TX Poll Watcher Report Submission – Digital Poll Watchers (dot) Org

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Report Date *

This is the date that the observations in this report were made.

Report Time

This is the time that the observations in this report were made.

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? *

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

General Information

Locality (county) *

Shift Start Time *

Shift End Time *

Voting Location FULL Name *

Address of Voting Location *

Address Line 1

City

State

Precinct Type *

Early Voting
Election Day

Is this report for the first day of early voting? *

Yes
No

Is this report for the last day of early voting? *

Yes
No

Judge Name *

First

Last

******HOTLINE OBSERVATIONS AND QUESTIONS:

Did you observe any issues that needed to be reported to the hotline? *

Yes
No

Please include in “Other Issues”/Comment section below and describe what you observed and/or reported to the Hotline.

Did you observe something concerning but did not feel comfortable calling the Hotline? *

Yes
No

Please include in “Other Issues”/Comment section below and describe what you observed and/or reported to the Hotline.

EQUIPMENT, SERIAL NUMBERS AND COUNTS

What is the vendor for the Election Equipment? *

ES&S
HART / Verity

How many Poll Pads (laptops) are there? *

Poll Pad Statistics

How many ballot scanners are there? *

Ballot Scanner Statistics

How many ballot Printers are there? *

How many curb-side stations are there? *

Layout

How many AccessWriter machines are there? *

Layout (copy)

Was the DATE/TIME on any equipment significantly inaccurate? *

Yes
No

Please describe the circumstances where devices had inaccurate Date or Time settings. Identify the device(s) and the settings that were incorrect. *

SECURITY SEALS

Did all AccessWriter devices have security seals in place and intact? *

Yes
No
Not Observed

If no, please include in “Other Issues”/Comment section below and describe what you observed.

AccessWriter Security Seal Information

Did all Curbside devices have security seals in place and intact? *

Yes
No
Not Observed

If no, please include in “Other Issues”/Comment section below and describe what you observed.

Curbside Security Seal Information

Did all Ballot scanners have a cover (case) security seals in place and intact? *

Yes
No
Not Observed

If no, please include in “Other Issues”/Comment section below and describe what you observed.

Did all Ballot scanners have thumb drive compartment security seals in place and intact? *

Yes
No
Not Observed

If no, please include in “Other Issues”/Comment section below and describe what you observed.

Did all Ballot scanners have ballot compartment security seals in place and intact? *

Yes
No
Not Observed

If no, please include in “Other Issues”/Comment section below and describe what you observed.

Ballot Scanner Security Seals

How are the poll pads (laptops) secured at this location for overnight / off-hours storage? *

Poll Pad Security Seals

Please describe how the poll pads are secured for overnight / off-hours storage. *

Did all Ballot printers have a cover (case) security seals in place and intact? *

Yes
No
Not Observed

If no, please include in “Other Issues”/Comment section below and describe what you observed.

Ballot Printer Seal Numbers

OPENING SHIFT INFORMATION

Did the polls open on time (If no, Please enter details below)? *

Yes
No

What was the reason for the polls not opening on time? *

Scanner Zero Tape(s) Information:

Did you confirm the ZERO Tape from Ballot Scanner(s) on 1st Day of EV or ED (Flip through the whole tape – All the candidates must be ZERO)? *

Yes
No

Scanner Zero Tape Information

AccessWriter Zero Tape Information

CLOSING SHIFT INFORMATION

Did the polls close on time? *

Yes
No

What were the circumstances and/or reasons for why the polls did not close at 7 PM?

How many provisional ballots were there? *

How many absentee mail-in ballots were collected? *

How many absentee mail-in ballots were surrendered? *

How many in-person ballots were spoiled? *

Scanner Result Tape(s) Information:

Scanner Report Tape Information

Curbside Result Tape(s) Information:

Curbside Report Tape Information

BLANK BALLOT SUPPLIES:

How many blank ballots are on hand (as of the time of your report)?

Ask the judge for this information.

How many blank ballots have been delivered to the site today (as of the time of your report)?

Ask the judge for this information.

BALLOT AND THUMB DRIVE CHAIN OF CUSTODY:

Were all the thumb drives removed from equipment and placed in “Specific” small bag and secured with a seal? *

Yes
No

What were the Security Seal numbers on the “Specific” thumb drive bag?

Leave blank if unknown

What are the thumb drive Serial #s?

Leave blank if unknown. Please designate which piece of equipment is associated with each thumb drive serial number. Example: "Scanner 1 = 12345, Scanner 2 = 23456, ..."

Were the “Voted” ballots stored in a bag/container under the scanner retrieved, zipped, sealed and locked (2 locks) with documentation signed by the PJ and AJ (if available) – (The 2 locks may not be required for your county)? *

Yes
No

What were the Security Seal numbers on the “Voted” ballots bag/container?

Leave blank if unknown

What are the Serial #s on the TWO Key locks on each “Voted” ballot bag/container (The 2 locks may not be required for your county)?

Leave blank if unknown

DROP BOX CHAIN OF CUSTODY:

Did you follow the election Judge to Ballot Drop-off Location?

Yes
No

If you followed election Judge, Please enter drop-off location below either Center Count or Rally (RSS) Location Site

BALLOTS SIGNATURE QUESTIONS:

Did all Ballots have signature of Election Administrator on back? *

Yes
No

Did all Ballots have signature of Election Administrator (EA) and/or Election Judge (EJ)? *

Yes
No

In some cases, the EA is the same as the EJ – One signature is fine in this situation – Please ask if the same person

OTHER OBSERVATIONS OR ISSUES NOT COVERED ABOVE:

Type of other issues or concerns encountered not yet reported (if any)

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

General Comments

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.

Your information

General Information

******HOTLINE OBSERVATIONS AND QUESTIONS:

EQUIPMENT, SERIAL NUMBERS AND COUNTS

SECURITY SEALS

OPENING SHIFT INFORMATION

Scanner Zero Tape(s) Information:

CLOSING SHIFT INFORMATION

Scanner Result Tape(s) Information:

Curbside Result Tape(s) Information:

BLANK BALLOT SUPPLIES:

BALLOT AND THUMB DRIVE CHAIN OF CUSTODY:

DROP BOX CHAIN OF CUSTODY:

BALLOTS SIGNATURE QUESTIONS:

OTHER OBSERVATIONS OR ISSUES NOT COVERED ABOVE:

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