Nebraska Revised Statute 32-939.03
Emergency response provider; outside of county of residence; application for ballot; when; form; voter's oath.
(1) A registered voter serving as an emergency response provider outside of the voter's county of residence for a period beginning on or after the forty-five days prior to any election may request an early voting ballot via facsimile transmission or electronic mail using a form prescribed by the Secretary of State. The election commissioner or county clerk shall send the requested ballot if the request is received not later than noon on election day and contains the required information.
(2)(a) Any person requesting a ballot under this section may receive and return the ballot and the oath prescribed in subdivision (b) of this subsection using any method of transmission authorized by the Secretary of State.
(b) An oath shall be delivered with the ballot and shall be in a form substantially as provided in this subdivision.
I, the undersigned voter, declare that the ballot or ballots contained no voting marks of any kind when I received them, and I caused the ballot or ballots to be marked.
To the best of my knowledge and belief, I declare under penalty of election falsification that:
(1) I, .................., am a registered voter in .................. County;
(2) I have voted the ballot and am returning it in compliance with Nebraska law; and
(3) I have not voted and will not vote in this election except by this ballot.
ANY PERSON WHO SIGNS THIS FORM KNOWING THAT ANY OF THE INFORMATION IN THE FORM IS FALSE SHALL BE GUILTY OF ELECTION FALSIFICATION, A CLASS IV FELONY UNDER SECTION 32-1502 OF THE STATUTES OF NEBRASKA. THE PENALTY FOR ELECTION FALSIFICATION IS IMPRISONMENT FOR UP TO TWO YEARS AND TWELVE MONTHS POST-RELEASE SUPERVISION OR A FINE NOT TO EXCEED TEN THOUSAND DOLLARS, OR BOTH.
I also understand that failure to sign below will invalidate my ballot.