Submit GA Poll Watcher Report – General

Please fill out as many of the fields as possible below. It is understood that every location is different and some information may not be readily available to you. A minimal number of required fields are indicated with a red asterisk (*).

Before you go to the polling place for your shift, if you don’t have your own paper form, you can print out a paper copy of this full form (use the “show all fields” checkbox below) in order to take handwritten notes during your shift. You can then copy your notes into the matching online form as time allows.

You should also make sure to have a print out of your party or candidates legal hotline and points of contact.

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StateGeorgia

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• Show All Fields

Note that if you have selected a specific locality and/or affiliation some fields may stay hidden at the poll watcher team lead request. To see all possible fields reload the page and do not select a locality before clicking this radio button.

Report Date - Date and time of last observation covered by this report. *

Date

Time

It is critically important that your poll watcher report be submitted as soon as possible after the completion of your poll watching duties. However, if you must fill out this form significantly after the fact, please enter the data and time of the last observation that is covered by your report.

Report Type *

• Opening shift report
• Mid-day shift report
• Closing shift report
• Other / Specific Incident Report

Your information

Name *

First

Last

Email *

Phone *

Party Affiliation? *RepublicanDemocratIndependenceOther / Specific Candidate

If "other", which party or candidate are you representing? *

General Information

County *APPLINGATKINSONBACONBAKERBALDWINBANKSBARROWBARTOWBEN HILLBERRIENBIBBBLECKLEYBRANTLEYBROOKSBRYANBULLOCHBURKEBUTTSCALHOUNCAMDENCANDLERCARROLLCATOOSACHARLTONCHATHAMCHATTAHOOCHEECHATTOOGACHEROKEECLARKECLAYCLAYTONCLINCHCOBBCOFFEECOLQUITTCOLUMBIACOOKCOWETACRAWFORDCRISPDADEDAWSONDECATURDEKALBDODGEDOOLYDOUGHERTYDOUGLASEARLYECHOLSEFFINGHAMELBERTEMANUELEVANSFANNINFAYETTEFLOYDFORSYTHFRANKLINFULTONGILMERGLASCOCKGLYNNGORDONGRADYGREENEGWINNETTHABERSHAMHALLHANCOCKHARALSONHARRISHARTHEARDHENRYHOUSTONIRWINJACKSONJASPERJEFF DAVISJEFFERSONJENKINSJOHNSONJONESLAMARLANIERLAURENSLEELIBERTYLINCOLNLONGLOWNDESLUMPKINMACONMADISONMARIONMCDUFFIEMCINTOSHMERIWETHERMILLERMITCHELLMONROEMONTGOMERYMORGANMURRAYMUSCOGEENEWTONOCONEEOGLETHORPEPAULDINGPEACHPICKENSPIERCEPIKEPOLKPULASKIPUTNAMQUITMANRABUNRANDOLPHRICHMONDROCKDALESCHLEYSCREVENSEMINOLESPALDINGSTEPHENSSTEWARTSUMTERTALBOTTALIAFERROTATTNALLTAYLORTELFAIRTERRELLTHOMASTIFTTOOMBSTOWNSTREUTLENTROUPTURNERTWIGGSUNIONUPSONWALKERWALTONWAREWARRENWASHINGTONWAYNEWEBSTERWHEELERWHITEWHITFIELDWILCOXWILKESWILKINSONWORTH

