PERMANENT EARLY VOTING LIST REQUEST FORM
Salt River Valley Water Users’ Association (the "Association")
and the Salt River Project Agricultural Improvement and Power District (the "District")
To request to be placed on an Permanent Early Voting List for future Association and District elections print and complete
the following form and return by mail to the SRP Corporate Secretary, SRP Mail Station PAB215, P.O. Box 52105,
Phoenix, AZ 85072-2105. If you have any questions completing this form call the SRP Elections Information Line at (602)
236-3048, Monday through Friday, 8:30 AM - 5:00 PM.
SECTION 1 - REQUIRED
Your Name:
First
Middle
Last
Title (Jr., Sr., II, III)
Address of Property to be Voted:
Property Address or Description of Location
Street Address
City
State
ZIP code
Street Address
City
State
ZIP code
Street Address
City
State
ZIP code
Residence Address:
(If Different than Property Address)
Mailing Address:
(If Different than Residence Address)
Print the Name of the Trust, if
Property Held in a Qualifying Trust:
Only one person may vote property in the name of a qualifying trust and must have been appointed by the trustee(s).
CHECK ONE:
The Trust was formed primarily in furtherance of my own estate planning and to accomplish a testamentary or
inter vivos disposition of assets to my family members or to a charitable organization. I am an authorized trustee
of the Trust and appoint myself to vote the real property owned by the Trust.
The Trust was formed primarily in furtherance of the estate planning of (print person's full name):
and to accomplish a testamentary or inter vivos disposition of assets to such person's family members or to a
charitable organization. I am a beneficiary of the Trust and related by consanguinity or affinity to no more than the
fourth degree to the person for whose estate planning the Trust was formed. I am also an authorized trustee of
the Trust and appoint myself to vote the real property owned by the Trust.
I am not an authorized trustee of the Trust, but have been appointed by an authorized trustee to vote the real
property owned by the Trust and I enclose, or have previously submitted, an “SRP Elections Appointment of Trust
Voter Form” signed by the trustee.
If you own other property to be voted in your name or have been appointed to vote on behalf of another qualified trust,
provide the information on the following lines:
SECTION 2
Add me to the Permanent Early Voting List to automatically receive an early ballot for every:
Association election for which I am eligible.
Yes
No
District election for which I am eligible.
Yes
No
SECTION 3A - REQUIRED FOR ASSOCIATION PERMANENT EARLY VOTING LIST
To receive an Association Early Ballot you must respond to the following and sign below:
I will be 18 years of age or older as of April 3, 2018.
Yes
No
SECTION 3B - REQUIRED FOR DISTRICT PERMANENT EARLY VOTING LIST
To receive a District Early Ballot you must respond to the following and sign below:
I am a qualified, registered Arizona voter.
Yes
Date of Birth:
No
Place of Birth:
State or Country
SECTION 4 - SIGNATURE REQUIRED
Daytime Phone: (
E-mail Address:
)
Optional
Optional
Signature:
Date:
REQUIRED