Lake County, MT · Lake County
Application for Designation of Agent by an Individual with a Disability
A voter with a disability who cannot provide a signature uses this application to designate an agent for election documents and assistance.
At a glance
- Issued by
- City of Lake County · Lake County, Lake County, Montana
- Notarization
- Not required: file this form without a notary.
- Official source
- lakemt.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This application lets a voter with a disability who cannot provide a signature designate an agent to sign election documents and provide assistance during registration and voting. The voter completes the designation and provides an identifying mark if possible; two disinterested people must witness it. The designated agent signs and files the original with the election administrator, and the voter may rescind the designation by notifying the election administrator.
Who needs it
A voter with a disability who cannot provide a signature and wants to designate someone to assist with election documents or the voting process needs this application.
How to submit it
Complete and return the form to the County Election Office; the designated agent must file the original application with the election administrator and retain a copy.
About notarization
This document is signed without a notary; the voter’s designation must instead be witnessed by two disinterested persons, and the designated agent signs and dates it.
How to submit this form
- 1
Download the Application
Download the Designation of Agent Application for an Individual with a Disability.
- 2
Complete the Voter Section
Print the voter’s name and the designated agent’s name, and provide the voter’s identifying mark if possible.
- 3
Get Two Witnesses
Have two disinterested persons witness the designation and sign and date the form.
- 4
Submit the Original
Return the form to the County Election Office. The designated agent files the original with the election administrator and retains a copy.
Frequently asked questions
- Do I need a notary for the Designation of Agent Application?
- No. This document does not require a notary, but the voter’s designation must be witnessed by two disinterested persons.
- How do I submit the Designation of Agent Application?
- Complete and return it to the County Election Office. The designated agent files the original application with the election administrator and keeps a copy.
- Who can choose an agent using this application?
- The application is for an individual with a disability who cannot provide a signature. The voter must choose the agent; the agent cannot be the voter’s employer, employer’s agent, or union officer or agent.