COVID BoE Amended Complaint and PI

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF NORTH CAROLINA
DEMOCRACY NORTH CAROLINA, THE

LEAGUE OF WOMEN VOTERS OF NORTH
CAROLINA, DONNA PERMAR, JOHN P.
CLARK, MARGARET B. CATES, LELIA
BENTLEY, REGINA WHITNEY EDWARDS,
AND ROBERT K. PRIDDY II,
Plaintiffs,
vs.
Civil Action No. 20-cv-457
THE NORTH CAROLINA STATE BOARD OF
ELECTIONS; DAMON CIRCOSTA, in his
official capacity as CHAIR OF THE
STATE BOARD OF ELECTIONS; STELLA JOINT MOTION TO EXPAND
ANDERSON, in her official capacity WORD LIMITS FOR BRIEFING
as SECRETARY OF THE STATE BOARD OF ON PLAINTIFFS’ MOTION FOR
ELECTIONS; KEN RAYMOND, in his PRELIMINARY INJUNCTION
official capacity as MEMBER OF THE
STATE BOARD OF ELECTIONS; JEFF
CARMON III, in his official
capacity as MEMBER OF THE STATE
BOARD OF ELECTIONS; DAVID C.
BLACK, in his official capacity as
MEMBER OF THE STATE BOARD OF
ELECTIONS; KAREN BRINSON BELL, in
her official capacity as EXECUTIVE
DIRECTOR OF THE STATE BOARD OF
ELECTIONS; THE NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION; J.
ERIC BOYETTE, in his official
capacity as TRANSPORTATION
SECRETARY; THE NORTH CAROLINA
DEPARTMENT OF HEALTH AND HUMAN
SERVICES; MANDY COHEN, in her
official capacity as SECRETARY OF
HEALTH AND HUMAN SERVICES,
Defendants.
Case 1:20-cv-00457-WO-JLW Document 7 Filed 06/04/20 Page 1 of 10

The parties respectfully move pursuant to Local Rule
7.3(d) for leave of the Court to exceed the word limits in
the local rules and extend the permitted length of Plaintiffs’
memorandum in support of their motion for preliminary
injunction, and of Defendants’ response in opposition to that
motion, to 15,000 words, and Plaintiffs’ reply memorandum to
7,500 words. In support of this motion, the parties state as
follows:
1. Plaintiffs filed this suit on May 22, 2020, raising
statutory and constitutional challenges to the
enforcement of provisions of North Carolina’s Election
Code, Chapter 163 of the North Carolina General
Statutes, in the context of the COVID-19 pandemic.
Plaintiffs allege in their complaint that restrictions
on voter registration, mail-in absentee ballots, in-
person early voting, and Election Day administration in
the context of the COVID-19 pandemic unduly burden
Plaintiffs’ right to vote in violation of the First and
Fourteenth Amendments, Title II of the Americans with
Disabilities Act, 42 U.S.C. §§ 12131, et seq., and
Section 504 of the Rehabilitation Act, 29 U.S.C. § 794.

2. Specifically, in Count One Plaintiffs allege that
Defendants’ administration and enforcement of N.C. Gen.
Stat. Gen. Stat. §§ 163-82.6(d) and 163-82.20(g), (h)
(imposing 25-day voter registration deadlines); N.C.
Gen. Stat. § 163-230.2(c), (e), and (e1) (imposing
restrictions on absentee ballot request assistance);
N.C. Gen. Stat. § 163-231(a) (imposing the double-
witness certification requirement); N.C. Gen. Stat. §
163-227.6(c) (requiring uniform hours in precincts);
and N.C. Gen. Stat. § 163-42(b) (requiring a majority
of poll workers to come from the precinct in which they
serve) (collectively, the “Challenged Provisions”), and
the Defendants’ failure to expand voter registration
via online portals available through DHHS services,
failure to establish contactless drop boxes for
absentee ballots, and to establish mechanisms for
requesting absentee ballots by phone, email, and
online, failure to establish mechanisms to cure
deficient absentee ballot requests and absentee
ballots, failure to allow for submission of Federal
Write-in Absentee Ballots (“FWAB”) from domestic
civilian voters, failure to provide Personal Protective

Equipment to county boards of election for use during
in-person voting, and failure to establish a more
accessible, centralized way in which voters and
advocates can monitor precinct consolidation (and thus
advocate against harmful precinct consolidations), in
the context of the pandemic, taken individually or in
combination, violate the First and Fourteenth
Amendments to the U.S. Constitution, as enforced
through 42 U.S.C. § 1983.
3. In Count Two, Plaintiffs allege that Defendants’
administration and enforcement of N.C. Gen. Stat. § 163-
230.2(c), (e), and (e1) (imposing restrictions on
absentee ballot request assistance), N.C. Gen. Stat. §
163-231(a) (imposing the double-witness certification
requirement), and failure to expand voter registration
establish contactless drop boxes for absentee ballots,
establish mechanisms for requesting absentee ballots by
phone, email, and online, in the context of the pandemic
and for the November 3, 2020, general election, taken
individually or in combination, violate the
unconstitutional conditions doctrine and thereby

Plaintiffs’ First and Fourteenth Amendment right to
bodily integrity, as enforced through 42 U.S.C. § 1983.
4. In Count Three, Plaintiffs allege that the restrictions
on who can assist voters with completing and returning
mail-in absentee ballot request forms pursuant to N.C.
Gen. Stat. § 163-230.2 in the context of the COVID-19
pandemic violates Plaintiffs’ Rights of Free Speech and
Association under the First and Fourteenth Amendments.
5. In Count Four, Plaintiffs allege that Defendants’
failure to afford mail-in absentee voters any notice of
or opportunities to cure material defects in their
absentee ballot request forms or absentee ballots
violates Plaintiffs’ right to Procedural Due Process in
violation of the Fourteenth Amendment.
6. In Counts Five, Six, Seven, and Eight Plaintiffs allege
that Defendants have failed to provide plaintiffs with
disabilities a reasonable accommodation, resulting in
a disparate impact with the effect of prohibiting
individuals with disabilities from participating in the
November 3, 2020, general election, all in violation of
Title II of the Americans with Disabilities Act and
Section 504 of the Rehabilitation Act.

7. Plaintiffs intend to file a Motion for Preliminary
Injunction that would enjoin enforcement of the
aforementioned provisions of North Carolina’s election
code and require Defendants to expand voter
registration via online portals available through DHHS
services, establish contactless drop boxes for absentee
ballots, establish mechanisms for requesting absentee
ballots by phone, email, and online, establish
mechanisms to cure deficient absentee ballot requests
and absentee ballots, allow for submission of FWAB
ballots, provide PPE to county boards of election for
use during in-person voting, and establish a more
accessible, centralized way in which voters and
advocates can monitor precinct consolidation, pending
the outcome of a trial on Plaintiffs’ claims.
8. Plaintiffs include two organizations and six
individuals, all of whom are impacted in distinct ways
by the Challenged Provisions.
9. Defendants include three government entities and eight
government officials, sued in their official
capacities, with varying roles in administering North
Carolina’s Election Code.

10. Unless otherwise ordered by the Court, Local Rule 7.3(d)
sets the word limit for memoranda in support of motions
and opposition thereto at 6,250 words, and reply
memoranda at 3,125 words.
11. Given the number of parties involved, the breadth and
number of the Challenged Provisions, the number and
diverse nature of the claims asserted, and the fact-
intensive nature of Plaintiffs’ claims, the parties
seek permission to extend the limits for the opening
and opposition memoranda on Plaintiffs Motion for
Preliminary Injunction to 15,000 words so as to allow
each party to address the issues adequately and assist
the Court in deciding the forthcoming motion. Any reply
memorandum would be limited to 7,500 words.
CONCLUSION
The parties respectfully ask that the Court grant the
parties leave to exceed the applicable word limits and file
opening and opposition memoranda addressing Plaintiffs’
Motion for Preliminary Injunction of up to 15,000 words. Any
reply memoranda would be limited to 7,500 words. A proposed
Order is enclosed with this motion.

Dated: June 4, 2020. Respectfully submitted,
/s/ Alexander McC. /s/ Allison Riggs

Peters Allison J. Riggs (State Bar #40028)
Alexander McC. Peters Jeffrey Loperfido (State Bar #52939)
Chief Deputy Attorney Southern Coalition for Social Justice
General 1415 West Highway 54, Suite 101
114 W. Edenton St. Durham, NC 27707
Raleigh, NC 27603 Telephone: 919-323-3380
Telephone: Facsimile: 919-323-3942
919.716.6400 Email: Allison@southerncoalition.org
Email: jeff@southerncoalition.org
apeters@ncdoj.gov
s/ Jon Sherman
Counsel for Defendants Jon Sherman
D.C. Bar No. 998271
Michelle Kanter Cohen
D.C. Bar No. 989164
Cecilia Aguilera
D.C. Bar No. 1617884
FAIR ELECTIONS CENTER
1825 K St. NW, Ste. 450
Washington, D.C. 20006
Telephone: (202) 331-0114
Email:jsherman@fairelectionscenter.org
mkantercohen@fairelectionscenter.org
caguilera@fairelectionscenter.org
/s/ George P. Varghese

George P. Varghese
Joseph J. Yu
Stephanie Lin
Rebecca Lee
Richard A. Ingram
WILMER CUTLER PICKERING HALE AND DORR LLP
60 State Street
Boston, MA 02109
Telephone: (617) 526-6000
Facsimile: (617) 526-5000
Email: george.varghese@wilmerhale.com
joseph.yu@wilmerhale.com
stephanie.lin@wilmerhale.com
rebecca.lee@wilmerhale.com
rick.ingram@wilmerhale.com

Counsel for Plaintiffs

CERTIFICATE OF WORD COUNT
Pursuant to Local Rule 7.3(d)(1), the undersigned counsel
hereby certified that the foregoing JOINT MOTION TO EXPAND
WORD LIMITS FOR BRIEFING ON PLAINTIFFS’ MOTION FOR
PRELIMINARY INJUNCTION contains 998 words (including headings
and footnotes) as measured by Microsoft Word.
/s/ Allison J. Riggs

Allison J. Riggs
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AND ROBERT K. PRIDDY II,
Plaintiffs,
vs.
STATE BOARD OF ELECTIONS; STELLA [PROPOSED] ORDER GRANTING
ANDERSON, in her official capacity JOINT MOTION TO EXPAND
as SECRETARY OF THE STATE BOARD OF WORD LIMITS
ELECTIONS; KEN RAYMOND, in his
BOARD OF ELECTIONS; DAVID C.
BLACK, in his official capacity as
ELECTIONS; KAREN BRINSON BELL, in
her official capacity as EXECUTIVE
ERIC BOYETTE, in his official
capacity as TRANSPORTATION
SECRETARY; THE NORTH CAROLINA
DEPARTMENT OF HEALTH AND HUMAN
SERVICES; MANDY COHEN, in her
Defendants.
Case 1:20-cv-00457-WO-JLW Document 7-1 Filed 06/04/20 Page 1 of 2

Having reviewed the parties’ Joint Motion to Expand Word
Limits (“Motion”), it is hereby ORDERED that the Motion is
GRANTED. The Court ORDERS as follows:
1. Plaintiffs may file a memorandum in support of their
motion for preliminary injunction of up to 15,000 words
in length.
2. Defendants may file a response in opposition to
Plaintiffs’ motion for preliminary injunction of up to
15,000 words in length.
3. Plaintiffs may file a reply memorandum in support of
their motion for preliminary injunction of up to 7,500
words in length.
SO ORDERED:
Dated:
___________________________
United States District Judge


ROBERT K. PRIDDY II, WALTER HUTCHINS,
AND SUSAN SCHAFFER,
Plaintiffs,
vs.

ELECTIONS; DAMON CIRCOSTA, in his official
capacity as CHAIR OF THE STATE BOARD OF
ELECTIONS; STELLA ANDERSON, in her
official capacity as SECRETARY OF THE STATE
BOARD OF ELECTIONS; KEN RAYMOND, in
his official capacity as MEMBER OF THE STATE
BOARD OF ELECTIONS; JEFF CARMON III, in
BOARD OF ELECTIONS; DAVID C. BLACK, in
BOARD OF ELECTIONS; KAREN BRINSON
BELL, in her official capacity as EXECUTIVE
ERIC BOYETTE, in his official capacity as
TRANSPORTATION SECRETARY; THE
NORTH CAROLINA DEPARTMENT OF
HEALTH AND HUMAN SERVICES; MANDY
COHEN, in her official capacity as SECRETARY
OF HEALTH AND HUMAN SERVICES,
Defendants.
FIRST AMENDED COMPLAINT

Plaintiffs Democracy North Carolina, the League of Women Voters of North
Carolina (together with Democracy North Carolina, the “Organizational Plaintiffs”), and
Donna Permar, John P. Clark, Margaret B. Cates, Lelia Bentley, Regina Whitney Edwards,
Robert K. Priddy II, Walter Hutchins, and Susan Schaffer, individuals (“Individual
Plaintiffs,” together with the Organizational Plaintiffs, the “Plaintiffs”), bring this civil
rights action under 42 U.S.C. § 1983, the First and Fourteenth Amendments, Title II of the
Americans with Disabilities Act (the “ADA”), 42 U.S.C. §§ 12131, et seq., and Section
504 of the Rehabilitation Act, 29 U.S.C. § 794, for preliminary and permanent declaratory
and injunctive relief against the Defendants the North Carolina State Board of Elections;
Damon Circosta, in his official capacity as Chair of the State Board of Elections; Stella
Anderson, in her official capacity as Secretary of the State Board of Elections; Ken
Raymond, Jeff Carmon III, and David C. Black, all in their official capacities as Members
of the State Board of Elections; Karen Brinson Bell, in her official capacity as Executive
Director of the State Board of Elections (together the “SBE Defendants”); Defendants the
North Carolina Department of Transportation and J. Eric Boyette, in his official capacity
as Secretary of the Department of Transportation (the “DOT Defendants”); and Defendants
the North Carolina Department of Health and Human Services and Dr. Mandy Cohen, in
her official capacity as Secretary of Health and Human Services (the “DHHS Defendants”).
Plaintiffs allege as follows:
NATURE OF ACTION
1. The COVID-19 pandemic presents an unprecedented challenge to our nation.
Caused by a novel coronavirus and transmitted by asymptomatic, otherwise-healthy

individuals as well as the symptomatic, this disease threatens the health of millions of
Americans, especially elderly people and those with pre-existing medical conditions. As
infection and death rates continue to climb, the fallout from COVID-19 has severely
strained health care systems, the economy, and all levels and branches of government.
2. This public health crisis has also endangered the machinery of our democracy
by threatening massive disruptions in election administration, especially in a presidential
election year that was on track for exceptionally high registration rates and turnout. Many
states have already taken drastic measures to counteract the spread of COVID-19 and
ensure that eligible voters can cast their ballots safely. North Carolina, however, has failed
to act: it has not altered its statutory electoral scheme in order to allow for safe and
accessible voting. As a result, millions of North Carolinians will likely either lose their
right to vote or be forced to compromise their health in order to access the franchise.
3. At present, North Carolina’s election code imposes numerous restrictions—
on voter registration, mail-in absentee ballots, in-person early voting, and Election Day
administration—that, in light of the COVID-19 pandemic, unduly burden Plaintiffs’ right
to vote in violation of the First and Fourteenth Amendments. With respect to voter
registration, the pandemic has already caused registration rates to plummet in comparison
with previous election years. North Carolina election code and registration practices can
be altered to address the voter registration crisis with reasonable accommodations that
make registering to vote easier and safer during this public health crisis. For example,
North Carolina law requires voters to submit their registration applications at least 25 days
prior to the election, or else, register in-person at an early voting site, therefore potentially

exposing themselves or their families to infection via COVID-19. By preventing voters
from registering in the three weeks leading up to the election, the 25-day registration
requirement unconstitutionally burdens the right to vote. Voters cannot be required by their
government to choose between registering to vote and preserving their health. Likewise,
online voter registration opportunities could be easily expanded to allow voters to register
to vote from the safety of their home.
4. Several aspects of North Carolina’s cumbersome absentee vote-by-mail
regime are unconstitutional because they will require Plaintiffs to risk exposure to COVID-
19 and to violate public health social distancing requirements in order to successfully vote
by mail. For example, North Carolina requires mail-in absentee voters to complete the
ballot in the presence of two witnesses or a notary. To comply, the Individual Plaintiffs
will need to expose themselves to individuals outside of their household, thereby risking
their health. The two-witness requirement thus creates a severe and unjustified burden on
Plaintiffs’ right to vote.
5. Finally, certain restrictions on the administration of in-person voting, both
during the one-stop absentee voting period (known more commonly as “early voting” and
so identified hereinafter) and on Election Day, will produce unsafe conditions for voters.
For example, North Carolina requires each county to maintain uniform hours across all
early voting sites, regardless of the capacity and demand at each site. This statutory
requirement, recently added in June 2018, resulted in a significant reduction in early voting
sites in the 2018 general election by inflating costs through the addition of unnecessary
hours. This will likewise result in reduced sites and days for early voting in the upcoming

