Form 400 "Uocava Affidavit & Cover Sheet" - Colorado

What Is Form 400?

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

Form Details:

  • Released on April 20, 2018;
  • The latest edition provided by the Colorado Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

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

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Download Form 400 "Uocava Affidavit & Cover Sheet" - Colorado

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UOCAVA Affidavit & Cover Sheet
Read, complete, and sign this form and return it with your ballot following all instructions below.
Contents of your online ballot delivery package
• Your Official Ballot.
• This Electronic Ballot Affidavit and Cover Sheet.
Instructions
• Mark and review your ballot following all voting instructions.
• Do not duplicate your ballot for any other elector.
• Click the Print button to print your ballot and this form, or click the Save button to save the files as a PDF document.
• If you are returning your ballot by mail, also print the return envelope template.
• Complete and sign this form. Fill out all fields marked with an asterisk (*).
• Follow the return instructions on the back side of this form.
Your identifying information
Last name*
First name*
Middle initial Your birthdate* (MM/DD/YYYY)
Your transmission information
Mail is the most secure method of transmitting your voted ballot. But, if you reasonably believe that your ballot will not be received in the Clerk & Recorder’s
office by the deadline, you can either request a replacement ballot by fax or email by contacting the Elections Office during regular business hours, or on
Election Day from 7:00 a.m. to 7:00 p.m. Mountain Time, or download a replacement ballot that you can return by fax or email from
https://GoVoteColorado.EveryoneCounts.com. Check the box next to the transmission method you are using to return your ballot and complete all required
fields marked with an asterisk (*) for that section to ensure your ballot is properly received and counted.
Mail
Fax
Provide the fax number that you are using to fax
For instructions on how to create an envelope and
your ballot to the USA*:
return your ballot by mail, please see the back of
this page.
International
International
Local Area/
Local
Prefix
Country Code
Province/
Number
City Code
If you are returning your voted ballot by fax, please
indicate the number of pages, including this form,
you are transmitting when you return your ballot:
Email
Returning by Email
Once you have finished voting your ballot, your voted ballot will be displayed on the screen.
1. Click the Download and Print My Ballot button to print your ballot, Affidavit and Coversheet, and instructions.
Or to Save and Sign without printing view:
Save A PDF
Sign a PDF If the signature is added electronically it must be a hand written signature (not a typed signature or certificate).
2. Complete and sign the Affidavit and Coversheet according to the instructions.
3. Scan your printed ballot and signed Affidavit and Coversheet into your computer.
4. Colorado now provides a new secure document transfer system to allow you to return your ballot electronically. Go to
https://
ballotreturn.sos.colorado.gov
and follow the instructions to securely upload your ballot for delivery to your county clerk and recorder.
Note: if you return your ballot electronically you do not need to fax or mail your ballot.
Confirm receipt of your ballot
You may contact your county clerk and recorder's office. Additionally, you may visit the Secretary of State's website at www.GoVoteColorado.com, look-up your
voter record, and check the "Mail ballot status" heading.
Read the following self-affirmation and sign or mark below
I swear or affirm, under penalty of perjury, that:
1. I am a member of the Uniformed Services or Merchant Marine on active duty, or an eligible spouse or dependent of such a member, or a U.S. citizen temporarily residing
outside the U.S., or Other U.S. citizen residing outside the U.S.; and
2. I am a U.S. citizen, at least 18 years of age (or will be by the date of the election), and I am eligible to vote in the requested jurisdiction; and
3. I am not incarcerated or on parole due to a felony conviction; and
4. I am not registering, requesting a ballot, or voting in any other jurisdiction in the U.S. except the jurisdiction cited in this voting form.
To vote, I have marked and sealed my ballot in private and have not allowed any person to observe the marking of the ballot, except for those authorized to assist voters under
state or federal law. I have not been influenced. The information on this form is true, accurate, and complete to the best of my knowledge. I understand that a material
misstatement of fact in completion of this document may constitute grounds for conviction of perjury.
My signature and date below indicate when I completed this document and I affirm that I mailed or transmitted this ballot by 7:00 p.m. MT on Election Day. I also understand
that by returning my voted ballot by electronic transmission, I am voluntarily waiving my right to a secret ballot and that Colorado law requires that I return this ballot by a more
secure method, such as mail, if available and feasible.
Signature or mark*
Date*
Form 400
Secretary of State Approved 04-20-18
Sections 1-8.3-108 and 1-8.3-110 , C.R.S.
UOCAVA Affidavit & Cover Sheet
Read, complete, and sign this form and return it with your ballot following all instructions below.
Contents of your online ballot delivery package
• Your Official Ballot.
• This Electronic Ballot Affidavit and Cover Sheet.
Instructions
• Mark and review your ballot following all voting instructions.
• Do not duplicate your ballot for any other elector.
• Click the Print button to print your ballot and this form, or click the Save button to save the files as a PDF document.
• If you are returning your ballot by mail, also print the return envelope template.
• Complete and sign this form. Fill out all fields marked with an asterisk (*).
• Follow the return instructions on the back side of this form.
Your identifying information
Last name*
First name*
Middle initial Your birthdate* (MM/DD/YYYY)
Your transmission information
Mail is the most secure method of transmitting your voted ballot. But, if you reasonably believe that your ballot will not be received in the Clerk & Recorder’s
office by the deadline, you can either request a replacement ballot by fax or email by contacting the Elections Office during regular business hours, or on
