: Un votante puede redbir ayuda para leer Ilenar la boleta solamente si el \rotante tiene una dismpacidad iisica
Ia cual Ie impide escribir ver. si no tiene Ia habilidad de leer el Ienguaje en el cual la boieta est? escrita. Si usled le proporcionara ayuda a un votante.
ueted debe leer el juramento Ilenar la slguiente seccion abajo, antes de asistir at votante.)

 

 

 

 

 

 

 

Oath of Person Assisting Voter". I swear tor af?rm) that i will not suggest. by word. son, or gesture now toe voter should vote: i will con?ne my assistance to answering
the voter's questions. to stating propositions on the ballot. and to naming candidates and. 1 listed. their political parties; I will prepare the voter's ballot as the voter directs.
and I am not the voter's employer. an agent of the voter?s employer, or an otticer or agent at a labor union to which the voter belongs. (Juramento de la Persona
Asls?endo at Votento: Juro (o a?rmo) que no sugerir? con palabras. se?ales. gates. la menere en la cual el votente oebe votar: limiters mi asistencia a responder
las oreguntas oel votante. leer propuestes en la Delete. nombrar a los candidates. 51 ea nencionado. su partido politioo. preparar? ta boleta del votante de acuerdo a
sus yo no soy el empteador del votante. un agents oel empleador del votante. 0 un otcial 0 agents do on slndicato at cual el vntante porteneoe.)

Page 13

 

Instructionsto Witness: You are serving as a witness for (name of voter) You must complete the section below it you
witness the mark of the voter. or it the voter eennot make a mark. it the voter cannot make a mark. check here . at Testigo: Usted esta fungtendo

coma tosn?go para (nombre Gel votante). Usted debe llenar ta siguiente seocidn abate si usted tue testigo de que el votante
ttrmo. ode que el votante no pueoe nrrnar. St at votante no puede firmer. marque sus aqui 

instructions to Person Depositing Carrier Envelope in Mail or to Common or Cataract Carrier: It you are assisting a voter by deposrting the center envelope in the
mail or with a common or contract carrier. you must complete the section below. to Persona Ouien Deposits el Sabre ottcial en el Correo Entregue
at 'l't?ansportista Publico Comerclat: usted asistira' at votante a depositar et sabre olicial en el oorreo 0 am on ptiblico comeroial. usted debe llenar
ta secoiOn que apareoe shale.)

 

 

It you are an assistant or witness, check the appropriate box below and provide information: (Si usted es un aststente testigo. marque la easilla correcta proporcione
su lniormaaon):
Ashram!
Assume
Worms! Signature (Fur-'3) Printed Name (Nombre intense) Street Address :Domici?o rastdenctal)
Tonga

Ass-star!)
new

may; Sognafum (Firma) Printed Name impress) Street Address (Domicitlo residential)
Moo

 

Completed by Early Voting Clerk: Name of Election (Nombre de Eloeci?n):

 

Name at Vat? (Ht-truism dal .. . . .. .. 

QV I TX-SOS-19-1113-E-000051

017 1221 HP FaxDat 6826265679

page 14

12:22 HP FaxDat 6826265679

2017

Apr 14

.. 4. Hunk: . 

. -- -5, . 91.1. .. A . . .f'I .: INC.Mms-v.

ashlar-g ,asa Mr.) I Fimz?N'?'ma

Residence Address: is?: 9:41 of 'Bus Io: ISi-lrzerulns. - 

    

 

 

 

. . 

 

 

If you ?to Hus ba?ul LII. mailed Io II rusIdunuI), Ind. c?nh- 
m" be mauled. Sc". In iIIslrucIions.

   

Vofmg by Mail:
IIA ago 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

val-n II :wlhut. r3 Ix-Evluxzx 2h: iml
uzh'II (lecls?suj?a) -
r-hun?mu nKr?Irl'rIi 'l I'Jlkl IzII-zm II 1.11:: 1.1m,
u-nvzt- In," ?hl: rountv 30x18{gun} ?manna-?I .-L-I only I: ,h .. 
)uh-vnrm In Bil I .. ..
5.1m POI mun?: only m1 
ONLY VnIvIs Years ?fAUc or Olderof Vulws 3 ?N'h'l you Rel/?2100 01626!an alumnae the (.001 Iy" er: Inverse ?uI -.IILII: Iluna - - 
Ir .1me mg [Jr om?: humanIn! 5'11 90?.me I'hx?llony Vi'ir, Adamyou can begun Io IN. nivr mail a! Ihis Unto Io maidens addresis.J
II -- - 
(will (Sumac: Intormatinn I "Wm" Wu I -
- ?l [Ht-Vt? ?1.311" at I: a II q? luvl II I. -II (I ??1'le will] ilk 
tlm?tzm l] LII . Li-zvai II: lIlI' Iz?u 1m. -. HIIUI OI Org
Pmmuj; .I, I. . I 
Any Runullmq 
ONLY from County or Votcm CnnIlm-Il In Jail: ul certify the? the infovmalion given In l5 IIUH, and I ImIIun-Imul tlIuI givlvg My inlmmalion -
Yuu my 2H7 .Imn'y for .1 ball-x by mu! I. I um- (his application la a cumc. 
swl-?xrt 30; me

I hr? nun?1?17 1| 
?war? Ck?dw I?k'mmrr. 
0m? SIGN HERE
Ln; I run aw
applicant Is unable to sign ormake a
[j Arw Rummy; Rum? mark in the presence of a witness, the

witness sha? complete Box f?lf??w . 77903' . . . .1 4753197915 . Wmaz Sf it? 
See back for and Assistant de?nitions. 
?amiicanl ls unabo tomark RI: (7 l0 and you are acting as V?hmss l0 :haI fad this Iqu and sign helm?, 

 

   
 

3? 3Y0

 

assisted ewl'rz?mt in ms .?ngi'rabnn the ayIIiC?ni 5 52mm ?1 e-maloymailod or famd ch emhmtion uf 1h?: JppL?H?l??. {?ea-Sf; check lime an Assistam and sun Mm Bf

  
    

am Haas?. 'n?xk bows. Fn?um (his nfrIur-r-I'JI s. .I Chg: A II war, OI ws mum/34? in IzmpIeImg the awn-I'm

  
  

 

 

I
x- .,
{?1me Nana? of ?lnn: XL 
A?hma??wqb; - Witness?ReIMansh-?p Io Appl'unt

 

 

 

- Rd!) Imm an hark .m Iutn?un?.)
TX I 353553;? .E .335: 
Zip UN 1

. v? av.-

 

 

 



Esta 95m en Par? consegub' In Vcrsiun t?n Espedof furor do Home" sin can)? nI 1.300.252.8683 a In and-inn I/el Seen-Mano do ?5;me 0 I3 do Vm-f-cion pm? 44 Mahmud.)

  
   
    
   

page 15

Apr 14 2017 12:22 HP FaxDat 6826265679

 

innovation .1, you, Seal mas omelopa. no then sign your name in some below. This melon;- must be coated by the voter baton it mm the voter's hand. Do not sign inn
mtopo the butot tun boon minted by you or at you- dtroctbn. This may not be used to return martian 3n- votcr ballot. However. more mm one
SW Involwl be placed In another am If the addition! corner anniopem belong to a person registered to wot. at tn. um. add: us. T?i: came: vwotopo must be
by mailpoison by tho voter on election day at the any young clerk?s of?ce. (instrucciones oi Vounto; Sane are men, 5959095 5m
sunombnondupacbpopaoimdomp. Nohrmastosoonamanosdoquotaboim hay;
Mambo?oiatnodcbomutimdomn homoemdounsotovm. Snot-numb. meadowsotosmoig'g
ponds ser onion-do denim do om: soot: st at spurts! ortotat adidonat to man?: I on votarm registrado para votar halo in mm: dreccion. Este some oticta! done our enviadopor
com. pormodio dour: mow: p?btioo doom-rust. serontrwado en mom nor oi votanto et din de la oteccton en la oticintt dot sacretznodo votocion tenures-u)

certify that the ?cloud ballot exam my wish? Mopendent 01 my dictation 0t undue pamasion by My person. (OI-tango Que ta bolota WIND "pron m? m?


 
   

SEAL ENVELOPE AND SIGN OVER SEALED FLAP 
(SELLE EL SOBRE FIRME ENCIMA DE SOLAPA DEL SOBRE)

 

SIGNATURE OR MARK OF VOTER (FIRMA MARCA DEL VOTANTE)

Instructions to Assistant: A voter may only be assisted with reading or marking the ballot if they have a ohysical disability that renders them unable Lo write or see. or
have an inability to road the language in which the ballot is written. it you are assisting the voter you must read the oath and complete the section below, betore
assisting the voter. at Asistonto: Un votante puede recibir ayuda para leer Ilanar la boleta solamente si el votante tiene una discapacidad ?sica
ta coal is impide over. si notiene la habilidad do leer el lenguaje en el coal is boleta esta escrita. Si usted le proporcicnara? ayuda a un votante
usted debe leer el juramento itenar Ia siguiente secci?n abalo. antes do asistir al votanta.)

 

 

Oath of Person Assisting Voter. I swear (or at?rm) that twill not suggest, by word. 51911.07 gesture. how the voter should vote; I Will confine my assistance to answering
the voter's questions. to stating proposttions on m. ballot, and to naming candidates and. if listed. their political parties: I will prepare the voter's ballot as me voter directs
and I am not the voter's employer, an agent at the voter's employer. or an otticer or agent of a labor union to which the voter belongs. (Juramento de ta Persona
Asistlondo at Votanta: Juro (0 ohm) que no sugenr? con paiaoras. sehales. gestos. la manera en to coal at votanta debe votar; limitare mi asister?c-?a a responder
tas preguntas det votanta. leer pmpuestas en la bolota. nombrar a tos candidatos. at as mencionado, so paltido politico: preparar? Ia bc-leta del votante oe acuendo a
sus imm?; yo no say at empleador dei votante, uh agents del empleador Gel votante. 0 un 0503: agente de un sindicato al cual el votahle pe'tEhece)

instructions to mum: You are serving as a witness tor {name of voter) You must complete the section below it you
witness the mark 0! the voter, or t? the voter cannot make a mark. it the voter cannot make a mark, cheek hare {Instruccionos ai Testigo. Usted esta? tungiendo
como testlgo para (hombre dot votante). Usled debe llenar ta siguzente section abaio si usted ?ue testigo Ge qua el voter-to
tirmo. 0 de que el votante no puede trmar. St a! votante no puede ilrmar. marque sus iniciales aqul 

Instructions to Person Depositing Carrier Envelope In Mail or to Common or Contract Carrier it you are a voEr by lhe ca'riei envelope the

mail or with a common or contract carrier. you must oomolete the section below. (instrucciones a la Persona Ouien Deposite et Sabre Oficial on at Correo Entreguo

at ?n'ansportista Pubtioo Comeroial: Si usted asasti'a' at votante a depositar at sobre o?cial an at correo 0 con un lransportista pIJ-btfco comeroal used code llcnar
ta seccion que apareoa abate.)

 

 

if yOu are an assistant or witness, check the appropriate box below and provide information. (Si usted es un aststente testigo, marque la casitla conecta proporcione
su lntormacidn):

Um Area-tam!

wmm/ Signature (Firms) Printed Name (Nombre impreso) Street Address (Domicile residence?
Testigo


Mutants

Dw Signature (Firm) Printed Name (Nombro impreso) Shoot Address [Domicile vesioonoialt
05?90

Completed by Barty Voting Clerk: Name of Eiectlon (Hombre do EioccionTX-SOS-19-1 1 13-E-000053

page 16

Apr ?4 2017 1223 HP FaxDat 6826265679

 
  

ll .: 

 



    
 

Jr. SI i Hrs! Nam
I


 

Mm! {allot to: i9 ?with. 

 

Dun ((lp'Iwml} 

IUD 

I Vntin? by Mail: _ll you me this ballot be maIlr?d to dill-"cut address lnvudnnc?) wIn-m bulk?

. . will be mailed. See lwmalruclmna.
4?3 0' (Emmet? 

 

Mayhnq 3* or my ?m ?Hutu :lrv mt tlv; Isul
.szth 295.81
Nursing hum: quack-II lIvirg hairy, II In I'm-n fualily 
In") .I: I 4 rg: rm ttvtuuli!) 
I .I '0 hr MW 54-- 
[all I: t' . .
?I?w "minor I1 mum mum: nq nth-Arm only t. It n. A Il.(l

  
  

 

 

b. c- -

 

 

ll you stain-ted ?expected ubsem: lrnnI com?Ity son [averse to: Instructions

f:

 

. 41x Volats s5 Yams Age 0! Older arVoIors with a Dimhtlity:
It .uwm In: una- I-kq Zion 50h bu):
ll mining dwelt)! cu 125110!? NYWII J'i?v4?lL'1 l'lf'llt it

Ann?! Ai?it'nlx'm

 

 

 

 

 

 

 

 

?ll" ?ml-"W ?OF-tn"? "win you nan begin to receive mm! at Ibis "Mo 0! return tr) rosidonce address
tkl?li?? ?"511 217-) l? Coma? Nauru val-I: ll'm-uw? ljll' :qu II I - -
arm?). Pimm; 'Iiul 11011" mjli'UIrIm-I It? dam-l Juk 
I Dulluzrlx?. Us- (1 ll' law ow Iifim hue: 
(Kim chml?icnn Primary Jim (.1. .- - 

Any [lemming Rmulf

 

 



't certify that the intomlation q'rven in this application is lma :u?ld understand lhal giving lake in
this application is a crime"

ONLY Votm Absent lrom County or Votnrz Confined in Jail:
You may only apply It)! a ballot by mail ks ulujim and any mull
Phase select 2w app?minute: box

:lnlunn (lf?lf_ (Mint ?ctitious Rm?riom: 1'
. Y-vu man! achr- gmr- Irma-m um, I.. r? 
Ma}: Himn 1? Du"
. 3? 
Nun-ml)? I {j L?crnocrabc lemrSIGN HERE
0mm 1' ll applicant ls unable to sign or make a
Any Runull mat in the presence of a w?ness. the

witness shall complete Box #11

 

 

  
 
  

     
 

Sec back tor Witness and de?nitions
II ?Inland Is :mhle tc mart [km 4 10 and you an: :15!an a: .1 Witness In 01le ?ch IIlmsI: max :m am: 3.in mm: 
fl you assisted IlIe crmp-?olhg WE appliculjo?l in the npi?h?ant's plasma) ?nal?! ?e?xud Elm I mi'umim l?Il? tic-Inn n! piggy) ("ht?x mi; My Assistant and sign twin

Ic Ill-0:730 dusk Millvw?. l0 - mm.- was; I'm: In aged in 3mm the div. Ilr. Itxn

  

 

 

- W'lne,s? Relationsh to A I
Apt Number ?4 ID cant

 

 

 

J. I. {ltelnr In?mcliuns (In Ull?Tk lrIr Flanlitiill'm)
{x 
- T50

 

 

  

 

.



Esre tormulm?o rsrzi an Espanul. Pa ra conseguir la version on Espm?ml {war dc llamar sin ca/go 311.600.252.868? a la chem-1 do! dc EstaIfo a la Searclaria dc 

        

page 17

2017 1223 HP FaxDat 6826265679



booted Morten ball Howmnmorot?tanone

me 





aroma-1mg total 


earthy that the undead balot expresses my wishes hdepondent of any dictation 0r undue persuasion by any person. (Conitaeo qua la boleta adjunta expose this duet);



SEAL ENVELOPE AND SIGN overt SEALED FLAP 

(SELLS EL SOBRE FIRME ENCIMA DE SOLAPA DEL sonata) SIGNATURE 0R MARK or: VOTER (FIRMA MARCA on. VOTANTE)

Instructions to Assistant: A voter may only be assisted with reading or marking the ballot if they have a physical disability that renders them unable lo write or see. or
have an Inability to read the language in which the ballot is written. It you are assisting the voter, you must read the oath and complete the section below, before
assisting the voter. al Asistente: Un votante puede recibir ayuda para leer llenar la bolela solamente si el votante tiene una discapacidad iisica
to coal le impide escribir over, 51 no tiene la habilidad de leer el lenguaje en el cual la boleta esta escrita. Si usled le proporcionara ayuda a un votante.
usted debe leer el juramenlo llenar la siguiente secci?n abajo. antes de aslstir al votante.)

