It is the duty of the election judge or official to fold the ballot or ballots in the manner specified by the statute for folding ballots prior to their deposit in the ballot box, and to enclose the ballot or ballots in an envelope unsealed to be furnished by him or her, which envelope shall bear upon the face thereof the name, official title, and post office address of the election authority, and upon the other side a printed certification in substantially the following form:
     I state that I am a resident of the …. precinct of the (1) *township of …. (2) *City of …. or (3) *…. ward in the city of …. residing at …. in that city or town in the county of …. and State of Illinois, that I have lived at that address for …. months last past; that I am lawfully entitled to vote in that precinct at the …. election to be held on …. .

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Terms Used In Illinois Compiled Statutes 10 ILCS 5/19A-40

  • State: when applied to different parts of the United States, may be construed to include the District of Columbia and the several territories, and the words "United States" may be construed to include the said district and territories. See Illinois Compiled Statutes 5 ILCS 70/1.14
  • Statute: A law passed by a legislature.

*fill in either (1), (2) or (3).
     I further state that I personally marked the enclosed ballot in secret.
     Under penalties of perjury as provided by law pursuant to § 29-10 of the Election Code, the undersigned certifies that the statements set forth in this certification are true and correct.

…………………..

    If the ballot enclosed is to be voted at a primary election, the certification shall designate the name of the political party with which the voter is affiliated.
     In addition to the above, the election authority shall provide printed slips giving full instructions regarding the manner of marking and returning the ballot in order that the same may be counted, and shall furnish one of the printed slips to each of such applicants at the same time the ballot is delivered to him or her. The instructions shall include the following statement: “In signing the certification on the early ballot envelope, you are attesting that you personally marked this early ballot in secret. If you are physically unable to mark the ballot, a friend or relative may assist you. Federal and State laws prohibit your employer, your employer’s agent, or an officer or agent of your union from assisting voters with physical disabilities.”
     In addition to the above, if a ballot to be provided to a voter pursuant to this Section contains a public question described in subsection (b) of Section 28-6 and the territory concerning which the question is to be submitted is not described on the ballot due to the space limitations of the ballot, the election authority shall provide a printed copy of a notice of the public question, which shall include a description of the territory in the manner required by Section 16-7. The notice shall be furnished to the voter at the same time the ballot is delivered to the voter.