(Form No. 81. Section 34, subd. 6 of Election Law.)

Form of Preliminary Oath on Challenge for Registry.

"You do swear (or affirm) that you will fully and truly answer all such questions as shall be put to you, touching your place of residence and qualifications as an elector."

Questions under Preliminary Oath.

1. What is your name?

2. What is your age?

3. Where do you reside? State precisely as you are able your residence, by street and number, if it have a street number, and otherwise describe the locality thereof.

(If not a householder), state the name of the householder with whom you reside, and in like manner describe the residence of such householder.

4. How long have you resided in this election district?

5. What was your last place of residence before you came into this election district?

6. How long have you resided in this country?

7. How long have you resided in this state?

8. Are you a native or naturalized citizen?

If a naturalized citizen the following questions should be asked:

9. When were you naturalized?

10. Where, and in what court, or before what officer?

11. How long have you resided in the United States?

12. Did you come into this election district for the purpose of voting at the next ensuing election ?

13. How long do you contemplate residing in this election district? 14. Have you made any bet or wager, or are you directly or indirectly interested in any bet or wager depending on the result of the next ensuing election?

15. Have you received, or offered to receive, or do you expect to receive, any money or other valuable thing as a compensation or reward for giving your vote at the next ensuing election?

16. Have you paid, offered or promised to pay, contributed, offered or promised to contribute to another, to be paid or used, any money or other valuable thing, or made any promise so influence the giving or withholding of any vote at the next ensuing election ?

17. Have you been convicted of bribery or any infamous crime, or if so convicted, have you been pardoned and restored to all the rights of a citizen?

In addition to all may be asked other questions which may tend to test the qualifications of the applicant for registry as a resident of the election district, citizenship and right to vote at such election at such polling place.

After receiving answers in full to these and such other questions as may be put, the board shall, if satisfied, enter name of applicant upon register, or, if not, are to point out to the challenged person the qualification or qualifications (if any) in respect to which he shall appear to

them to be deficient. If he persists in his claim to be registered and the challenge be not withdrawn, one of the board may then administer to him the following:

Form of General Oath.

"You do swear (or affirm) that you are twenty-one years of age, that you have been a citizen of the United States for ninety days, and an inhabitant of this state for one year next preceding this election, and for the last four months a resident of this county, and for thirty days a resident of this election district, and that you have not voted at this election."

If the person so offering to vote shall be challenged for causes stated in section two of article two of the constitution of this state the following additional oath shall be administered by one of the inspectors:

"You do swear (or affirm) that you have not received or offered, do not expect to receive, have not paid, offered or promised to pay, contributed, offered or promised to contribute to another, to be paid or used any money or other valuable thing as a compensation or reward for the giving or withholding a vote at this election, and have not made any promise to influence the giving or withholding of any such vote; and that you have not made, or become directly or indirectly interested in any bet or wager depending upon the result of this election."

If the person so offering shall be challenged on the ground of having been convicted of bribery or any infamous crime, the following additional oath shall be administered to him by one of the inspectors: "You do swear (or affirm) that you have not been convicted of bribery or any infamous crime, or if so convicted, that you have been pardoned and restored to all the rights of a citizen."

(Form No. 32. Section 35, subd. 1.)

Form of Certificate of Registration.

(To be made at the close of each meeting for registration of electors for general or other election elsewhere than in a city, or in a district wholly within a village having five thousand inhabitants or more.)

We hereby certify that the above register as it now is, comprising (here insert the number) names, is a true and correct register of all electors qualified to vote at such election in such district, who have personally applied for registration, or whose names the board was required to place thereon.

Dated,

189..

Inspectors.

(Form No. 33. Section 35, subd. 1.)

Form of Certificate of Registration.

(To be made at the close of each meeting for registration of electors for general or other election in a city, or an election district wholly within a village having five thousand inhabitants or more.)

We hereby certify that the above register as it now is, comprising (here insert the number) names, is a true and correct register of the names and residences of all the electors qualified to vote at the election in this district, who have personally appeared before the board of registration.

Dated,

....

189..

Inspectors.

Torm of ballot return to be prepared by the ballot clerks, and
attached to the original statement of canvass made by the
inspectors and to each copy, in compliance with subdivision
two of section one hundred and three of the Election Law:
. The number of full sets of official ballots furnished to elec-
tion district number (five) of the (town of Canandaigua),
county of (Ontario), were.

The number of sets of official ballots cancelled before deliv-
ery to voters by reason of one or more of the set being
found defective in printing or mutilated, all of which were
destroyed by us, were.

3. The number of sets of official ballots spoiled and returned
by voters, all of which were destroyed by us, were...
1. The number of sets of official ballots returned to the county
clerk or other officer, unused, were...

5. The number of sets of official ballots actually voted were ..

800

5

10

300

485

3. Total sets of official ballots accounted for are

800

7. The number of sets of detached stubs were.....

500

8. The number of sets of stubs on unused ballots were.

300

9. The total sets of stubs accounted for are

800

We hereby certify that the foregoing ballot return for election district number (five) of the (town of Canandaigua), county of (Ontario), for the election held November (5th, 1895), is correct.

(Signed.)

Ballot Clerks.

(Form No. 36. Section 84.)

Form of Inspectors' Return and Statement of Canvass.*

SAMPLE.

Inspectors' returns and statement of canvass.- Original official statement of the result of a (general) election, held on the (fifth) day of November (1895), in the (fifth) election district of the (town of Canandaigua), county of (Ontario), state of New York, made by the inspectors of election in and for said district, which return is made as provided in section one hundred and eleven of the Election Law.

* See section 103, subd. 2, of Election Law.