 

 

 

 

 

 

 

 

Oath oi Person Assisting Voter. swear (or aliirrn) that i will not suggest. by word. sign. or gesture. how he voter should vote; I will con?ne my assistance to answering
the voter?s questions. to stating propositions on the ballot and to naming candidates and. it listed. their political parties; 1 w:l' prepare the wter's ballot as the voter directs;
and I am not the voter?s employer. an agent of the voter's employer. or an of?cer 0r agent at a labor un?on to which the voter belongs. (Jurarnento do la Persona
Asistlendo at Votante: Juro (o ammo) que no sugerir? con palabras, senales. gestos. la manera en la cual el volante debe voter; Iimitare mi asistenoa a responder
las preguntas del votente. leer propuestao en la boleta. nombrar a los canddatos. si es mencionado. Su partido politioo; preparare la boleta del votante de acuerdo a
sus yo no soy el ompleador del votante. un agents del empleador del volante. 0 un oliclal agente de un smdicato at cual el votarte pertenece)

Instructions to Witrtess: You are serving as a ??tness for (name 0! voter] You must complete the section below if you
witness the mark oi the voter, or it the voter cannot make a mark It the voter cannot make a mark. check here . al Testigo Usted esta lungendo

corno testlgo para (nombre del votante). Usted debe llenar la slguiente seoo'on abalo sl usted lue testigo de que el volante
tinno. a de que el votanta no suede firmer. Si el votante no puede tinnar. marque sus aqui 

 

 

Instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier. it you are assisting a voter by depositing the carrier envelope to the
mall a common orcontract carrier. you must complete the sec?on below. a la Persona Qulen Deposits el Sabre O?cial en el Como Entroguo

al Trertsportista Ptlallco Comeroial: Si usted asistiri al votante a depositar el sobre 06an en el 00on 0 con un transportista poolico comermal. usted debs llenar
la seed?n one aparece abate.)

It you are an assistant or witness, check the appropriate box below and provide information: (Si usted es un aslslente lestigo, marque la casilla correcta proporcione
su inlonnaclcn):

?v
Signature (Erma) Printed Mme (timbre ?moresol Street Address (Damiano residencial)
Yesrqo
Awe
Aim

Cl ram Sim (Firm; Printed Name momma improso) Street Address (Damiano residenoall

 

Completed by Early Voting Cleric Name of Election (Nombre de 
Name otVotor (Hombre del votante):

 

Date of Election (Fecha do Eleccion]: I

 

TX-SOS-19-1 1 13-E-000055

Apr 14 2017 12:24 HP FaxDat 6826265679 page 18

Resident: clalm signatures on some Dallas Co. mall-in ballots were torgad 4/13/17, 4:24 PM

Residents claim signatures on some Dallas Co. mail-in 
were forged

Demon! Fernandez. WFAA 9:43 AM. CDT April ll . 20]?

DALLAS - Early voting for the May 6 elections begins April 24
in Dallas County. However. before a ballot is even cast. there
are some new concerns about possible fraud.

Across Wesl Dallas. lawn signs show neighbors are preparing
for District Six elections.

 

Family members at Alice Washington?s house say a mail-in
ballot recently arrived. There is just one major problem.

go to the poll andvote.? Washington as - 'i don'tvote by mail.?

Washington and her niece. Barbara Roberson. say the 81-year-old never requested a mall-in
ballot from Dallas County Elections. Roberson called the elections of?ce to investigate.

said. Would you please send me a copy of that application. because I?d like to see her
signature?" Roberson explained.

The famil as the elections workers sent copies of the mail-in application

?Tl'lat's not my signature.?

The tamll cllu

 

said as she looked at the application.

 
     

. hington never saw nor executed the documents.

   

?Someone forget! her signature.? oberson explained.

The family says their home isn't the only household that received mail-in ballots that were not
requested. Other neighbors are also getting the forms.

Dallas County Elections administrator. Toni Pippins-Pooie. said her of?ce has received about 36
similar complaints about questionable mall?in ballots. Poole says her team is working with the
District Attorney's Office to review the complaints, examine documents, and determine how to
move forward.

Roberson and Washington believe the issue may be wide-spread in West Dallas.

The Dallas County Elections of?ce is taking the complaints seriously.

For now, Pippins-Poole is urging anyone who has received a mall-in ballot. and did not request

Page 1 of 2

TX-SOS-19-1 1 13-E-000056

Apr 14 2017 1224 HP FaxDat 6826265679 page 19

Residents clalm slgnetures on some Dallas Co. mail-In ballola were forged I 4/13/17. 4:24 PM

one. to report I to The Dallas County Elections O?lce by saline 214-819-6359 between 8 am. to
4:30 pm. Monday - Friday. You can also ?l out 11W

WW)
0 2017 WFAA-TV

JOIN THE CONVERSATION
To ?nd out more about Facebook commenting please read the

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OVE RSI HT TX-SOS-19-1113-E-000057

Apr

14 2017

$2224 HP FaxD?dL 6826265679

page 23

1 my; uni"3'11391:1333:3:- .. .

gum-gum: 3 

'M?g 

1 13-E-000058

From:
To:
Subject:
Date:
Attachments:

Aaron Harris
Keith Ingram
Dallas County Complaints
Friday, April 14, 2017 1:13:51 PM

Keith - per our conversation, attached are four complaints for Dallas County. Let me know if
you have any questions or concerns. Thanks for your help. We also faxed these over. 
Sincerely,
Aaron Harris
Direct Action Texas
(682) 626-5679

TX-SOS-19-1113-E-000059

Texas Secretary of State PO. Box 12060 Austin Texas 78711-2360 1-800-252-VOTE t8683) sosstate tx us

 

ELECTION COMPLAINT TO THE TEXAS SECRETARY OF STATE

 

Docket Number OFFICE USE Date Hand-delivered or Date Postmarked
ONLY 04 14 2017

 

 

 

Please read the Important Information at the end of this document. The Secretary of State has no authority to
order a new election, change an election result, or conduct a criminal investigation. A complaint filed with this
form will not alter the results of an election.

This complaint form MUST BE SIGNED before it Is submitted to the Secretary of State; therefore you must print
it out and sign it before mailing or faxing a copy or emailing a scanned, signed copy.

 

I. IDENTITY OF COMPLAINANT

 

NAME 
SUI 

2 COMPLAINANT Itg.?

KY: 5397 Si TE IF 3L: STAT: CCDE

PHYSICAL

(Full homo or busmoss address, Including stroot City. state. and zip code)

 

3 'rI. N?l arr art-mane: - 5m: 21.9003;
MAILING
ADDRESS

If same as aboIeI

IFuIIhome orbustness address. including street City. state. and no code)

4 COMPLAINANT can: SHONE - 5 COMPLAINANT 
TELEPHONE E-MAIL

NUMBER ADDRESS

 

 

  

 

ll. IDENTITY OF RESPONDENT

PERSON 0a ENTIW cowmwc; ALLEGED VIOLATIONS)

 

'v'S 

6 RESPONDENT
NAME

:w ME

7 RESPONDENT
POSITION OR
TITLE

8 RESPONDENT mm". .5- 3',er 

..,
ADDRESS 13

(Full ?tune or business address. Inc?luaing street. City. state. and z_Ip code)

 

 

 

 

 

 

9 RESPONDENT ADDRESS .ZINtIul?f AP. :57" STATE 

MAILING

ADDRESS

ICHEEI II same as 

(Fulhomc or Dusmess addrisiirjludmg street. city. state. and up codel 

10 RESPONDENT my. PIICINZ .3: 11 RESPONDENT

TELEPHONE E-MAIL

NUMBER ADDRESS

.IF mow'.)

 

 

 

GO TO PAGE 2
TV one AA 

4m
uonce; THIS COMPLAINT Is puauc RECORD once REVIEW IS COMPLETED BY ms op sv?a??ih?dfol??r?r 

Rel swarm; .114

 

Texas Secretary of State Box 12060 Austin, Texas 78711-2060 1-800-252-VOTE (8683) 
NATURE OF ALLEGED VIOLATION Pagez

If you believe that acriminal violation of the Code has occurred, please state the specific acts committed by the person or
entity named in this com plaint. along with a reference to the section of the Code alleged to have been violated. if known. If
you need more space. please attach a separate sheet.

 

Unlawful Witness per Sec. 84.003 of the Election Code as well as Forgery and Tampering with a Governm
ent Record under Sec. 32.2l of the Penal Code.

Sec. 84.003. SIGNING APPLICATION BY WITNESS: ASSISTING APPLICANT. An early voting ballot
application signed for the applicant by a witness other than the early voting clerk or a deputy must indicate the
witness's relationship to the applicant or, if unrelated. indicate that fact.

A person who acts as a witness for an applicant for an early voting ballot application commits an offense if
the person knowingly fails to comply with Section 1.011. A person who in the presence of the applicant
otherwise assists an applicant in completing an early voting ballot application commits an offense if the person
knowingly fails to comply with Section 1.011(d) in the same manner as a witness.

An offense under this section is a Class A misdemeanor.

Sec. 32.21. FORGERY For purposes of this section:

(1) "Forge" means:

(A) to alter, make, complete. execute. or authenticate any writing so that it purports:

to be the act of another who did not authorize that act:

(ii) to have been executed at a time or place or in a numbered sequence other than was in fact the case; or
to be a copy of an original when no such original existed:

(B) to issue. transfer. register the transfer of. pass. publish. or otherwise utter a writing that is forged within the
meaning of Paragraph (A): or

(C) to possess a writing that is forged within the meaning of Paragraph (A) with intent to utter it in a manner
specified in Paragraph B).

(2) "Writing" includes:

(A) printing or any other method of recording information:

(B) money, coins, tokens. stamps. seals. credit cards. badges. and trademarks: and

(C) symbols of value. right. privilege. or identification.

A person commits an offense if he forges a writing with intent to defraud or harm another.

(0) Except as provided by Subsections and an offense under this section is a Class A
misdemeanor.

An offense under this section is a state jail felony if the writing is or purports to be a will. codicil. deed, deed
of trust, mortgage, security instrument, security agreement. credit card, check. authorization to debit an account
at a financial institution. or similar sight order for payment of money. contract. release, or other commercial
instrument.

An offense under this section is a felony of the third degree if the writing is or purports to be:

(1) part of an issue of money, securities. postage or revenue stamps;

(2) a government record listed in Section 37.01 or

(3) other instruments issued by a state or national government or by a subdivision of either. or part of an issue
of stock, bonds. or other instruments representing interests in or claims against another person.

ATTACH ADDITIONAL PAGESAS NEEDED

 

 

TV
THIS COMPLAINT IS PUBLIC RECORD ONCE REVIEW IS COMPLETED BY THE SECRETARY OF ATTORNEY GENERAL.

Reusec 

Texas Secretary of State PO. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 
N. STATEMENT OF FACTS P3993

State the facts constituting the alleged violation(s), including the dates on which or the period of time in which the alleged
violation(s) occurred. Identify allegations of fact not personally known to the complainant, but alleged on information and
belief. Please use simple. concise. and direct statements.

 

 

 

ELECTION IN WHICH OCCURRED

 

2016 DATE OF ELECTION Various
NAME OF ELECTION 
Dallas (bunt) Various
coum'v OR POLITICAL SUBDIVISION PRECINCT

 

 

 

 

 

We have attached only 2 examples. more are available.
plications. The signatures do not match the voter's sigi

?is clearly ?lling out and signing the ap
Ia ures.

 

 

 

ATTACH ADDITIONAL PAGES AS NEEDED

 

 

4 40 
COMPLAINT lS PUBLIC RECORD ONCE REVIEW Is COMRLETEO av THE o: 

Rev sea 21281201 a

 

Texas Secretary of State PO Box 12060 Austin. Texas 78711-2060 (8683) 
V. LISTING OF DOCUMENTSAND OTHER MATERIALS Page4

List all documents and other materials filed with this complaint. Additionally. list all other documents and other materials
that are relevantto this complaint and that are within your knowledge. including their location. if known

 


Attached are 1 Applications tor Ballot By Mail (ABBMs) and their corresponding L'arrier Envelopes that VI
olate the Election Code.

See Exhibit A



ATTACHADDITIONAL PAGES AS NEEDED

?once. nus COMPLAINT IS PUBLIC RECORD ONCE REVIEW IS COMPLETED BY THE SECRETARY or erI

Rex-sec 2/23/11

 

 

 

- .1 -
- .1

$03 $1339 

 

VI. SIGNED STATEMENT

Page 5

 

 

NOTICE: THIS COMPLAINT IS NOT CONFIDENTIAL: ONCE REVIEWED BY
THE SECRETARY OF STATE. IT WILL BE TREATED AS A PUBLIC RECORD.

 

REMINDER: YOU MUST SIGN THIS FORM PRIOR TO SUBMITTING

IF MAILING. DLEASE SEND TO

e-as '913'. :tate
. 

- A - r.
-L. -2?FAXING PLEASE SENC TO




IF EMAILING. PLEASE SEND TO

*2 3 

 

A53 QLNIVA.

TX-SOS-19-1113-E-000064

 

    
   
   
  

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envotope unless 1'10 ballot has been marked by you or at you erection. This comer onveloa not be used to return mom than one voter's ballot. However. more than one
carrier envelope nay be paced together i" another envelope ti the additional comer envelope?; belong to a person regutcrad to vote at me same aadms ca'rrer t_-rwetope trust 39
returned by man, by common or contract carrier. or .n person by the voter on electron day at the only voting clerk's at Votanto: Selle esto sabre despots firm.
on hombre an al esoacro proporclonado abate. Esta sobre debs or? ser sellado por el vota'tie antes do one at votanlo to entregue. Na tum-to este sob? a news 19 cue to inlets haya
cido llonada par mind. a halo su Esta sabre ofidot no dob. sor utilizndoggo ia bot-ta a. min do =an vaunto. Sin embargo. mo: 9: un nero 9.2er 
puodo cotocado dontro do otro sabre 5: al sobreis) o?cial adiclonal le portenece a on votante rogustrado para votnr bejo la misma direction. Esle sabre o?sral done tar enviada par
.coreo. pot memo do un transportisu pdbtico comntoi. 5?1 wire-93cm an persona por el minute at on: de la eleccton en la Oran; Ool sacmtano De reunion tenrprana 

certify that the enclosed baitoi expresses my wrongs independent ot any dictatron or undue porsuamon by any person. our: to Dolela adiunta expresl ms desecs




SEAL ENVELOPE AND SIGN OVER FLAP I 
(SELLE EL SOBRE FIRME ENCIMA DE SOLAPA DEL SOBRE) SIGNATURE OR MARK OF VOTER (FIRMA MARCA DEL VOTANTE)

instructions to Assistant: A voter may only be or marking the ballot .t they have a disability that renders them unable to write or see. or
have an Inability to read the language in which the L?aflui is wtilieri. it you are true voter. you must read the oath and complete the section below; betore
assisting the voter. ai Asistento; Un votante puece rembtr ayuda para leer Ilonar la boleta solamenie s: :l viziante none and discepactdad iisica
la coal to lmpide escribiro ver, si no iiene la habiliclad de leer el languate en el cual la boleta est? escrita. Si usted le proporcronara ayuda a un votanto.
usied debe leer el ruramento Ilenar la srguienle seccion abaio. antes de agisir?r at votante 

 

 

 

 

Oath of Person Assisting Voter swear (or affirm) that iwrll not Suggest. by word_ or gesture, how the vote. shoutj Me. I con?ne my .0 answering
the voter's questions to stating proposnionson the ba?oi. and to naming candidates and ii irsled. their political parties; prepare ihe voter's ballot as the rater directs;
and i am not the veters employer. an agent at the voters employer. or an ottrcer' 0r agent ot a labor union to the voter belongs. lJuramonto de la Persona
Adstiendo at Votento' Juro (o oirrmo) que no con palobras. senates gesios la manera en la cual oi voiante det-e voter. imr?tdre mt esrstencra a responder
ias preguntas del votanie. leer propuesies en la boteta. nombrar a to: candidates =l as menctonado. Su partido politico; preparare la bolela dot vomnta do aCuordo a
sus instruccrones; yo no soy ei empleador cel voter-to un agenie dai empieador del voianie. 0 un olioai agenie tie on al mat el votante pertenece)

instructions to Witness: You are serving as a witness ior meme ot Wye? you must mmpme l'te 5:,an below you
witness the mark at the voter. or it the voter canrot make a mark it ire voter cannot make a mark. check here linstrucciones al Testigo Usted esra lungiendo

corno iestlgo para (hombre del votanie) Usteo deoe llenar ta sgulenie seceibn abaio sr usieo foe o'e Que el votante
?rm. be Que el voianie no puede trrmar St at votante no puede marque sus interales aqur

 

 

 

i

instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier. it you a'e assisting a vote-r by decosning the carrier envelope in the
mall or a common or contract carrer, you must complete the section below a la Persona Ouien Deposlte el Sobre Olicial en el Correo Entreguo
at Transportista Pablico Comercial. Si osteo a' voianle a depos tar el sobre choral an e! correo 0 con un transpo'trsta pt?tblico cornerciat ustec debe llanar
la seco??n aparece abato.)

it you are an or Witness. check the appropriate box below and provrde rSi often es un aSrsterrte tesitgo. morgue 13 casrlta Lorrecta lJI'OpOi'cione
su intormacron);

Asu?ian'

Lest-me

?'t'ugm Signature Printed Hu'ne INnmure Ir?lpreeol Street Address (Dommlro t85idenc-al
Toszqn

 

Asmrlo

?.erer Signature P'Inleo Nome (Hombre uv'tpeso) Street ?cdress reade'cralr
Iowan

Corr-plated by Early Voting Clerk. Name of Election (Nombre de Eleccion):

 

 

0' lNombm dO' Data 0! Election (Fer-ha rte 1

0V I TX-SOS-19-1 113-E-000066

 

  

- Application for Ballbt by Mail

lrl! Nmno- 

  
 

MaIllny In! Volmu n) Mm.