2020 general election because counties will have to close numerous early voting sites to
comply with the law and still stay within their budgets. On Election Day, moreover, a
majority of poll workers must reside in the precinct where they serve. This “home precinct”
requirement will exacerbate shortages of poll workers and lead to precinct consolidation.
Both the uniform-hours requirement for early voting sites and the home-precinct
requirement for Election Day poll workers will produce unsafe conditions by reducing the
number of sites in which voters can cast an in-person vote, which will, in turn, result in
long lines and large crowds, as seen in the recent Wisconsin primary election. Further, it is
not possible for a state like North Carolina— where historically, the vast majority of voters
choose to cast their ballot in person—to shift entirely to vote-by-mail methods in mere
months. North Carolina simply lacks the infrastructure necessary to conduct an election
predominantly by mail without overwhelming both county election administration systems
and the local U.S. Postal Service infrastructure. Immediate steps must be taken to ensure
that in-person voting opportunities are preserved and conducted in accordance with public
health guidance.
6. In short, with its high transmission and mortality rates, COVID-19 poses a
risk to all voters, especially those who could develop severe complications like some of
the Individual Plaintiffs. The pandemic has already decimated voter registration rates and
third-party voter registration initiatives, and makes it impossible for voters to comply safely
with certain requirements for mail-in absentee voting, including the two-witness or notary
requirement. In addition, election officials anticipate severe shortages of poll workers, who
justifiably fear contracting the disease, resulting in fewer polling sites. A number of states’

election officials, including in North Carolina, have already felt compelled to postpone
primary and other elections by weeks or months in the face of this unprecedented public
health emergency.
7. As of the filing of this complaint, Defendants have failed to implement any
election-related measures to mitigate the impact of the COVID-19 crisis on North
Carolina’s upcoming general election and safeguard the voting rights of countless eligible
North Carolina voters. 1 This failure to act, leaving the current electoral structure in place,
imposes an undue burden and an unconstitutional condition on the right to vote in violation
of the First and Fourteenth Amendments to the U.S. Constitution and a violation of
procedural due process. In addition, the State’s failure to accommodate the needs of high-
risk voters and others violates the ADA and the Rehabilitation Act.
8. Judicial intervention is warranted now, in advance of the 2020 general
election, to ensure that the State has adequate time to implement the measures necessary to
ensure that the right to vote may be exercised safely during this global pandemic. North
Carolina law sets forth an inflexible calendar of pre-election administrative steps and
milestones. For example, mail-in absentee ballots, their container-return envelopes with
witness certifications and signature blocks, and instruction sheets must be available for use
60 days in advance of a statewide general election and 50 days in advance of all other
1
Plaintiffs are aware of at least two bills that have been filed purporting to address a
small number of the issues identified in this litigation. Plaintiffs have no basis to believe
that either bill will be enacted into law, certainly not in a timely-enough fashion, and
even if they were, those bills are entirely inadequate to address the constitutional
violations implicated in this lawsuit.

elections, which in this case would be September 4, 2020. See N.C. Gen. Stat. §§ 163-
227.10(a), 163-229(b), 163-229(c). This means that all the text and design for mail-in
absentee ballots must be finalized well in advance of the 60th or 50th day before an election
such that these materials can be timely printed, delivered, and distributed to voters.
Moreover, in “emphasiz[ing] that lower federal courts should ordinarily not alter the
election rules on the eve of an election,” the Supreme Court has suggested that challenges
to a state’s election administration should be brought as soon as possible. Republican Nat’l
Comm. v. Democratic Nat’l Comm., 140 S. Ct. 1205, 1207 (2020) (per curiam).
9. Election administration plans for the June 23, 2020 Republican second
primary in Congressional District 112 have unfortunately been irreversibly set in motion.
But it is not too late to safeguard the right to vote in November’s general election, when
the pandemic is expected to resurge and once again threaten the functioning of our
democracy.
JURISDICTION AND VENUE
10. This Court has jurisdiction over Plaintiffs’ claims pursuant to 28 U.S.C.
§§ 1331 and 1343 because this case arises under the U.S. Constitution and the laws of the
United States and seeks equitable and other relief for the deprivation of constitutional and
federal statutory rights under color of state law.
2
N.C. State Bd. of Elections, Emergency Exec. Order (Mar. 20, 2020),
https://s3.amazonaws.com/dl.ncsbe.gov/State_Board_Meeting_Docs/Orders/Executive%
20Director%20Orders/Order_2020-03-20%20.pdf (rescheduling the Republican second
primary in Congressional District 11 from May 12, 2020, to June 23, 2020).

11. This Court has jurisdiction to award attorneys’ fees and costs pursuant to 42
U.S.C. § 1988 and 28 U.S.C. § 1920.
12. This Court has jurisdiction to grant declaratory relief pursuant to 28 U.S.C.
§§ 2201 and 2202.
13. Venue is appropriate in the Middle District of North Carolina, under 28
U.S.C. § 1391(b)(1).
PARTIES
Plaintiffs
14. Plaintiff Democracy North Carolina (“Democracy NC”) is a nonpartisan,
nonprofit organization dedicated to increasing voter access and participation and reducing
the corrupting role of money in politics through research, organizing, and advocacy.
Democracy NC’s volunteers, who are registered North Carolina voters across every region
of the state, form grassroots coalitions and are advocates in communities throughout the
state, including Wake County, Edgecombe and Nash Counties (the “Twin Counties”),
Alamance County, Mecklenburg County, Fayetteville, Wilmington, Winston-Salem,
Asheville, New Bern, Salisbury and Greenville. Democracy NC works for pro-democracy
reforms that strengthen the enforcement of election laws, protect voting rights, and improve
government accountability and ethics. Democracy NC engages in substantial election
protection efforts to ensure that voters are able to access the ballot, and spends substantial
time and effort producing voter guides to educate voters about the candidates that will be
on their ballots. Democracy NC advocates spend thousands of hours fighting for more early
voting sites and times to ensure that all voters have easy access to the franchise. In previous

elections, Democracy NC has also run rides-to-the-polls programs to ensure that voters
who lacked transportation and could not or did not want to use mail-in absentee voting
could nonetheless cast a ballot. Through original research, policy advocacy, grassroots
organizing, civic engagement, and leadership training, Democracy NC seeks to achieve a
fair and representative political system and advance a just and equitable North Carolina.
15. Plaintiff the League of Women Voters of North Carolina (“LWVNC”) is a
nonpartisan community-based organization, formed in 1920, immediately after the
enactment of the Nineteenth Amendment to the U.S. Constitution granting women's
suffrage. The LWVNC is dedicated to encouraging its members and the people of North
Carolina to exercise their right to vote as protected by the U.S. Constitution and the Voting
Rights Act of 1965. The LWVNC’s mission is to promote political responsibility through
informed and active participation in government and to act on selected governmental
issues. The LWVNC impacts public policies, promotes citizen education, and makes
democracy work by, among other things, removing unnecessary barriers to full
participation in the electoral process. Currently the LWVNC has 17 local leagues and over
1,912 members, each of whom, on information and belief, is a registered voter in North
Carolina. The LWVNC is affiliated with the League of Women Voters of the United States,
which was also founded in 1920. The LWVNC began as an organization focused on
training women voters, and has evolved into an organization concerned with educating,
advocating for, and empowering all North Carolinians. With members in almost every
county in the state, the LWVNC’s local leagues are engaged in numerous activities,
including hosting public forums and open discussions on important issues to the

community. Individual League members invest substantial time and effort in voter training
and civic engagement activities, such as voter registration assistance and get-out-the-vote
(GOTV) efforts leading up to elections, including during the early voting period. The
LWVNC has developed a First Time Voter Engagement Program, which partners with
local election boards and schools to encourage young voters to register to vote. The
LWVNC also devotes substantial time and effort to ensuring that government at every level
works as effectively and as fairly as possible in implementing voting regulations and
procedures. To do so, the LWVNC advocates to make elections more transparent, to
support a strong and diverse judiciary, and to urge for appropriate government oversight.
16. Plaintiff Donna Permar is a U.S. Citizen and a Durham County resident who
is completely blind and lives with her spouse who is also completely blind. Ms. Permar is
a registered voter who is eligible to vote in the November 2020 general election. Ms.
Permar only feels confident voting in-person and thus relies on polling places being open
and accessible by public transportation. Ms. Permar must utilize an ADA-compliant
machine in order to vote, because she cannot fill out an absentee ballot with confidence or
privacy.
17. Plaintiff John P. Clark is a U.S. citizen and a resident of the town of Apex in
Wake County, North Carolina. He is 79 years old and a registered North Carolina voter
who is eligible to vote in the November 2020 general election. He has severe chronic
obstructive pulmonary disease (“COPD”) and has lived with this disease, which severely
limits his activities, for the last 12 years. Whenever he is active at all, walking around or
working in the yard, he carries an oxygen tank. He can walk only two blocks, even with
10

oxygen. He has also become more susceptible to exacerbated bouts of pneumonia,
contracting it about four times in the last six years. The most recent episode was in January
2020, which has caused a further deterioration of his respiratory condition. COPD makes
him more vulnerable to severe complications or even death from COVID-19 and, therefore,
it is too high a risk for him to vote in person. It is a necessity that he vote by absentee ballot
in the November general election. To avoid any risk of contracting COVID-19, Mr. Clark
has been quarantined along with his wife for approximately the last eight weeks. He lives
with his wife, and the only people who have entered their house during the lockdown have
been three service people whom he completely avoids. He and his wife never leave their
property except for necessary medical appointments, short walks, and occasional drives
including a weekly trip to the grocery store, during which Mr. Clark stays in the vehicle.
He has voted in every presidential election since 1968, and votes regularly in state and
local elections. He wants to vote in the November 2020 general election and has already
applied for his mail-in absentee ballot. His wife could serve as one witness for his mail-in
absentee ballot, but Mr. Clark could not safely obtain a second witness, given his COPD
and the risk COVID-19 poses to Mr. Clark’s life. Each person he interacts with poses an
additional, serious risk to his life. Given the two-witness-signature requirement, he does
not know how he can safely cast a ballot by mail, and he cannot safely vote in person.
18. Margaret B. Cates is a U.S. citizen and a resident of the Town of Faison in
Duplin County, North Carolina. She is 85 years old and a registered North Carolina voter
who is eligible to vote in the November 2020 general election. She lives alone and has had
chronic fatigue syndrome for the last 27 years since 1993. This is a severely debilitating
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disease and has severely curtailed Ms. Cates’ ability to move about and be active. Today,
she is in poor health, having suffered several falls recently and a urinary tract infection that
she has been fighting for a year. As a result, she has been weak, using a walker in the house,
and bedridden for twelve hours at night and for two in the afternoon. Ms. Cates has not left
her house in three months, except to go to a doctor's appointment right before March and
before the social distancing guidelines were put in place. She has voted in every
presidential election since 1956, and also votes in many state and local elections. She wants
to vote in the November 2020 general election, and she has never voted by mail. Under the
current North Carolina election procedures, there is no way for Ms. Cates to request an
absentee ballot online. If this option were available, with some assistance, she could and
would request a ballot that way. She would also be able to request a ballot by phone call.
Her nearest family member is her son, who lives a two-hour drive away in Southern Pines,
North Carolina. Without an online or phone option to request an absentee ballot, Ms. Cates
cannot request an absentee ballot on her own and would depend on others to mail or
otherwise provide it to her. As to the two-witness requirement, Ms. Cates’ assistant—who
comes to the house to help with daily tasks and is the only person to enter Ms. Cates’
home—could serve as one witness for her absentee ballot, but Ms. Cates cannot take the
additional risk of securing a second witness given her poor health and debilitated state.
Each additional person she interacts with poses a risk to her life. Voting in person is not an
option for her, as it would pose too much of a risk to her health. Given the current rules for
voting by mail, she does not know how she will safely cast a ballot by mail in the upcoming
election.
12

19. Lelia Bentley is a U.S. Citizen and a 62-year-old registered voter in
Wilkesboro who lives on her own. She has been diagnosed with hypertension, which she
controls through diet, exercise, and meditation. About once a year, Ms. Bentley develops
a cold, which often progresses to include symptoms like sinus and chest congestion, a
hacking cough, and shortness of breath. As a result of her medical history, she has been
self-isolating at her home since March 10. Consistent with the Governor's stay-at-home
order, she does not leave her home unless absolutely necessary. Since March 15, if she has
needed groceries, she has ordered them online and had them delivered. Ms. Bentley does
not know if she can satisfy the two-witness requirement in order to request and cast an
absentee mail-in ballot. She has observed some of her neighbors breaking social distancing
guidelines, including hosting social gatherings in their homes. Other neighbors are
themselves self-isolating in order to protect elderly family members and she worries that,
even if they would agree to be her witnesses, she could accidentally expose them to the
virus, in spite of the precautions she has been taking. She does not know if her remaining
neighbors have been taking appropriate precautions to prevent contracting the novel
coronavirus, and therefore does not feel safe asking them to be witnesses. Even if she can
obtain two witnesses, she does not know if she will risk contact with them in order to
vote because she fears that it will lead her to contract COVID-19. Ms. Bentley will not vote
in person because that would be too much of a risk to her health. She does not know what
she will do if she cannot vote by mail.
20. Regina Whitney Edwards is a U.S. citizen and resident of Durham County.
She is 30 years old and a registered North Carolina voter who is eligible to vote in the
13

