Form 400 "Board of Elections Voting Machine Equipment, Supplies and/or Ballots Custody Form" - Ohio

What Is Form 400?

This is a legal form that was released by the Ohio Secretary of State - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2021;
  • The latest edition provided by the Ohio Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 400 by clicking the link below or browse more documents and templates provided by the Ohio Secretary of State.

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Download Form 400 "Board of Elections Voting Machine Equipment, Supplies and/or Ballots Custody Form" - Ohio

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Form No. 400 Prescribed by the Secretary of State (03-21)
Board of Elections Voting Machine Equipment,
Supplies and/or Ballots Custody Form
The purpose of this form is to track the custody and location of voting equipment, including electronic poll books,
supplies and/or ballots from the time the voting equipment, supplies and/or ballots leave the board of elections office
until returned to the board of elections offices. A signature is required whenever the equipment, supplies and/or ballots
change hands or location. By signing the Chain of Custody Log, the signer is certifying that he or she took custody of
the voting equipment, supplies and/or ballots or delivered it to a particular location. Whenever custody of the voting
equipment, supplies and/or ballots changes, the individual transferring custody or receiving custody must examine the
voting equipment, supplies and/or ballot packets to ensure that that equipment and supplies are intact and in sufficient
working order as can be determined by a visual inspection and that all seals or locks recorded below are intact and
match the number on the seal or lock.
County Name:
Description of Equipment, Supplies and/or Ballots
Voting Machine or Equipment Identifier, if any:
Serial Number:
Lock/Seal Number(s):
Other Supplies and/or Ballots (describe by type and number):
Container Lock/Seal Number(s):
Designated for Precinct Name/Number:
Description of condition of the Voting Equipment, Supplies and/or Ballots:
(The description must include the name of the voting equipment and whether a memory card or cartridge is already installed (e.g., AccuVote-TSX
with memory card installed or ES&S M100 without memory card installed)).
Chain of Custody Log
This Chain of Custody Log must be reproduced on a single paper, front and back to prevent separation of papers. This
Chain of Custody Log must be maintained by the board of elections and the voting location manager of a voting
precinct depending on voting equipment location. Whenever the voting equipment, supplies and/or ballots change
hands or location the person taking custody must sign the Chain of Custody Log. This Chain of Custody Log must be in
the possession of either the board of elections or the voting location manager of the voting precinct to which the subject
voting equipment, supplies and/or ballots has been assigned.
For example, before the equipment, supplies and/or ballots leave the board of elections office, the board of elections
employee transferring custody of the equipment, supplies and/or ballots to another individual must sign under the
“RECEIVED FROM or TAKEN CUSTODY FROM LOCATION” column. The person receiving custody must sign in the
presence of the board employee the “RECEIVED BY or DELIVERED TO LOCATION” column next to the board
employee’s signature. Whenever the voting equipment, supplies and/or ballots change custody again, the persons
transferring custody and receiving custody must sign under the appropriate columns. This will document the custody
and location of the voting equipment, supplies and/or ballots at all times while it is outside of the board of elections.
Form No. 400 Prescribed by the Secretary of State (03-21)
Board of Elections Voting Machine Equipment,
Supplies and/or Ballots Custody Form
The purpose of this form is to track the custody and location of voting equipment, including electronic poll books,
supplies and/or ballots from the time the voting equipment, supplies and/or ballots leave the board of elections office
until returned to the board of elections offices. A signature is required whenever the equipment, supplies and/or ballots
change hands or location. By signing the Chain of Custody Log, the signer is certifying that he or she took custody of
the voting equipment, supplies and/or ballots or delivered it to a particular location. Whenever custody of the voting
equipment, supplies and/or ballots changes, the individual transferring custody or receiving custody must examine the
voting equipment, supplies and/or ballot packets to ensure that that equipment and supplies are intact and in sufficient
working order as can be determined by a visual inspection and that all seals or locks recorded below are intact and
match the number on the seal or lock.
County Name:
Description of Equipment, Supplies and/or Ballots
Voting Machine or Equipment Identifier, if any:
Serial Number:
Lock/Seal Number(s):
Other Supplies and/or Ballots (describe by type and number):
Container Lock/Seal Number(s):
Designated for Precinct Name/Number:
Description of condition of the Voting Equipment, Supplies and/or Ballots:
(The description must include the name of the voting equipment and whether a memory card or cartridge is already installed (e.g., AccuVote-TSX
with memory card installed or ES&S M100 without memory card installed)).
Chain of Custody Log
This Chain of Custody Log must be reproduced on a single paper, front and back to prevent separation of papers. This
Chain of Custody Log must be maintained by the board of elections and the voting location manager of a voting
precinct depending on voting equipment location. Whenever the voting equipment, supplies and/or ballots change
hands or location the person taking custody must sign the Chain of Custody Log. This Chain of Custody Log must be in
the possession of either the board of elections or the voting location manager of the voting precinct to which the subject
voting equipment, supplies and/or ballots has been assigned.
For example, before the equipment, supplies and/or ballots leave the board of elections office, the board of elections
employee transferring custody of the equipment, supplies and/or ballots to another individual must sign under the
“RECEIVED FROM or TAKEN CUSTODY FROM LOCATION” column. The person receiving custody must sign in the
presence of the board employee the “RECEIVED BY or DELIVERED TO LOCATION” column next to the board
employee’s signature. Whenever the voting equipment, supplies and/or ballots change custody again, the persons
transferring custody and receiving custody must sign under the appropriate columns. This will document the custody
and location of the voting equipment, supplies and/or ballots at all times while it is outside of the board of elections.
If equipment, ballots and/or supplies are being delivered to a location without human supervision (e.g., a polling place
before an election), the deliverer must sign his or her name under the “RECEIVED FROM” column and enter “NONE”
and sign his or her name under the “RECEIVED BY” COLUMN. In all instances, the person who signs in the
“RECEIVED BY” column must complete the column, “DATE/TIME/PLACE” at the time of the transfer of the equipment
In the case where custody of the equipment, supplies and/or ballots is released to an unsupervised polling location
before Election Day and not to an individual, the voting location manager on Election Day must enter “NONE” sign and
under the “RECEIVED FROM” column when he or she arrives at the polling place location and is responsible for
custody of the voting equipment, supplies and/or ballots before the polls open on Election Day. In such case, this Chain
of Custody form for each voting machine, along with any corresponding supplies and/or ballots in the precinct must be
in the voting location manager’s supply bag.
WHENEVER VOTING EQUIPMENT, SUPPLIES AND/OR BALLOTS CHANGE HANDS OR LOCATION THIS FORM
MUST BE SIGNED. BY SIGNING THIS FORM, YOU ARE STATING THAT YOU HAVE EXAMINED THE
EQUIPMENT, SUPPLIES, SEAL NUMBERS, AND/OR BALLOT CONTAINERS TO ENSURE THAT ALL SEALS
ARE IN PLACE AND THAT THE EQUIPMENT, SUPPLIES AND/OR BALLOT PACKETS APPEAR TO BE INTACT
AND IN SUFFICIENT WORKING ORDER AS CAN BE DETERMINED BY A VISUAL INSPECTION. IF YOU FIND A
PROBLEM, PLEASE IMMEDIATELY NOTIFY THE BOARD OF ELECTIONS AND SEEK FURTHER INSTRUCTION.
RECEIVED FROM or TAKEN
RECEIVED BY or DELIVERED
DATE/TIME/PLACE:
CUSTODY FROM LOCATION:
TO LOCATION:
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