. I- 4 (Lmuyluu (Ssuwluc Hun sun
Uu sum In Lmupkm: .u Ob

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lt.mplu.anl l5 unalalu II) sign (II ?who II
In the museum: 0! wuneen 
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Ins! Name

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.IlII. 1:1.Texas Secretary of State PO Box 12060 Austin Texas 78711-2060 1-800-252-VOTE (8683) 
ELECTION COMPLAINT TO THE TEXAS SECRETARY OF STATE

Docket Number USE Date Hand-delivered or Date Postmarked
ONLY 04 14 2017

Please read the Important Information at the end of this document. The Secretary of State has no authority to
order a new election, chan an election result, or conduct a criminal investigation. A complaint filed with this
form will not alter the resu ts of an election.

 

 

 

 

 

This complaint form MUST BE SIGNED before it is submitted to the Secretary of State; therefore, you must print
it out and sign it before mailing or faxing a copy or emailing a scanned. signed copy.

I. IDENTITY OF COMPLAINANT

 

 

 

COMPLAINANT 225* 
NAME Mr. -\2imn
KNAME- 59.3.;
2 .02: re a casts gm 
PHYSICAL
. (Fullnomu or business addressinoudmg streetcuty state. and zip code) 
3 COMPLAINANT Sure :r an x-m 
MAILING
ADDRESS I
(check if same as mom

(Full or busmess address. including street City state. and zip code)

4 COMEEAINANT 7 AREA ans; mm: mum-'9 an 5 COMPLAINANT 
TELEPHONE E-MAIL

NUMBER ADDRESS

 

II. IDENTITY OF RESPONDENT

mason on emrv :owirmc moan nounovls)

 

MC Lia's. LID

6 RESPONDENT
NAME

   

:mm

 

 

7 RESPONDENT

TITLE
8 RESPONDENT >3 31,311: ZIPCODE
PHYSICAL -. 

(Fu I home or business address. including street city. state. and up code)

9 RESPONDENT mm bL?wf: ail Arvi '5'L?l't 

MAILING

ADDRESS

ICMCA II sang a! about]

7 . (Ful home orgusinoss address. including streetcuy 
10 RESPONDENT mp. rm; may.? 9.1 11 RESPONDENT

TELEPHONE E-MAIL

NUMBER ADDRESS

(IF wa?m

 

 

 

GO TO PAGE 2

NOTICE THIS coupuum IS puauc RECORD once REVIEW IS coma-.5750 BY THE secaeunv or $1me 

>832 

 

Texas Secretary of State PO Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 

Ill. NATURE OF ALLEGED VIOLATION P3932

If you believe that acriminal violation of the Code has occurred, please state the specific acts committed by the person or
entity named in this com plaint. along with a reference to the section of the Code alleged to have been Violated. if Known. If
you need more space. please attach a separate sheet



 

Unlawful assistance per Sec. 86.010 of the Election Code.

Sec. 86.010. ASSISTING VOTER. A voter casting a ballot by mail who would be eligible under Section
64.031 to receive assistance at a polling place may select a person as provided by Section 64.032(c) to assist
the voter in preparing the ballot.

Assistance rendered under this section is limited to that authorized by this code at a polling place.

The person assisting the voter must sign a written oath prescribed by Section 64.034 that is part of the
certificate on the official carrier envelope.

If a voter is assisted in violation o1 Subsection or the voter's ballot may not be counted.

(8) A person who assists a voter to prepare a ballot to be voted by mail shall enter the person's signature,
printed name, and residence address on the official carrier envelope of the voter.

A person commits an offense if the person knowingly fails to provide the information on the official carrier
envelope as required by Subsection (6).

ATTACHADDITIONAL PAGESAS NEEDED

 

 

1-u 4n 

NOTICE: THIS COMPLAINT IS PUBLIC RECORD once REVIEW IS COMPLETED BY THE sscnennv or: 
Reyisec 

 

Texas Secretary Of State PO Box 12060 Austin, Texas 78711-2060 1-800-252-VOTE (8683) 
N. STATEMENT OF FACTS P3993

State the facts constituting the alleged violation(s). including the dates on which or the period of time in which the alleged
violation(s) occurred. Identify allegations of fact not personally known to the complainant. but alleged on information and
belief. Please use simple, concise. and direct statements.

 

 

 

ELECTION IN WHICH OCCURRED

 

20K) tlections DATE OF ELECTION Various
NAME OF ELECTION 
Dallas ('ounl) Vartous
COUNTY OR POLITICAL SUBDIVISION PRECINCT

 

 

 

 

The ?rst ABBM attached shows an ABBM in her handwriting and with her completed assist portion of the 
orm. The remaining are in her handwriting. but without the completed assist portion. This is only a sample.
There are hundreds. if not thousands in this same handwriting.

 

 

ATTACH ADDITIONAL PAGES AS NEEDED

 

 

Tv_ono 4n 4440 
NOTICE: tNIs Is pueuc RECORD ONCE nevusw Is COMPLETED av THE SECRETARV OF sf??sWIS?fO?aA KEV 

Rewseo 2/26/2014

 

Texas Secretary of State Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 

V. LISTING OF DOCUMENTSAND OTHER MATERIALS Page4

List all documents and other materials ?led witn this complaint. Additionally. list all other documents and other materials
that are relevantto this complaint and that are within your knowledge. including their location if known

Attached are Applications tor Ballot By Mail lABiMil that Violate the Election L'ode.

I. ABBM with assistant portion completed by 'hose handwriting matches ABBMs also atta

ched. where the assistant portion is blank.
2. 2 ABBMs With matching handwriting indicating unlawful assistance as the assistant portion of the appli

cation is blank.

 

See Exhibit A



ATTACHADDITIONAL PAGES AS NEEDED

 

TV DAD 4n 4?40 
noncs- THIS COMPLAINT lS pueuc necono once IS COMPLETED av THE or: 
Reusec2/25/2C14

 

 

 



?at" 

 

 

 

 

 

 

7 VI. SIGNED STATEMENT Page 5
- 
NOTICE: THIS COMPLAINT IS NOT CONFIDENTIAL: ONCE REVIEWED BY
I
THE SECRETARY OF STATE, IT WILL BE TREATED AS A PUBLIC RECORD.
I 
REMINDER: YOU MUST SIGN THIS FORM PRIOR TO SUBMITTING
IF MAILING DLEASE SEND TO
'eras ?sh-eta'v Sate
i ?es: .r?siusc"
FAXING, PLEASE SEND 
I 4'5 253'
IF EMAILING PLEASE SEND To
:ezt:?S?s:s sza'etv ..s
I


 

9.0! (Ha. 

0.1

any. .b-T?Il;

I'm uv 'Ng r!

. 

TX-SOS-19-1113-E-000073

 

 TII 

 

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Cll?Ilk?tIrI'Sb II IIWM. ?hp.I.I. .I. [3 
I II- I II-II 

Hm)

1 I I 
DH .IIAI . 
(It: Ycun?Jumy- ?'ld'm-lumh

".Hl IIHI lUulIuImIII,

ONIY VUlL?lb Abmml Cu?unly 
I I, . I-y I II .II: I. II

 

 

"l I I-I llus Is I ?mm? 

I-. .I 
VII-1.. 

I II I I ., 
SIGN HERL

pIcsunuI II wunuss 

wihmss shall I II.- Hun-s I111 I II

I .I. 
I: "com-om hoIpod? you to IpIIn'prm-tho yo?u.?I in Induction may! amplm cuctonubolowqu,11b 5m. hack Inns-I Avustnul 

I..,

.I I um]
2.. Iggy?

ss' I0 Applicant IA-DUS- Isr-I 
tsle lounulunu was In an P.IIIn.- Adulauladu



 

 

 

 

 

 

instructions to your oeel this envetope, and then sign your name In space Dtiow. item envelope must be sealed by the voter before it leases the voter?s hands Do not sign this
envelope unless the ballot has been merited by you or at your direction This carrier envelogg me! not be used to [am more than one water?: ballot. However. more then one
center may he pieced together in another envetooe it the Mortal carrier smuooats) belong to a person to vote at the same address This can-er must be
returned by mail. by common or contract carter. or in person by the vote: on election day at tn eerty voting clent's ot'toe. (instruociones ei Votenta Selle estc snore. amuse time
In hombre en el sspacio proporcionedo abepo. Esta score done do but eetiado pet or votente antes 0e que oi votante to entregue. No time este score a mans: de que ?a boieta hiya
side iienede por meted. 0 beta so direccibn. Este sobre oflciei no debs 39L utilizedo Dare eager to bolets do mas de un soio votante. Sm embargo. mas on un solo eobre o?cini
puede ser coiocedo dentro de ctro eotn ti el sobrats) oticiu sductonel Ie portenece a on votante registrado para voter sage ta mama direccron. Esta score otlcrai debs some oor
com. pat medic do tn trensponists ptmlioo cornered. 0 set entrogedo en persone pm at votonte oi do do to election en la del secretarlo de veteran :emaranaJ

 

I certify that the enciosed ballot expresses my wishes independent at any dictation or unoue by any person. (Centtloo que la boieta adjut?iia express mas desens
persona.)

 

SEAL ENVELOPE AND SIGN OVER SEALED FLAP 
(SELLS EL SOBRE FIRME ENCIMA DE SOLAPA DEL SOBRE)

instructions to Assistant: A voter may only be assisted with reading or marking the ballot i they have a physical disablitiv :hat rer :iezs them mable to arts or see. or
have an inability to read the language in which the ballot is written it you are assisting the voter. you must read the oath and complete the section below. beiore
assisting the voter. al Asistente; Un votante puede recibir ayuda para leer iienar la boiela solamente St at votante home one discapacidad tisica
Iacual le over. OSI no tiene la de leer el lenguate en el coat '3 Delete esta Sr usted le preporc'cnara a un votante
usted debe leer el jurarnento ilenar Ia srguiente seccl6n abaro. antes de esistlr at volante 

 

SIGNATURE OR MARK OF VOTER (FIRMA MARCA DEL VOTANTE)

 

 

Oath of Person Assisting Voter: i swear (or affirm) that I will not suggest. by word sign. or gesture. how the voter should vote: i writ confine my assistance to answering
the voters questions. to stating proposmons on the ballot. and to naming candidates and. it rated, their political parties; I mil prepare the voter's ballot as the voter directs.
and i am not the voter's employer. an agent oi the voter?s employer. or an officer or agent oi a labor union to which the voter belongs (Juramento de la Persons
Aeietiendo oi Votente: Juro (o atirmo) que no sugerir? con palabras. se?aies. gestos. la manera en la Cu?? at votante debe votar: limitare mi aStstenCta a responder
las praguntas del votante. leer propuestas en la boieta. nombrar a los candidates si es mencionado su partldo politico. preparar? la boleta del votante de acuerdo a
sus mstrucciones; yo no soy el empieador det votante. un agente del emo'eador dei votante. 0 on 01:03! 3 agents do on smzitcato at coal at volante pertenece.;

instructions to Witness: You are sewing as a witness tor (name at voter; Yziu must complete the section below it you
witness the merit oi the voter. or it the voter cannot make a mark it the voter cannot make a mark. check here (Instrucciones al Testigo: Usted esta tungtendo

como testigo para (hombre dei votante) Usted debe ilenar ia StQUiGnie seccton abato sr usted toe testtgo de cue cl votente
firmo. 0 de que el votante no puede ?rmer. St at votante no puede iirmar. marque Sus lniciaies aqui 

Instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier: it you are assustmg a voter my rte-positing the carrier envelope in the
mail or with a common or contract center. you must complete the section below. a la Persona Ouien Deposits el Sabre Oticial en et Correo Entregue
al Transportists P?biico Comercial: Si usted ai votante a daposrtar ei sabre ottcial en el wow 0 con un biblico comeroai. usted debe iienar
la secciOn qua aparece abate.)

 

 

it you are an assistant or Witness. check the appropriate box below and provide iniorn?atlcn. (Si usted es on asstente tesugo. marqtie 7a casilta consuls :roporcione
su intormacidn);


Acetone

Witnm? Signature (F?lrma) Printed Name Nombre Irv-preset Street Address Domiciro msuonaah
Tostigo

 

Assistant:
0 Aum

witness Signature Printed Name -Nornbre impresoi Street Address (Dornlcilio residensail
Test-go

 

Completed by Eerty Voting Cleric Name of Election (Nombre de Eleccion):

 

Name at Voter (Nomi-mi dot . -

OVERSIG HT 



.

.
.






 

szo?191113Eo. 

 

 to vow! as. true envelope. no then sign you name tn space below. this envelope must be seam try the voter bolero rt leaves the voters hands Dc not 5th this
.nvolop. unless the ballot has been marked by you or at your directlm. rrlor srwolo used to return more one voter?s be t. Howsvor. more than one
corner envelope may be placed togsthov in soother envelope rt tho cantor snvelopols) belong to poroon homered to vote at tr- same scores. carrier envelop. must be
?ore. 
nu on at proporclonsdo sbslo Est. sabre debs do so: sollsoa nor at votsnle antes a. quo ol votsnlo entroguo. No fume est. soar-o mono: oe Is bolots hays
sloo Isnods pot uotod. 0 Dale so dlroccton. Eta sobro o?clsl no debs pars crawls bolota do gas do un solo votants. embargo. mas de un solo sabre o?clat
mode so! colocsoo om do one sobto It at secrets) o?ctst solctonsl ls paw a un votante 9er vols: Date is dlroccmn Eats score onctal ease so: ?made nor
com. por rnod?to do on moortlots pdblico oomerc'tsl. sorenuogsdo sn persons car at votmte ot do Is elooclon on to ucretano cc votac-on 

that the enclosed ballot expresses my wlshea independent of any or undue persuasion by any person. tCortr?co cue la bolata adjunta express mt; down
mammommwmodecmwa)

SEAL ENVELOPE AND OVER SEALED FLAP 

(SELLE at soon: 1 FIRME ENCIMA oe SOLAPA DEL SOBRE) 0" 0? V0753 0 MARCA DEL VOTANTE)

Instructlona to A voter may only be readlng or marking the ballot If they have a phy5rcal that renders them unable to write or see. or
have an lnabillty to read the language in which the ballot is written. If you are the voter. you must read the oath and complete the sectron below. before
assisting the voter. sl Aslstonto: Un votante puede ayuda para leer Irenar la boleta solamente sr el votante trene one atscapac'Oad 
la cual lelmpide escribrro ver. at nations to do leer eI lenguare en el cual la boleta esta? Sr usteo le atuda a un votante.
usted debe leer el juramento Ilenar la slgulente seccidn abajo. antes de at votante.)

 

 

 

 

 

 

 

 

Oath 01 Person Assisting Voter. I swear (or affirm) that not suggest. by word. sign. or gesture. how the voter Shbuld vote. I centre my lo anmerrng
the voter's questions. to stating propositions on the ballot. and to namrng candidates and. it Irsted. their polrtical partres. I prepare the voter 5 ballot as the voter directs:
and I am not the voter's employer. an agent of the voter's employer. or an officer or agent ol a labor union to the toter belongs (Juramento do to Persons
W0 8| VOW: JUIO (0 a?rmo) QUG "0 00? palabras. senales, gestos la manera en la coal at volanre debe voter; mt aerstencra a responder
las pregunlas del volante. leer propuestas en la boleta, nombrar a los candidates. st es mencionado. su partido properare Ia boleta oel votanle de acuerdo a
we instruoolonea: yo no soy el empleador del votante. un agente del empleador del votante a un clrcial agon'a do on sindrcalo at el voter-rte pertenece)

 

?0 W1 YOU 3'0 SGMW 35 a wrtness lor (name of voter You must complete the section below it you
Wrtness the mark at the voter. or It the voter cannot make a mark. It the voter cannot make a mark. check here at Testlgo: Usted esta lungiendo

coma testigo para (hombre del votante). Usted debe llenar la sigurente seccion abate st rrsted lue test-go de que el \?olante
lirrno. 0 de que el votante no pueda ltrmar St at votante no puec-e trimar, marque SUS ranrales aqui .)

Instructions to Person Depositing Cantor Envelope in Mail or to Common or Contract Carrier. ll y0u are a voter by the canna- envelope -n the
mall or with a common or contract carrier, you must complete the sectron below a la Persona Onion Deposite st Sobre Of?cial on at Correo Entrogus

at Comorclal: Sl usted aslstira at votante a deposilar el sobre o?cial en el correo 0 con un cornercral usled debe llenar
la seamen que apareoe abajo.)

