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Municipality: ABSENTEE BALLOT LOG Election Date: Voter Information Misc. Application Ballot Name and Address Ward Ballot Style Date App. Received Mail/ In Person/ Fax or Email (M/P/F/E) Military/ Overseas (M/O) Date Ballot Issued Date Ballot Returned Ballot Rejected/ Ballot Counted (R-Serial Number/ C-Voter Number) Comments _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ _______________________________ EL-124 | Rev 2016-09 | Wisconsin Elections Commission, P.O. Box 7984, Madison, WI 53707-7984 | | 608-266-8005 | web: elections.wi.gov | email: [email protected] |

ABSENTEE BALLOT LOG Election Date · 2017-11-22 · EL-124 | Rev 2016-09 | Wisconsin Elections Commission, P.O. Box 7984, Madison, WI 53707-7984 | | 608-266-8005 | web: elections.wi.gov

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Page 1: ABSENTEE BALLOT LOG Election Date · 2017-11-22 · EL-124 | Rev 2016-09 | Wisconsin Elections Commission, P.O. Box 7984, Madison, WI 53707-7984 | | 608-266-8005 | web: elections.wi.gov

Municipality: ABSENTEE BALLOT LOG Election Date:

Voter Information Misc. Application Ballot

Name and Address Ward Ballot Style

Date App. Received

Mail/ In Person/

Fax or Email (M/P/F/E)

Military/ Overseas

(M/O)

Date Ballot Issued

Date Ballot Returned

Ballot Rejected/ Ballot Counted

(R-Serial Number/ C-Voter Number)

Comments

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

EL-124 | Rev 2016-09 | Wisconsin Elections Commission, P.O. Box 7984, Madison, WI 53707-7984 | | 608-266-8005 | web: elections.wi.gov | email: [email protected] |