Iowa Statutes § 43.43 Voter's declaration of eligibility

Each person voting at a primary election shall sign a declaration of eligibility which shall be in substantially the following form:

I do solemnly swear or affirm that I am a resident of the ............................................ precinct, .................................... ward or township, city of ........................, county of ........................, Iowa.

I am a registered voter. I have not voted and will not vote in any other precinct in this election.

I am affiliated with the ........................ party. If my current voter registration record indicates another party affiliation or no party affiliation, I swear or affirm that I have in good faith changed my previously declared party affiliation, or declared my party affiliation, and now desire to be a member of the party indicated above.

..............................................

Signature of voter

..............................................

Address

(........)..........................

Telephone (optional)

Approved:

..............................................

Election board member

..............................................

Date