 

 

it you are an or witness. check the appropriate box below and provide rnlormatron' (St usteo es un aSrslente testrgo marque la casrlla correcta proporcione
su lntormacl?n):
Ass-slaw
0 Anton-
WW Slgnaturo (Puma) ancd (Nomnm "?9390, Street Address lDor'ntc'llto residence!)
rm
Autumn;
Asletenls

Srgnature (PM) Pnnted Name (No'nbre 'mpresol Street #0077555 lDO?thllO resuenoall
Testes

 

 

Completed by Early Voting Clerk; Name at Election (Nombre do Eloccidn):
NsrnootVotorMombudslvotantolTX-SOS-19-1 1 13-E-000077

 

 

Application for Ballbt by Mail

 

 

 

 

Last .I .- 

 
 
 

 

A

       

 

 

I I. I
(y?v I - 
Vulmg by 
I I lr? (II-I Itbub]
?In us
. I .II: Bur Hob)
on Yo u? 0? Ann ()ldw Vfl(l?l\ .I 
I?m? .I-l I I .I, I In 
Ill1.1?

(I 


m" .II .x 

VuIm? Al?sm?t o! Von-Is JJII

 

 

 

II- ?I?lI-ll II . 
I.I.I II,

[Sunni I - 





City

Inducte- (In: bullavl In? luslluI 

.I.. 
I. . ., -.. DIM II. ..-.. . I.

[jun I..you vim-I IPII I 410?]. mm ?warm. LII lu.II-.

ill I I l-l I

l?nlh' yum t? I In In?: Jl (um: ul lc'ul" In wsulc noIl?v l?g 

ll

I I llII- Is I (?Vlhq Irtl?ul? 
llIIt; applu l\ I I 



SIGN HUN. 
Is II.) nuke 
walk in (he prI-squI ul .I 
Bones II lI-l).

 

 

 

 

 

I- 

I I I.- II -.I [11 XII,



Il-61M
A$>I5tdlu I II I I uviuv.

'5 E- 000078

 
 
  
 

   

 

 

 

 u) 'Ut?l . 0w moo uvumuw. unu u-uu- >gn yaw none In awry-.75 ., . . _4 
envelope unless the ballot has been marked by you or at your drecrior Thin curler onvelw not be used to return more mono voter's ballot. Hanover. more mgr. on.
corner envelope may be placed together in another envelope rt the edaitional tamer envelooets) belong to pe'uon to vote at the same address. Tm; mm. mm must be
returned by mall. by common or contract corner. or tn person by he voter on electron day at the early voting clerks of?ce. at Votnnte: Selle eete were am 
hombre en el oepecio proporcionedo abate. Eete eobre deb. so oer sellado por el wot-ante antes de que el vozante lo enmuo. No ?rms one more a memos no que la botete hay;
eido llonede pot ueted. 0 beta eu direccion. Elte eobre o?clal no debe ser are entr or in hotel; de mas de solo votente. Sm embargo. mes cc U1 solo otrcral
mode at demo do ova :0er It at eobnts) em ?1ch lo pertmece a un votante registraoo para votar bago la mum airecctort. Esta some 055;. ?Mac 90,
come. por modoo do an tnmportieta puoloco 0 comment. 0 nor ontnqado en omen: pm at volume at dc: do to etecczon en la o?cma eel We do matron te-nprana i

I certify that the enclosed beilot expresses my wrshes independent ol any doctation or undue persuaeton by any person. tCerti?co nue la boeta adtunta express mus 398.09
indeomdtentermnte do ninofm dicteoo persuaebn indebida por pate do cualouror person) i

SEAL ENVELOPE AND SIGN OVER SEALED FLAP 
(SELLE EL SOBRE ENCIMA DE SOLAPA DEL SOBRE) SIGNATURE OR MARK OF VOTER (HRMA MARCA DEL VOTANTE)

 

 

 

 

Instructions to Assistant: A voter may only be assisted watt eating or the ballot tl they have a physical disablMy that renders them wable to Ame C, see or
have an inability to read the language in which the ballot lS written yCu are assisting the voter. you must read the oath and the semen below belote
assisting the voter. (Inetrucclonee al Asletente: Un votanze puede reelbir ayuda para leer llenar la boleta solamente St at .rotante trene una c-scapacrdad 
Ia cue! to impide ver. 0 si no tiene la habilrdad do leer el lenguate on at cual la bole-ta esta escrita. Si usted -e a un vo'ante
usted debe leer el ruramento llenar la srgutenle seccrOn abalo. antes de 356!? at votante 

Oath ol Person Assisting Voter: I swear (or affirm) that not suggest. by word. sign. or gesture how the voter shou'd wte will ?:on'me my ass:stance to answering
the voter?s questlons. to stating propositions on the ballot. ard to nammg candidates am. it hsled the-r parties I o'epate the 5 ballot as the role: dllects
and I am not the voter's employer. an agent of the voter's emplomr or an offer-r or agent of a lat-or union to the voter 'Juramento do la Pomona
Aels?endo el Votante: Juro (o a?rmo) que no sugerlre con palabras. senales. 0 995103. la mar-era en la cual et votante debe volar tmra-e mt asts?enoa a responder
las preguntas del votante. leer propuestas en la bolela. nombrar a los candidatos. si es mencionado, su partldo politico; preparar? la ooleta del votanle 09 acuerdo a
sus yo no soy el empleador del votante. un agente del empleador eel ntarte ?va e?vc-al 0 agent; de un al 3:42.49 peneneoe 

Instructions to Wltnese: You are sen/mg as 8 Witness for tname ol voter) You must complete the section below rt you
witness the mark at the voter. or ll the voter cannot make a rrark. It the vote.- cannot make a rrark. check here al Testigo Usted ssta lungtenco
como para (hombre de' voter-let. Usted debe ltertar la sgwente sermon abaro Si trsted lue de que er votante
firmo, 0 de que el votante no puede hn'nar. St at votante no puede lirmar. margue sus tnicrales aqut .)

Instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier ll you are a vote: by the cart er antelope tn the
mail or with a common or contract carrier. you must complete the section below. a la Persona Gluten Deposite el Sabre Olicial en at Come 0 Entregue
al Trencportieta Pt'lblico Comerclal: St usted aslstira al votante a caposrtar el sabre ottoal en el correo ocon ul?l comercral tis?ed dene llenar
la seccit'm que aparece abajo.) 

ll yOu are an assistant or check the approprrate box below and provide iniormaticn is: usteo es un as'SIente 3 testrco argue ta castle; CQ'recga -, pmpor?one
su inlorrnaCtOn): - . .

Assistant;

mm

WW Siemlum (Fltmal P'Imed Nar?te lNomcve Forest? Street Address wswjenaall
Toetrgo

 



Anslente
Somalure Pnnted Name (Nombte o'hpresol Street Address 
7esllgo

Completed by Early Voting Clerk: Name at Election (Hombre do Eleccl6n):

 

 

Name of Voter (Hombre del votantet: .. -. . .. ..

OVERSIG HT 

Texas Secretary of State PO Box 12060 Austin. Texas 1-800-252-VOTE (8683i tx?us

ELECTION COMPLAINT TO THE TEXAS SECRETARY OF STATE
OFFICE USE Date Hand-delivered or Date Postmarked

ONLY 04 14 /2017

Please read the Important Information at the end of this document. The Secretary of State has no authority to
order a new election, chan an election result, or conduct a criminal investigation. A complaint filed with this
form will not alter the resu ts of an election.

 

 

Docket Number

 

 

 

This complaint form MUST BE SIGNED before it is submitted to the Secretary of State; therefore, you must print
it out and sign it before mailing or faxing a copy or emailing a scanned. signed copy.

 

I. IDENTITY OF COMPLAINANT

 

 

1 COMPLAINANT ms MRS :33? 
.AST 31,:le
2 A91 up, .LAELL- :ln 53,55 5"?th
PHYSICAL
(Pull norm: or business address. InCrUdIf?lg ?w??2Xf?f?ii?9j'Pfi?f) 
3 AINANT ARTIRFSN 3 LL31 0- CITV STPTE ZIDCODE
MAILING
ADDRESS

(check if samo as above)

(Full homo or business address. Including street city state. and ZIP code)

TELEPHONE - E-MAIL

NUMBER ADDRESS

 

ll. IDENTITY OF RESPONDENT

PERSON on moan nounovIs)

6 RESPONDENT 
NAME

 

 

SLIFSIX
7 RESPONDENT
POSITION OR
TITLE
8 RESPONDENT LDC-RESE- ?i?T $91712: gr. STATE 

PHYSICAL

(Full home or businou addrass. street, Eliy. slate. and zip cudel

 

 

 

ADDRESS TC: DE E'gi't: 'f-W STATE CODE

9 RESPONDENT

MAILING

ADDRESS

some as above)
if 7 i - Iful: homeorbusmess state. and_z_i_pc_od_e_l 
1? RESPONDENT ARE-2. czar: mime NUMBER 11 RESPONDENT

TELEPHONE E-MAIL

NUMBER ADDRESS

HF KNOWNI

 

 

 

GO TO PAGE 2

AA 444'} 
NOTICF- THIS COMPLAINT IS puauc RECORD ONCE REVIEW IS COMPLETED av THE o: srk?i?i?ih?iid? 

 

Rev 59:32-91:31:

Texas Secretary of State PO. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 

Ill. NATURE OF ALLEGED VIOLATION Page2

If you believe that acriminal violation of the Code has occurred. please state the specific acts committed by the person or
entity named in this com plaint, along with a reference to the section of the Code alleged to have been violated. if known. If

YOU need more space. please attach a separate sheet.

 

Unlawful Assistance per Sec. 80.0w of the Election Code.

Sec. 86.010. ASSISTING VOTER. A voter casting a ballot by mail who would be eligible under Section
64.031 to receive assistance at a polling place may select a person as provided by Section 64.032(c) to assist
the voter in preparing the ballot.

Assistance rendered under this section is limited to that authorized by this code at a polling place.

(0) The person assisting the voter must sign a written oath prescribed by Section 64.034 that is part of the
certificate on the official carrier envelope.

If a voter is assisted in violation of Subsection or the voter's ballot may not be counted.

(9) A person who assists a voter to prepare a ballot to be voted by mail shall enter the person's signature,
printed name. and residence address on the official carrier envelope of the voter.

A person commits an offense if the person knowingly fails to provide the information on the official carrier

envelope as required by Subsection 

ATTACH PAGESAS NEEDED

 

TY

nonca: THIS COMPLAINT IS PUBLIC RECORD once REVIEW I8 COMPLETED BY THE secaeunv or s??r?e ATTORNEY GENERAL.
Rewsec 2/28/2514

 

Texas Secretary of State PO. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 
IV. STATEMENT OF FACTS P3993

State the facts constituting the alleged violation(s). including the dates on which or the period of time in which the alleged
violation(s) occurred. Identify allegations of fact not personally known to the complainant, but alleged on information and
belief. Please use simple, concise, and direct statements.

 

 

 

ELECTION IN WHICH OCCURRED

 

2015 tlections DATE OF ELECTION \arlous
NAME OF ELECTION 
Dallas (hunt) Various
COUNTY OR POLITICAL SUBDIVISION PRECINCT

 

 

 

 

The ?rst ABBM attached shows an ABBM in his handwriting and with his completed assist portion of the
form. The remaining are in his handwriting. but without the completed assist portion. This is only a sample.
There are hundreds. if not thousands in this same handwriting.

 

 

ATTACH ADDITIONAL PAGES AS NEEDED

 

 

 

NOTICE. COMPLAINT Is PUBLIC RECORD ONCE REVIEW Is COMPLETED av THE SECRETARY OF 
Rev sedZ/28/2014

Texas Secretary of State PO. Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 
V. LISTING OF DOCUMENTSAND OTHER MATERIALS Page4

List all docoments and other materials ?led with this complaint. Additionally, list all other documents and other materials
that are relevantto this complaint and that are Wlthin your knowledge. including their location. if known.

 

Attached are Applications for Ballot By Mail (A I ate the Election Code.
1. ABBM With aSSIstant portion completed by hose handwriting matches ABBMs also at
tached. where the assistant portion is blank.

2. 10 ABBMs with matching handwriting indicating unlawful assistance as the assistant portion of the appl
ication is blank.

See Exhibit A

 

ATTACH ADDITIONAL PAGES AS NEEDED

 

 

TV DAB 
NOTICE: nus COMPLAINT is puauc necono once REVIEW is av THE SECRETARY OF 

Revised 2/28/2014

 

 

 

 

 

 

 

 

 

81.1. SCUCJ I 513:5? I
I VI. SIGNED STATEMENT pagos


I

I
NOTICE: THIS COMPLAINT Is NOT ONCE REVIEWED BY
THE SECRETARY OF STATE. IT WILL BE TREATED AS A PUBLIC RECORD.

 

REMINDER: YOU MUST SIGN THIS FORM PRIOR TO SUBMITTING

IF MAILING SEND TO

A. \oat;
?4 .

exas CMEIB 

. 53pvub
.. i. 



IF FAXING. PLEASE SEND TO:



.?vgu

IF EMAILING PLEASE SEND 

A
. --. .. -..V. 
..S

 

NOIICE . NCEQL. (I. f; n? 'wt 274': AND 5" GENINA.



 

 
 

  
 

 



 

 

 

Suffix (Jr it: Ill utr) Middle Initial

 

 

 

 

Mail my ballot to: If "tailing address 111 ers lrorn residence- ndtt'ess. please complete Box 3 7

 

.
Zi Code

 

 

 

 

State Ip ode

 

 

 

 

Date of Birth (Optional)

  

 

or Voting by Mail;
(a yum: ml 300 (r (_C_orv_19ie_t_e_8_o_g QSQ) 

 

[3
(Commete Box #ga)

absence from the countv. (quplgle?pxj?b)
Be sure to complete Box #8

Confinement in rail Box ?ts)

 

it you are requesting ballot be mailed to a ditlerent address (other than residence).
indicate where the ballot will be mailed See revorse for instructions

Mailino Address as listed on mv voter registration rertilrr.atr- Arlrirr?ss :rl rail

Nursing home. llvruq (ll inn-4 term Ldl'.? Relative: .

Address outside the county lsm- Rm 

Retirement Center

 

ONI Voters 65 Years ot Age or Older or Voters with a Disability-

It for um- electron. select approprrate box
It "enp'vrnq once in! all county electrons the calendar year, select ?Annual Apparel. on 

8 Annual 

Primary Electrons

l?luf-l rim lmr- Lgive' tw'ty ll 4 l-

and Other Electrons

May intiz'lt)?
li'r'tlmr

lltt?r-r

.3 
Democratic Primary
Primary

RAW Resulting Runoff

 

If you selected ?expected absonco from the county." reverse for instructions

3D HUNT-DDJU

Date you can begin to receive mail at this address Date 01 return to residence address

 

 

 

 

 

 

 

 

Contact Information (Optional)?
Please- plume anglur 
User: rn mso which has questions 2?

 

ONLY Voters Absent from County or Voters Confined in Jail:
V'ou may only apply 'or a hallot bv mail for one elefllon and any resulting runoff
VII-asp select the appropriate hm


\?uu 151 (mourn um pr Jillrc?l party in unit In

traction; 
May 
?mm" Demmralrc Prvmary
Republican Prrmary
Any Resu'tmlt anmlt

Iirlm-VY

  
 

qlqna me 

   

Am Number


Stri??guress
all;

State

   

certify that the information given in this application is true, and I understand that giving talsr: hformation in
this application is a crime 

   
  

SIGN HERE
ltapplicant is unabl- . . . . .
mark in the presence of a witness, the

 

 

   
  

witness shall complete Boxes #11a~b.

 

See back for Witness and Assistant definitions.

    

It you are acting as :1 Witness.

please check this. bit?

If mu am ar'ting as an Assistant.
please check this box

It are acting as Witness and
please 9937199135
Witness' Relationship to Applicant
(R919 to Instructions on hack for clarification)

 

 

TY-QOQ-1 0-1 1 1 

 

 

Est? formulario esta' disponible en Espariol.

Para conseguir la version on Espariol favor de llamar sin cargo a! 1.800. 257.8683 a la o?cina do! Socmtario do Eslado la Secretaria do Votacidn por Adelantac

 
  

VotTnSEy?i?'u.
2; nl mu! on?: Lquupjm_BoLmj
Isa)

:11 In Ill urluy 09! 
to complete Box ?8

mm" 1 ul 

Van's?65 You: ol Ago 0! Oldol or Vol 1. mm a mummy


 

 

 

 

    
   
 
   

ll 1uptynu low mw 

ll dullvm-l 0111- lm Al uulnty '0 .llcn?." wan, .- I ?Ann: :2 Au? .l'u-u

Ill-Ml qurllum



- . tv I

  

?q [Il'l? Cy

I 

()llml


Dv-vvn 
.w l'luvhuy

Any "1 "ultanq Hun-?

ONLY Vote". Absent ltom County at Vohts Conl'mod in Jaal
You may Imly apply In: try mall la um- Mm Inn and .my .ulluu; mun"
lln- .omunpquw [In

 
 



[Suffix in 

Hum": unit)": I lam-n.

Mclv? bu [Mn
Nvm'n ln-v Ia-Hr -n

turn-
v?vll 'llux' -ln- an; ml".

,1 .Iu.