Election Day from 7:00 a.m. to 7:00 p.m. Mountain Time, or download a replacement ballot that you can return by fax or email from
https://GoVoteColorado.EveryoneCounts.com. Check the box next to the transmission method you are using to return your ballot and complete all required
fields marked with an asterisk (*) for that section to ensure your ballot is properly received and counted.
Mail
Fax
Provide the fax number that you are using to fax
For instructions on how to create an envelope and
your ballot to the USA*:
return your ballot by mail, please see the back of
this page.
International
International
Local Area/
Local
Prefix
Country Code
Province/
Number
City Code
If you are returning your voted ballot by fax, please
indicate the number of pages, including this form,
you are transmitting when you return your ballot:
Email
Returning by Email
Once you have finished voting your ballot, your voted ballot will be displayed on the screen.
1. Click the Download and Print My Ballot button to print your ballot, Affidavit and Coversheet, and instructions.
Or to Save and Sign without printing view:
Save A PDF
Sign a PDF If the signature is added electronically it must be a hand written signature (not a typed signature or certificate).
2. Complete and sign the Affidavit and Coversheet according to the instructions.
3. Scan your printed ballot and signed Affidavit and Coversheet into your computer.
4. Colorado now provides a new secure document transfer system to allow you to return your ballot electronically. Go to
https://
ballotreturn.sos.colorado.gov
and follow the instructions to securely upload your ballot for delivery to your county clerk and recorder.
Note: if you return your ballot electronically you do not need to fax or mail your ballot.
Confirm receipt of your ballot
You may contact your county clerk and recorder's office. Additionally, you may visit the Secretary of State's website at www.GoVoteColorado.com, look-up your
voter record, and check the "Mail ballot status" heading.
Read the following self-affirmation and sign or mark below
I swear or affirm, under penalty of perjury, that:
1. I am a member of the Uniformed Services or Merchant Marine on active duty, or an eligible spouse or dependent of such a member, or a U.S. citizen temporarily residing
outside the U.S., or Other U.S. citizen residing outside the U.S.; and
2. I am a U.S. citizen, at least 18 years of age (or will be by the date of the election), and I am eligible to vote in the requested jurisdiction; and
3. I am not incarcerated or on parole due to a felony conviction; and
4. I am not registering, requesting a ballot, or voting in any other jurisdiction in the U.S. except the jurisdiction cited in this voting form.
To vote, I have marked and sealed my ballot in private and have not allowed any person to observe the marking of the ballot, except for those authorized to assist voters under
state or federal law. I have not been influenced. The information on this form is true, accurate, and complete to the best of my knowledge. I understand that a material
misstatement of fact in completion of this document may constitute grounds for conviction of perjury.
My signature and date below indicate when I completed this document and I affirm that I mailed or transmitted this ballot by 7:00 p.m. MT on Election Day. I also understand
that by returning my voted ballot by electronic transmission, I am voluntarily waiving my right to a secret ballot and that Colorado law requires that I return this ballot by a more
secure method, such as mail, if available and feasible.
Signature or mark*
Date*
Form 400
Secretary of State Approved 04-20-18
Sections 1-8.3-108 and 1-8.3-110 , C.R.S.
Return your ballot
Your ballot must be mailed, faxed, or sent as an email attachment by 7:00 p.m. Mountain Standard Time on Election Day. The ballot must also be in the hands of
the Clerk and Recorder's Office by the close of business on the 8th day following Election Day. Mail is the most secure method of transmitting your voted ballot.
But, you may return your voted ballot by fax or email if you reasonably believe your ballot will not reach the Clerk and Recorder’s office by the deadline if it is
mailed.
Return by Mail:
1. Print your voted ballot.
2. Wrap a blank sheet of paper around your printed ballot.
3. Place your ballot (wrapped in a blank sheet of paper) and this completed, signed form into an envelope.
4. To return to your County Election office, you have two options:
a. If you are mailing your ballot within the U.S., or from a U.S. consulate or embassy, you may use the postage paid envelope template. Fold the return
envelope template and tape it securely around the envelope containing your ballot.
b. If you are mailing your ballot from a location outside the U.S., use a pen to copy the return mailing address from the return envelope template onto the
envelope containing your ballot. If you use this method, you must affix appropriate postage and write "OFFICIAL BALLOT ENCLOSED" on the face of the
envelope.
Return by Email
Once you have finished voting your ballot, your voted ballot will be displayed on the screen.
1. Click the Download and Print My Ballot button to print your ballot, Affidavit and Coversheet, and instructions.
Or to Save and Sign without printing view:
Save A PDF
Sign a PDF If the signature is added electronically it must be a hand written signature (not a typed signature or certificate).
2. Complete and sign the Affidavit and Coversheet according to the instructions.
3. Scan your printed ballot and signed Affidavit and Coversheet into your computer.
4. Colorado now provides a new secure document transfer system to allow you to return your ballot electronically. Go to
https://ballotreturn.sos.colorado.gov
and follow the instructions to securely upload your ballot for delivery to your county clerk and recorder.
Note: if you return your ballot electronically you do not need to fax or mail your ballot.
Return by Fax:
Fax your printed ballot and this completed, signed form to your County Elections Office.
Your county clerk and recorder and the Colorado Secretary of State's Office contact information
Secretary of State contact information:
The Colorado Secretary of State, Elections Division
1700 Broadway
Denver, CO 80290
Ph: (303) 894-2200
Fax: (303) 869-4861
state.electiondivision@sos.state.co.us
Insert clerk contact information here
County clerk and recorder contact:
Form 400
Secretary of State Approved 04-20-18
Sections 1-8.3-108 and 1-8.3-110 , C.R.S.
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