Signature of Candidate or Other Approving Authority Title of Approving Authority
Signature of Candidate or Other Approving Authority Title of Approving Authority
CANDIDATE
The following person has been appointed to serve as a poll watcher on my behalf.
Voter registration VUID Number of Poll Precinct or other location Poll Watcher is to
Watcher: serve:
________________________________ ___________________________________
Signature of Candidate or other Approving Authority Title of Approving Authority
___________________________________________
Signature of the Watcher
_______________________________
Signature of Poll Watcher
Sworn to and subscribed before me this the _________ day of ______, ____.
________________________________
Signature of Election Judge
____________________________________
Printed Name of Election Judge
INSTRUCTIONS
The following persons have the authority to appoint a poll watcher on behalf of a candidate whose name
appears on the ballot.
a. In an election for an office of the state government that is filled by voters of more than one county, by
the candidate’s campaign treasurer.
b. In an election for an office of the federal government that is filled by voters of more than one county, by
the chair or treasurer of the candidate’s principal campaign committee or by a designated agent of the
chair or treasurer.