)mnuu ?tn S'nm uy

I ?u ml? le

 

Kalil)! be tu-n than?rogitlon?ca? 
Indicate when! the ballol will be mauled 3H lovelsu l0! nulluctluns

Nullmu .1 . axlml 1::an k-r yup-[Linn I v-Hllu .uto Anthems uf Ilk-lel
rum hump .rWutu-d Ln My n! luau Irlu: Lu My


l\ :tm urn! ?3 I-h 

H-{uwl- .n ulzdap

.. may um um

 

It you winded ?olpo-ttml alnmco ltom the county," sco- revolse lot Instructions

UDU DD JUDU

Onto you can begin to mcolvo mail at this Date ul mtum to msuloncc- 

 

 

 

a

 

 

 

Contact lnlonmtmu (t)plum.1l)'
l?lvww lust mnvh-l .nut'm -m.ul .ultln- 
ll A m: nl?l -- .h pm?lur

?l udlly that the unlomlatlon qnen In this IS tme. and I ?Mk-Island that QlVl?q- {alw?mlocmatton 
that w. .5 crime 

 



 

 

SIGN MERE
"applicant is unab

("luv

(mutt. .m l?mmuy

Any lbmultmq Ruma

 

 

 





.quW 10 this .s .l (IL?l-n A nu ?tram-41w l' ":Iglxalnm- mm" can! or 
was .huxtml 'n cunvlutmq .lmleutmu



thlfulull! of Winn->5 :Asurtlunl

If aomudh? holp?d'yeu lo c?b?m??lo'l?o (WISE

It applicant ls unable to mall: Box I to. the witness shall check um. box



l?l mul Name at 

Numly-t
.u (le lhlr}



Slum! 

ru-

  
 
 
   

in the presence 0! a witness. the
witness shall completn Boxes 

Sec back to: Witness and de?nition?

il ynu .umm; as a Witness.
I'll-354' I ht? tn-




ll ym. .uv .vlmg .os Witnoss and
m. ?h 

ll '11] m0 :u lull: g- ,m Assay-mt.
plNiL'io?: ?run "In bvv'

Wltness' Relatuonship to 
Huh I "n hr ran?



It'-

TX-SOS-19-1 113-E-000086 I

.ll?

 

 

 

 

slo formulan'o 0le dispouible en Espanol. Para couseguu Ia vomicm en Fspauul lawn Ham." in mm. wl 

 
  

 

 

     
      
  

 

 
  
     

 

 

 

 

   

 

Su?ll I 

 

          

 

R?m . 
I

 



 

I

 

 

Stale by Code

 

 

 

 

 

.4 .g a ICUHIDIMC 



?mums 

mun?. Box lob)
8-: sun to lion .8

. I up. II .l?lII?Qmuuklc Box HID)

I 

Vote": 05 Yard!? ul Age on Ulum VuIcIs man a 
I- I 

'l I. plylc- lul?)f Ilr- .oll'lI.II- 4|
II Auyu.-- 

[le?yfh-lI-QI
I - 



1 I




(ml Vokls Iwm (.mme o- Vuu?u Loulmml Jul
"Ln ?In, Art?y I. 1 .l lull. I II I lb'h IIMI 

?l 

'illvl

 

huh 

'hlu

lI-.5- I In 

DMJVIIH In.




HuhI'Lll'
u: 7

Mr; luumll

[3 Am In-

It .Ippluaul I: Io Bu: 3 10. the quIIoss shalt (lurk lhIs bo-

u?lufl? l'lnl' I - LI . . .Ih'uh' II I i'

.Ill? 

.IIluu- II I ?a I. ll? ?pulmo' .s I. .mlm; . I: .

Aux-I" . 



Ivy-uh Ic-

2L

77'1"" . A A. 

 

I I






 

 

 

 

 

van an: Icquuslmg Hus ballot no "unlud lo a address (othel than Iesldencc).

 

     

 

""Il?l -l rLI?l 

mun 
[3 Im; I.-l l- II
II- II

N. 1.1. I



SIGN HERE

is unaqu lo 509" 0! make a
"1th presence 0! .1 
shall compleIc Boxes ?113 b.

If moon. hclpo'd you to complm Ih?Io 1mm 9r mall. the term (or you.



ondtcalc ?hole [he ballul be maIIod Soc n-vorsn Innuuchun:

Add?
.In;
Adlilta?lnl IIyou whack-d ?caveat-d absence hum the county 



Ddll' you can hegm lu "Lowe "Id? at "us 

:01} 3: Im unlluumns



Data 0! Iclum Io Imam-nee adult-55

 

 

 

 

 

 

 

 

Infomulmu (Ophmull'
I "'hll"

'l 1..

t-Hup' '1le

llul mloulumm 9mm: in (ms Is uuc. .md I Ilul gIvmg Ialse mloamallon In
"us applocatxm Is a rum. 

 

 

than umponon mungqm'plplo thouctlom below.

   

500 back In! and Axsnsunt 

Cl


II I, ll] .?eI UH.) and
[Imam mpg-.3.

 

I Wltnes?



ll .IN- 
. lw

II .ll.l"lq m. .Ilv ASSISIMII.

I 



 

Wilness' RuIMIonshIp Io ApplIcanl

35 

 

 

I 

 

 

 

 

 

 

Ap'pncaitio?'fdr Ball'otw

lastName l?lnasv mm mlwmainnj

 

 

 

uh-hmnd)

    

 

 

 

 

 

 

a ,voung by Matt a . I - ?Tofu. requestiE; tilt-ballot be mallnd tgta?(trlt?otent address (?nllun' n.1'fu33chpL -
u! 10: (Comulote Boxml mdvcato whmo ballot will be mauled Soc revmso lot 
Hutu-t Alkhrus w: vm 'nv wt"! t'ur'JIah-m rum-cat. A114 hv'm? nt ltu? .avl
am (Rom: 6.91 166)
mm human 1155.?.th twin) ll'u lmtu lo Lu it, Rululm- LllmuJup
tot .th?umucomplain Ba- :3 Amman out-?tn mu 1m)
inn-men! II [.ul aunt-91
ONIY Votus 65 Ym of Age 0! Older or Voty's with a It you ?elected ?expected .?lnmu- 1mm tho county," see wvovsc lm instructions

   
 

ll In unn l'l?tlb'" till-I1 -- - - -
:t .uqvlqu Inn-tut ml or ml'y . t-xuur. w- ma ?1 ?wuum/qut 
. .3, .. JED 
by,? a [late you can hogan to vecotvc null at this addn-ss Date a! letum to msulonce Add"): - 
y! llut

l?muty

 

   
  

   
 
 

 

h'luu "v I- ll

Contact lnlocmatton 
tn ?l?vnn :Iul?m an.? .c-l Ite- 

. 
N?M'mw' Lu? It (I mutmlu l?hnuvy

pm Mr 'rn ullp -- lulu tun I.


Hoputiu .m l'ruualy
MW Runnll

 

 

 

ONLY Vote" County Con?ned 'l that "It! g'von tn ts mm, and mule-Hum! that gmug false In 
You may only apply In! a ha? 1 tr/ Iml It?: may "Lulu-n. .0011 .my 1. 'unutl this animation a (tuna 
l't-mm (?mug-?tr- Lox

 

 

 

 

 

LII-lama"! (J'It'll tu tum. Funny I Mn-
. . V?uurmrt l-<l nu talra'l utv'u. 1: u. 
May! In tun ??an
l?lmwy 
Reputmzm l?nvay HERE 
tlawllcant ls unable to sugn or wake a
Aw RmMuu; ?lmn? mark in the presence 01 .1 witnesz. the

  
 

witness shallcomplete Boxes Mia-h.
som?amhapaa y?fofiift?? (gnaw. ?ip ?t'u?t ecinbl?t??ia??tfom below.

It applmant ts unabte to mall 80:: I to, me mlnoss check this box. [3

 

 

 
  

  
       
       
 

See tuck lot and Ava-slam Itomntlons

It you .Iqu as -I Wanna?.
"tr-aw ?hark 'hH tun

Lulu? to?umpt.to ml-xmatum as .l (?lms A r? ut-uuhuv wan . I tm-humt
was auras-tut 1911195 tug "to: athIchKt?



finnatmn nl M?szst ml Punt-.2! Tl 

It you .ms acting as an Assistant
gut-44v dunk mm {?11

It you an: .19 Witness and
Assistant. pk-aw (thl?nk lath my.

?aunt/Muir?s Witness 
       
   
 
  
 

[w .. "can .0 pawl mt nu 

 

   

 

 

 

 

     

  
   

 

   

 

 

 

 

 

 

  
  
  
  
  

 

 

Suffix I It. I Hut
. aimsCoda 

Mall my - "1.ququ Ct'y ., in Cht?t?
Onto ot 


lm Vulinqby Maol To" aw wmm?inq ltn? ballnl lw mull-d to a dilton-nt tulhm than t?<lt10tlt o) 
I, r?-lm (Cm?lcttemk?w) Indicate who-Io the ballot In Sew u-vmgn lm 
a Liv-5*! 'r In, . 'c I May -Iu .H(Contact: Bord?)
|l ?1 ink; ?pm I g. H: 7 u-Lx?. I.
.Ihm-Iu hum :mmlv 

Ba sure to covnploto Rm- 

Nth-mwwm-nn-ul m? 

ONLY Voters 65 Years OI Aqe ct Older 0t Votets with a Disability It you selectod 'oxpoctmt abunco lvom tlu- county. ww- vow-1v- tm 
ll amiqu 10' um olm? Wm but

?ow" '1 plank-W. In tho Aland." t! 1??de App?: u'nm

HAW Aug-h .Ilnu

 

 

 

 
 
 
 

In] . "up, .-. Data ynu (an b?qon to mail at ?ux .uhtvoss nntv- o! tot-u" u. 
'9?.qu .l .4 
I lm 

 

  

Contact lntovmatkm 
It"! [vt?ntu- lumvlu-I "'ql I - 

wv?ntuv luv t; u.

(Hum

 

)n-nnu l?nnuly
Nutunldn l'nn 

MW 

(NU Volt-n Abumt from County 00 Voteus Con?ned In Jatl
You tray miv apply ht a lull"! by nl ?w nun o'lwtum .uu! Iltv rum -ll
I'vaw It" tn-

Uvulpun mu] [lua?l'nv . Pluthuy IN hut 
ha k?vttn- ?qu- :ul'll .01 1? 
May low 1.. 

N-- nmtu-v I IN 
4 I lkumn 1 Hr Rum." 

[3 (mm Wm. Hm. . SIGN HERE
"applicant is unable to Sign or make .1
mart In the presence 01 a wutmss, tho
Wilht??". shall complete Boxes "la-b.

rt ?mono hulpw you to comp!? Mormons ?on form mtyou than that . non ?mst twptotnm? 

.n-t .v .- mu . .Pt. I- . 1,1" 

 

 

 

"l u-m'iy that tho mlovnutlou qwen tmo, .vml I Luisa 
this as a 

 

My Rn-u'l-tv? Hutu 

    

 

 

If appt'cant is unablo to math 80: I 10, the ?all (back this hm 

Sov- and (Intuulnna

h) lha I Ic-rm man IK lav. A ., 4 cu,? "um .- Wm.? H, my v" Mr; I. ?Witnoxx
muntnl In lho floti"Hm; v. 

 

 

 

 

- . 33. 
'Quum'lm- 1" Wl'nl's" f?nr-m-l 
vw- l?wl 4v Wltm?? and
.. . 9w both 
E-?Iw?l AM ?lanhI-r I?n.

Witne?' Rolatnonshm to Applicant
llull'. I?ll .NL 91!] Il't I)

t, TX-SOS-19-1113-E-000089

If 

 

 

 

 

 

 

 

 

 

 

crOn 'nrmuI-on'n nod? do'rmnikla  

ApplicatipnforaanothyMan .. . .. ..

 

 

 

 

 

 

 

 

 

 

 

 

 

a ll you ate HM hallo! maun-d lo 

?lulu-0?0 whovo Hu- ballot be mauled kn .uslcusluons

    
   
   
 

Kim") . .u ?l .I. I: \Ib'v' ?upwind: -ll . I'lh?n a! "in 
?Imam?. lUquvch-f 

un?hm- II Ir. In L: I'pu..h.u? 
I (kvmuwk 095mm
00 snu- 80- ll! . 

Nth-"- . lily llv: . y; ll"
Inn-1:. HI If. mun-"()ka ul Vole?. mm a Duabaluy - I you sch-Lied ?elm-(led llom I'm Lounly levels? to: 

 

1r". a-htl 1-in0.11:: you man began 10 "have luul endless ?Mr n-Ium to wuuoncu 
- . . . Cunuu lulovnulmn(Oplwnalr
Iu- . .1 

a hul- u. r'nlbl' .. . .

'h'wulnm try
I Hun-ll

ONLY Volux Ahwm hum (?nally on Vulc-u all J.u|
pl, v-u-u-l- .li? m? u. .Mll 

 

 

 

 

 

 

cum, llul the mlmnulum gun-:- It applu .mon vs "no. and I drum! "Idl lake mkmvuuon 
"us 1mm; anon .u . ume 
a- .- I llu~ 4.4 I: 1le luv:

h! Iv
'I'l 
mu 

I 

ml". SIGN HLRK
:5 unth 10 sign 0: make a
., In .H a mark In tho 0! 4 Witness, (he
wmu-sz. shall Boxer. ?1.31)

mm him for you.

 



 

 

 

   
  

mm that mson may; tho action- below.? 

  
  

 
 
 

unablq- I [hu- 0 Nu- wnum as \hme "us [min See Imgh luo Wulncb? and Awsmm 

- . . mm . 'Ihh

. "w Wm; owwawu.
Mon

Jaw Mn" 3

,uvm l?loInn.
II 'll . 

. ?Low
hm. ?(my Wang; mg
Assuslalvl. [II-lazu- huh mm It":

lo Applmanl
?Ct-'ul I I) 

 

 

l? 13. Inn! I,

111- *l

5137??- - 1.. TX-SQS-19-1113-E-000090 

Ir Inunuhum .r . d: .pulublv on >pdnul PJIJ i4 vul>oull . I 21mm! Iwnr m. ?no arm 1r.) Ema:

 

 

 

 

 

 

. . . 

 



 

   

[ml Namn Innl 

. I -l 

 

 

  
    
  

  
  

Ilnnd FY

  

Date of Bid?! 


 

l' )v f! 

 

  

ling by 
m; ml .ny- IConml?c Box #63)

 
   
  
  
 

mum? IConIpl?c Udall

Inc-I Iml Im'n h- I (Complete Boa 
Bo sun- lo complain 0m .8

?2001.)th 

ONLY Vote? 65 Years MW 0! Older 00 Volevs mm a Disabx 
ll Irv mIl? I- s?ncl npwn?mlv 
II v- .Ilh In "In: Van

ani?ll 

(m'r-I 

 

,nlv-l 

I'Ivn u) 

 

II

 

Il-Ifn 
(my 711.. 

 

Cl?y [up

 

 



ll you .110 "In. hallo! ho IllnvIt?lI In .1 IlillnImIl .ulcluw; (nlIIt-I Hun maulqu-I
who? Ilw hallnl wIlI ho mmlod Sm- uwmso In! 
I [Mun-I - .

. 
pl'lul lel-I ,Iln

II- 



 

?It you selected expound Item county um lm IanucIIons



0an you can h?qm mcmvo Inn" a! ?ux 

 

 

 

 

0.1" 0! mlum In .ulIlInv.

 

 

 

 

  

NIIw-c-vhoII II lI-v

Iv-In"Wu. l-nq Rum."

 

   
 
  

II npplican! Is unable Io math 80: I I9 Im- wilnmu shall chock thus lon



 

 

 

 

  
 

 

Ipuh'u. - - 
mMuy I Il- I . I I Coo-Md lnlovmaI-on {Opnunnll'
. :l I . 
I'la- In? Jp?u an nu'n'ni I ?ha
I I
. WMIWIIJII ?l . .J. 
.. 
Any 
.I 
Vote" Absent lrom 60me at We" Con?ned in Jad ("my "1.11 IN- quI In "In .mplicalmn Ix hue. and I mulmxland IlmI qmm; 
"my nnzy nmiv .u by man In nu- .In-l my II mum; [his aIIpIIcalion l? .1 uivno 
Won-.0 .Ippropt 
kruki'n v! 0 I?mnmy DKIUV 
.I I-Ihu.

 

  

 

SIGN HFRF
HapplIcanI is unable Io sign 0:

aka .1
maIlI in the of a w?noss. the
witness shall complete Boxes N'lmb.

 

   
 

SM hark .vu-In.) .I I -Ast.v<l1nl
.n hull . 
ul IIA-puxmn' I-m- nl 
'Ip? .?lnl and
I A?<i<lnnl a'v . I b0"! 
IIlthI N'Jnhqu I R'Ia'lon<h'p '0 Apphcan'
I n? I- l' 
I TX- SOS-1931135000091

. I 

      

 

 

 

"ml my foz'rIVII?ilnn; .I In 

  

 

Dlle 04 Bath In?