November 2020 general election. She is at high risk of developing severe illness from
COVID-19 because she has a serious pre-existing medical condition, type 1 diabetes. She
has had type 1 diabetes for 21 years. To protect her health from the impact of COVID-19,
she has remained at home since mid-March and has not seen another person except her
partner, whom she lives with. She is uncomfortable leaving her home or being in proximity
to people other than her partner. She has voted in multiple elections in North Carolina. But
for the threat of COVID-19, she would vote in the November 2020 general election in
person. Because of the pandemic and the health risks posed by in-person voting, she is not
willing to vote in person during the November 2020 general election, and instead would
like to vote by mail-in absentee ballot to protect her health. Ms. Edwards cannot safely
comply with North Carolina’s two-witness requirement. Her partner is available to serve
as the first witness, but she is not willing to jeopardize her physical well-being by asking
another person to serve as the second witness. Although she strongly wishes to vote in the
November 2020 general election, she will not do so if the two-witness requirement remains
in effect.
21. Robert K. Priddy II is a U.S. citizen and a resident of Brunswick County. He
is a 70-year-old registered North Carolina voter who is eligible to vote in the November
2020 general election. He is at high risk of developing severe illness from the novel
coronavirus because he has several serious pre-existing health conditions, and because of
his age. In 2010, he received a kidney transplant. To ensure that his body does not reject
the transplant, he takes medication that suppresses his immune system. The medication
also causes borderline diabetic issues, so he receives treatment for diabetes. To protect his
14

health, Mr. Priddy’s doctor has advised him to stay home and avoid contact with people
outside his household. He has remained at home since mid-March. He relies on his wife to
shop for groceries and run other errands. The only time he has gone outside since mid-
March was to pick up prescriptions from a drive-thru pharmacy, during which he remained
in his vehicle without interacting directly with the pharmacist. He is uncomfortable leaving
his home or being in close proximity to people other than his wife. He has voted in
numerous elections in North Carolina. But for the threat of COVID-19, he would vote in
the November 2020 general election in person. Because of the pandemic and the health
risks posed by in-person voting, he is not willing to vote in person in the November 2020
general election. He would like to vote by mail-in absentee ballot, but he cannot safely
comply with North Carolina’s two-witness requirement. His wife is available to serve as
the first witness, but he would have to jeopardize his physical well-being to ask another
person to serve as the second witness. Although he strongly wishes to vote in the November
2020 general election, his health will be at risk if the two-witness requirement remains in
effect, and he is not sure he will be able to vote.
22. Walter Hutchins is a U.S. citizen and a resident of Wilmington County. He
is a 91-year-old registered North Carolina voter who is eligible to vote in the November
2020 general election. He is legally blind and lives in a nursing home. Due to his age, he
is at very high risk of developing severe illness from COVID-19. To keep residents safe,
the nursing home where he lives has been under lockdown since mid-March. No visitors,
including family members, are allowed. Mr. Hutchins has voted in numerous elections in
North Carolina. His wife, who does not live at the nursing home, has helped him fill out
15

his ballot in previous elections. However, because of the lockdown and the COVID-19
pandemic, he has not seen her since mid-March and is uncertain whether she will be able
to help him with filling out his ballot in the upcoming November election. He has only
voted in-person for elections, and thus is unfamiliar with the absentee ballot process. The
nursing home does not have procedures set up to assist voters who are blind. Furthermore,
under North Carolina law, the nursing home staff cannot assist Walt fill out or submit an
absentee ballot. He would like to vote in the upcoming election by mail, but is unable to
request an absentee ballot through the mail because he is legally blind, and would like to
do so by phone. Although he strongly wishes to vote in the November election, he is not
sure how he will be able to if the restrictions on requesting absentee ballots and restrictions
on nursing home assistance in filling out and submitting absentee ballots remain in effect.
23. Susan Schaffer is a U.S. citizen and a Durham County resident who
volunteers in her community assisting eligible people with registering to vote, requesting
absentee ballots, as well as completing their absentee ballots. In the past, Mrs. Schaffer has
assisted voters at assisted living facilities and other locations that are now prohibited spaces
for people seeking to assist voters with their absentee ballot request forms if they are not a
near relative or a member of a multi-partisan assistance team (“MAT”). Mrs. Schaffer
serves as an intermediary for many voters who are not familiar with the absentee ballot
process or who otherwise are not eligible for assistance under the current state of the law
as created by Senate Bill 683. Thus, these prohibitions severely burden the right to vote of
all of the voters that Mrs. Schaffer would otherwise be able to assist and prevent her from
providing that assistance as a volunteer for an organization that has among its core missions
16

helping voters gain access to the ballot box, thereby impairing her fundamental First
Amendment right of association and right to free speech.
Defendants
24. Defendant North Carolina State Board of Elections is the agency responsible
for the administration of the election laws of the State of North Carolina.
25. Defendant Damon Circosta is the Chair of the North Carolina State Board of
Elections. Mr. Circosta is sued in his official capacity.
26. Stella Anderson is the Secretary of the North Carolina State Board of
Elections. Ms. Anderson is sued in her official capacity.
27. Ken Raymond is a Member of the North Carolina State Board of Elections.
Mr. Raymond is sued in his official capacity.
28. Jeff Carmon III is a Member of the North Carolina State Board of Elections.
Mr. Carmon is sued in his official capacity.
29. David C. Black is a Member of the North Carolina State Board of Elections.
Mr. Black is sued in his official capacity.
30. Defendant Karen Brinson Bell is the Executive Director of the North
Carolina State Board of Elections. Ms. Brinson is sued in her official capacity.
31. The North Carolina Department of Transportation is the agency that
implements the online voter registration system in the State of North Carolina.
32. J. Eric Boyette is the Secretary of the North Carolina Department of
Transportation. Mr. Boyette is sued in his official capacity.
17

33. The North Carolina Department of Health and Human Services is the agency
that administers online public benefits renewal in the State of North Carolina.
34. Dr. Mandy Cohen is the Secretary of the North Carolina Department of
Health and Human Services. Dr. Cohen is sued in her official capacity.
STATEMENT OF FACTS
I. The COVID-19 Pandemic
A. COVID-19
35. In December 2019, health officials in mainland China detected a novel
coronavirus, SARS-CoV-2, which causes a disease known as COVID-19. On January 30,
2020, the World Health Organization (“WHO”) declared COVID-19 to be a Public Health
Emergency of International Concern. On March 11, 2020, the WHO declared that it had
become a pandemic. COVID-19 has now spread throughout the world, including to every
state in the United States and to every county in North Carolina.
36. The novel coronavirus that causes COVID-19 continues to spread at an
unprecedented pace around the world and within the United States. As of June 4, 2020,
there were 1,842,101 confirmed cases in the United States, and there have been 107,029
deaths nationwide. 3 As of June 4, 2020, the North Carolina Department of Health and
3
Coronavirus Disease 2019 (COVID-19), Cases in the U.S., CDC,
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html (last updated
June 4, 2020).
18

Human Services had confirmed 31,966 positive cases of coronavirus and 960 deaths in
North Carolina.4
37. COVID-19 appears to be much more contagious than other respiratory
illnesses, such as influenza, SARS, or MERS, in significant part because of its capacity for
asymptomatic transmission, and substantially more lethal than influenza.
38. According to the U.S. Centers for Disease Control and Prevention, (“CDC”),
individuals are at higher risk of severe complications and death from COVID-19 if they
are 65 years old or older or have underlying health conditions and diseases, including
chronic lung disease, moderate to severe asthma, serious heart conditions, severe obesity
(body mass index (“BMI”) of 40 or higher), diabetes, chronic kidney disease undergoing
dialysis, liver disease, and other health conditions that suppress immune systems like
HIV/AIDS.5 The CDC’s website, relying upon research from the National Center for
Immunization and Respiratory Diseases (“NCIRD”), Division of Viral Diseases, notes that
immunocompromised individuals are at severe risk from COVID-19: “Many conditions
can cause a person to be immunocompromised, including cancer treatment, smoking, bone
marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS,
and prolonged use of corticosteroids and other immune weakening medications.” 6
4
COVID-19 Response, COVID-19 North Carolina Dashboard, NCDHHS,
https://www.ncdhhs.gov/divisions/public-health/covid19/covid-19-nc-case-count (last
updated June 4, 2020, at 10:45pm).
5
Coronavirus Disease 2019 (COVID-19), People Who Are at Higher Risk for Severe
Illness, CDC, https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/people-at-
higher-risk.html (last updated May 14, 2020).
6
Id.
19

39. Severe COVID-19 cases can cause a wide variety of secondary infections
and pathologies, including but not limited to: pneumonia, acute respiratory distress
syndrome, kidney failure, liver failure, strokes, heart attacks, cardiac inflammation, and
gastrointestinal infections, among others. 7 Furthermore, everyone is at some risk of severe
complications and death from COVID-19, as health officials have recently associated
COVID-19 with pulmonary embolism and stroke in younger patients without known risk
factors 8 and subsequent inflammatory disease in young children. 9 In critical cases, some
patients need to be intubated and put on a ventilator. Many critical care patients ultimately
die. There is also evidence that individuals of color are dying of COVID-19 at a higher rate
than other demographic groups. 10
7
Meredith Wadman et al., How does coronavirus kill? Clinicians trace a ferocious
rampage through the body, from brain to toes, SCIENCE (Apr. 17, 2020),
https://www.sciencemag.org/news/2020/04/how-does-coronavirus-kill-clinicians-trace-
ferocious-rampage-through-body-brain-toes.
8
Robert Glatter, M.D., Why is COVID-19 Coronavirus Causing Strokes in Young And
Middle-Aged People?, FORBES (Apr. 27, 2020),
https://www.forbes.com/sites/robertglatter/2020/04/27/why-is-covid-19-coronavirus-
causing-strokes-in-young-and-middle-aged-people/#598e78fe34df.
9
Pam Belluck, New Inflammatory Condition in Children Probably Linked to
Coronavirus, Study Finds, N. Y. TIMES (May 13, 2020),
https://www.nytimes.com/2020/05/13/health/coronavirus-children-kawasaki-pmis.html.
10
Shelby Lin Erdman, Black Communities Account for Disproportionate Number of
Covid-19 Deaths in the US, study finds, CNN (May 6, 2020),
https://www.cnn.com/2020/05/05/health/coronavirus-african-americans-study/index.html.
20

40. The CDC has warned that asymptomatic COVID-19-positive individuals can
transmit the disease to others. 11 Studies have confirmed this. 12 As a result, individuals can
spread the disease for a week or more before realizing they are infected, facilitating rapid
contagion. Currently, there are no therapeutic treatments or vaccinations that have been
shown to significantly alter the trajectory of the COVID-19 outbreak. Leading
epidemiology experts anticipate that the pandemic will continue into fall and winter of
2020, and potentially well into 2021.
B. North Carolina’s Response to COVID-19
41. In North Carolina, Governor Cooper declared a State of Emergency on
March 10, 2020, which remains in effect as of the date of this filing. Within a week
thereafter, the Governor imposed social distancing guidelines for individuals and
businesses, closed public schools, and prohibited mass gatherings.
42. Governor Cooper has announced a three-phase plan to slowly ease
restrictions in North Carolina that will depend on whether North Carolina has successfully
met key metrics regarding infection in the state. 13 On May 5, 2020, Governor Cooper
11
Coronavirus 2019 (COVID-19), Prevent Getting Sick: How COVID-19 Spreads, CDC,
https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html (last updated
Apr. 13, 2020).
12
Mary Van Beusekom, Studies profile lung changes in asymptomatic COVID-19, viral
loads in patient samples, CTR. FOR INFECTIONS DISEASE RESEARCH & POL’Y, UNIV. OF
MINN. (Feb. 25, 2020), http://www.cidrap.umn.edu/news-perspective/2020/02/studies-
profile-lung-changes-asymptomatic-covid-19-viral-loads-patient.
13
Press Release, North Carolina Office of the Governor, Governor Extends Stay At Home
Order Through May 8, Plans Three Phase Lifting of Restrictions Based on Virus Trends
(Apr. 23, 2020), https://governor.nc.gov/news/governor-extends-stay-home-order-
through-may-8-plans-three-phase-lifting-restrictions-based.
21

issued an executive order modifying North Carolina’s stay at home order and transitioning
the state to “Phase 1” of slowly easing certain COVID-19 restrictions. 14 This order advised
North Carolinians to maintain six-feet social distancing from non-family or household
members and encouraged high risk individuals to stay home and travel only for “absolutely
essential purposes.” 15 On May 20, 2020, the Governor issued an order moving North
Carolina into “Phase 2” and superseding the Phase 1 order. 16 The Phase 2 Order notes that
“the risk of contracting and transmitting COVID-19 is higher in settings that are indoors,
where air does not circulate freely and where people are less likely to maintain social
distancing by staying six (6) feet apart,” and “very strongly encourage[s]” individuals at
high risk of severe illness, including those 65 years or older and with underlying medical
conditions, to stay home and travel only for “absolutely essential purposes.” 17 It maintains
the prior guidance that individuals maintain at least six feet of social distancing from other
individuals, and requires businesses to limit occupancy and take other measures promoting
social distancing. It also encourages individuals, including restaurant workers and personal
care patrons, to wear face coverings. Mass gatherings of more than 10 people indoors and
25 people outdoors remain prohibited. 18
14
Governor Roy Cooper, Exec. Order No. 138 (May 5, 2020),
https://files.nc.gov/governor/documents/files/EO138-Phase-1.pdf.
15
Id.
16
Governor Roy Cooper, Exec. Order No. 141 (May 20, 2020), https://htv-prod-
media.s3.amazonaws.com/files/eo141-phase-2-1590009188.pdf.
17
Id.
18
Id.
22

43. The Governor has also issued an executive order allowing non-profit
corporations incorporated under the laws of the State of North Carolina to vote on matters
by electronic balloting to “prevent members and directors from having to gather in a place,
and thereby to promote social distancing and the mitigation of the spread of COVID-19.”19
44. The DHHS Defendants similarly recommend that individuals “put distance
between yourself and other people” and advise, “[t]he very best evidence on reducing the
spread is to maintain social distance and stay at home.” 20
45. These measures are far from temporary and similar measures will likely be
required for the remainder of 2020. Governor Cooper’s current Phase 2 executive order
notes that “it may be necessary to reinstate certain restrictions eased by this Executive
Order,” 21 and, in any event, even the final “Phase 3” guidelines encourage social distancing
and minimizing exposure, and any spike in infections may require tightening restrictions
again.22
46. Epidemiologists and infectious disease specialists have already concluded
that there will very likely be a COVID-19 resurgence in the United States this fall. Dr.
Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, has
19
Governor Roy Cooper, Exec. Order. No. 136 (Apr. 24, 2020),
https://files.nc.gov/governor/documents/files/EO136-Nonprofit-Corp.pdf.
20
COVID-19 Response, Individuals and Families, NCDHHS,
https://www.ncdhhs.gov/divisions/public-health/covid19/individuals-and-families (last
accessed May 19, 2020).
21
Governor Roy Cooper, Exec. Order No. 141 (May 20, 2020), https://htv-prod-
22
Id.
23

said a second wave of infections in the United States is “inevitable.” 23 South Korea,
Germany, and China are already seeing a resurgence of COVID-19 after loosening
restrictions in response to declining new COVID-19 cases. Pointing to the spread of
COVID-19 cases in southern hemisphere countries as those regions enter their winter
seasons, Dr. Fauci remarked, “And if, in fact, they have a substantial outbreak, it will be
inevitable that we need to be prepared that we’ll get a cycle around the second time.” 24 He
concluded, “[W]e really need to be prepared for another cycle.” 25 Furthermore, experts
from the Harvard T.H. Chan School of Public Health’s Center for Communicable Disease
Dynamics warned that, to avoid exceeding hospital critical care capacities, prolonged or
intermittent social distancing may be necessary into 2022.26
C. Inadequacies in North Carolina’s Administration of the Upcoming 2020

General Election in Light of the COVID-19 Pandemic
47. The general election for all federal offices, including the presidential
election, will be held on November 3, 2020. COVID-19 will have an unprecedented impact
23
Miriam Berger et al., Drug trial shows modest benefits in treating coronavirus, Fauci
says, WASH. POST (Apr. 20, 2020),
https://www.washingtonpost.com/world/2020/04/29/coronavirus-latest-news/; see also
Remarks by President Trump, Vice President Pence, and Members of the Coronavirus
Task Force in Press Briefing, WHITE HOUSE (Mar. 25, 2020),
https://www.whitehouse.gov/briefings-statements/remarks-president-trump-vice-
president-pence-members-coronavirus-task-force-press-briefing-11/.
24
Id.
25
Id.
26
Stephen M. Kissler et al., Projecting the transmission dynamics of SARS-CoV-2
through the postpandemic period, SCIENCE (Apr. 14, 2020),
https://science.sciencemag.org/content/early/2020/04/24/science.abb5793.
24

on this upcoming election. Even before the COVID-19 pandemic, the Brookings Institution
predicted that “turnout in 2020 could break all records and test our election machinery as
it has never been tested before.” 27 Other experts also anticipate record-breaking turnout in
the 2020 presidential election. 28
48. North Carolina’s election laws and procedures are not designed to facilitate
safe, fair, and free elections during such a public health crisis, and the legislature has failed
to take action to remedy this situation. Given the rapidly spreading infection, North
Carolina’s current election laws will force voters to choose between exposing themselves
to severe risks to their health and exercising their constitutionally-protected right to vote.
49. The inadequacies of North Carolina’s election laws and procedures to
facilitate safe, free, and fair voting during a pandemic have not gone unnoticed by state and
county election officials. On March 26, 2020, Defendant Karen Brinson Bell, Executive
Director of the North Carolina State Board of Elections, wrote to Governor Cooper and the
leadership in North Carolina’s General Assembly requesting statutory changes to address
27
William A. Galston, What does high voter turnout tell us about the 2020 elections?,
BROOKINGS INST. (Nov. 20, 2019),
https://www.brookings.edu/blog/fixgov/2019/11/20/what-does-high-voter-turnout-tell-us-
about-the-2020-elections/.
28
See, e.g., Susan Milligan, Preparing for a Voter Surge, U.S. NEWS & WORLD REPORT
(Sept. 20, 2019), https://www.usnews.com/news/elections/articles/2019-09-20/experts-
predict-huge-turnout-in-2020; Nate Cohn, Huge Turnout Is Expected in 2020. So Which
Party Would Benefit?, N.Y. TIMES (July 15, 2019),
https://www.nytimes.com/2019/07/15/upshot/2020-election-turnout-analysis.html;
Ronald Brownstein, Brace for a Voter-Turnout Tsunami, THE ATLANTIC (June 13, 2019),
https://www.theatlantic.com/politics/archive/2019/06/2020-election-voter-turnout-could-
be-record-breaking/591607/.
25

the impact of the COVID-19 pandemic on North Carolina’s upcoming elections. 29 Among
other recommendations, Defendant Bell requested (i) expanding options for voters to
submit mail-in absentee ballot requests beyond the current mail-only option to enable
requests by fax, email, and an online portal; (ii) establishing a fund to pay for postage for
returned absentee ballots; (iii) reducing or eliminating the requirement that two witnesses
sign an absentee mail container envelope in order for the ballot to be counted; (iv) lifting
the requirement that a majority of Election Day poll workers reside in the precinct in which
they work; and (v) lifting the uniformity requirement for early voting sites, days and hours.
In a follow-up letter sent April 22, 2020, Defendant Bell emphasized that changes were
required immediately during the April 28 legislative session of the General Assembly in
order to be effective for North Carolina’s 2020 elections, including the 2020 general
election. 30
50. On April 27, 2020, dozens of county board of elections officials from eleven
counties in North Carolina’s 11th Congressional District similarly issued an “urgent
request” of North Carolina’s legislators to protect upcoming elections. 31 They warned that
regular poll workers were “reluctant to serve” during the pandemic given that a large
percentage of them are elderly and at higher risk of severe complications and death from
29
Letter from Karen Brinson Bell, Exec. Dir., N.C. State Bd. of Elections, to Governor
Roy Cooper et al. (Mar. 26, 2020) (Exhibit 1).
30
See Letter from Karen Brinson Bell, Exec. Dir., N.C. State Bd. of Elections, to
Governor Roy Cooper et al. (Apr. 22, 2020) (Exhibit 2).
31
Letter from Board of Elections Members in Congressional District 11 to General
Assembly Leaders et al. (Apr. 29, 2020) (Exhibit 3).
26

