Form 12-M "Ohio Secretary of State Verification of Uocava Compliance" - Ohio

What Is Form 12-M?

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, 2019;
  • 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 12-M by clicking the link below or browse more documents and templates provided by the Ohio Secretary of State.

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Form No. 12-M Prescribed by Secretary of State (03-19)
Ohio Secretary of State Verification of UOCAVA Compliance
R.C. 3511.04
This form must be completed and submitted on the 46
th
day prior to each election.
County Name
This verification is for the Election to be held on:
MM/DD/YYYY
We the undersigned verify that Federal and State
provisions requiring the transmission of UOCAVA ballots
on the 46
th
day prior to an election have been satisfied on:
MM/DD/YYYY
Number of valid ballot requests received:
Number of ballots transmitted:
Director's Signature
Deputy Director's Signature
Note: For boards that may not have a Deputy Director, the Board Chairperson must sign this form. If no Director is
appointed, a Board Member of opposite party must sign this form.
Once the form is completed, print the form, obtain the proper signatures and then transmit the signed form via
email to
Mtlachac@ohiosecretaryofstate.gov
on the 46
th
day prior to each election.
Form No. 12-M Prescribed by Secretary of State (03-19)
Ohio Secretary of State Verification of UOCAVA Compliance
R.C. 3511.04
This form must be completed and submitted on the 46
th
day prior to each election.
County Name
This verification is for the Election to be held on:
MM/DD/YYYY
We the undersigned verify that Federal and State
provisions requiring the transmission of UOCAVA ballots
on the 46
th
day prior to an election have been satisfied on:
MM/DD/YYYY
Number of valid ballot requests received:
Number of ballots transmitted:
Director's Signature
Deputy Director's Signature
Note: For boards that may not have a Deputy Director, the Board Chairperson must sign this form. If no Director is
appointed, a Board Member of opposite party must sign this form.
Once the form is completed, print the form, obtain the proper signatures and then transmit the signed form via
email to
Mtlachac@ohiosecretaryofstate.gov
on the 46
th
day prior to each election.