Provisional Ballot Cure Affidavit Instructions and Form

This affidavit is for a voter whose provisional ballot certificate does not include the voter's signature or whose signature does not match the voter's signature on file.


English (Form DS-DE 210)

EspaƱol (formulario DS-DE 210)


Please complete the affidavit and return it to:

Dana Southerland
Taylor County Supervisor of Elections
433 U S 19 N - Perry, FL 32347
P O Box 1060 - Perry, FL 32348
Phone: (850)838-3515
Fax: (850)838-3516