COVID-19. These county officials requested that the legislators eliminate the requirement
that a majority of poll workers reside in the precinct in which they serve and instead permit
officials to recruit poll workers from anywhere in the entire county.
D. Voter Registration
51. Those eligible to vote in North Carolina can register in person, by mail, or,
under some circumstances, online with the Department of Motor Vehicles (“DMV”), a
division of Defendant the North Carolina Department of Transportation. 32 To register by
mail, eligible voters can download a voter registration form from the State Board of
Elections website and then print, complete, and sign the form. Voters cannot submit this
form electronically and they must mail in the original form with a wet-ink signature to the
local county board of elections. See N.C. Gen. Stat. § 163-82.6(c). Voters must also include
their drivers license number, non-driver identification card, or last four digits of their Social
Security number. See N.C. Gen. Stat. § 163-230.2.
52. Alternatively, eligible voters who are existing DMV customers with a North
Carolina drivers license or DMV-issued ID may register to vote online. See N.C. Gen. Stat.
§ 163-82.19. Until recently, this option required users to complete a DMV transaction, such
as a license renewal or duplicate, at the same time. 33 For this registration method, voter
32
See Registering to Vote in North Carolina, N.C. State Bd. of Elections,
https://www.ncsbe.gov/Voters/Registering-to-Vote (last accessed May 20, 2020).
33
See Press Release, N.C. State Bd. of Elections, State Board, DMV Partner to Expand
Online Voter Registration Service (Mar. 30, 2020), https://www.ncsbe.gov/Press-
Releases?udt_2226_param_detail=2195.
27

registration applications must be submitted at least 25 days before the election in which the
voter wishes to cast a ballot. 34
53. Eligible voters may also register to vote through certain state agencies such
as the Division of Social Services, Division of Public Health/WIC, and Division of Services
for the Blind—all divisions of Defendant N.C. Department of Health and Human
Services—among others. See N.C. Gen. Stat. §§ 163-82.20 – 82.23.35 Voters may submit
forms to state agencies in lieu of mailing the application but must do so at least 25 days
before the election in which they wish to vote, see N.C. Gen. Stat. § 163-82.20(g), (h), and
may not do so online, even though those agencies, upon information and belief, possess
“wet-ink” signatures for those customers.
54. Finally, voters may register in person at an early voting site using same-day
registration with valid identification. 36 This option is available up until the last Saturday
before the election. See N.C. Gen. Stat. § 163-227.2(b)
55. The COVID-19 pandemic and resulting stay-at-home orders in North
Carolina have significantly hindered third-party voter registration efforts for the 2020
general election. For example, Plaintiff LWVNC has had to cancel and otherwise reduce
34
See also Registering to Vote in North Carolina, N.C. State Bd. of Elections,
https://www.ncsbe.gov/Voters/Registering-to-Vote (last visited May 19, 2020) (“Voter
registration applications submitted [through the DMV] fewer than 25 days before an
election will not be processed until after the election.”)
35
See NVRA Agency Forms, N.C. State Bd. of Elections, https://www.ncsbe.gov/Voter-
Registration/NVRA (last accessed May 19, 2020).
36
One-Stop Early Voting; Same-Day Registration, N.C. State Bd. of Elections,
https://www.ncsbe.gov/Voting-Options/One-Stop-Early-Voting (last accessed May 20,
2020).
28

its in-person voter registration initiatives, which typically comprise a significant portion of
its voter registration efforts. Plaintiff Democracy NC has had to cancel its in-person voter
education forums where voter registration forms are usually provided. Furthermore, voters’
ability to access the resources needed to register to vote—whether they be printers, postage,
and access to a post-office box, state agency, county board of election or the DMV—have
also been significantly hindered by the COVID-19 pandemic. As a result, voter registration
is significantly lagging this year as compared to previous general election years. While
January 2020 showed an approximately 162 percent increase in registrations compared to
January 2016 (indicating increased intent to vote in this election cycle), April 2020 showed
an approximately 50 percent decrease in voter registrations compared to April 2016.37
E. Absentee Vote-By-Mail
56. There will be a dramatic increase in the number and proportion of mail-in
absentee ballots cast in the upcoming 2020 elections. While North Carolina permits all
registered voters to cast an absentee ballot if they choose, see N.C. Gen. Stat. § 163-226(a),
recently-enacted restrictions on absentee voting as well as other pre-existing provisions in
the North Carolina election code impose undue burdens on voters wishing to cast mail-in
absentee ballots in light of the current pandemic, and will force voters to choose whether
to exercise their right to vote or protect their health.
37
See N.C. State Bd. of Elections, NVRA Data (2008 to present),
https://s3.amazonaws.com/dl.ncsbe.gov/NVRA/nvra_stats_all.txt. This data file is
accessible by going to https://www.ncsbe.gov/Public-Records-Data-Info/Election-
Results-Data and navigating to “FTP Site”  “NVRA”  “NVRA_stats_all.txt”.
29

57. Wisconsin’s recent election, which was held after its governor declared state
of emergency in response to COVID-19, shows that there will likely be an increased use
of mail-in ballots in North Carolina. Like North Carolina, Wisconsin does not require an
excuse to vote by mail. In its April 7, 2020 spring election, nearly 1.3 million registered
Wisconsin voters requested a mail-in ballot, 38 the most in the state’s history. Of the 1.6
million voters who cast ballots in the spring election, 39 more than 70 percent, that is 1.1
million, voted by mail-in absentee ballot. 40 This was a dramatic increase from the
percentage of mail-in absentee ballots cast in the 2016 presidential primary election, in
which mail-in absentee ballots made up just 11.8 percent of total ballots cast. 41
58. Defendant North Carolina State Board of Elections anticipates a similar
dramatic increase in mail-in absentee voting in 2020 to 30 to 40 percent, 42 and thus needs
to prepare for such an increase. As it currently stands, North Carolina’s election code
imposes severe burdens to voters who need to cast absentee mail-in ballots, in light of the
current pandemic, and to the expected influx of voters wishing to vote by mail for the first
time.
38
Absentee Ballot Report - April 7, 2020 Spring Election and Presidential Preference
Primary, WIS. ELECTIONS COMM’N (Apr. 16, 2020), https://elections.wi.gov/node/6856.
39
Unofficial Spring Election Turnout - 34.3 % - 4/14/2020, WIS. ELECTIONS COMM’N,
https://elections.wi.gov/blog (last accessed May 21, 2020).
40
Updated municipal absentee ballot data, WIS. ELECTIONS COMM’N,
https://elections.wi.gov/blog (last updated 4/13/20 9:35am).
41
Absentee Ballot Requests for April 7 Exceed 1 million - COVID-19, WIS. ELECTIONS
COMM’N (Apr. 1, 2020), https://elections.wi.gov/node/6802.
42
Governor Roy Cooper et al. (Apr. 22, 2020) (Exhibit 2).
30

1. Senate Bill 683
59. North Carolina law has permitted all eligible citizens to vote by mail in all
federal and state elections since 2001. See N.C. Gen. Stat. § 163-226(a). Voters must
submit a completed State Absentee Ballot Request Form to their county board of elections
in order to receive an absentee ballot. N.C. Gen. Stat. § 163-230.2(a).
60. In November 2019 North Carolina made it significantly more cumbersome
for its voters to cast absentee ballots by mail by enacting Senate Bill 683. See An Act to
Amend the Laws Governing Mail-In Absentee Ballots (“SB 683”), S.L. 2019-239, § 1
(Nov. 6, 2019).43 Among other provisions, SB 683 imposes restrictions on who can assist
voters with completing mail-in absentee ballot request forms. See S.B. 683 § 1.3(a)
(amending N.C. Gen. Stat. § 163-230.2(e), (e1)). Requests are invalid if “completed
partially or in whole, or signed by anyone other than the voter, or the voter’s near relative
or verifiable legal guardian.” N.C. Gen. Stat. § 163-230.2 (e)(2). Members of multi-partisan
teams (“MATs”) trained and authorized by county boards of elections may assist in
completion of the request, id., but in certain North Carolina counties, the availability of
MATs has been inadequate. Voters requiring assistance to complete the written request
form due to blindness, disability, or inability to read or write may request another person
if “there is not a near relative or legal guardian available to assist that voter.” N.C. Gen.
Stat. § 163-230.2(e1).
43
See https://www.ncleg.gov/EnactedLegislation/SessionLaws/PDF/2019-2020/SL2019-
239.pdf.
31

61. There are also restrictions on who may help return a completed absentee
ballot request. Under N.C. Gen. Stat. § 163-230.2(c), the completed request form may only
be delivered to the county board of elections by the voter, the voter’s near relative or
verifiable legal guardian, or a MAT team member.
62. Unlike for completing an absentee ballot request form, there is no exception
in the statute for a voter who needs assistance with returning the request form by reason of
their blindness, disability, or inability to read or write. See N.C. Gen. Stat. § 163-
230.2(e)(4).
63. There are also no such exceptions to the similar restrictions for marking,
completion and submission of mail-in absentee ballots. People, who by reason of their
blindness, disability, or inability to read or write, require assistance are still restricted to
the voter’s near relative or verifiable legal guardian, or a MAT team member. See N.C.
Gen. Stat. §§ 163-226.3(a)(4), 163-226.3(a)(5), 163-231(b)(1).
64. By doing so, SB 683 has effectively banned organizations like LWVNC and
individuals like Plaintiff Schaffer from assisting voters with requesting absentee ballots.
This is especially damaging where, as here, the State Board expects a dramatic increase in
voting-by-mail, indicating that many individuals will be seeking to vote by mail for the
first time. Without assistance by organizations like LWVNC or individuals like Plaintiff
Schaffer, which was available up until SB 683’s passage in late 2019, many of these voters
will lack needed assistance to navigating the ballot request process during a time when that
assistance is crucial to ensuring individuals can vote safely.
32

65. SB 683 also narrowed the list of identification voters could submit with their
request form to only a North Carolina driver’s license number, special identification card
number, or the last four digits of his or her Social Security number. See N.C. Gen. Stat. §
163-230.2(a)(4), (f). There is no provision allowing individuals to submit alternative proof
of residency such as those documents provided for under the Help America Vote Act
(“HAVA”), i.e., a current utility bill, bank statement, government check, paycheck, or other
government document showing the name and address of the voter. Defendant Executive
Director Bell requested in her March 26, 2020 letter that North Carolina permit voters to
submit this alternative documentation with their absentee request forms, noting that the
State Board had received “multiple reports from county boards of elections and from voters
that, without this option, some voters are no longer able to request an absentee ballot, and
that “[a]llowing this option will make it easier for those most at risk of contracting COVID-
19 to vote absentee by mail.” 44
2. Two-Witness Requirement
66. North Carolina’s two-witness or notary requirement for mail-in absentee
voting will also force voters to decide whether to break quarantine or violate social-
distancing directives, and thereby risk their own health, in order to successfully cast a ballot
this year. Among other requirements, North Carolina election law requires that an
44
See Letter from Karen Brinson Bell, Executive Director, to Governor Roy Cooper et.
al. (Mar. 26, 2020),
https://s3.amazonaws.com/dl.ncsbe.gov/sboe/SBE%20Legislative%20Recommendations
_COVID-19.pdf.
33

individual voting an absentee ballot do so “[i]n the presence of two persons who are at least
18 years of age.” N.C. Gen. Stat. § 163-231(a).45 The only alternative is to obtain the
signature of a notary public. Id. However, during the current pandemic a notary public is
not a viable option for many voters because many businesses are closed and the recent
exclusion of absentee ballots from the recent COVID response bill allowing for electronic
notaries. See An Act to Provide Aid to North Carolinians in Response to the Coronavirus
Disease (COVID-19) Crisis, S.L. 2020-3 § 4.1(c) (May 4, 2020).46 Accordingly, even when
they do have access to a notary public, individuals again would have to breach social-
distancing measures and leave their home to have their ballot notarized.
67. North Carolina is one of just twelve states that requires a witness or notary
to observe the voter casting the absentee ballot and then sign the ballot’s certificate
envelope and one of just three states that requires two witnesses. 47 In a time when social
45
Other restrictions include prohibiting any candidate for nomination or election from
serving as a witness unless the voter is the candidate’s near relative, prohibiting owners,
managers, directors, employees of any hospital, clinic, nursing home, or rest home from
witnessing for a voter who is a patient or resident, and certain office-holders. See N.C.
Gen. Stat. §§ 163-226.3(a)(4) and 163-237(b)(1).
46
See https://www.ncleg.gov/EnactedLegislation/SessionLaws/PDF/2019-2020/SL2020-
3.pdf (at PDF p. 31) (“Nothing in this section shall apply to any notarization under
Article 20 of Chapter 163 of the General Statutes [regarding absentee ballots].”).
47
See Ala. Code §§ 17-9-30(b), 17-11-7, 17-11-10; Alaska Stat. § 15.20.030; La. Stat.
Ann. § 18:1306(2)(a); Minn. Stat. §§ 203B.07, 203B.121; Minn. R. 8210.2450; Miss.
Code Ann. §§ 23-15-627, 23-15-635, 23-15-633; Mo. Rev. Stat. §§ 115.279, 115.283,
115.295; N.C. Gen. Stat. § 163-231; Okla. Stat. tit. 26, § 14-108; 17 R.I. Gen. Laws § 17-
20-23; S.C. Code Ann. §§ 7-15-220, 7-15-230; Va. Code Ann. §§ 24.2-706, 24.2-
707; Wis. Stat. § 6.87(4)(b)1; see also Jay Chaudhury, NC absentee ballots require 2
witnesses. Is that unique?, POLITIFACT (Apr. 23, 2020),
https://www.politifact.com/factchecks/2020/apr/23/jay-chaudhuri/nc-absentee-ballots-
require-2-witnesses-unique/; Voting Outside the Polling Place: Absentee, All-Mail and
34

