ONE STOP APPLICATION NORTH CAROLINA y, COUNTY OF MACON ci _ 10 ‘aia Voter's Certification of Voting Qualifications |MEADOWS, I | oo DEBRA P REP maaan 495 MCCONNELL RD rare anor \SCALY MTN, NC 28775 mecbare 09/19/2020 “el re 10 “p10 atin dies Po RON 18 SKYLAND, NC 28796 DEBRA P MEADOWS, certify that Batam registered voter in his county and I shall have resided the eres noted above for 30 days immediately pro this election. BQ. tam atid Sates Chien Baa at as 18 years of ag, o il be by the dt ofthe gener eleton [1 For perasan primary elections ONLY: | ax relseted and wil esse a ball Ded understrdthat tis felony to vote more than oe tine ian election | am not curently serving a felony sentence, incinding any probation, post-releae supervision, or purole OR I am serving aa extended term of prob ding fines, fees, or restitution, and To not know of another reason that my [Ell ctstse or Veriintion of Nameand Address (iirc vi shes wat var ies waa) New Former ame: — ‘ame: New Foner Addis Ades: ew Bermer oo ~ Maina Malling Aes Adee Have you ved ber for 30 cays or mare? Yes C]No 1 cen hat ave tet 30 ays ze tis esti tthe new adres rg, date moved? ' i Gi crite Attn ast nonionic) Ido solemnly shea (or aim) that tem aegis veser in rect That booame of age or pysialdsabinny, [are unabito snter the voting plac to vote npeion without physical asian “That dese w vot ouside the voting place or enclsire, twnderstand that» false statement a5 to my condition will bein Yolation of Nordh Carolina am. XxX xX pactingea bac | nia OFMELSE Somaina—Warwnenss | NPROW | anghact wesc = vor nmr — |