Free Complaint Form - Wyoming

Complaint Form
Office of the Wyoming Secretary of State

This form may be used when any person believes there has been or is about to be a violation of Title III of the Help America Vote Act of 2002, P.L. 107-252. A letter in substantially the same form may be used so long as it is signed, sworn, and notarized. Title III concerns voting system (machine) standards; provisional voting; voter registration, and the registration list requirements. If this form indicates other possible violations, the Complaint may be referred to other authorities. A person with a complaint may also speak or write directly to local election officials.

This form must be filed within thirty (30) calendar days of the date of the alleged violation, and it must be sent to the Wyoming Secretary of State, Elections Division, State Capitol Building, 200 West 24th Street, Cheyenne, Wyoming 82002-0020. For prompt resolution, it is helpful to have all pertinent information be provided as requested below. If space is inadequate, please attach additional pages. 1. Printed name of person making complaint _____________________________________ Address ________________________________________________________________ Telephone number(s) ___________________ E-mail address ______________________ State the facts of the alleged violation including date, time, place, and relevant actions of people involved.

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In which category do you think the complaint belongs? Voting machine standards. Provisional voting. Voter registration, registration by mail, and identification required. Voter information requirements. Computerized voter registration list standards. Other: ____________________________________________________________

4.

State the requirement that you believe has been violated or which is about to be violated, and, if you know, identify the section, subsection, and paragraph of the law stating the requirement.

This form is available in alternate formats from the Secretary of State upon request.

5.

If anyone else observed the alleged violation, name that person or those people and provide information so we can contact them, if you can. Statements from other witnesses may be attached to this form.

6.

Attach, to this form, materials which demonstrate that a violation may have occurred, if there are any. When the complained of violation first came to your attention, did you attempt to correct it with local or state authorities? If you did, describe what you did, how, when, where, and with whom you did it, and what the result was. (There is no requirement that you do this.)

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What would you like to see changed in the conduct of elections in order to correct the alleged violation(s), if you know?

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Your assistance in providing the requested information will speed resolution of this Complaint. If you are dissatisfied with the resolution made by the Secretary of State based upon the written Complaint and its attachments, you may then request a hearing.

____________________________________________ Signature of Person Filing Complaint

State of Wyoming

) ) ss: County of ___________________ )

Subscribed and sworn to before me this _______ day of ________________, 20_____. ________________________________________________ Notary Public My commission expires:

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