distancing is a crucial measure to protect public health, the two-witness requirement
unconstitutionally forces individuals to choose between voting through an absentee mail-
in ballot that will count or protecting their health, and constitutes an insurmountable hurdle
for many eligible North Carolina voters seeking to protect their health and the health of
their family or co-habitants. Those eligible North Carolina voters under self-quarantine,
particularly those at risk of severe complications and death from COVID-19, who live
alone or who do not have two other adults in their household, will be unable to safely satisfy
the state’s double-witness signature requirement and cast a mail-in absentee ballot. This is
no small number: According to the U.S. Census, there are 1,113,548 single-member
households in North Carolina.48 Of those single-member households, 416,121, or 37
percent, are occupied by someone 65 or older. 49
68. Plaintiffs Clark, Cates, Edwards, Priddy, and Bentley are all eligible North
Carolina voters who need to vote by mail-in absentee ballot to safeguard their lives and the
health and well-being of their family members or co-habitants. Mr. Clark, who is 79 years
old, has severe COPD that puts him at serious risk of severe complications and even death
from COVID-19. After several bouts of pneumonia in recent years, Mr. Clark has been
other Voting at Home Options, NAT’L CONF. OF STATE LEGIS. (Apr. 14, 2020),
https://www.ncsl.org/research/elections-and-campaigns/absentee-and-early-voting.aspx
(select tab titled “Processing, Verifying, and Counting Absentee Ballots” and scroll down
to the chart “Verifying Authenticity of Absentee/Mailed Ballots.”).
48
Table S2501, Occupancy Characteristics, American Community Survey, U.S. CENSUS
BUREAU,
https://data.census.gov/cedsci/table?q=S2501&g=0400000US37&tid=ACSST5Y2018.S2
501.
49
Id.
35

quarantining himself at home. Ms. Cates, who is 85 years old, lives with chronic fatigue
syndrome, a debilitating disease that makes it hard for her to engage in normal daily
activities and has suffered a urinary tract infection and fallen several times over the last
year. Since the social distancing guidelines were put in place, Ms. Cates has not left her
home, and only allows an assistant to visit and help with household chores while carefully
maintaining distance from Ms. Cates. Ms. Edwards has a pre-existing medical condition,
type 1 diabetes, which puts her at high risk for developing severe illness from COVID-19.
In light of the risks to her health, she is uncomfortable leaving her home or being in close
proximity to people other than her partner. Mr. Priddy’s doctor has informed him that he
is at high risk of developing severe illness from the novel coronavirus due to his age and
serious pre-existing health conditions, including his use of medication that suppresses his
immune system related to a kidney transplant in 2010, and treatment for diabetes. To
protect his health, Mr. Priddy’s doctor has advised him to stay at home and avoid contact
with people other than his wife. Ms. Bentley has been diagnosed with hypertension and has
a history of developing cold symptoms attacking her lungs, also putting her at risk of severe
illness from COVID-19. As a result, she has been self-isolating in her home since March
10 to avoid contracting novel coronavirus. Ms. Bentley lives alone and does not have any
family nearby and does not feel safe asking her neighbors to serve as witnesses because
she has observed some breaking the Governor’s stay-at-home order. Other neighbors are
themselves self-isolating to protect vulnerable family members, and Ms. Bentley does not
know what precautions her remaining neighbors are taking. Accordingly, Plaintiffs Clark,
Cates, Edwards, Priddy, and Bentley have no way to safely comply with the two-witness
36

requirement and are therefore effectively disenfranchised by N.C. Gen. Stat. § 163-231(a).
Plaintiffs Clark, Cates, Edwards, Priddy, and Bentley will be forced to choose between
exercising their fundamental right to vote or running the risk of contracting and spreading
COVID-19 and further worsening the pandemic in North Carolina.
3. Other North Carolina Election Laws and Procedures that Must

Be Adjusted to Protect the Right to Vote By Mail During This
Public Health Crisis
69. In addition to the restrictions imposed by SB 683 and the two-witness
requirement, North Carolina’s election laws lack crucial mechanisms for guaranteeing that
eligible individuals in North Carolina will be able to cast a mail-in absentee ballot that is
counted. As pointed out by Defendant Director Bell, North Carolina has no mechanism for
requesting absentee ballots by phone, email, or online. Accordingly, voters wishing to
request an absentee mail-in ballot must either have the necessary equipment at home
(printer, envelope, postage, and access to mail pick-up), violate social-distancing directives
and guidelines and put themselves at severe risk by seeking these items outside the home,
or rely on others to provide them with a form. By contrast, at least twelve states allowed
voters to request an absentee ballot online, and an additional three allowed voters to submit
a scanned application via email. 50
70. Furthermore, North Carolina voters need a fail-safe for absentee voting to
prevent the unlawful denial of the right to vote given North Carolina’s lack of experience
50
VOPP: Table 6: States With Web-Based and Online Absentee Ballot Applications,
NAT’L CONF. OF STATE LEGIS. (May 4, 2020), https://www.ncsl.org/research/elections-
and-campaigns/vopp-table-6-states-with-web-based-and-online-absentee-ballot-
applications.aspx.
37

with the anticipated volume of mail-in absentee ballot requests for the November general
election. This is especially critical given the recent evidence out of Wisconsin and Ohio
that state and local election officials, as well as the U.S. Postal Service, are failing to deliver
thousands of absentee ballots to voters in the mail. 51 Those voters who timely request an
absentee ballot but who do not receive their requested absentee ballot in time to vote and
drop them off or mail them by Election Day—i.e., within a certain number of days of the
election of their request and/or within a certain number of days of the request—will be
disenfranchised unless they are permitted to use the Federal Write-In Absentee Ballot
(“FWAB”) as an alternative of last resort to cast their votes. 52 FWABs are already offered
to overseas civilians, who can download them and print them for use, but domestic civilian
absentee voters are denied the same option, even when their regular mail-in absentee ballot
does not arrive in time or at all.
71. Additionally, voters without access to postage and mail pick-up must also
violate social-distancing directives and guidelines to submit mail-in absentee ballots. To
successfully vote by mail, voters must mail their ballots such that they are postmarked on
or before Election Day and delivered no later than 5:00 pm on Election Day, or return their
voted ballots to the county board of elections (not a polling location) no later than 5:00 pm
on Election Day. However, there is currently no provision in North Carolina law for
51
See, e.g., Carrie Levine, Ohio’s Mail-in Ballot Brouhaha: A Sign of Coming Trouble?
THE CTR. FOR PUBLIC INTEGRITY (Apr. 28, 2020),
https://publicintegrity.org/politics/elections/ohios-mail-in-ballot-brouhaha-a-sign-of-
coming-trouble/.
52
See https://www.fvap.gov/uploads/FVAP/Forms/fwab2013.pdf.
38

contactless drop boxes for absentee ballots, which would allow voters to avoid severe
delays with the U.S. Postal Service, reduce the overall burden on the U.S. Postal Service,
and allow those voters with their own vehicles to submit absentee ballots without requiring
contact with anyone to obtain required postage or deliver in-person to the county board of
elections.
72. Finally, there is no adequate statewide-mandated procedure in North
Carolina for voters to cure deficient absentee ballot requests or the ballots themselves. In
the March 2020 North Carolina primary, almost 15 percent of submitted absentee mail-in
ballots were rejected. 53 This number was even higher for voters of color, with 19 percent
of mail-in ballots submitted by black voters rejected and almost 16 percent of mail-in
ballots submitted by Latinx voters rejected. 54 In light of the anticipated dramatic increase
in the use of absentee ballots and the new restrictions under SB 683 on who may assist a
voter to request an absentee ballot, there is a heightened risk that voters new to mail-in
absentee voting will fail to follow the proper procedures without being afforded any
opportunity to cure any deficiencies. As it stands, North Carolina’s election code risks
disenfranchising vast numbers of voters attempting to submit mail-in absentee ballots.
53
See N.C. State Bd. of Elections, March 3, 2020 Absentee File,
https://s3.amazonaws.com/dl.ncsbe.gov/ENRS/2016_03_03/absentee_20200303.zip. This
data file is accessible by going to https://www.ncsbe.gov/Public-Records-Data-
Info/Election-Results-Data and navigating to “FTP Site”  “ENRS”  “2020_03_03”
 “absentee_20200303.zip”. The statistics generated from the absentee file do not
include absentee by mail ballots that were either requested and not sent to the voter, or
sent to the voter but not returned to the State Board of Elections.
54
Id.
39

F. In-Person Voting
73. North Carolina’s electorate has expressed a clear preference for in-person
voting, with just 4 percent of voters casting mail-in absentee ballots in the 2016 general
election. 55 In general, preference for in-person voting holds disproportionately true for
voters of color. 56 There are a multitude of causes for this voter behavior pattern, but one
reason stems from the machinations used to steal votes from and defraud voters of color,
among others. 57 This means that North Carolina has not needed to, and indeed has not,
built the infrastructure to accommodate such a dramatic increase in voter demand for
absentee ballots without overwhelming current systems and causing mass
disenfranchisement. 58 Thus, it is critically important that voters be provided with ample
and as-safe-as-possible in-person voting options.
55
See N.C. State Bd. of Elections, November 8, 2016 History Statistics,
https://s3.amazonaws.com/dl.ncsbe.gov/ENRS/2016_11_08/history_stats_20161108.zip
This data file is accessible by going to https://www.ncsbe.gov/Public-Records-Data-
Info/Election-Results-Data and navigating to “FTP Site”  “ENRS”  “2016_11_08”
 “history_stats_20161108.zip”.
56
See David Becker, Mail-in ballots to avoid coronavirus? Yes, but here’s how to
minimize chaos and unfairness, WASH. POST (Mar. 18, 2020),
https://www.washingtonpost.com/opinions/2020/03/18/mail-in-ballots-avoid-
coronavirus-yes-heres-how-minimize-chaos-unfairness/.
57
See generally, CAROL ANDERSON, ONE PERSON, NO VOTE: HOW VOTER SUPPRESSION
IS DESTROYING O UR DEMOCRACY 19-22 (2018); STEVEN LAWSON, BLACK BALLOTS:
VOTING RIGHTS IN THE SOUTH, 1944-1969, Ch. 2 (1999).
58
See Ryan McCarthy, Whether the Ballot You Mail Is Counted May Depend On Where
You Vote, PROPUBLICA (Apr. 30, 2020), https://www.propublica.org/article/whether-the-
ballot-you-mail-is-counted-may-depend-on-where-you-vote.
40

74. The CDC has issued guidance directing election officials to “reduce crowd
size at polling stations” such as encouraging “early voting, where voter crowds may be
smaller throughout the day,” which “minimizes the number of individuals a voter may
come in contact with.” 59 There are two provisions of North Carolina law that have already
and will continue to hinder county boards in providing safe and adequate in-person voting
options, and there are a number of other adjustments needed to ensure voter and poll worker
safety.
1. Ensuring Adequate Number of Poll Workers
75. The first problematic provision is North Carolina’s requirement that a
majority of poll workers reside in the precinct where they serve on Election Day. See N.C.
Gen. Stat. § 163-42(b). Upon information and belief, as of May 14, 2020, eight county
boards have requested to eliminate 64 precincts for the upcoming Congressional District
11 Second Republican Primary, impacting over 50,000 voters. 60 Several of these county
boards specifically cited a lack of poll workers as a reason for consolidated precincts.
76. As the pandemic persists into the fall, older poll workers will continue to
withdraw in numbers sufficient to preclude the operation of countless polling places. In the
2014 general election, over 60 percent of North Carolina poll workers were 61 years of age
59
Coronavirus Disease 2019 (COVID-19), Recommendations for Election Polling
Locations, CDC, https://www.cdc.gov/coronavirus/2019-ncov/community/election-
polling-locations.html (last updated: Mar. 27, 2020).
60
See
https://dl.ncsbe.gov/index.html?prefix=Public_Records_Requests/June%2023%20Second
%20Primary_temporary_precinct_transfers/.
41

or older and, as a result, a significant portion of poll workers are in the 65-years-old-plus
CDC risk category.61
77. Defendant Director Bell requested a change in state law to allow county
boards to recruit and train poll workers from across the county, 62 and county board
members from Congressional District 11 similarly conveyed to North Carolina’s leadership
that this change “would significantly help us staff polling places in these challenging
times.” 63
78. As North Carolina faces the withdrawal of countless poll workers statewide,
this requirement will make it extremely difficult, if not impossible, to cure those critical
shortages, prevent the closure of any polling places, and minimize the lines, crowds, and
wait times at operational polling places. Long wait times and crowds unduly place
vulnerable voters at a greater risk of contracting COVID-19.
2. Early Voting Flexibility
79. North Carolina must also change its hours-uniformity requirement for one-
stop, better known as “early voting,” sites. Currently, if any early voting site is open in a
county, all early voting sites must be open and all sites other than the county board office
61
U.S. Election Assistance Comm’n, The 2014 EAC Election Administration and Voting
Survey Comprehensive Report (Table 39), at 248,
https://www.eac.gov/sites/default/files/eac_assets/1/1/2014_EAC_EAVS_Comprehensiv
e_Report_508_Compliant.pdf.
62
Governor Roy Cooper et al. (Mar. 26, 2020) (Exhibit 1).
63
Letter from Board of Elections Members in Congressional District 11 to General
Assembly Leaders et al. (Apr. 27, 2020) (Exhibit 3).
42

must be open 8:00 a.m. to 7:30 p.m. See N.C. Gen. Stat. § 163-227.6(c). As a result,
precincts are unable to provide flexible hours that accommodate the specific behaviors and
needs of the local voting population using that site. Precincts that might otherwise close
due to low anticipated activity must stay open, increasing costs for the entire county and
causing precinct consolidation. 64
80. After North Carolina imposed this requirement in June 2018 mandating
uniform hours across all early voting sites within each county, 65 the costs of implementing
this measure caused 43 counties to reduce the number of early voting sites in the 2018
general election compared to 2014 and over two thirds of counties to reduce weekend
hours. This disproportionately impacted black voters, who in 2018 made up approximately
22% of registered voters but 27% of those who cast ballots on the last Saturday of early
voting. 66
81. As discussed above, the anticipated shortage of poll workers will already
cause precinct consolidation in light of the global pandemic; the uniform hours requirement
64
See Blake Paterson, Bipartisan Furor as North Carolina Election Law Shrinks Early
Voting Locations by Almost 20 Percent, PROPUBLICA (Sept. 24, 2018),
https://www.propublica.org/article/bipartisan-furor-as-north-carolina-election-law-
shrinks-early-voting-locations-by-almost-20-percent.
65
See An Act to Set Hours for One-Stop Early Voting Sites, S.L. 2018-112 (June 15,
2018). As originally written, the statute removed the final Saturday of early voting
beginning in 2018; this was subsequently postponed.
66
See Voting Rights and Election Administration in North Carolina: Field Hearing
Before the Subcomm. on Elections of the H. Comm. on House Administration (Apr. 18,
2019) (testimony of Tomas Lopez, Exec. Dir., Democracy North Carolina),
https://docs.house.gov/meetings/HA/HA08/20190418/109315/HHRG-116-HA08-Wstate-
LopezT-20190418.pdf.
43

will compound this, causing long lines and limited early voting sites during the early voting
period when social distancing and reducing crowds is required for safe election
administration. Individuals accustomed to early voting may very well be deterred by large
crowding and the inherent heightened risk of infection; they will thus be forced to choose
between risking their health to cast a ballot or foregoing their right to vote.
3. Information Regarding Precinct Consolidation
82. The State Board of Elections must also create a more accessible, centralized
way in which voters and advocates can monitor precinct consolidation, and thereby
advocate against harmful precinct consolidations. Currently, each county board of elections
must give notice at least 45 days before the election when altering or consolidating
precincts. See N.C. Gen. Stat. § 163-128(a). This notice must be posted in a generally
circulated newspaper, posted on the door of the county courthouse and county board of
elections, and mailed to the chairmen of every political party in the county. Id. Voters only
need to be notified of changes in their particular precinct 30 days before an election. Id. In
order to ensure that all voters have access to information about precinct consolidations
necessitated by poll worker and/or site shortages, the State Board must provide that
information in a centralized and accessible manner.
4. Personal Protective Equipment
83. Finally, there is currently no provision for counties to provide poll workers
and voters with Personal Protective Equipment (“PPE”) for use during in-person voting,
such as protective masks and gloves for poll workers and/or voters, separation shields,
antiseptic wipes for equipment, and single-use pens. Effective use of PPE can dramatically
44

