(1) A person whose name does not appear on the precinct list of registered voters at the polling place for the precinct in which he or she resides, whose name appears on the precinct list of registered voters at the polling place for the precinct in which he or she resides at a different residence address as described in section 32-914.02, or whose name appears with a notation that he or she received a ballot for early voting may vote a provisional ballot if he or she:
(a) Claims that he or she is a registered voter who has continuously resided in the county in which the precinct is located since registering to vote;
(b) Is not entitled to vote under section 32-914.01 or 32-914.02;
(c) Has not registered to vote or voted in any other county since registering to vote in the county in which the precinct is located;
(d) Has appeared to vote at the polling place for the precinct to which the person would be assigned based on his or her residence address; and
(e) Completes and signs a registration application before voting.
(2) A voter whose name appears on the precinct list of registered voters for the polling place with a notation that the voter is required to present identification pursuant to section 32-318.01 but fails to present identification may vote a provisional ballot if he or she completes and signs a registration application before voting.
(3) Each person voting by provisional ballot shall enclose his or her ballot in an envelope marked Provisional Ballot and shall, by signing the certification on the front of the envelope or a separate form attached to the envelope, certify to the following facts:
(a) I am a registered voter in ........... County;
(b) My name or address did not correctly appear on the precinct list of registered voters;
(c) I registered to vote on or about this date .................;
(d) I registered to vote
.... in person at the election office or a voter registration site,
.... by mail,
.... by using the Secretary of State's web site,
.... through the Department of Motor Vehicles,
.... on a form through another state agency,
.... in some other way;
(e) I have not resided outside of this county or voted outside of this county since registering to vote in this county;
(f) My current address is shown on the registration application completed as a requirement for voting by provisional ballot; and
(g) I am eligible to vote in this election and I have not voted and will not vote in this election except by this ballot.
(4) The voter shall sign the certification under penalty of election falsification. The following statements shall be on the front of the envelope or on the attached form: By signing the front of this envelope or the attached form you are certifying to the information contained on this envelope or the attached form under penalty of election falsification. Election falsification is a Class IV felony and may be punished by up to two years imprisonment and twelve months post-release supervision, a fine of up to ten thousand dollars, or both.
(5) If the person's name does not appear on the precinct list of registered voters for the polling place and the judge or clerk of election determines that the person's residence address is located in another precinct within the same county, the judge or clerk of election shall direct the person to his or her correct polling place to vote.