California Code, Elections Code - ELEC § 3106

“OATH OF VOTER

I,_________________________________________________________, acknowledge that by returning my voted

ballot by facsimile transmission I have waived my right to have my ballot kept secret. Nevertheless, I understand that, as with any vote by mail voter, my signature, whether on this oath of voter form or my identification envelope, will be permanently separated from my voted ballot to maintain its secrecy at the outset of the tabulation process and thereafter.

My residence address (last U.S. residence for voter qualification purposes)

is________________________________________________________________________________________________.

  Street Address)

(City)

(ZIP Code)

My current mailing address is ____________________________________________________________________.

(Street Address)   (City)     (ZIP Code).

My email address is ___________________________________________________. My facsimile transmission

number is _______________________________.

I am a resident of ____________________ County, State of California, or am qualified as an elector pursuant to paragraph (2) of subdivision (b) of Section 321 of the Elections Code and I have not voted, nor intend to * * * vote * * *, a ballot from any other jurisdiction for the same election.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Dated this ____________________ day of ____________, 20__________.

(Signature)________________________________________________________________________________________

(voter)

(power of attorney cannot be accepted)

YOUR BALLOT CANNOT BE COUNTED UNLESS YOU SIGN THE ABOVE OATH AND INCLUDE IT WITH YOUR BALLOT AND IDENTIFICATION ENVELOPE, ALL OF WHICH ARE RETURNED BY FACSIMILE TRANSMISSION.”