 

bar??
I II ul 

- am?; (?Me 898.96.!)

I 1 Yd ("in Dr (CoIancIc DoVoIm 65 Yuan oI Ago VOIMS a "Nah-My

II .1)"qu 0? ?It I I II IIvIIquc 

II .Ileva on: II: I91 .clr 'Amm.? In 




Mummy 1 .Ipzfn';
II I v-

 

Ial?o?p' 


[Hwy I .I.-um

I 

Dirk?

I J. "ulnar. II

I I may
Hunky i?mlmn
I?mnmx


 

      
    
   
   
  
   
 

MY VoIa's AbscnI CounIy OI VoIon Con?ned 
In." p) 1.: bdkI?h- cw I Ilm .x "undo Lox

 


Ia-Iln -.I- I.


Mn I 
lot-10"



Whoa L?mu 51b

. (V
?murmur F?nmmy
I?mnry

4!

II Is unable Io Box 3 10. "In shall choc;- Ihxz. box

   



II IIUJI



vum'um In!

 

dun .-
mum: I--



.-.I.II 

I .

?Md. 

 

 

If you are quuo- Ihis ballot be mailed I0 .I Ihnn IosId :IIcr)
vmlIcan when! the ballot he muled See Ion-I50 IOI InsIIucIIons

him .I. no!" I1: 'IInly 

. untm

.. I. *I'Ivll~| I 

a" you 'IprncIMI .I:bmm l? lIum "In I: mme." 900 

LJ. JJUUDU

Ilato you can Io rec-Ive.- quI .II Dan: In I-nidoncc 

 

 

 

Coal. Infommllon (Oplionalr
II InIn" Illwm 

 

I ?Is! "It q-von SIGN HERE
Is unable to or make a
Ihc of .I Ihc
witnens shall complete 80qu. 81in 

 

 

Soc back IOI and AssIsIanI 


[j

II ym .u um um wanes: [nu
I-lo-mw rho II (1001(an .

WiInoss' Io ApplicanI

In QA1IIG-EH000092

   

mm II .Is Witness,
.

     

pinaxl- . buy

If 


.Is an Assistant.
I m:

I Tm! II 'Io- 

 

 
 
   

 

 

 

 

 t" -. . 

- .--..




  

 

   
 

 

 

  

 

 

 

 

 

 

 

 

 

 

   

 

 

 

 

 

 

 

 

 

 
   
   

 

  
  
  
  
  
   
  
 

    

 

 

 

 

.umnw 1100a,; ?1133- -J to. .. Ultra: - rtnl. .

l. "llnk?u; I 
Su?inrState Malt. ll you are requestmg ballot be (o I address (other than "Hm-or.) -
?90? wm?gw Indicate ?hero tho oaltot mil in manta. See venue for :nstructlons 
Muslim/5.01m? as ?utmt at? w. mhu mun-m mat-fur.? Alldm-n. . m. md

I Nummq hmw, ae?mt-x! hang l,..Hny_ Ion; Mu. MM, Rnl?h?u. {vdelmuJ?up
:nbwru Inm- Ivmumty 
complete 80- to :va'r. kylf<m tr? and. ?w an
(Wham mama: arm A
OMY W015 '5 0? with 3 Ulsahllily. you selected "unoctod abunco (run (N cocmly, we tonne 90: Instructions
.m ?ung I en. aha-n mutt amuqmate 5-2! A . -
I strum i W) Inf a? (cunt; nloctmu the mum-til pikuum I II VI '1 1 ID

MIA, . 0 - 4 -
?)qu 914; 00"" ?(3113?; {11113:} (nu-nu? Data yuu can osgln to run!" met! at N: m1.? Ou- oi Iotum to makhno. wan?
w- emu . tu.l 0.: 
Limbo! a Contacumomwoo {Optloulr
. . Its! chum numb?! my; .49 u! 02;
urlev i M6 0 
01"? ""le 'J?md In gum ?urulhm kn marmulh
DOB-.1 . . . 
Any Rosukmg Rune"
OMYVotuc Absent from County at Votvn Con?ned In 't certify that the uhmn true. and I that [also mlomuaon 
You my; uriv an)? tor .. taH by ?m r'vck?rv. nuts 0 ?3 this applcat-on cs a 1.1mm."
Wriu- Muj ft- npwwurw. 
Heal-um.
Bus, er rats? 11: a. puy h: wt.) to
agimmy
"nu-I
00"" Hd'intl?lu?nn Hun-"y SIGN HI:

"applicant is unable to sign: u: make a
man In the presence of a witnus. the
witness shun compute Boxes ?13-h.

     

Any Health-J Runutt

   

 

 
  

someone helped you to complete th farm or malls the form for you, then ma: persow n?usx the sections below.
3" back to: ?no? and Assbtanl 

    

ll axial! ls to mad: Box .10. the witness she" chook "is Don 

   

5 0m Hmm'alum A :ermcar-r-r Ingmar-o was Mina-sat .45 pin-rant
was 330'?th I'm applinsuon





gunman! WWI I 7. Mat.- .1

 
 

It ,u-I am 3:26qu a What!?
piano crunch his tow

    
 
  

 
  

if you are Ming an Asuslml. 
l?hork ma hm: 
I

:3'91'1'?'i?3?gg20093

Mme-(v; :0 Applicant



Ozl'tteJ than n! Witn-mam: .u-lml

   
 

 

 

I

 

 

     

i 

   

kl? ?mix-v IS,
114 .J

     

 

 

3 Applicatlbn for Ballot by Mail -

I..- Al- 
(lama-.. 

 

 



  

.n (Complex: 
45 (emulate 591161!

1pv- lm! War-:- loo (Pr aunly (Wmm
Bo sum to cunpmto?ox .8

vmlm-uwml 0 dl- 

 

 

Sulfa JV 1%

Middle Inn! 3!

 

 

 

 

 

 

ll you are :Ns bahcl be 7.: led to .v addvess (omcv than rex dcncoll
the Intel will be mad. Sm.- uvcrso lat unlructlons

Iilend an m, min! mll?: m- [1 mum um and

?"5an lmnu 3.1M, nth-an, Mn: . lr.? L?mey rulamnslap .
H'lsnipl ultimo; nutho ha (:mm (940. Mm 1H.

Hunk-Ir". .I I 317111

 

 

 

ONLY Vol-n8 as Ye: ts ?040" a Vour: mm 1 
I datiyzn; nun alt-?t r. val-v.1 amxx. la hm
It .wpuyu-uwm fur all any elem:

   
 

Ann 11ml Apply. Mun


Jblaa ganuylmd oqty 
?5 unwary

Pin-my
anmt?hnl' l?t?nu?
Any Rea-?ing. Run A

   
 
 
 

  

Na wont-n - lu tun

 

OILY Mon Mutt! fro." County 0: Voters Con?ned Jail:
they only 4p|llv Pt II by won-I rA-W?um, MVJ any 
'r?lovn mac! PM 4110300;- rm-

?uuxl lctzilwsz'
In :quI om! 1-2 pm,- 3 9'1 ?n n"
Vinny
.I "it. l?nmmy
Rnwtotalpummy

My Rusult-m] i?m?dl

?110!er 4 nl Oil-2' f7" . ?rms
May 'invlivn
Linux 



 

It 50619:?, helped ycu t: compl?le this form arm '5 ma form fat you. met perscr? must :omp?ola 2?18 sectio-ts be'ow

Cl

was. av} I

ll unable to mull Box I 10. "n mums shun this hot

?but It Dru (mum: Clan 
7an 5:94 .omola ling Iv ooplvca'lvm

 

qa awn: 

Thu-a: 3? nfrr. - my

I 

who rut wk? 'Amn.? hut-111M011 



u.

-. In: Incl: Murillo. mm :0 ll?; app elk-m .s (11.0 and any?: ad flu! lam: Wonnabou In
his Wki'mnr .I win?) -

.- 

windJain-g a: :m Mslafnnl. I 1
- - Jesu- rho). tr?; ~x
Pm (ulnar; 9? W: ?Ims?v?hwst r! 

 

 

 



 

so. "nurse 'or Instructions

[11 

Data 0? roman ln 

"you soiocuu "oxnectevj duo-cc Non Inn calmly.?

[1 1.11

Dab you Wu to rtcov. ll 

 

 

 

Conuct (Op?olan?
?039' rumba any.? mum! on ?My.

um \(Tlu- ha?. nus-lo ml



 



SIGN HIRE
?applicant ls unable 56ng a malt. a
marl: in the presence of a the
times: shall complete 

 

  

 

 

 
 
   

Sea has): Io: and Assistant ?Mons.

if you ?a acme :t a 

[1

 

*.l.-uln.1tnq r.Wlnarsm

911 ?l 

?my lot to App?carn



 

\V'm?u




 9 beam"

 

 

 

:"inuSg by Mant-
a at .u ?u MM (CQmDIeto. Drum}

"My (momma 80); 16.0)

wyin? fu ml tt?m rt mu!) m0)
Jo sum to complete Box ?8

(I. uer-mvnt In I ul (C omplu?njqu 

ONLY Voters 65 Years at A91: or Older or Votcu with a DnabuI-Iy.
In: 1w: 

ul nnvu- t: -r 11 um: "but. I .Ih-nLu you .. -- ~t An mu 
Muunt Namath"
410mm 1 Mm?. ?tummy I In! 
Yuu'vu .- Illa. hut?Dunn-l Hun-dry
Ruput?tu .m I?mmuy

Any mellmq ?nun"

   
 
  

Nmmuu-r tun

(Irv-r

 

ONLY Voters Abmnt trom County or Voters Con?ned Jant
?ll may ?my Mr .I or"! by 'n to 4m u-n" and .my I- .uthu; n. 
select the ho!

than") and (thr Eu 1' n.
I tartan
tum?

DOUIH

?mmuy . a a

In? 1th: lily .I.

:zu'm I

Ruumtu? .m 
0 Any Houuttmq Ramon

 

 

It ap?ncant In minute to mark Box 8 to. the wane)? shalt check this box?

humus tn Lunurtow ?1":thqu It xNILIltm,? r. wm?
was ul tut; 3 twphiutmn

- 

n, Witt?c?s? 

bur-I \dmn .:
rt .Imxludhh'l

s. 

 

4' 

 

 

sIe formulario osta dispomblo L?sponol Para conscguu In versron [spannl do Harm: sm mum at 1 mo man 11-. ..

- i

'I'lt 

.



Number "v

~C?w v-vv?v

 

Moddo Initial

 

 

Indicate whore the be mailed Soc reverse tor instructtons

[3 

k?Nntw- I m-nmv

AdIIr-o.\ u. .I. '1 "Vy ouufy 7111?

Human; hon-v, .c . LsIt-zt n; .u (?nu Hm .w by lint)

.putol

RI-tm'mn-nt (1 "Int

NHr-?n mm ttn- mu-t, wo dm 

  

 

you ?touted "cape-um! 3|)ch 1mm the county." revm'u: for Instructions

mm HI 1H

Date you can begun to romiw rut! at this address Date ot return to maximum address

 

Contact lntormmon Immortal)?
Mum? list [hour ?Int-n: amt/In mutt "Mus .

'ul-orlIn-u- 

 

I, 5.1- 

certify that tho In this apptocation Is true. and I understand that qivmg tame mtounation in
[hm is a con": 

 



SIGN HERE
"applicant ts unable to sign or make a
mark in the presence ot a witness. the
witness shall complete Boxes It 13-h.

  

 

 

 

     
  

 

 

.1 .. yr 
. 7,;2 - 

 

Sco back tor Witness and Asmstanl de?nitions

It you me John? as an 
phase (Lhak box

you us. .1 Witness.
ttus box

 

It are acting as gun
Assistant, ?ma: 1 I-e-w: bums

Witness? Relationship to 
?(tfft?l Instruunmw .m bank tn! tildll?k-HHIIU

- TX-SOS-19-1113-E-000095 



 

 

vw 

Texas Secretary of State PO Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 
ELECTION COMPLAINT TO THE TEXAS SECRETARY OF STATE

Docket Number OFFICE USE Date Hand-delivered or Date Postmarked
ONLY 04 14 2017

Please read the Important Information at the end of this document. The Secretary of State has no authority to

order a new election. change an election result. or conduct a criminal investigation. A complaint filed with this
form will not alter the results of an election.

 

 

 

 

 

This complaint form MUST BE SIGNED before it is submitted to the Secretary of State; therefore, you must print
it out and sign it before mailing or faxing a copy or emailing a scanned, signed copy.

I. IDENTITY OF COMPLAINANT

 

 

 

1 COMPLAINANT "33? 
VIC 


 

2 COMPLAINANT ADDRESS wimp; ?we Li v.25: STATE ZIPCODE

PHYSICAL
TX -

(Full home or business address. Including street. :Ity, state. and zip code)
3 COM PLAINANT ADDRESS as? 5|;an a i? amizaeLE 71 9mm gm;
MAILING
ADDRESS

0' same 38 

(Full home or busm_ess add_. ess l?ncluding street any. Sta?ta. _ano zi_p_ cooe?)

?4 ?305 PHONE NUMBZ we 5; 5 

. 

NUMBER ADDRESS

 

ll. IDENTITY OF RESPONDENT

PERSON 05: 5mm cowurrmo ALLEGED matron-?5)

 

 

 

 

6 RESPONDENT 
NAME
SUFFIX
7 RESPONDENT
POSHWON OR 
TITLE
8 RESPONDENT meme; an: . Cam: ZIPCODE

(Full home or business address. Including street City. state. and up code)

 

 

 

 

9 RESPONDENT it) i-l? Sty": g. AWL ?Jab-J: 
MAILING
ADDRESS
[check it same as abovel
.7 7 home or busaness addressincvlu?tg street. code: i
10 RESPONDENT APE-10305 P--CNE NLMBEF an 11 RESPONDENT
Tr=i FPHONF 
NUMBER ADDRESS
HF KNOWN:

 

 

 

GO TO PAGE 2

A Ann

 

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Re Isa-.1212? 

A An
THIS COMPLAINT is puauc RECORD ONCE IS COMPLETED av THE SECRETARY OF 

Texas Secretary of State PO Box 12060 Austin. Texas 78711-2060 1-800-252-VOTE (8683) 

 

NATURE OF ALLEGED VIOLATION P3992

If you believe that a criminal violation of the Code has occurred. please state the speci?c acts committed by the person or
entity named in this com plaint. along with a reference to the section of the Code alleged to have been violated, if known. If
you need more space. please attach a separate sheet.

Unlawful Witness per Sec. 64.005 of the Lode as well as l?orgery and lampering With a Uovemm
ent Record under Sec. 32.21 of the Penal Code.

Sec. 84.003. SIGNING APPLICATION BY ASSISTING APPLICANT. An early voting ballot
application signed for the applicant by a witness other than the early voting clerk or a deputy must indicate the
witness?s relationship to the applicant or. if unrelated. indicate that fact.

A person who acts as a witness for an applicant for an early voting ballot application commits an offense if
the person knowingly fails to comply with Section 1.011. A person who in the presence of the applicant
otherwise assists an applicant in completing an early voting ballot application commits an offense if the person
knowingly fails to comply with Section 1.011(d) in the same manner as a witness.

An offense under this section is a Class A misdemeanor.

Sec. 32.21. FORGERY. For purposes of this section:

(1) "Forge" means:

(A) to alter. make. complete. execute. or authenticate any writing so that it purports:

to be the act of another who did not authorize that act;

(ii) to have been executed at a time or place or in a numbered sequence other than was in fact the case; or
to be a copy of an original when no such original existed:

(B) to issue. transfer. register the transfer of. pass. publish. or otherwise utter a writing that is forged within the
meaning of Paragraph or

(C) to possess a writing that is forged within the meaning of Paragraph (A) with intent to utter it in a manner
specified in Paragraph (B).

(2) "Writing" includes:

(A) printing or any other method of recording information;

(B) money. coins. tokens, stamps. seals. credit cards, badges. and trademarks: and

(C) symbols of value, right, privilege. or identification.

A person commits an oftense if he forges a writing with intent to defraud or harm another.

(0) Except as provided by Subsections and an offense under this section is a Class A
misdemeanor.

An offense under this section is a state jail felony if the writing is or purports to be a will. codicil. deed, deed
of trust, mortgage. security instrument, security agreement. credit card, check, authorization to debit an account
at a financial institution. or similar sight order for payment of money. contract. release. or other commercial
instrument.

An oftense under this section is a felony of the third degree if the writing is or purports to be:

(1) part of an issue of money, securities, postage or revenue stamps:

(2) a government record listed in Section 37.01 or

(3) other instruments issued by a state or national government or by a subdivision of either. or part of an issue
of stock, bonds. or other instruments representing interests in or claims against another person.

