ELECTION INCIDENT DECLARATION
The purpose of this document is to provide voters in Los Angeles County with the ability to document first-hand accounts of incidents of potential fraud or corruption which they have either witnessed or experienced. The Bradley for Congress Campaign will share the information provided with the Election Integrity Project – California for review and tabulation.
The Election Integrity Project – California is working on collaboration with citizen groups and volunteer candidates in a non-partisan effort to provide eye-witness documentation to attorneys at the state and federal level, with the goal of taking appropriate action where necessary. Please carefully and accurately describe what you saw experienced in the form below. If your account is electronically signed, send it via the SUBMIT button. If you have printed and signed a hard copy, please scan and email to: ElectionIntegrity@BradleyCongress.com
Date of Incident: _________________________________
Name: _________________________________________
Address: ____________________________________________________________________________________
Street City Zip Code
Email Address: __________________________________
Location of Incident: (include suite or apartment number)
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Street City Zip Code
Description of Incident: Please describe in detail using facts rather than opinions, judgment or emotions.
Examples: 1. My registration was changed without my knowledge or permission;
- I was made to vote at a table with other voters, instead of a private booth;
- I received ballot information for a person that does not live at my address;
If you are quoting an individual, please use quotation marks to delineate specific words or statements.
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I, _______________________________ declare under penalty of perjury under the laws of the State of California that the foregoing statements are true and correct.
Executed on _______________ __, 2020, at _________________, California.
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Signature