Exhibit 2-902-4-5 - STATEMENT OF CERTIFICATION

Current through April 7, 2022

District: _______________________________ Soil and Water Conservation District

Election Date: _____________________________

Beat Number: ________________ Ballot Box Number: _____________

Voting Location: _____________________________________________________________

RESPONSIBILITIES OF THE ELECTION JUDGE

1. Be present during voting hours, which begin at ________________ a.m. and end at ____________ p.m.
2. Make sure all individuals read and sign the REGISTER OF VOTERS (ELC-4) before voting.
3. Place REGISTER OF VOTERS (ELC-4) and this form in ballot box with OFFICIAL BALLOTS and seal ballot box.

TO: MISSISSIPPI SOIL AND WATER CONSERVATION COMMISSION:

I hereby certify that the above listed responsibilities have been carried out to the best of my knowledge and ability.

Signed:

______________________________

Election Judge

___________________________

Date

Notes

ELC-6 (Adopted 3/27/89)

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