Indiana Code
Chapter 4. Eligibility and Application for Absentee Ballot
3-11-4-21. Envelope; Affidavit

Sec. 21. (a) On the other side of the envelope required by section 20 of this chapter shall be printed an affidavit in conformity with 52 U.S.C. 20302(b) and with the name of the precinct completed by the county election board, providing that the voter affirms under penalty of perjury that the following information is true:
(1) That the voter is:
(A) a resident of; or
(B) entitled under IC 3-10-11 or IC 3-10-12 to vote in;
the precinct.
(2) The voter's complete residence address, including the name of the city or town and county.
(3) That the voter is entitled to vote in the precinct, the type of election to be held, and the date of the election.
(4) That:
(A) the voter has personally marked the enclosed ballot or ballots in secret and has enclosed them in this envelope and sealed them without exhibiting them to any other person; or
(B) the voter personally marked the enclosed ballot or ballots, enclosed them in this envelope, and sealed them with the assistance of an individual whose name is listed on the envelope and who affirms under penalty of perjury that the voter was not coerced or improperly influenced by the individual assisting the voter or any other person, in a manner prohibited by state or federal law, to cast the ballot for or against any candidate, political party, or public question.
(5) The date and the voter's signature.
(b) The side of the envelope containing this affidavit must also set forth the penalties for perjury.
[Pre-1986 Recodification Citation: 3-1-22-6(a) part.]
As added by P.L.5-1986, SEC.7. Amended by P.L.17-1993, SEC.12; P.L.12-1995, SEC.79; P.L.3-1995, SEC.100; P.L.3-1997, SEC.281; P.L.38-1999, SEC.40; P.L.209-2003, SEC.117; P.L.103-2005, SEC.8; P.L.128-2015, SEC.164; P.L.169-2015, SEC.104; P.L.157-2019, SEC.16.

Structure Indiana Code

Indiana Code

Title 3. Elections

Article 11. Voting Methods, Supplies, and Equipment

Chapter 4. Eligibility and Application for Absentee Ballot

3-11-4-0.5. When an Absentee Ballot Is Considered Sent to a Voter

3-11-4-1. Entitlement to Vote by Absentee Ballot in Clerk's Office or Satellite Office; Conditions

3-11-4-1.5. Application of Chapter to Certain Voters

3-11-4-2. Application for Absentee Ballot; Completion; Execution; Handling; Affidavits

3-11-4-2.1. False, Fictitious, or Fraudulent Absentee Ballot Application; Delivery to County Election Board; Sworn Statement; County Election Board Action

3-11-4-3. Time Periods During Which an Application for Absentee Ballot May Be Received; Application Received by Election Division

3-11-4-4. Manner of Making Application; Furnished Forms; Fax and Electronic Mail Applications

3-11-4-5. Repealed

3-11-4-5.1. Application Form; Contents

3-11-4-5.2. Direct Mailings Including Application for Absentee Ballot; Required Information About Sender of Communication

3-11-4-5.5. Election Division Designated as Single Office for Voter Registration and Absentee Ballot Procedures for Overseas and Absent Uniformed Services Voters; Move Exception

3-11-4-5.7. Military and Overseas Voter Empowerment Act; Delegation of Authority to Counties; Designation of Communications Means; Providing Applications to Voters; Security and Privacy of Application Requests; Providing Information to Voters; Free A...

3-11-4-5.8. Voter With Print Disabilities; Requesting Voter Registration Application, Absentee Ballot Application; Use of Electronic Mail, Fax, or Web Publication

3-11-4-6. Absent Uniformed Services Voters, Overseas Voters, Address Confidentiality Voters, and Voters With Print Disabilities; Transmission of Applications and Ballots

3-11-4-6.1. Repealed

3-11-4-7. Uniformed Services Voters, Overseas Voters, and Address Confidentiality Voters; Requirements for Application

3-11-4-8. Nonresident Overseas Voter; Entitled to Receive Only Federal Ballots; Precinct of Voter

3-11-4-9. Repealed

3-11-4-10. Estimate of Number of Ballots Required

3-11-4-11. Repealed

3-11-4-12. Repealed

3-11-4-12.5. Absent Uniformed Services Voter or Overseas Voter; Use of Federal Write-in Absentee Ballot Form; Waiver of Confidentiality Not Required

3-11-4-13. Repealed

3-11-4-14. Ballots Other Than Those Specified in Ic 3-11-4-12.5; Preparation and Printing Under Direction of County Election Board

3-11-4-15. Ballots Prepared and Printed Under Direction of County Election Board; Delivery to Circuit Court Clerk

3-11-4-16. Marking on Label Attached to Package of Ballots Delivered to Circuit Court Clerk; Distribution of Ballots

3-11-4-17. Filing of Application Received; Recording of Information in Statewide Voter Registration List

3-11-4-17.5. Consideration of Application; Determinations; Denial of Application; Casting Provisional Ballot; Filing Additional Documentation; Transfer of Registrations

3-11-4-17.7. Replacement Official Ballots

3-11-4-17.8. Official Replacement Ballots; Procedures

3-11-4-18. Transmitting Ballots; Tracking Ballots; Additional Documentation; Voter Education Program

3-11-4-18.5. Challenge Absentee Voter Application; Affidavit; Referral to County Election Board

3-11-4-19. Necessity of Circuit Court Clerk's Official Seal and Signature and Initials of Members of Absentee Voter Board

3-11-4-20. Envelope; Enclosure of Ballot; Addressee

3-11-4-21. Envelope; Affidavit

3-11-4-22. Repealed