ATTACH ADDITIONAL PAGES AS NEEDED

 

 

THIS COMPLAINT IS puach RECORD once REVIEW IS COMPLETED BY THE SECRETARY or: 51? .
Rev.sed2I28/2014

 

Texas Secretary of State PO. Box 12060 Austin. Texas 78711?2060 1-800-252-VOTE (8683) statetxus

IV. STATEMENT OF FACTS P3993

State the facts constituting the alleged violation(s), including the dates on which or the period of time in which the alleged
violation(s) occurred. Identify allegations of fact not personally known to the complainant, but alleged on information and
belief. Please use simple. concise. and direct statements.

 

 

 

ELECTION IN WHICH OCCURRED

 

ZUI6 Elections DATE OF ELECTION V3TI0US
NAME OF ELECTION 
Dallas V?arlous
COUNTY OR POLITICAL SUBDIVISION PRECINCT

 

 

 

 

 

 

Attached are a few samples of ABBMs and Carrier Envelopes where?as clearly signed, or cause
someone else to sign. the ABBMs who is not the voter. The signatures on the ABBMs do not match those on th
Carrier Envelopes. The handwriting on the ABBMs all match the handwriting of?

Voters have called the Dallas County Elections Office and complained About receiving ballots that they did not
request. The ABBM of Alice Washington. shown in the attached WFAA story, has the handwriting of -

 

 

ATTACH ADDITIONAL PAGES AS NEEDED

 

 

TY one 10 111
NOTICE. COMPLAINT :5 PUBLIC RECORD ONCE REVIEW Is COMPLETED BY THE SECRETARY or STATE ATTORNEY GENERAL.

Rev se-32/281251-1

Texas Secretary of State Box 12060 Austin, Texas 78711-2060 1-800-252-VOTE (8683) wwsos state.tx.us

LISTING OF DOCUMENTS AND OTHER MATERIALS Page4

List all documents and other materials ?led with this complaint. Additionally. list all other documents and other materials
that are relevantto this complaint and that are within your knowledge. including their location. if known

 

 

Attached are the following:

1.Applications for Ballot By Mail (ABBMs) and their corresponding Carrier Envelopes that
violate the Election Code.

2.An article from WFAA News with a link to a news story that aired on Monday. April 10th,
concerning this same canvasser. evidenced by the application shown during the
news broadcast.

3.A screensho
handwriting of

Washington, shown during the broadcast, with the

  

See Exhibit A

 

 



ATTACHADDITIONAL PAGES AS NEEDED

 

 

TV An 
NOTICE THIS COMPLAINT IS PUBLIC RECORD once is COMDLETED av THE secesnnv or: 

Revisec 

 

 

 

 

 

 

 

'c-Vs Scc?c?aa 7? v.33?wax-450$ state 
I VI. SIGNED STATEMENT pages

i

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I
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NOTICE: THIS COMPLAINT IS NOT ONCE REVIEWED BY
THE SECRETARY OF STATE, IT WILL BE TREATED AS A PUBLIC RECORD.


 

. REMINDER: YOU MUST SIGN THIS FORM PRIOR TO SUBMITTING

IF MAILING PLEASE SEND TO

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IF EMAILING PLEASE SEND TO

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?Humvee". u: out- . own-M. mm new am" pm ram: II space MW tins envelope be 308560 cy L00 your colon: it runs: an: harm: um Sty-r 'll!
envelope unless the ballot has been marked by you or at your duoct'ron We came: envelope may not be raged to return more than one voter's ballot However. more than one
tamer envelope may be placed together In another envelope ll the additional carrier envelopes) belong to a person registered to vote at the same address. This carrier envelope must be
returned by mail. by :ommon or contract mar. or in person by the voter on election day at the early votng dent's ot'tce. oi Vonnte: Selle ette sabre. dnpu?s time
an mm on a! ?panic proportlonadc abajo Es?e ?bra debo do oer sellado put at vii-ante am. do qua oi votanto lo ontrogue. No hrme cote ochre a menos de Que la boleta neya
ado llenada por ustod. a beta so direccion. Eote satire oflclal no debo ser udlgdo pare entronar la boleta de mas de up; polo votgnt_e. embargo. mas de un solo sabre ofrcral
puedo oer colocado centre de otro eobre at at sob'etsl o?cial adlciond :o pertm a un votantn para voter hero la misma direocron Esta score c?ctd debo sor enviado pot
zmo. permeate de un publrco corners-pl. oer entregado en persona pm at votante el de de la eleccidn en lo del aocretano de votecio't tempranal

gently that the enclosed hello! expresses my wishes independent 0' any dictation or undue erauaalon an person. (Certifico que la boleta adjunta exprasa rm: dams


  
   

SEAL ENVELOPE AND SIGN OVER SEALED FLAP 

(SELLE EL SOBRE FIRME DE SOLAPA DEL SOBRE) SIGNATURE OR MARK OF VOTER MARCA DEL VOTANTEL

 

 

 

 

Instructions to Assistant: A voter may on'y be reading or marking the ballot rt they have a physical disability that renders thorn unable to write or see. or
have an inability to read the language in which the ballot IS written. It you are asSisting the voter. you must read the oath and complete the section below, betore
assisting the voter (lnetrucclones al Asletente' Un votanto puede ayuda para leer llenar !a boleta solamento si el votanlo tiene una dis:apacidad tisica
to coal to oscriblr ver. si no liens la habilidad do leer el lenguaje en al cuaI la boleta esta Si usted Io proporcronara ayuda a un votante,
ustcd debo leer ol Juramento llenar la siguionte socmon abajo. antes do asistir al votante.)

Oath 0! Person Assisting Voter: I swear (or attirm) that I Will not Suggest. by we'd. srgn,or gesture. how the voter should vote: I will conlrne my aSSistance to answering
the voter's questions. to stating propositions on the ballot, and to naming candidates and. it listed. their political parties; i will prepare the voters ballot as the voter directs;
and I am not the voter's employer. an agent of the voter's employer. or an oft-cor or agent of a labor union to which the voter belongs. (Juramento de la Persona
Aetetiendo ol Votante: Juro (o alirmo) qua no Sugarire con palabras. senales, gestos. la manera en la coal at votante debo votar; Iimitaro mi asistoncia a responder
Ias preguntas del votanto. leer propuestas en la boieta. nombrar a los candrdatos. si es moncionado. su partido polltico: preparar? Ia boleta del votanlo do acuordo a
sus instrucoionos; yo no soy ol emploador del votante un agents del empleador del volanto. 0 un otcial agento do un srndicalo at cual el votante pertonoce.)

 

 

 

Instructions to thneeo: You are serving as a wtnoss lor (name 0! voter) You must complete the section below it you
witness the mark of the voter, or ll the voter cannot make a mark. It the voter cannot makes mark. check here . (lnotmcciones al Testioo; Usled osta lungiondo
oomo tostioo para (hombre del votante) Used debo llenar la siguiente soccidn abajo 5i ustod tue tosliqo do oI votanto

trrmo. 0 do quo el votanto no puede iirmar. 5| 6| votante no puede ?rmer. marque sus intcialos aqul



Instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier. It you are assisting a voter by depositing the carrier envelope in the
mail or with a common or contract carrier. you must complete the section below. a la Pomona Oulen Deposlte el Sobro Ollcial en ol Correo Entregue
al Publico Comorclal: Si uolod aoistira al votanto a dopositar el sobro cheat en el corroo 0 con un transportista publico comorcral. usted debo llenar
la socddn quo aparoco abajo)

It you are an assistant or witness. check the appropriate box below and provide information (Si usted es un asistente testigo. marque Ia casulla correcta proporcione
su lnlormaci?n):
Mutant:

Nit'toss? Srmmuro (Puma) Printed Name (Hombre impreso) Street Address iDornicrlio rosrdoncral)
Tooled
[3 mm?
A: slonte

WNW signature (Firm) Printed Name {Non-?bro lmpreso) Street Address (Domcilio residencral)
Testiqo

 

 

Completed by Early Voting Cleric Name of Election (Non-we do Elecclonl:

 

Name at Voter lNombre del votantel    

m?mflm' I I l' 

?Hui.? In I.. 0|

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I. . II . "llIn? Vuu .I'?'If' I I. I. II-I .Lla \?Iml .l .l.I20ml .IJ .I 
I . . . Ib' :I'llIn:

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'Il?l t. -nIl 1.id!" 1? l? II II ~IiI-IHuhh- . Int/1'4 II.II- um I in)? I WIN) it." ma Ilul [4w mm II- I alulw .. II I Ad. I .-

 to Voter . Seal the envelope. and then sari your name in space below. This emclooe r?rust be sealed by the voter before it leaves the voter?s hands. Do not sign the
envelope unless the ballot has been manned by you or at your dmction. This comer envelope may not be to roam more one voter?s ballot. However. more than one
cantor 80W may a. placed together in another envelope it the additional comer onvolopots) belong to a person registered to vote at the some ?Toms. TM comer envelope must be
ruined by the". by mm 0' contact comer. or in person by the voter on election day It the early voting my on?, mm cl Votante: we m. "m
su hombre on at more proporoionedo chap. Esta sabre debs do not swede por ol votante antes de que el votante lo entrogue. No firms sale 50er a menos de que la hoists haya
aldo honed. por noted. 0 Mo on diroccron. Est. oobro of?cial no dob. cor pare ?mutual?. do "'60 do un solo votante. Sin embargo. mu do un solo sabre oticial
oucdesorcolocadodentvo deotro sobresa ol sobrets) oft-at adtcionalle Waco sun Est. sooreoncaldeboseremudopor
some. por medlo do un publlco comercial. ser entregedo on persons por el votante el the no la eleccitSn en la oticina dot secretsne do votacrdn human)

I certify that the enclosed balot expresses my wishes independent of any dictation or Una?. persuasion by my person. I. bolcta adtunta 0W mu do
.

 
   

SEAL ENVELOPE AND SIGN OVER SEALED FLAP 
(SELLS EL SOBRE FIRME ENCIMA DE SOLAPA DEL 

 

 

 

SIGNATURE MARK VOTER (FIRMA 0 MARCA DEL VOTANTE)

 

 

 

Instructions to Assistant A voter may only be asSIsted with reading or marking the ballot it they have a physical disability that renders them unable to write or see, or
have an inability to read the language in which the ballot is written. it you are assisting the voter. you must read the oath and complete the section below. betore
assisting the voter. el Aslstente: Un votante puede recibir ayuda para leer llenar la boleta solamente si el votante tiene una discapacidad lisica
ta Cual le impide escriblr 0 ver. si no tiene la habilidad de leer el lenguate en el cual Ia boleta esta escrita. Si usted le proporcionara ayuda a un votante,
usted debe leer el juramento llenar la slgulente secctOn abate. antes de at votante.)

Oath of Person Assisting Voter I swear (or affirm) that I will not suggest. by word. Slgn. or gesture. how the voter should vote: I will con?ne my assistance to answering
the voter?s questions. to stating propositions on the ballot and to naming candidates and. it listed. their political parties; I will prepare the voters ballot as the voter directs
and I am not the voter's employer. an agent at the voters employer. or an ol?cer or agent ol a labor union to which the voter belongs. (Jtnmento de la Persona
al Votante: Juro (o afirmo) que no sugerire con palabras, senales. gestos. la manera en la cual el votante debe voter: mi asislencia a responder
las preguntas dol votante. leer propuestas en la boleta. hombrar a Ios candidatos. si es menctonado. su partido politioo; preparer? la boleta del votante de acuerdo a
sus yo no soy el empleador del votante. uh agenle del empleador del votante. 0 un otcial agente de un sindicato al coal at votante pertenooe.)

Witness: You are serving as a witness for (name ol voter) You must complete the section below it you
wrtness the mark of the voter. or it the voter cannot make a mark. It the voter cannot make a mark. check here (instrucclonos at Teetlgo; Usted esta lungiendo

como lestigo para (hombre del votante) Usted debe llenar la sigunente seccion abajo si usted tue testlgo de que el votante
?rrno, 0 de que el votante no puede firmer. St el votante no puede firmer. marque sus iniclales aqui 

Instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier: It you are assisting a voter by depositing the earner envelooe in the
mail or With a common or contract carrier. you must complete the section below. a la Persons Qulen Deposits cl Sobre O?cial en el Como Entrogue

al Pt'tblico Comorclal: Si usted al votante a depositar el sabre o?cral en el correoo con un transportista comercial. usted debe Itenar
la seoclon que aparece abate.)

 

 

 

It you are an assistant or witness. check the appropriate box below and promo inlermation: (Si usted es un asistente lestigo. marque ta casilla correcta proporcione
5u intorrnaclon):

Antietam
Perm

Witness' Signature (Firms) Name (Nontbre Impreso) Street Address (Domenic 
range

 

Aulstent/
Asrsterm

Nurse 3.9mm (Fume) Pnnteo Name (Nomb'e impreso) Street Address (Domrcilio residence!)
Testlgo

Completed by Eary Voting Clerlc Nam ol Election (Hombre do 



OVERSIG HT 

 

 

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Um: to Voter Seal tnio 8"?9?096, and then sign your Home is space below. The envelope must be cooled by tho voter More it havoc tho voter's hands. Do not sign 
onveiopo union the bollot has been marked by you or at your direction. Mr envelop. may not be used to return more than veg} ballot. However. more than one
came: envelope may be placed together in another onvelopo it the additional corner onvotopet?o) belong to person mgiotored to veto at the who ?dross This came: envelope must :2
Mumod by MI, by common or contract corner. or in by mo voter on election doy ot tho oarty timing clerk?s of?ce. anouucdmoo oi Votonto: Sollo eve sabre. doopueo time
an hombre on ol macro proporcionado abate. Esta oobre dob. do sor sellado por el votante antoo do que el votante lo entrogue. No time ooto some a mono: de que la boleto haya
ode llonodo pot uotod. 0 03:0 ou dimoron. Eoto sabre oticiol no dobo oor utilizodo meanest lo boloto do moo do an votante. Sin embargo. mas de un solo sabre o'ictat
puede oer calocodo dontro do our: oobro ct ol eobroio) o?oiol odioonol lo portonoco a un votante reg-strode pom voter bajo lo ntiomo direccidn. Esta sobro o?cal done sor onvtodo per
entree. por media do an transponlsta puolico comerc-ol. 0 set ontregodo on persona per ol votante el do de la en lao?clno dot oocrotono do votoclon tomprana.)

cortity that the ballot eup'ooaes my wishes independent oi any dictation or undue by any person. (Cortr?co quo la boiota odiunta espreso mi: degeo?


 
   

SEAL ENVELOPE AND OVER SEALED FLAP

ELSOBRE FIRMS ENCIMA DE SOLAPA DEL SOBRE)

SIGNATURE OR MARK 0F VOTER (FIRMA MARCA DEL VOTANTE)

 

 

 

 

Instructions to Assistant: A voter may only be assisted with reading or marking the ballot it they have a physical disability that renders them unable to wnte or see. or
have an inability to read the 'anguage in which the ballot is written. it you are assisting the voter. you must read the oath and complete the section below. before
assisting the voter. ilnotrucclonoo ol Aoiotonto Un votante puede reCibir ayuda para leer Ilenar Ia holeta soiamente si el votante trene una discapactdad fisica
la cual leimpide escribir 0 ver. si no tiene la habilidad de leer el lenguaie en el cual la boleta esta Si usted le proporCtonara ayuda a un votante.
us:ed debe leer el iuramento Ilenar la siguiente seccidn abajo. antes de a5istir al votante 

Oath at Pomn Assisting Voter; I swear (or a?tirm) that i wil not suggest. by word. Sign. or gesture. how the voter should vote: I Will confine my ass:stence to answering
the voter's questions. to stating propositions on the ballot, and to naming candidates and. it listed. their polibcal parties; I will prepare the voters ballot as the voter directs,
and I am not the voter's employer. an agent at the voter?s employer. or an o?rcer or agent ot a labor union to which the voter belongs (Juremonto do to Poroona
Aslotiondo at Votanto: Juro (o atirmo) que no sugenre con palabras senales. gestos la manera en la cual el votante debe votar; Iimitare mi asistencia a responder
las preguntas del votante. leer propuestas en la ooleta. nomprar a los candidates. st es menoonado. su partldo poittrco; preparare la boleta del votante de aCuerdo a
sus yo no soy el empieado: del votante. un agente del empleador del votante. 0 un oficial agente de un sindicato cl cual el votante pertenece.)

Instructions ?0 m3 YOU 3'9 serving 35 a Witness (name ol voter) You must complete the section below it you
wttness the mark of the voter. or it the voter cannot make a mark. it the voter cannot make a mark. check here .ilnotruccionos ol Testigo: Usled esta iungiendo

00010 para (hombre dei votante). Usted aebe ltenar Ia siguiente secciOn abeio si usted rue tesrigo rle Que ei votante
?rmo. 0 de que oi votante no puede firmer Si el votante no puede firmer. marque sus inictales aqur .)

Instructions to Person Depositing Cantor Envelope In Mail or to Common or Contract Carrier: it you are assisting a voter by deposrting the carrier enveiope in mg
mail or with a common or contract carrier. you must complete the section below. la Persona Ouien Deposito ol Sabre Oficiol en el Correo Entregue
al Transportiota Publico Comordol: Si usted asistir? at votante a depositar el sobre o'tcial en el correo 0 con un transportista pubiico cornercial. usted debe llenar
ta secci?n que aparece abate.)