reduce the likelihood of coronavirus transmission, 67 and these measures are needed to
adequately protect voters exercising their constitutional rights. In a May 15, 2020, meeting
of the State Board of Elections, Defendant Director Bell stated that she had ordered PPE
for those counties holding the second Republican primary election on June 23, 2020. The
same provisions are required for the 2020 general election and, because of the state-wide
nature and expected high turnout of this election, the SBE Defendants must take action
immediately to ensure counties obtain adequate supplies. Without these measures,
plaintiffs will be forced to choose between their right to vote and their right to bodily
integrity.
CLAIMS
COUNT ONE
(All Defendants)
(Undue Burden on the Right to Vote in Violation of the First and Fourteenth
Amendments to the U.S. Constitution and 42 U.S.C. § 1983)
84. Plaintiffs reallege and reincorporate by reference all prior paragraphs of this
Complaint and the paragraphs in the counts below as though fully set forth herein.
85. Under the First and Fourteenth Amendments to the U.S. Constitution, any
burden on the right to vote must be balanced against a state’s interest in that requirement.
The Supreme Court has set forth the following test:
[T]he rigorousness of our inquiry into the propriety of a state election law
depends upon the extent to which a challenged regulation burdens First and
Fourteenth Amendment rights. Thus, as we have recognized when those
67
See, e.g., Zeynep Tufekci et al., The Real Reason To Wear A Mask, THE ATLANTIC
(Apr. 22, 2020), https://www.theatlantic.com/health/archive/2020/04/dont-wear-mask-
yourself/610336/.
45

rights are subjected to “severe” restrictions, the regulation must be “narrowly
drawn to advance a state interest of compelling importance.” Norman v.
Reed, 502 U.S. 279, 289 (1992). But when a state election law provision
imposes only “reasonable, nondiscriminatory restrictions” upon the First and
Fourteenth Amendment rights of voters, “the State’s important regulatory
interests are generally sufficient to justify” the restrictions. Anderson v.
Celebrezze, 460 U.S. 780, 788 (1983); see also id., at 788–789, n. 9.
Burdick v. Takushi, 504 U.S. 428, 434 (1992).
86. “A panoply of regulations, each apparently defensible when considered
alone, may nevertheless have the combined effect of severely restricting participation and
competition.” Clingman v. Beaver, 544 U.S. 581, 607-08 (2005) (O’Connor, J.,
concurring); see also N.C. State Conf. of NAACP v. McCrory, 831 F.3d 204, 231 (4th Cir.
2016) (because there were fewer early voting days, more voters would have to vote on
Election Day, and “[t]ogether, these produce longer lines at the polls on Election Day, and
absent out-of-precinct voting, prospective Election Day voters may wait in these longer
lines only to discover that they have gone to the wrong precinct and are unable to travel to
their correct precincts. Thus, cumulatively, the panoply of restrictions results in greater
disenfranchisement than any of the law’s provisions individually.”).
87. Unless Plaintiffs are granted the relief requested, the right to vote and ability
to freely associate of thousands of North Carolinians, including Individual Plaintiffs and
Organizational Plaintiffs and their members, will be severely burdened (if not denied
entirely) in the general election on November 3, 2020.
Voter Registration
88. North Carolina’s requirement that voter registration applications be
submitted at least 25 days before the election in which the voter wishes to cast a ballot
46

