REPORT OF DECEASED VOTER

If on election day an individual wishes to report a deceased voter to an election judge, the individual reporting the deceased voter must complete notification of death of the registered voter in accordance with Minnesota Statutes, section 201.13 . The notification of death must be in substantially the following form: In accordance with Minnesota Statutes, section 201.13 , I am a registered voter and I have personal knowledge that __________________________ is deceased. . Name of Registered Voter . . Signature of Registered Voter Date Deceased's Date of Birth: . Date of Death: . Deceased's Last Known Address: .