 

 

It you are an assustant or Witness check the appropriate box below and prowde (Si usted es un esrstente testigo. marque la casrlla correcta proporciona
su informecion):


Auto-no
[3 Witness Sgnature (Fume) Printed Name rh?ombre impreso) Street Address iDomicrIio residencial)
73590
Asasranr.?
Wo

ng Signature (Fame) Printed Name (hombre lmprosol Street Address ~Dorhicilio residencal)
?iesttgo

 

 

Competed Dy Earty Voting Clerk: Name at Election (Hombre do Elocd?n):

OV R8 HT 

 



 

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moon: to vow seat mic emcee. and men sign your ?m -n space new. we emcee. mun be sealed by the voter betoro It team the voters none: 00 not sign ms
.nyoiq). unless the ballot has been marked by you or at your direction This carrier M22 221 not be god to one voter! bum However. more than one
carrier envelope may be placed together tn another envelope ri the additional carrier envelopefs) belong to a person registered to vote at the same address corner envelope mint be
mm by melt. by common or contract comer. or in person by the voter on election day at tho early voting clerk's om. tlnotmcolonoo oi Votenlo: Selle este some. desmes fume
cu hombre on at oopacio propactonodo abajo. Esta some debe do eat undo por oi votante antes do one el votante to outrague. No ?irme este some a mono: do cue to balm hoyo
alco toned: oor noted. 0 bole to direction. Eat. sabre otlclal no debe oer outgdo gore can! lo bolota do trio do un solo votante. Sin embargo. this do un solo sobre otrciat
puede colocodo dontro do otro more 9 el Mamet-l adtclonal lo penemco a un votante root-trade para vow bole to mism- olreoclm Est. sobr- o?ctal debe sor envlodo por
correo. porrnedlo do on tron-pom :30me comlel. oer unmade on persona not at votante eldlo do in doociOn on laofrcino dot socretnrio do votacidn tomorana)

certify that the enclosed ballot expresses my wishes Independent of any dictation or undue persuasion by any person. (Cortt?co que la boleta adiunta express mis cums


 
   

SEAL ENVELOPE AND SIGN OVER SEALED FLAP .
(SELLE EL SOBRE FIRME ENCIMA DE SOLAPA DEL SOBRE)

 

 

SIGNATURE MARK VOTER [Fl MA 0 MARCA DEL VOTANTE)

 

 

instructions to Assistant A voter may only be assisted reading or marking the ballot it they have a physical disability that renders them unable to write or see. or
have an inability to read tre language in which :he ballot ts written. It you are assisting the voter. you must read the oath and complete the section below. betore
assisting the voter oi Aeiotonte: votante puede recibrr ayuda para leer llenar le boleta solarnente 8| el votante tiene una dlScapactdad iislca
la cual te tmpide ver. si no tiene la do leer el lenguaie en el cual ta boleta este Si usted le ayuda a un votante.
usted debe leer el juramento 'Ienar ta srgurente seccton abajo. antes de asistrr al votante.)

Oath of Person Assisting Voter: I swear lor aittrm) that not Suggest by word, sign, or gesture. how the voter should vote: I Will coniine my to answering
the voter?s questions. to stating propositions on the baifct. and to naming candidates and. it listed. their political parties; i will prepare the voters ballot as the voter directs;
and I am not the voter's employer. an agent ot the voter's employer. or an otfrosr or agent oi a labor union to which the voter belongs. (Juremento do to Persona
Asistiendo at Votante: Juro (o aiirmo) que no sugertr? con palabras. sehales. gestos. la manera en la cual ei votante debe votar: ltmitare mt aSIStencia a responder
las preguntas del votante. leer propuestas en la boleta. nombrar a los candidates. si es mencionado. su parttdo politrco; preparare la boleta del votante de acuerdo a
sus mstrucciones; yo no soy el empleador del votante. un agente del ernpleador del votante. 0 un otcral agente de un srndicato el cual ol votante perteneoe.)

Instructions to Witness; You are serving as a witness for (name at voter) You must complete the section below it you
witness the mark 01 the voter. or It the voter cannot make a mark. It the voter cannot make a mark. check here . at Testigo: Usted esta lungtendo
como teetlgo pare {hombre del votante). Usted debe llenet la siguiente seccron abajo si usted testtgo do que el votante
?rmo. 0 de que el votante no puede ?rmer St at votante no puede ftrmar, marque sue inicrales aqur 

 

Instructions to Person Depositing Carrier Envelope In Mail or to Common or Contract Carrier: it you are assisting a voter by depositing the carrier envelope in the
marl or With a common or contract carrier, you mus! complete the section below la Persona Oulen Deposit. el Sabre Oticiol en el Como Entrogue
at Transportisto Notice 0 Comercial: St usted asistira at votante a el sobre olicial en el correo 0 con un transportista ptiblico comercial. usted debe llenar
ta seocien que aparece abate.)

it you are an assistant or witness. check the box below and information. (SI usled es un asrstente lestigo. marque la casilla correcta proporcione
su 

Asetstant'

Asutente

mm. Signature (Ftrma) Pinnted Name (Nombre Wrasse) Street Address restderml)
T0900

 

Assistant

menu

witness Signature Pmted Name (Nombre impreso) Street Address (Domtc?lo residenCtal)
Tostrgo

Completed by an Voting Clerk. Norm oi Election (Nombro do 

 

 

Home of Voter (Hombre rial mtmtot 

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Instructlons to Voter Seal envelope. and then your name in spam below. This envelooe must be sealed by the .-:ter bo?ore it leaves the voter's hands Do not sq: up,
envelope unless the ballot has been marked by you or at your drrectton. This ulnar envelope my not be used to return more than one voter's ballet. However. more than me
My .nvolope may be plmed together In another envelope rt the eddmonal corner envelopots) belong to person registered to vote at the some odd'os: This corner envelope must no
returned by mat, by common or mt cantor. or in Mon by the voter on election day at the early vcting clerk?s of?ce. (tmtrucctones al Votanle sets.) use some. W3 hnne
su nombrs en el espacm proporclonsoo soap. Esta sobre dobe do our sellado por el votante 81le de que el votarlte Io entregue. No lrrme uste scare at menos 0e gas In bolets hays
"so (Ian-d. por usted, bqo su dweccim Est. sobns o?erol no dobe ser pore savior ls bolota 6- mos do un solo votsnte. Sun mbargo. me: de un solo sob". ohcial
etude set clentro do otno sabre st cl sebum Otto-cl mortal le ports-noes a tin votantn pars voter bare to :lrreocron. Este some Shela! Jeoe ser moo pot
correo. our media de un pt?ibllco cornmeal. sor entregado en persona por el vctante et do :le ls eleccion en la ohcrne del secretano oe votecron temp'anal

I certify that the enclosed ballot expresses my wishes rndependen? ol any dictation or undue persuasion a rson, Cemluco no la boteta a 'unta ext-rose down


  

 

SEAL ENVELOPE AKD SIGN OVER SEALED FLAP I 
(SELLE EL SOBRE FIRME ENCIMA DE SOLAPA DEL SOBRE) 0R MARK OF (FIRMA 0 MARCA DEL VOTANTE)

 

 

 

to Assistant: A voter may only be with reading or marking the ballot if they have a disability that renders them unable to write or see, or
have an to read the language In which the ballot is written It you are the voter. you must read the oath and complete the sectron below. belore
assisting the voter. sl Aslstente. Un votanle puede reciblr ayuca para leer Ilenar la boteta so'arnente St at votante trene una d.s:apaCrdac lisrca
la cual le impide escribir 0 ver. si no tiane la habilidad de leer el lenguare en el cual la boleta esta Sr usted le a un votante.
usted debe leer et turamento Ilenar la srgurente secmort abaio. antes oe at votante 

Olth of Person Assisting Voter.l swear tor affirm) that I not suggest. by word. sign. or gesture. how the voter should vote: conlrne my assistance to answerrng
the voter's questions. to stating proposrtlons on the ballot. and to naming candidates and rt listed. their political parties. I prepare the voter's ballot as the voter directs,
and I am not the voter's employer. an agent at the voters employer. or an ottrcer or agent at a labor u'llOl'l to which the voter belongs. (Juramento de la Persona
Asletlondo al Votanto: Juro (o afirmo) que no sugerire con palabras. senales gestos. la menera en la coal at votante debe voter; Imitare mi asrstencra a responder
las preguntas del votante. leer propuestae en la boleta. nombrar a los candldatos. st es mencr'onado. St. partrdo polrtico preparara la bo'eta del votar-le de acuerdo a
sue instrucciones yo no soy el empleador del votante. Ln agente del empieador eel votante. 0 un ofrcral agente de un srndicato at Cual el vntante penenece 

Instructions to Witness: You are sen/mg as a witness lor name ol voter) You must complete the section below rt you
wltness the mark at the voter. or If the voter cannot make a mark. It the voter cannot make a mark. check here . at Testlgo; Usteo esta lungiendo
como testigo para (nombre dot votante). Usted debe llenar la siguiente seccrOn abap sr usted lue testigo rte Que el totante
tirmo. 0 de que el votante no puede tlrmar. St at votante no puede ?rmer. marque sus iniciales aqui 

 

Instructions to Person Oepoelting Center Envelope in Mail or to Common or Contract Carrier: It yOu are assisting a voter by deposning the game enveIOpe in the
mail or a common or contract earner. you must complete the section below. rlnetrucclones a la Persona Oulen Deposite el Sobre O?cial en el Correo Entregue
al Publlco Comerolel: Si usted aslstira? al votante a depositar et sobre o?cial an at correo 0 con un publico cornercial. usted debe llener
la secclon qua apareoe abate.)

If y0u are an assistant or wrtness. check the appropnate box below and provide l?fOlmallOHC (Si usted es un aSrstente testtgo. marque la casilla corrects pmporoone
su inlormacrOn):

MMWU

Meme

wine?! Slgnature (Ft'mat Pnnlod Name (Nombro Impreso) Street Address (Domrcmo resroerrcrall
7??th

Assrsu'rt?
Ammo

wow Srgnature (Fitmar Pnnted Name (Nombre mpresor Street Address resrdenoall
Tesltqo

Completed by Early Voting Clerk: Nuns ol Election (Nombre de Elecolom:

 

 

 

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 unless we cannot nes oesn me: by yea or at your direction this corner envel not be used to turn more one voter's ballot. However. more one
carrier envelope may be pieced together in another envelope it the additional carrier onveiopels) belong to a person registered to vote at the same address. This corner envelope must be
returned by mail. by common or contract carrier. or in person by the voter on election day at the early voting clerk's of?ce. tlrutrucciones et Votante: Selle este sabre. despuee time

Iido llenadn por noted. 0 bejo so dirscoien. Sue eebne oficiol no deb. eer utilixodo para mi. bolus de mes do un solo votante. Sm embargo. mas do un solo soors olicial
puede ser colocado dentro de otro sabre at at sebum adic?lonel le penenece a un votante registrodo pare vo?ar beta is misine direccion. Esto sabre olicial debe set enviado por
com. por memo do on pumice comerciat. 0 set entropedo en persona por el volmte eldh da la eleccion en in client! net secretano do votacion 

I certify that the enclosed ballot emmees my wishes Menondent of any dictation or undue persuasion by any person (Certi?ed que la boleta adjunta express this dosoos
WamWMMomumiMapaMedeWm)

 

 

SEAL ENVELOPE AND SIGN OVER SEALED FLAP 
(SELLS El SOBRE FIRMS ENCIMA DE SOLAPA DEL SOBRE) SIGNATURE OR MARK OF VOTER (FIRMA MARCA DEI. VOTANTE)

Instructions to Assistant A voter may only be with reading or marking the ballot it they have a physical disability that renders them unable to write or see. or
have an inability to read the language in which the ballot is written it you are assisting the voter. you must read the oath and complete the section below. before
assisting the voter. (Instrucclonea al Asistente. Un votante puede recibir ayuda para leer llenar la boleta solamente si el votante tiene una drscapacrdad hsica
Ia coal to implae escriblr 0 ver. 0 Si no tiene la habllided de leer el lenguaie en el coal to boleta esta Si usted le proporCionara ayuda a un votante.
usted debe leer el iuremento llenar ta siguienle secmon abajo. antes de aslstir at votante 

 

 

 

 

Oath ot Person Assisting Voter: I swear (or alhrm) that not suggest. by word. sign. or gesture. how the voter ShOuId vote; i will contine my to ane/vering
the voter's questions. to stating propositions on the ballot and to naming candidates and. ll listed. their political parties; I prepare the voter?s ballot as the voter directs;
and i am not the voter?s employer. an agent at the voter's employer. or an officer or agent of a labor union to which the voter belongs. (Jurarnento do to Persona
Aetstlendo at Votante: Juro (o a?rmo) que no sugerir? con palabras. senales, gestos. la manera en la cual el votante debe votar. timitare mi asustencra a responder
res preguntas del votante. leer propuestas en la boleta. nombrar a los candidates. si es mencionado. su partido potitico. preparare' Ia boleta del votarte de acuerdo a
sus instruociones; yo no soy el empleador del votante. un agente del empleador del votante. 0 un olicial 0 agents de un sindlcalo al coal at votante pertanece)

 

Instructions to Wltnees: YOU are serving as a witness tor inarne ot voter) Y0u must complete the section below it you
witness the mark at the voter. or it the voter cannot make a mark. It the voter cannot makes mark. check here . el Testigo: Usted esta lunglendo

come testigo para (hombre del votante). Usted debe llenar la srguiente seccion aba;o sr usted tue lestigo de que el votante
?rmo. 0 de que el votante no puede ?rmer. Si el votante no puede firmer. marque sus iniciales aqui 

Instructions to Person Depositing Carrier Envelope in Mail or to Common or Contract Carrier: it you are assisting a voter by depositing the carrier envelope in the
mailer with a common or contract carrier. you must complete the section below. a la Persona Qulen Deposits el Sabre Otlcial on at Corr-e0 Entregue
at Publlco Comorclal: Si usted asistira al votante a o'epositar el sobre ofrcial en el correo 0 con un publico comercral, tsted debe llenar
la secclon que aperece abajo.)

 

 

It you are an assustant or Witness. check the appropriate box below and prowde inlormalion. (Si usted es un asrslente tastigo. marque la casrlla correcta proporcrone
su informacidn).

 

 

Aim

[31?me Signature (Firmal Name (Nombre impresoi Street Address iDornicnio residenc-al)
Assistant/



Em Swami-1m) Printed Name (Nombre mpresoi Street Address iDornlcilio residence"
Yestigov

Convicted by Early Voting Clerk: Home ?Election (Hombre de Eleccidn):
Name of Voter (Hombre del votante):

 

Date 0! Election (Fecha de Eleccion): I 

OVE R8 HT 

 

Resdents claim Signatures on some Dallas Co. mail-in be lots were forged WFAA corn 4/13/17, 4:24 PM

Residents claim signatures on some Dallas Co. mail-in I
were forged

Demand Fernanda. AU. DTApri; H. 30/ 

DALLAS Early voting for the May 6 elections begins April 24
in Dallas County. However. before a ballot IS even cast. there
are some new concerns about possible fraud.

Across West Dallas. lawn signs show neighbors are preparing
for District Six elections.

 

(Photo WFAA, WFAA)

Family members at Alice Washington's house say a mail-in
ballot recently arrived. There is just one major problem.

don't vote by mall.?

Washington and her niece. Barbara Roberson. say the 81-year-old never requested a mail-in
ballot from Dallas County Elections Roberson called the elections office to investigate.

go to the poll and vote." Washington 53 .

   

said. ?Would you please send me a copy of that application. because Id like to see her
signature?? Roberson explained.

The famil sa 5 the elections workers sent copies of the mail-in application.

"Thet'e not my elsneture.?

The famil cl

 

ashington said as she looked at the application

 
     

in Washington never saw nor executed the documents.

    
 

"Someone forced her signature.? 'oberson explained

The family says their home isnt the only household that received mail-in ballots that were not
requested Other neighbors are also getting the forms

Dallas County Elections administrator Toni Pippins-Poole. said her of?ce has received about 36
similar complaints about questionable mail-in ballots. Poole says herteam is working with the
District Attorney's Of?ce to review the complaints. examine documents. and determrne how to
move forward

Roberson and Washington believe the issue may be wide-spread in West Dallas

The Dallas County Elections of?ce is taking the complaints seriously.

For now. Pippins-Poole is urging anyone who has received a mail-in ballot. and did not request

Page 1 of 2

TX-SOS-19-1 1 13-E-0001 13

Residents claim signatures on some Dallas Co. mail-in be lots were forged 4/13/17, 4:24 PM

One to report it to The Dallas County Elections Of?ce by calling 214-819-6359 between Monday- Friday You can also ?ll out 
W)

2017 WFAA-TV

JOIN THE CONVERSATION

To ?nd out more about f-accbook commenting please read the

 

Page 2 of 2

CV SIG 113-E-0001 14

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