under N.C. Gen. Stat. § 163-82.6(d), and the DMV’s requirement that those registering
online do so at least 25 days before the election, is a severe burden on the right to vote in
light of the COVID-19 pandemic, which has caused a dramatic decrease in voter
registration rates. If a voter is not able to register at least 25 days before the election, then
their only recourse is to do same-day registration at an early voting site, therefore
potentially exposing themselves or their families to infection via COVID-19. See N.C. Gen.
Stat. § 163-82.6(f). Furthermore, North Carolina’s failure to provide online voter
registration through other state agencies, and specifically Defendant DHHS, places a severe
burden on those individuals who need to register online but are not registered with the
DMV.
89. Any administrative burden created by extending the voter registration
deadline and/or expanding online voter registration through Defendant DHHS is “de
minimis” and Defendants cannot put forth a compelling or legitimate state interest in
keeping the deadline as such in face of the emergency situation that COVID-19 has created
and will create. See Democratic Nat’l Comm. v. Bostelmann, No. 20-cv-249-wmc, 2020
U.S. Dist. LEXIS 48394, at *14 (W.D. Wis. Mar. 20, 2020); Fla. Democratic Party v.
Scott, 215 F. Supp. 3d 1250, 1257 (N.D. Fla. 2016); Ga. Coal. for the Peoples’ Agenda,
Inc. v. Deal, 214 F. Supp. 3d 1344, 1345–46 (S.D. Ga. 2016).
90. Since DMV has only allowed voters to register online without requiring a
DMV transaction at the same time since March 2020, voters are generally unaware of this
option. The 25-day deadline will hinder LWVNC’s efforts to promote voter registration
and require LWVNC and its members to divert significant resources. The lack of other
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online registration options offered by the DHHS Defendants further impedes LWVNC’s
ability to educate and engage in its voter registration efforts, and frustrates its mission to
ensure that all eligible voters can register safely during the COVID-19 pandemic.
91. In the midst of this ongoing public health crisis, there is no state interest in
favor of enforcing this 25-day deadline or failing to provide online voter registration
through Defendant DHHS that justifies the burden placed on Plaintiffs’ constitutional right
to vote, especially given that North Carolina allows for same-day registration at one-stop
early voting sites up until the Saturday before the election and has already implemented an
online voter registration method through DMV for certain voters. Upon information and
belief, Defendant DHHS possesses “wet-ink” signatures of its benefits recipients.
Accordingly, any purported state interests in enforcing this 25-day deadline or failing to
provide Defendant DHHS online voter registration are neither narrowly drawn to advance
nor justified by this interest, in light of the ongoing public health crisis.
Vote-by-mail assistance restrictions
92. North Carolina’s restrictions on who can assist voters with completing and
returning mail-in absentee ballot request forms pursuant to N.C. Gen. Stat. § 163-230.2(c),
(e), and (e1) is a severe burden on the fundamental right to vote and Plaintiff LWVNC,
their members, and the voters they will assist during the upcoming election. This restriction
impairs LWVNC’s efforts to help voters cast a ballot and limits the assistance LWVNC
and its members can provide to voters wishing to vote by mail, during an election in which
a voters are expected to vote by mail—and do so for the first time—in unprecedented
numbers. Additionally, Plaintiff Schaffer’s First Amendment speech and associational
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right to help people cast a ballot is impaired given that under the current law she is not able
to assist voters as she has in the past through various volunteer opportunities.
93. Likewise, the failure of North Carolina election code to allow individuals to
submit alternative proof of residency such as HAVA documents with their absentee request
forms unnecessarily impedes and restricts the ability of North Carolina voters to
successfully request absentee ballots at a time when the need to request those ballots will
be at an all-time high.
favor of imposing and enforcing these restrictions that justifies the burden placed on the
constitutional right to vote. Any purported state interest in enforcing the restriction on who
can assist individuals in requesting absentee ballots is neither narrowly drawn to advance
nor justified by this interest, in light of the ongoing public health crisis.
Vote-by-mail Witness Requirement
95. North Carolina’s two-witness or notary requirement for mail-in absentee
voting pursuant to N.C. Gen. Stat. § 163-231(a) is a severe burden on Plaintiffs’ right to
vote in light of the COVID-19 pandemic, because it will require voters, particularly voters
at high risk of severe complications and death from COVID-19, to break their self-
quarantine and violate social distancing directives at risk to their health. For example,
Plaintiffs Clark, Edwards, and Priddy, who are each self-quarantined with one other person
in their household, will be forced to choose between staying home and avoiding contact
with people outside their households or seeking out another person to serve as a second
witness despite guidance from the CDC and medical professionals to stay quarantined and
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limit contact with people outside their households. Plaintiffs Cates and Bentley, who are
also self-isolated at home, live alone and do not have any family members nearby.
Satisfying the two-witness requirement will require them to put themselves at risk of
contracting COVID-19 in order to satisfy the two-witness certification requirement.
favor of enforcing the two-witness or notary requirement that justifies the burden placed
on Plaintiffs’ constitutional right to vote. Any purported state interest in enforcing the two-
witness or notary requirement is neither narrowly drawn to advance nor justified by this
interest, in light of the ongoing public health crisis.
Vote-by-mail lack of fail-safe for absentee ballots that are not timely delivered to voters
97. North Carolina lacks any fail-safe option for mail-in absentee voters, if the
state’s election administrators, as anticipated, cannot successfully deliver mail-in ballots
on time to ten times as many absentee voters as usual. In order to prevent the wholesale
and unlawful denial of the right to vote to voters who cannot risk voting in person at a
polling site on or before Election Day, Defendants must afford voters who timely request
an absentee ballot but who do not receive their requested absentee ballot in time to vote
and drop them off or mail them by Election Day—i.e. within a certain number of days of
the election of their request and/or within a certain number of days of the request—the
option to use the Federal Write-In Absentee Ballot (“FWAB”) as an alternative of last
resort to cast their votes. 68 Plaintiffs Clark, Cates, Edwards, Priddy, and Bentley all intend
68
See https://www.fvap.gov/uploads/FVAP/Forms/fwab2013.pdf.
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to vote by mail-in absentee ballot, in order to safeguard their health. If, as expected, North
Carolina’s state and local election officials and their staff cannot keep pace with the
unprecedented rise in absentee ballot requests, some or all of these five Plaintiffs may well
not receive their absentee ballots in a timely fashion such that they can be cast and counted.
Accordingly, in order to protect their right to vote, just like overseas civilian voters,
Plaintiffs Clark, Cates, Edwards, Priddy, and Bentley must be permitted to cast FWABs,
as a fail-safe option.
98. Particularly in the midst of this ongoing public health crisis, the failure to
offer this standardized fail-safe option for mail-in absentee voters, which would completely
deny the right to vote to countless domestic civilian absentee voters, cannot be justified by
any legitimate or important state interest. This option is already afforded to overseas
civilian voters; the exclusion of domestic, civilian voters, at least in the limited context
where a voter does not receive a requested absentee ballot in the mail, is unreasonable and
discriminatory. See Burdick, 504 U.S. at 434 (“But when a state election law provision
imposes only reasonable, nondiscriminatory restrictions upon the First and Fourteenth
Amendment rights of voters, the State’s important regulatory interests are generally
sufficient to justify’ the restrictions.”) (emphasis added, internal quotations omitted). Any
purported state interest in failing to provide these services is neither narrowly drawn to
advance nor justified by this interest, in light of the ongoing public health crisis.
Vote-by-mail failure to provide other accommodations
99. North Carolina’s failure to provide mechanisms for requesting absentee
ballots by phone, email, or online, its failure to provide contactless drop boxes for absentee
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ballots that would allow voters to submit their absentee ballots from their vehicles instead
of violating social-distancing directives and guidelines, and its failure to provide a
statewide-mandated procedure for voters to cure deficient absentee ballot requests are all,
individually or in combination, severe restrictions on Plaintiffs’ right to vote and will
require them to put their own health at risk in order to successfully vote by absentee ballot.
See Clingman v. Beaver, 544 U.S. 581 607–08 (2005) (O’Connor, J., concurring); N.C.
State Conf. of NAACP v. McCrory, 831 F.3d 204, 231 (4th Cir. 2016). Plaintiff Cates
cannot secure an absentee ballot request form on her own, though she could if online or
phone request options were made available. LWVNC will also have to redirect a significant
amount of its limited resources toward helping eligible voters to access absentee ballot
request forms without a phone, email, or online option to request an absentee ballot.
100. Additionally, Plaintiffs Clark, Cates, Edwards, Priddy, Bentley, and
Hutchins all intend to vote by mail-in absentee ballot, some for the first time, and may well
make errors on their absentee ballot request forms or absentee ballots and/or their
certificate envelopes. Procedural due process requires a cure procedure for these defects.
Furthermore, the lack of any uniform mechanism to cure will require LWVNC and
Democracy NC to devote additional resources towards researching these various rules to
help ensure the voters they assist have followed all procedures for requesting and filling
out absentee ballots precisely, in addition to their general educational efforts.
failing to provide these services that justifies the burden placed on Plaintiffs’ constitutional
right to vote, especially given the numerous other states that do provide these services. Any
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purported state interest in failing to provide these services is neither narrowly drawn to
advance nor justified by this interest, in light of the ongoing public health crisis.
Poll worker “home precinct” requirement
102. North Carolina’s requirement that a majority of poll workers reside in the
precinct where they serve on Election Day pursuant to N.C. Gen. Stat. § 163-42(b) is a
severe burden on Plaintiffs’ right to vote, as it will exacerbate a shortage of poll workers,
force precinct consolidation and relocation, and create long lines and crowds on Election
Day that contravene social distancing directives needed to protect Plaintiffs’ health.
103. This constitutes a severe burden on voters, particularly those who cannot wait
in line for hours to vote. SBE Defendants are on notice that precinct consolidation due to
lack of poll workers is likely, given the requests for precinct consolidation for the June 23,
2020 second Republican Primary, and their failure to prepare for this same eventuality in
the November 3, 2020 general election will severely burden the rights of voters who rely
on in-person voting. See Ury v. Santee, 303 F. Supp. 119, 124 (N.D. Ill. 1969) (finding that
the defendant’s failure to provide adequate voting facilities despite their foreknowledge of
precinct consolidations deprived voters of their constitutional rights); see also League of
Women Voters of Ohio v. Brunner, 548 F.3d 463, 478 (6th Cir. 2008) (finding long lines
and inadequate voting machines severely burdened Ohio voters’ right to vote).
104. Plaintiff Permar relies on polling sites being open in order to vote in-person
given her disability and her need to use an ADA compliant voting machine. She also relies
on polling places being located in places that are accessible by public transportation, which
she uses to independently travel. Ms. Permar’s right to vote and others similarly situated
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would be severely burdened if precincts are consolidated in such a way as to force her or
others similarly situated to travel to a polling place that is not accessible by public
transportation or to wait in long lines exposing themselves to COVID-19 when they get to
the polling place. Plaintiff LWVNC will also be required to divert resources to recruit poll
workers, as well as in its voter education efforts to alert its members and those in their
communities about precinct consolidations if the in-precinct requirement for poll workers
remains in place and precincts are consolidated as a result. Democracy NC’s poll monitors
will also have to divert their resources to ensure voters find the correct precinct, instead of
providing the help they would otherwise provide voters.
enforcing this requirement that justifies the burden placed on Plaintiffs’ constitutional right
to vote. Any purported state interest in enforcing this requirement is neither narrowly
drawn to advance nor justified by this interest, in light of the ongoing public health crisis.
In-person voting uniform hours
106. North Carolina’s requirement that early voting sites in every county maintain
uniform hours pursuant to N.C. Gen. Stat. § 163-227.6(c) is a severe burden on Plaintiffs’
right to vote, as the costs of maintaining uniform hours and limited resources in counties
will cause precinct consolidation and long lines and crowds on early voting days that
contravene social distancing directives needed to protect Plaintiffs’ health. Additionally,
given the SBE Defendants’ knowledge about the effect that COVID-19 has had on the June
2020 runoff election and could have on the November 2020 general election, they have an
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obligation to mitigate precinct consolidation as much as possible so as to not severely
burden voters’ right to vote. See Ury, 303 F. Supp. at 124.
107. Plaintiff Permar works at Duke Hospital as a staff assistant, thus it is
important that she is able to vote at a time that is in line with her work schedule. Further,
Ms. Permar or other similarly situated disabled individuals should not have to wait in long
lines further risking their health or potential COVID-19 infection. Plaintiffs Democracy
NC and LWVNC will also be required to divert resources in its voter education efforts to
alert their members/advocates and those in their communities about precinct consolidations
if the uniform hours requirement remains in place.
enforcing this uniform hours requirement that justifies the burden placed on Plaintiffs’
constitutional right to vote. Any purported state interest in enforcing this requirement is
neither narrowly drawn to advance nor justified by this interest, in light of the ongoing
public health crisis.
Precinct-consolidation monitoring
109. North Carolina’s failure to provide a more accessible, centralized way in
which voters and advocates can monitor precinct consolidation is a severe burden on
Plaintiffs’ right to vote. The lack of centralized access to this information will impede and
confuse voters’ ability to determine where and how best to vote in-person and will impede
the efforts of advocates to oppose harmful precinct consolidations. Plaintiff Permar and
other voters rely on being able to know in advance where early voting locations are, or
where their election-day polling place is, so as to ensure that they are able to properly
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schedule a time to vote. Democracy NC is a central hub for voter information, and it would
be a huge drain on its resources to not have easy access to proposed precinct consolidations
to inform voters. In the midst of this ongoing public health crisis, there is no state interest
in failing to provide this service that justifies the burden placed on Plaintiffs’ constitutional
right to vote. Any purported state interest in failing to provide this service is neither
narrowly drawn to advance nor justified by this interest, in light of the ongoing public
health crisis.
Personal Protective Equipment
110. North Carolina’s failure to provide PPE to all counties for use during early
and Election-Day in-person voting is a severe burden on Plaintiffs’ right to vote, as the
failure to provide this will exacerbate the shortage of poll workers and increase the risk
present to all individuals that vote in person. In conducting its Election Protection hotline
and poll monitoring program, Democracy NC volunteers will almost certainly be queried
about PPE, who has it, and how to get it if is not provided. In the midst of this ongoing
public health crisis, there is no state interest in failing to provide PPE that justifies the
burden placed on Plaintiffs’ constitutional right to vote. Any purported state interest in
failing to provide PPE is neither narrowly drawn to advance nor justified by this interest,
in light of the ongoing public health crisis.
111. Defendants, acting under color of state law, have deprived and will continue
to deprive Plaintiffs of their rights under the First and Fourteenth Amendments to the U.S.
Constitution by administering and enforcing the above laws and/or by failing to provide
the above accommodations and services during the COVID-19 pandemic.
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112. For the foregoing reasons, Defendants have deprived and will continue to
deprive Plaintiffs of the right to be free of undue burdens on their right to vote in violation
of the First and Fourteenth Amendments to the U.S. Constitution as enforced by 42 U.S.C.
§ 1983.
COUNT TWO
(SBE Defendants)
(Unconstitutional Condition on Right to Vote Compelling Forfeiture of Right to
Bodily Integrity in Violation of the Fourteenth Amendment to the U.S. Constitution
and 42 U.S.C. § 1983)
114. Voting is protected by the First Amendment as a means of political
association and political expression. See Cal. Democratic Party v. Jones, 530 U.S. 567,
574 (2000); Norman v. Reed, 502 U.S. 279, 288–90 (1992); Anderson v. Celebrezze, 460
U.S. 780, 787–89, 806 (1983); Kusper v. Pontikes, 414 U.S. 51, 56–58 (1973); Williams v.
Rhodes, 393 U.S. 23, 30–31 (1968).
115. Under the unconstitutional conditions doctrine, the government may not
require an individual to forfeit one constitutional right in order to exercise another. See
Lefkowitz v. Cunningham, 431 U.S. 801, 807–08 (1977); Simmons v. United States, 390
U.S. 377, 394 (1968); Howard v. Walker, 406 F.3d 114, 129 (2d Cir. 2005); Bourgeois v.
Peters, 387 F.3d 1303, 1324 (11th Cir. 2004); Green v. Brigano, 123 F.3d 917, 921 (6th
Cir. 1997).
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116. “[W]hen a condition on a government benefit burdens a constitutional right,
it generally triggers the same scrutiny as a direct penalty would.” McCabe v. Sharrett, 12
F.3d 1558, 1562 (11th Cir. 1994). Government actions that threaten the right to bodily
integrity are subject to strict scrutiny. See Kallstrom v. City of Columbus, 136 F.3d 1055,
1064 (6th Cir. 1998). The Supreme Court has invalidated voting requirements or conditions
that require the forfeiture of another fundamental right. See Dunn v. Blumstein, 405 U.S.
330, 346, 353 (1972) (finding that durational residency requirement for voter registration
placed unconstitutional condition on fundamental right to interstate travel).
117. The Fourteenth Amendment guarantees the right to bodily integrity, and this
right is violated if government officials are deliberately indifferent to the violation of the
plaintiff’s bodily integrity. See Missouri v. McNeely, 569 U.S. 141, 159 (2013); Guertin v.
Michigan, 912 F.3d 907, 919 (6th Cir. 2019) (recognizing that “individuals possess a
constitutional right to be free from forcible intrusions on their bodies against their will,
absent a compelling state interest”) (quoting Planned Parenthood Sw. Ohio Reg. v.
DeWine, 696 F.3d 490, 506 (6th Cir. 2012)).
118. “Involuntarily subjecting nonconsenting individuals to foreign
substances with no known therapeutic value . . . is a classic example of invading the core
of the bodily integrity protection.” Guertin, 912 F.3d at 921–22.
119. Defendants require Plaintiffs Clark, Cates, Edwards, Priddy, and Bentley to
satisfy unnecessary requirements for mail-in absentee voting that cannot be reasonably and
safely accomplished without severely threatening their right to bodily integrity. Because
in-person voting even more severely threatens to violate Plaintiffs’ bodily integrity by
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subjecting them to the significant risk of contracting COVID-19, Defendants’ enforcement
of North Carolina’s requirements as to mail-in voting force Plaintiffs to forfeit their right
to bodily integrity in order to exercise their right to vote. Should Plaintiffs Clark, Cates,
Edwards, Priddy, and Bentley exercise their right to vote by mail under these
circumstances, Defendants will have knowingly subjected Plaintiffs to a foreign
substance—the novel coronavirus that causes COVID-19—without a therapeutic basis or
Plaintiffs’ consent.
120. Defendants, acting under color of state law, have deprived and will continue
to deprive Plaintiffs of their rights under the Fourteenth Amendment to the U.S.
Constitution, by requiring them to forfeit their right to bodily integrity in order to exercise
their right to vote.
121. For the foregoing reasons, Defendants have deprived and will continue to
deprive Plaintiffs of the right to be free of unconstitutional conditions on their rights to vote
in violation of the Fourteenth Amendment to the U.S. Constitution as enforced by 42
U.S.C. § 1983.
COUNT THREE
(SBE Defendants)
(Violation of the Rights of Free Speech and Association in violation of the First and
Fourteenth Amendments to the Constitution of the United States and 42 U.S.C. §
1983)
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123. The First Amendment to the United States Constitution, as applied to the
states through the Fourteen Amendment, prohibits an abridgment of the freedom of speech
or associational rights. Any burden, regardless of how slight, “must be justified by relevant
and legitimate state interests sufficiently weighty to justify the limitation.” Norman, 502
U.S. at 288– 89.
124. The restrictions on who can assist voters with completing and returning mail-
in absentee ballot request forms pursuant to N.C. Gen. Stat. § 163-230.2 effectively
prohibits the Organizational Plaintiffs and their members’ core political speech and
expressive conduct, which includes assisting voters with requesting and submitting
absentee ballot requests in an effort to engage potential voters and encourage them to vote.
Plaintiff Schaffer’s individual speech and associational rights are also impaired by N.C.
Gen. Stat. § 163-230.2, because she is no longer able to assist as she has in the past. These
efforts are particularly important in the midst of the current public health crisis, where for
many voting by mail is crucial to protecting their health and the health of their co-habitants
and family members, and where the anticipated surge in individuals voting by mail means
many will be doing so for the first time and without prior experience. Because of this
prohibition, the Organizational Plaintiffs and their members will not be able to effectively
engage potentially eligible absentee voters, nor will they be able to effectively facilitate
those eligible voters requesting absentee ballots.
125. N.C. Gen. Stat. § 163-230.2 therefore chills the Organizational Plaintiffs’
speech and associational rights, and Plaintiff Schaffer’s individual speech and associational
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rights, 69 and does so without being narrowly-tailored to serve a compelling state interest.
The restrictions on who can assist voters with completing and submitting absentee ballot
requests are not justified by a state interest, especially in light of the current COVID-19
pandemic, where allowing individuals to follow social-distancing guidelines and self-
quarantine is crucial to protecting their health and the health of their co-habitants and
family members.
COUNT FOUR
(SBE Defendants)
(Denial of Plaintiffs’ Right to Procedural Due Process in violation of the Fourteenth
Amendment to the Constitution of the United States and 42 U.S.C. § 1983)
127. The Due Process Clause of the Fourteenth Amendment prohibits the
deprivation of “life, liberty, or property, without due process of law.” U.S. CONST. amend.
XIV § 1. “Where the government seeks to deprive someone of a liberty interest protected
by due process, due process demands that certain procedural safeguards be provided.”
United States v. Baker, 45 F.3d 837, 843 (4th Cir. 1995). A liberty interest that is governed
by due process can be created by the Constitution or “may arise from an expectation or
interest created by state laws or policies.” Wilkinson v. Austin, 545 U.S. 209, 221 (2005).
69
Plaintiffs’ contend that Schaffer’s First Amendment right to free speech and
association are restricted under the Anderson/Burdick test, or, alternatively, under
exacting scrutiny similar to Meyer v. Grant, 486 U.S. 414, 422–23 (1988).
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128. At a minimum, “procedural due process requires fair notice of impending
state action and an opportunity to be heard.” Snider Int’l Corp. v. Town of Forest Heights,
739 F.3d 140, 146 (4th Cir. 2014) (citing Mathews v. Eldridge, 424 U.S. 319, 333 (1976)).
129. “Proper notice is ‘an elementary and fundamental requirement of due
process,’ and must be reasonably calculated to convey information concerning a
deprivation.’” Snider Int’l, 739 F.3d at 146 (quoting Mullane v. Cent. Hanover Bank & Tr.
Co., 339 U.S. 306, 314 (1950)); see also Presley v. City of Charlottesville, 464 F.3d 480,
490 (4th Cir. 2006).
130. As for the opportunity to be heard, “Mathews set forth the familiar three-step
inquiry for determining the adequacy of the opportunity to be heard: a balancing of the
private interest and the public interest, along with ‘the risk of an erroneous deprivation of
such interest through the procedures used, and the probable value, if any, of additional or
substitute procedural safeguards.’” Snider Int’l, 739 F.3d at 146 (quoting Mathews, 424
U.S. at 335). “Fundamental to due process is an opportunity to be heard—‘an opportunity
which must be granted at a meaningful time.’” Sciolino v. City of Newport News, Va., 480
F.3d 642, 653 (4th Cir. 2007) (quoting Armstrong v. Manzo, 380 U.S. 545, 552 (1965)).
131. Absent exigent circumstances, due process requires pre-deprivation
procedures. See Cleveland Bd. of Educ. v. Loudermill, 470 U.S. 532, 542 (1985) (“We have
described ‘the root requirement’ of the Due Process Clause as being ‘that an individual be
given an opportunity for a hearing before he is deprived of any significant property
interest.’” (quoting Boddie v. Connecticut, 401 U.S. 371, 379 (1971) (emphasis in
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original)); Sciolino, 480 F.3d at 653 (“An opportunity to clear your name after it has been
ruined by dissemination of false, stigmatizing charges is not ‘meaningful.’”).
132. North Carolina law gives all registered North Carolina voters statutory rights
to request and cast a mail-in absentee ballot that will be processed and counted, thereby
vesting them with liberty interests. Eligible, registered voters enjoy an “individual and
personal” right to vote under North Carolina law. Gill v. Whitford, 138 S. Ct. 1916, 1929
(2018) (quoting Reynolds v. Sims, 377 U.S. 533, 561 (1964)).
133. However, the SBE Defendants do not afford mail-in absentee voters any
notice of or opportunities to cure material defects in their absentee ballot request forms or
absentee ballots including their certificate envelopes that will result in rejection, thereby
depriving Plaintiffs and other registered North Carolina voters of their liberty interests in
requesting and casting a mail-in absentee ballot and exercising their fundamental right to
vote.
134. The risk of erroneous deprivation is high, as these eligible, registered North
Carolina voters are entitled by law to request an absentee ballot and to vote an absentee
ballot and, therefore, must be provided with an additional procedural safeguard, the
opportunity to timely cure any defect that would cause the absentee ballot request form’s
rejection or the absentee ballot’s rejection.
135. Plaintiffs Clark, Cates, Edwards, Priddy, and Bentley all intend to vote by
mail-in absentee ballot, some for the first time, and may well make errors on their absentee
ballot request forms or absentee ballots and/or their certificate envelopes. Procedural due
process requires a cure procedure for these defects.
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136. Defendants cannot advance any interests that outweigh the risk of erroneous
deprivation. The threat of disenfranchising Plaintiffs and their members far outweighs any
increased administrative burden in affording voters an opportunity to cure their absentee
ballot request form defects or their absentee ballot defects, including any defects on the
certificate envelope. Defendants’ interest in conducting fair election administration and
preserving election integrity would not be compromised in the slightest, and they would
satisfy their weighty interest in abiding by federal constitutional requirements.
137. For the foregoing reasons, SBE Defendants have violated and will continue
to violate Plaintiffs Clark, Cates, Edwards, Priddy, and Bentley’s federal constitutional
rights to procedural due process.
138. At all relevant times, Defendants have acted under color of state law.
139. Defendants have deprived and will continue to deprive Plaintiffs Clark,
Cates, Edwards, Priddy, Bentley and all voters seeking to vote by mail of their right to
adequate notice and a meaningful opportunity to be heard in order to cure deficiencies with
their absentee ballot request forms and their absentee ballots. This wholly fails to meet
these minimum requirements of procedural due process, as guaranteed to Plaintiffs by the
Fourteenth Amendment to the U.S. Constitution and 42 U.S.C. § 1983.
COUNT FIVE
(SBE Defendants)
(Failure to Provide Reasonable Accommodations in Violation of Title II of the
Americans with Disabilities Act, 42 U.S.C. §§ 12131, et seq.)
Compliant and the paragraphs in the counts below as though fully set forth herein.
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141. Under Title II of the Americans with Disabilities Act, state and local
governments must not impose requirements on participation in public services, programs,
or activities, including voting, that screen out individuals with disabilities from fully and
equally enjoying those programs and must make reasonable modifications in policies,
practices, or procedures, including voting and election procedures, when the modifications
are necessary to avoid discrimination on the basis of disability.
142. A disability exists under the ADA when an individual has (1) a physical
impairment; (2) that affects at least one major life activity; (3) in a substantial way. Heiko
v. Colombo Sav. Bank, F.S.B., 434 F.3d 249, 254 (4th Cir. 2006).
143. Plaintiff Clark, who is 79 years old, suffers from severe COPD, which
interferes with several major life activities, including breathing. His COPD has rendered
him highly susceptible to complications from COVID-19, a disease that often causes severe
respiratory distress. Plaintiff Edwards possesses type 1 diabetes, a physical impairment that
has detrimental effects on her health, especially her ability to operate a major bodily
function, her endocrine system, and puts her at risk of severe illness from COVID-19.
Plaintiff Priddy’s pre-existing conditions, which include being immunocompromised due
to taking medications to address complications from a kidney transplant, are physical
impairments that puts him at risk of severe illness from COVID-19. This substantially
influences his major life activities because the function of his immune system is directly
affected. Plaintiff Hutchins is legally blind, which substantially affects a number of his
major life activities, such as seeing, reading, writing, and walking. These physical
impairments substantially affect the various major life activities of Plaintiffs Clark,
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Edwards, Priddy, and Hutchins. Accordingly, Plaintiffs Clark, Edwards, Priddy, and
Hutchins have disabilities as defined by the ADA and should be provided meaningful
access to the ballot through a more accessible mail-in voting process.
144. Plaintiffs Clark, Edwards, and Priddy are unable to safely obtain two witness
signatures without ignoring the CDC’s guidelines and putting themselves at risk of
contracting COVID-19 and suffering serious health consequences, including death.
Plaintiffs Clark, Edwards, and Priddy would be unable to safely vote by absentee ballot
unless SBE Defendants eliminate the two-witness signature requirement.
145. Plaintiff Hutchins is prohibited from asking staff and nurses at his nursing
facility to assist him with returning an absentee ballot request form, marking and
completing an absentee ballot, and submitting an absentee ballot. As a result of the
COVID-19 pandemic, his nursing home is closed to visitors and he is not able to receive
assistance from his wife in any of these steps in the absentee voting process. Plaintiff
Hutchins would be unable to vote by absentee ballot unless SBE Defendants allow nursing
home staff to assist him with each of these steps.
146. The CDC has deemed that individuals who suffer from the impairments that
Plaintiffs Clark, Edwards, Priddy possess are “at higher risk for severe illness from
COVID-19.” Defendants’ failure and refusal to ensure that plaintiffs with disabilities are
given the ability to vote without risks of serious illness or death constitute a failure to make
a reasonable accommodation for those, such as Plaintiffs Clark, Edwards and Priddy,
whose health limits their ability to have contact with others in this time of public health
emergency created by COVID-19, in violation of the ADA.
66

