2.A.3.a. Reproduction of Poll Watcher Credential Form

POLLWATCHER CREDENTIALS TO THE JUDGES OF ELECTION:

In accordance with the provisions of the Election Code, the undersigned hereby appoints
POLL WATCHER'S NAME (name of pollwatcher)
who resides at
POLL WATCHER'S ADDRESS (address)
in the county of COUNTY,
TOWNSHIP OR MUNICIPALITY (township or municipality)
of WARD (if relevant) (name),
State of Illinois and who is duly registered to vote from this address,
to act as a pollwatcher in the PRECINCT precinct*
of the WARD ward (if applicable) of the MUNICIPALITY (township or municipality) of COUNTY
at the PRIMARY / GENERAL / MUNICIPAL / SPECIAL election
to be held on DATE (insert date).


APPOINTING AUTHORITY

SIGNATURE OF APPOINTING AUTHORITY (Signature of Appointing Authority)

NAME OF ORGANIZATION OR CAMPAIGN

TITLE (party official, candidate, civic organization president, proponent or opponent group chair)


Under penalties provided by law pursuant to Section 29-10 of the Election Code, the undersigned pollwatcher certifies that he or she resides at
POLL WATCHER ADDRESS (address)
in the county of COUNTY,
MUNICIPALITY (township or municipality) of COUNTY (name), State of Illinois,
and is duly registered to vote in Illinois.


PRECINCT/WARD (Precinct and/or Ward Which Pollwatcher Resides)

SIGNATURE OF POLL WATCHER (Signature of Pollwatcher)

* Other than an Election Day in–precinct Polling Place credential form, write-in the name of the voting center, early voting place, or other temporary polling place where the form asks for the precinct.

If the poll watcher is assigned to more than one polling place or to a polling place with more than one precinct, thenfill out the form leaving the "precinct" field blank and copy the form for as many precincts as needed.

The poll watcher may find it more convenient to fill out the precinct identifier at the polling place.

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