Correcting a Return Envelope

The owner listed below declares and certifies under penalty of perjury
under the laws of the State of California as follows:

Choose one of the following: *

NO SIGNATURE. I was informed by the Inspector that I did not sign the return envelope as required by Civil Code 5115(c)(1). Please accept this affidavit of authenticity and attach it to my previously submitted ballot so that my ballot may be opened and tallied in the current election. WRONG RETURN ADDRESS. I was informed by the Inspector that the address on my return envelope is not the same as my address in the Association that entitles me to vote in accordance with California Civil Code 5115(c)(1). Please accept this affidavit of authenticity confirming that the address listed below is my address in the Association and attach it to my previously submitted ballot so that my ballot may be opened and tallied in the current election.

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Property Owner's Name *

First

Last

Email *

Phone Number *

Community Name *

HOA Property Address *

Line 1

Line 2

City

State

Zip Code

Country

Today's Date *

AFFIDAVIT
I, the undersigned, do hereby declare and certify under penalty of perjury under the laws of the State of California that I am the legal owner of the property listed above and that the statements I have submitted are truthful.

Full Legal Name *

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