05:02:17:11Official

canvass sheet -- Municipalities, school districts, and other local jurisdictions. The official canvass sheet used by the governing body of a municipality, school district, or other local jurisdiction to canvass an election shall be in the following form: OFFICIAL CANVASS SHEET Date of Election:______________________ Type of Election:______________________ Jurisdiction:__________________________ OFFICE OR QUESTION Names of Candidates or "Yes" and "No" Precincts Precinct 1 Precinct 2 Precinct 3 Precinct 4 Precinct 5 Precinct 6 Totals STATE OF SOUTH DAKOTA ) ) SS COUNTY OF _____________ ) We, (list names) , appointed as the Board of Canvassers because of our positions on the governing board in the jurisdiction of _______________ for the ________________election held on the ______ day of __________, 20____, hereby certify that the foregoing is a true abstract of the votes cast in the jurisdiction of ______________ at the election as shown by the returns certified to the person in charge of the election. ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ Sworn to before me this ______ day of ______________, 20____. ________________________________ Person in Charge of the Election

Source: 16 SDR 20, effective August 10, 1989.