Precinct *Choice 288COWETA - 01 - SENOIACOWETA - 02 - MORELANDCOWETA - 03 - PINE ROADCOWETA - 04 - DRESDENCOWETA - 05 - NEWNANCOWETA - 06 - SHARPSBURGCOWETA - 07 - FISCHER ROADCOWETA - 09 - GRANTVILLECOWETA - 10 - HARALSONCOWETA - 11 - WELCOMECOWETA - 12 - PANTHER CREEKCOWETA - 13 - RAYMONDCOWETA - 14 - TURINCOWETA - 15 - SMOKEY ROADCOWETA - 17 - CENTRALCOWETA - 18 - THE NEWNAN CENTRECOWETA - 19 - GREENTOPCOWETA - 20 - EXPO CENTERCOWETA - 21 - WHITE OAKCOWETA - 22 - MADRASCOWETA - 23 - CANNONGATECOWETA - 24 - WESTSIDECOWETA - 25 - NORTHSIDECOWETA - 26 - THOMAS CROSSROADSCOWETA - 27 - COWETA CENTRAL LIBRARYCOWETA - E2 - CENTRAL COMMUNITY CTRCOWETA - E1 - COWETA VOTER REG OFFICEFAYETTE - 01 - BLACKROCKFAYETTE - 02 - BROOKSFAYETTE - 03 - EUROPEFAYETTE - 04 - FAYETTEVILLE EASTFAYETTE - 05 - FAYETTEVILLE WESTFAYETTE - 06 - FLINTFAYETTE - 07 - HOPEFULFAYETTE - 08 - MORNING CREEKFAYETTE - 09 - RAREOVERFAYETTE - 10 - SANDY CREEKFAYETTE - 11 - SHAKERAG EASTFAYETTE - 12 - SHAKERAG WESTFAYETTE - 13 - STARRSMILLFAYETTE - 14 - WHITEWATERFAYETTE - 15 - WOOLSEYFAYETTE - 16 - MCINTOSHFAYETTE - 17 - OAK GROVEFAYETTE - 18 - KEDRONFAYETTE - 19 - ABERDEENFAYETTE - 20 - WINDGATEFAYETTE - 21 - FLAT CREEKFAYETTE - 22 - BRAELINNFAYETTE - 23 - KENWOODFAYETTE - 24 - BANKSFAYETTE - 25 - HARPS CROSSINGFAYETTE - 26 - WILLOW PONDFAYETTE - 27 - DOGWOODFAYETTE - 28 - OAK RIDGEFAYETTE - 29 - JEFF DAVISFAYETTE - 30 - MURPHYFAYETTE - 31 - FIELDING RIDGEFAYETTE - 32 - WILLOWBENDFAYETTE - 33 - CAMP CREEKFAYETTE - 34 - RISING STARFAYETTE - 35 - SPRING HILLFAYETTE - 36 - ANTIOCHFAYETTE - E1 - FAYETTE ELECTION OFFICEFAYETTE - E2 - FAYETTEVILLE LIBRARYFAYETTE - E3 - PEACHTREE CITY LIBRARYFAYETTE - E4 - TYRONESPALDING - 01 - 2ND BAPTISTSPALDING - 02 - FAIRMONT COMM CTRSPALDING - 03 - SPALDING CO SR CTRSPALDING - 05 - UGA GRIFFIN CAMPUSSPALDING - 06 - CITY PARK GYMSPALDING - 07 - 1ST UNITED METHODISTSPALDING - 08 - ST. JOHN LUTHERANSPALDING - 09 - UNION BAPTISTSPALDING - 10 - CARVER FIRE STNSPALDING - 11 - 1ST PRESBYTERIANSPALDING - 12 - FAIRVIEW BAPTISTSPALDING - 13 - COUNTY LINE METHODISTSPALDING - 14 - SUNNY SIDE METHODISTSPALDING - 16 - GARY REID FIRE STNSPALDING - 17 - AMBUCS PARK GYMSPALDING - 19 - 1ST ASSEMBLY OF GODSPALDING - 20 - ROBERTS FIRE STATIONSPALDING - 21 - EAGLES LANDING BAPTISTSPALDING - E1 - ELECTION OFFICESPALDING - E2 - ATHLETIC HALL OF FAMEMY PRECINCT IS NOT LISTED

Not all counties have their precinct data listed in the dropdown, as we were unable to obtain a statewide master list of county precinct information. If you would like us to add your specific county information to the dropdown above, please contact us and we will be happy to work with you add the necessary precinct information for your county.

