Submit VA 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 your poll watching shift, you should make sure to have your party or candidates legal hotline number and points of contact. You can also print out a paper copy of this form in order to take handwritten notes during your shift, and copy them into this digital form after your shift is completed.

It is critically important that your poll watcher report be submitted as soon as possible after the completion of your poll watching duties.
Shift worked:

Your information

Name

General Information

In VA there are 133 different voting localities.
The ID number and name of the precinct.
Precinct Type
What time did you begin observation?
What time did / will you stop observation?
Chief Name

Pol Pad / Poll Book Device Information

Is there an up to date paper copy of the poll book available at the site as a backup to the electronic pollbook systems?
This question likely only needs to be filled out the first time a site is observed by a poll watcher team member, or on election day.
Do all poll pad device date & time settings appear correct?
1 Does device date & time appear correct?
2 Does device date & time appear correct?
3 Does device date & time appear correct?
4 Does device date & time appear correct?
5 Does device date & time appear correct?

Other observations not covered above:

Type of other issues or concerns encountered to be noted or reported (if any)

General Comments

ID Verification

This form is provided free of charge by the Electoral Process Education Corporation (“EPEC”) as a public service for Poll Watcher teams. As a tax exempt non-partisan 501c(3), EPEC does not endorse, and is not affiliated with any particular candidate or political party. Poll Watcher team leads that are interested in having their team utilize this form, and receiving e-mail updates whenever a report is submitted by their team members, please contact us.

If you find EPECs work useful and would like to donate, it would be greatly appreciated.