C.R.S. § 1-13.5-605

I state under penalty of perjury that I am an elector who is eligible to vote each of the ballots that I have cast in this election; that my signature and name are as shown on this document; that I have not and will not cast more than one ballot for a matter to be decided in this election; and that my ballots are cast in accordance with applicable law. Name:.................................. Date:.................................... Signature of elector:................................... If the person’s name is found on the registration list or property owners list, as applicable, by the election judge having charge thereof, he or she shall repeat the name, and the elector shall be allowed to enter the immediate voting area.

I, (printed name), who reside at (address), am an elector of this (name of special district) district and desire to vote at this election. I do solemnly swear (or affirm) that I am registered to vote in the state of Colorado and qualified to vote in this special district election as: ____ a resident of the district or area to be included in the district; or ____ the owner of taxable real or personal property situated within the boundaries of the special district or area to be included within the special district; or ____ a person who is obligated to pay taxes under a contract to purchase taxable property in the special district or the area to be included within the special district; or ____ the spouse or civil union partner of (name of spouse or civil union partner) who is the owner of taxable real or personal property situated within the boundaries of the special district or area to be included within the special district. I have not voted previously at this election. Date ________________ Signature of elector ________________.