Precinct ID, if not listed above in dropdown *

Precinct Name, if not listed above in dropdown *

Precinct Address *

Address Line 1

City

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Zip Code

Physical address of the site where the election observations occurred.

Precinct Type *

• Early Voting
• Central Absentee
• Election Day

Shift Start Time *

What time did you begin observation?

Shift End Time *

What time did / will you stop observation?

Poll Manager Name

First

Last

During your shift, how many absentee ballots did you personally observe being spoiled?

Please describe the method that was used to spoil the absentee ballots you observed.

Pol Pad / Poll Book Device Information

Was there an updated paper copy of the poll book available at the site?

• yes
• no

You may need to ask the poll chief for this information.

How many electronic poll pads / electronic poll books at the site? *

Are the poll pad counts at this location being reset to zero every day, or are they cumulative? *

• Poll pad count is reset to zero every day
• Poll pad count is cumulative

Total Check-in's, County-Wide and Precinct-Wide 
Records on top of screen.

Do all poll pad device date & time settings appear correct? *

• Yes
• No

Number of Countywide Records shown on the poll pads? *

Number of Precinct Records shown on the poll pads? *

Number of Total Check-Ins shown on the poll pads? *

Ballot Marking Device Information

How many ballot marking devices are in use at this location? *

Upper Left: BMD ID #
Upper Right: BMD Clock
Lower Left: Ballot Count

BMD 1 Ballot Count? *

Does BMD 1 Clock Appear Correct *

• Yes
• No

BMD 5 Ballot Count? *

Does BMD 5 Clock Appear Correct *

• Yes
• No

BMD 9 Ballot Count? *

Does BMD 9 Clock Appear Correct *

• Yes
• No

BMD 13 Ballot Count? *

Does BMD 13 Clock Appear Correct *

• Yes
• No

BMD 2 Ballot Count? *

Does BMD 2 Clock Appear Correct *

• Yes
• No

BMD 6 Ballot Count? *

Does BMD 6 Clock Appear Correct *

• Yes
• No

BMD 10 Ballot Count? *

Does BMD 10 Clock Appear Correct *

• Yes
• No

BMD 14 Ballot Count? *

Does BMD 14 Clock Appear Correct *

• Yes
• No

BMD 3 Ballot Count? *

Does BMD 3 Clock Appear Correct *

• Yes
• No

BMD 7 Ballot Count? *

Does BMD 7 Clock Appear Correct *

• Yes
• No

BMD 11 Ballot Count? *

Does BMD 11 Clock Appear Correct *

• Yes
• No

BMD 15 Ballot Count? *

Does BMD 15 Clock Appear Correct *

• Yes
• No

BMD 4 Ballot Count? *

Does BMD 4 Clock Appear Correct *

• Yes
• No

BMD 8 Ballot Count? *

Does BMD 8 Clock Appear Correct *

• Yes
• No

BMD 12 Ballot Count? *

Does BMD 12 Clock Appear Correct *

• Yes
• No

BMD 16 Ballot Count? *

Does BMD 16 Clock Appear Correct *

• Yes
• No

Optical Ballot Scanner Device Information

Were there issues with scanners rejecting ballots and requiring multiple attempts to scan that you observed? *

• Yes
• No

How many instances of scanners rejecting ballots did you observe? *

How many ballot scanners are in use at this location? *

Ballot Counter and Clock on lower part of 
information screen

Scanner 1: ID / Serial #? *

Scanner 1: Ballot Counter? *

Scanner 1: Does device date & time appear correct? *

• Yes
• No

Scanner 2: ID / Serial #? *

Scanner 2: Ballot Counter? *

Scanner 2: Does device date & time appear correct? *

• Yes
• No

Scanner 3: ID / Serial #? *

Scanner 3: Ballot Counter? *

Scanner 3: Does device date & time appear correct? *

• Yes
• No

Scanner 4: ID / Serial #? *

Scanner 4: Ballot Counter? *

Scanner 4: Does device date & time appear correct? *

• Yes
• No

Scanner 5: ID / Serial #? *

Scanner 5: Ballot Counter? *

Scanner 5: Does device date & time appear correct? *

• Yes
• No

How many total in-person ("election day") ballots were cast?

