REGISTER POLL LIST.
List of qualified electors in the election district composed of the __________ of __________, in the county of __________, and state of __________, for an election to be held in the said election district, on Tuesday, the _____ day of November, 18_____:
Adams, James | Little, Joseph
Babcock, George | Mann, Oscar.
(Write the surnames in alphabetical order, and leave sufficient space between the alphabetical letters to insert all additional names.)
Notice is hereby given that the undersigned judges of election of said election district, will be present at the __________, in said __________, at the times named below, for the purpose of making corrections in the foregoing list, viz.: On "Wednesday, October _____, and (here insert the days and times of the day they are to meet), from 9 o'clock A.M. till 4 o'clock P.M. of each day, and also on the morning of election day, from 7 o'clock A.M. to 9 o'clock A.M."
Given under our hands this _____ day of October, 18_____.
(Signed by all the judges of election.)