Disclaimer
Understand that any person, who (1) willfully affirms falsely to any affirmation in connection with elections, (2)perpetrates any fraud in connection with any vote to be cast in any election, or (3) any person who releases any information about votes cast for or against any candidate or ballot measure or any results of any election before the closing of the polls in Broward County on election day, can be convicted of a felony of the third degree, fined up to $5,000, imprisoned for up to 5 years, and punished as otherwise provided by Sections77.082, 775.083, or 775.084, Florida Statutes.
By signing your name electronically on the last field in the form, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form