You should be able to get these numbers from the precinct chief at the end of the day.

How many total in-person absentee ("early vote") ballots were cast?

You should be able to get these numbers from the precinct chief at the end of the day.

How many mail-in absentee ballots were placed in the drop-box?

You should be able to get these numbers from the precinct chief at the end of the day.

How many absentee mail-in ballots were surrendered and the voter then voted in-person?

You should be able to get these numbers from the precinct chief at the end of the day. For Election Day, this number should be 0.

Were all surrendered mail-in ballots properly spoiled and marked?

• Yes
• No

How many non-Mail-In spoiled/voided ballots were there?

You should be able to get these numbers from the precinct chief at the end of the day.

How many voters were flagged as having an absentee ballot issued, that did not surrender their absentee ballot but then voted in-person?

You should be able to get these numbers from the precinct chief at the end of the day.

How many provisional ballots were there?

You should be able to get these numbers from the precinct chief at the end of the day.

How many Voter-Needs-Assistance forms were there?

You should be able to get these numbers from the precinct chief at the end of the day.

Did each voter who needed assistance have a separate form submitted?

• Yes
• No

Did any memory cards get removed from the scanners? *

• Yes
• No

Where are the memory card(s) currently? *

Who transported the memory card(s) *

Did the ballot container get emptied due to there being over 1000 ballots, or at the close of election day? *

• Yes
• No

Was there a previous security seal on the ballot container compartment that was removed? *

• Yes
• No

Did the previous ballot compartment security seal have an ID number? *

• Yes
• No

What was the previous ballot compartment security seal ID number used? *

Was there a new security seal placed on the ballot container compartment? *

• Yes
• No

Did the new ballot compartment security seal have an ID number? *

• Yes
• No

What was the new ballot compartment security seal ID number used? *

Were there at least two people escorting the ballots after the containers were emptied? *

• Yes
• No

Was there a security seal used on the container transporting the ballots? *

• Yes
• No

Did the ballot transport security seal have an ID number? *

• Yes
• No

What was the ballot transport security seal ID number? *

Central Absentee Precinct Specific Items

How many mail-in ballots were received?

How many mail-in ballots were marked for adjudication?

How many mail-in ballots successfully processed?

Other observations not covered above:

Type of other issues or concerns encountered

• Voter Challenged
• Poll Pad Check-In issues and/or significant delays
• Poll Watcher Denied Entry
• Voter Intimidation
• Voters told they already voted
• Other equipment issues or concerns (Printer Issues, Scanners rejecting ballots, etc.)
• Data discrepancies
• Poll watchers prohibited from observation
• Ran out of ballots or other supplies
• Disruptions +/or unruly behavior
• Electioneering inside the polling place
• Other Improper or illegal procedures
• Issues with no voter ID but voting using regular ballot
• Something else not on this list ...

Please describe in detail any of the issues or concerns that arose during your shift and any resolution

Did you report the issues you observed to your party / candidate legal hotline?

• Yes
• No

If so, was there a resolution provided by legal hotline? Please explain below.

Did you report the issues you observed to the Registrar or Electoral board?

• Yes
• No

If so, was there a resolution provided by the Registrar or Electoral Board? Please explain below.

General Comments

General Comments or other concerns?

Are you a robot? Please answer the following question. *

=

ID Verification *

• By electronically signing this form I attest that I am an authorized poll watcher and that the statements made here are truthful and accurate to the best of my ability.

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