147. Defendants’ failure to ensure that voters like Plaintiff Hutchins, who wishes
to vote by mail because he is blind, vulnerable to COVID-19 due to his advanced age, and
resides in a nursing home, can receive the assistance he needs from nursing home staff to
return an absentee ballot request form and complete and submit an absentee ballot is a
violation of the ADA.
148. The failure to accommodate these voters constitutes a condition on access to
the ballot box that has the effect of screening out such individuals from participating in the
November 3, 2020 general election, in violation of Title II of the Americans with
Disabilities Act.
COUNT SIX
(SBE Defendants)
(Failure to Provide Reasonable Accommodations in Violation of
Section 504 of the Rehabilitation Act, 29 U.S.C. § 794)
150. Under Section 504 of the Rehabilitation Act, federally funded programs,
including state and local programs related to elections and voting, must not discriminate
against individuals with disabilities and must make reasonable accommodations to allow
individuals with disabilities to access the federal funded program, activity, or service.
151. The State of North Carolina receives federal funding to conduct its elections.
Thus, Defendants are obligated to comply with the Rehabilitation Act.
67

152. A disability exists under the Rehabilitation Act when an individual has (1) a
physical impairment; (2) that affects at least one major life activity; (3) in a substantial
way. Heiko v. Colombo Sav. Bank, F.S.B., 434 F.3d 249, 254 (4th Cir. 2006).
153. Plaintiff Clark, who is 79 years old, suffers from severe COPD, which
interferes with several major life activities, including breathing. His COPD has rendered
him highly susceptible to complications from COVID-19, a disease that often causes severe
respiratory distress. Plaintiff Edwards possesses type 1 diabetes, a physical impairment that
has detrimental effects on her health, especially her ability to operate a major bodily
function, her endocrine system, and puts her at risk of severe illness from COVID-19.
Plaintiff Priddy’s pre-existing conditions, which include being immunocompromised due
to taking medications to address complications from a kidney transplant, are physical
impairments that put him at risk of severe illness from COVID-19. This substantially
influences his major life activities because the function of his immune system is directly
affected. Plaintiff Hutchins is legally blind, which substantially affects a number of his
major life activities, such as seeing, reading, writing, and walking. These physical
impairments substantially affect the major life activities of Plaintiffs Clark, Edwards,
Priddy, and Hutchins. Accordingly, Plaintiffs Clark, Edwards, Priddy, and Hutchins have
disabilities as defined by the Rehabilitation Act and should be provided meaningful access
to vote through a more accessible mail-in voting process.
154. Plaintiffs Clark, Edwards, and Priddy are unable to obtain two witness
signatures without ignoring the CDC’s guidelines and putting themselves at risk of
contracting COVID-19 and suffering serious health consequences, including death.
68

Plaintiffs Clark, Edwards, and Priddy would be unable to safely vote by absentee ballot
unless Defendants eliminate the two-witness signature requirement.
155. Plaintiff Hutchins is prohibited from asking staff and nurses at his nursing
facility to assist him with returning an absentee ballot request form, marking and
completing an absentee ballot, and submitting an absentee ballot. See N.C. Gen. Stat. §§
163-226.3(a)(4), 163-226.3(a)(5), 163-230.2(e)(4), 163-231(b)(1). As a result of the
COVID-19 pandemic, his nursing home is closed to visitors and he is not able to receive
assistance from his wife in any of these steps in the absentee voting process. Plaintiff
Hutchins would be unable to vote by absentee ballot unless SBE Defendants allow nursing
home staff to assist him with each of these steps.
156. The CDC has deemed that individuals who suffer from the impairments that
Plaintiffs Clark, Edwards, Priddy possess are “at higher risk for severe illness from
COVID-19.” Defendants’ failure to ensure that plaintiffs with disabilities are given the
ability to vote without risks of serious illness or death constitutes a failure to make a
reasonable accommodation for those, such as Plaintiffs Clark, Edwards, and Priddy, whose
physical impairments limit their ability to have contact with others in this time of public
health emergency created by COVID-19, in violation of the Rehabilitation Act.
157. Defendants’ failure to ensure that voters like Plaintiff Hutchins, who wishes
to vote by mail because he is blind, vulnerable to COVID-19 due to his advanced age, and
resides in a nursing home, can receive the assistance he needs from nursing home staff to
return an absentee ballot request form and complete and submit an absentee ballot is a
violation of Section 504 of the Rehabilitation Act.
69

158. The failure to accommodate these voters constitutes a condition on access to
the ballot box that has the effect of screening out such individuals from participating in the
November 3, 2020 general election, in violation of Section 504 of the Rehabilitation Act.
COUNT SEVEN
(SBE Defendants)
(Disparate Impact Claims in Violation of Title II of the Americans with Disabilities
Act, 42 U.S.C. §§ 12131, et seq.)
160. Under Title II of the Americans with Disabilities Act, States cannot
promulgate standards, criteria, or methods of administration that have the effect of
discriminating against individuals based on their disabilities.
161. The Defendants are all public entities covered by Title II of the ADA.
162. The CDC has declared that individuals with co-morbidities such as Plaintiffs
Clark, Edwards, and Priddy and individuals over the age of 65, such as Plaintiff Hutchins,
are significantly more likely to risk serious illness or death if they contract COVID-19.
Defendants’ enforcement of current voting regulations will unnecessarily expose Plaintiffs
Clark, Edwards, Priddy, and Hutchins to an unjustifiable risk of severe illness from
COVID-19 in order to vote. This will result in disparate impact upon Plaintiffs Clark,
Edwards, Priddy, and Hutchins if they attempt to vote because they will be more harshly
affected by COVID-19, in violation of the ADA.
70

163. Defendants will be unable to show that the current voting regulations are
justified by legitimate state interests.
164. The disparate impact that will result from enforcing these conditions has the
effect of prohibiting individuals with disabilities from participating in the November 3,
2020 general election, in violation of Title II of the ADA.
COUNT EIGHT
(SBE Defendants)
(Disparate Impact Claims in Violation of Section 504 of the
Rehabilitation Act, 29 U.S.C. § 794)
166. Section 504 of the Rehabilitation Act prohibits federally funded programs,
including state and local programs related to elections and voting, from enacting facially
neutral policies that have a discriminatory impact on persons within a protected class.
167. The State of North Carolina receives federal funding to conduct its elections.
Thus, Defendants are obligated to comply with the Rehabilitation Act.
168. The CDC has declared that individuals with co-morbidities such as Plaintiffs
Clark, Edwards, and Priddy and individuals over the age of 65, such as Plaintiff Hutchins
are significantly more likely to risk serious illness or death if they contract COVID-19.
Defendants’ enforcement of current voting requirements will unnecessarily expose
Plaintiffs Clark, Edwards, Priddy, and Hutchins to an unjustifiable risk of severe illness
from COVID-19 in order to vote. This will result in disparate impact upon Plaintiffs Clark,
71

Edwards, Priddy, and Hutchins if they attempt to vote because they will be more harshly
affected by COVID-19, in violation of the Rehabilitation Act.
169. Defendants will be unable to show that the current voting regulations are
justified by legitimate state interests.
170. The disparate impact that will result from enforcing these conditions has the
effect of prohibiting individuals with disabilities from participating in the November 3,
2020 general election, in violation of Section 504 of the Rehabilitation Act.
COUNT NINE
(Section 208 of the Voting Rights Act of 1965, 52 U.S.C. § 10508)
172. Section 208 of the Voting Rights Act of 1965 (VRA), 52 U.S.C. § 10508,
provides: “Any voter who requires assistance to vote by reason of blindness, disability, or
inability to read or write may be given assistance by a person of the voter’s choice, other
than the voter’s employer or agent of that employer or officer or agent of the voter’s union.”
173. The word “vote” is expressly defined in 52 U.S.C. § 10310(c)(1) as follows:
The terms “vote” or “voting” shall include all action necessary to make a vote
effective in any primary, special, or general election, including, but not limited to,
registration, listing pursuant to this chapter, or other action required by law
prerequisite to voting, casting a ballot, and having such ballot counted
properly and included in the appropriate totals of votes cast with respect to
candidates for public or party office and propositions for which votes are received
in an election.
72

OCA-Greater Houston v. Texas, 867 F.3d 604, 614–15 (5th Cir. 2017) (quoting 52 U.S.C.
§ 10310(c)(1)) (“‘To vote,’ therefore, plainly contemplates more than the mechanical act
of filling out the ballot sheet.)
174. Under Section 208, a voter who is blind, disabled, or unable to read or write
(“208-covered voter”) possesses the right to choose any person other than their
employer/union representative—regardless of whether the person is a near relative or legal
guardian—to assist them with the voting process, including the steps necessary to obtain,
cast, and submit an absentee ballot. See 52 U.S.C. § 10508; OCA-Greater Houston, 867
F.3d at 614–15.
175. North Carolina restricts absentee voters to only assistance from their near
relatives, verifiable legal guardians, or MAT team members, for absentee ballot request
return, absentee ballot marking and completion, and absentee ballot return. Unlike for
completing an absentee ballot request form, there is no similar exception for any of these
steps for absentee voters who need assistance by reason of their blindness, disability, or
inability to read or write. See N.C. Gen. Stat. §§ 163-226.3(a)(4), 163-226.3(a)(5), 163-
230.2(e)(4), 163-231(b)(1).
176. By imposing additional restrictions on who can assist a Section 208-covered
voter who needs assistance with submitting their absentee ballot request form, marking and
completing their absentee ballots, and returning their absentee ballots, specifically, by
limiting valid assistors to the voter’s near relative, legal guardian, or county board multi-
partisan team members, N.C. Gen. Stat. §§ 163-226.3(a)(4), 163-226.3(a)(5), 163-
73

230.2(e)(4), and 163-231(b)(1) violate Section 208 of the VRA by failing to allow these
voters to choose any assistor who is not their employer or union representative.
177. Defendants’ failure to allow eligible voters who need assistance by reason of
their blindness, disability or ability to read or write in any part of the absentee voting
process, from any person of their choice, other than their employers or union officials, as
described herein, is a violation of Section 208. Plaintiff Walter Hutchins is harmed by these
restrictions on assistance with absentee ballot request, absentee ballot marking and
completion, and absentee ballot submission, and the corresponding lack of any disability-
based exceptions. Plaintiff Hutchins is blind and requires assistance to submit an absentee
ballot request form, and assistance in reading, marking, and submitting his ballot according
to his preferences.
178. By depriving Plaintiff Hutchins of rights and privileges under Section 208 of
the VRA under the color of state law, Defendants have violated and are liable under 42
U.S.C. § 1983.
PRAYER FOR RELIEF
Plaintiffs respectfully request that this Court:
(a) Assume jurisdiction over this matter;
(b) Declare that Defendants’ administration and enforcement of N.C. Gen. Stat.
Gen. Stat. §§ 163-82.6(d) and 163-82.20(g), (h) (imposing 25-day voter registration
deadlines); N.C. Gen. Stat. § 163-230.2(a) (requiring requests for absentee ballots be made
by a form created by the State Board); N.C. Gen. Stat. § 163-230.2(c), (e), and (e1)
(imposing restrictions on absentee ballot request assistance); N.C. Gen. Stat. § 163-231(a)
74

(imposing the double-witness certification requirement); N.C. Gen. Stat. § 163-
230.2(a)(4), (f) (to the extent disallows election officials from accepting any proof of
residency document acceptable under the Help America Votes Act (HAVA)), N.C. Gen.
Stat. § 163-227.6(c) (requiring uniform hours in precincts); and N.C. Gen. Stat. § 163-
42(b) (requiring a majority of poll workers to come from the precinct in which they serve),
and the Defendants’ failure to expand voter registration via online portals available through
DHHS services, failure to establish contactless drop boxes for absentee ballots, and to
establish mechanisms for requesting absentee ballots by phone, email, and online, failure
to establish mechanisms to cure deficient absentee ballot requests and absentee ballots,
failure to allow for submission of FWAB ballots, failure to provide PPE to county boards
of election for use during in-person voting, and failure to establish a more accessible,
centralized way in which voters and advocates can monitor precinct consolidation (and
thus advocate against harmful precinct consolidations), in the context of the pandemic,
taken individually or in combination, violate the First and Fourteenth Amendments to the
U.S. Constitution, as enforced through 42 U.S.C. § 1983;
(c) Declare that Defendants’ administration and enforcement of N.C. Gen. Stat.
§ 163-230.2(c), (e), and (e1) (imposing restrictions on absentee ballot request assistance),
N.C. Gen. Stat. § 163-231(a) (imposing the double-witness certification requirement), and
failure to expand voter registration via online portals available through DHHS services,
establish contactless drop boxes for absentee ballots, establish mechanisms for requesting
absentee ballots by phone, email, and online, in the context of the pandemic, taken
individually or in combination, violate the unconstitutional condition doctrine and thereby
75

Plaintiffs’ First and Fourteenth Amendment right to bodily integrity, as enforced through
42 U.S.C. § 1983;
(d) Declare that Plaintiffs’ First Amendment associational rights are violated by
N.C. Gen. Stat. §§ 163-226.3(a)(4), 163-226.3(a)(5), 163-230.2(a), 163-230.2(e)(4), and
163-231(b)(1);
(e) Declare that the lack of a cure mechanism for Plaintiffs’ mail-in absentee
ballot request forms and mail-in absentee ballots violates their rights to procedural due
process;
(f) Declare that N.C. Gen. Stat. §§ 163-226.3(a)(4)-(a)(6), 163-230.2(e)(4), 163-
231(a), and 163-231(b)(1) violate Title II of the Americans with Disabilities Act, 42 U.S.C.
§§ 12131, et seq., and Section 504 of the Rehabilitation Act, 29 U.S.C. § 794;
(g) Declare that N.C. Gen. Stat. §§ 163-226.3(a)(4), 163-226.3(a)(5), 163-
230.2(e)(4), and 163-231(b)(1) violate Section 208 of the Voting Rights Act, 52 U.S.C. §
10508;
(h) Preliminarily and permanently enjoin Defendants from administering and
enforcing during the COVID-19 pandemic:
i. Gen. Stat. §§ 163-82.6(d) and 163-82.20(g), (h), imposing 25-day voter
registration deadlines;
ii. N.C. Gen. Stat. § 163-230.2(a), requiring requests for absentee ballots be
made by a form created by the State Board of Elections;
iii. N.C. Gen. Stat. § 163-230.2(a)(4), (f), to the extent that it limits the proof of
residency documents that voters must submit with their absentee ballot
76

request forms to only a North Carolina driver’s license number, special
identification card number, or the last four digits of his or her Social Security
number, and instead allow election officials to accept any proof of residency
document acceptable under the Help America Votes Act (HAVA);
iv. N.C. Gen. Stat. §§ 163-226.3(a)(4), 163-226.3(a)(5), 163-230.2(e)(4), 163-
231(a), and 163-231(b)(1), imposing restrictions on assistance for absentee
ballot request return, absentee ballot marking and completion, and absentee
ballot submission;
v. N.C. Gen. Stat. § 163-231(a), imposing the double-witness certification
requirement;
vi. N.C. Gen. Stat. § 163-227.6(c), requiring uniform hours in precincts; and
vii. N.C. Gen. Stat. § 163-42(b), requiring a majority of poll workers to come
from the precinct in which they serve.
(i) Preliminarily and permanently enjoin Defendants from violating Plaintiffs’
constitutional and federal statutory rights with respect to any election in the state during
the COVID-19 pandemic.
(j) Order the SBE Defendants to extend the voter registration deadline in N.C.
Gen. Stat. §§ 163-82.6(d) and 163-82.20(g), (h), until 5:00pm on the last Saturday of early
voting and the DOT and DHHS Defendants to process voter registrations online and
received in their offices up until and including 5:00pm on the last Saturday of early voting
during the COVID-19 pandemic.
77

(k) Order Defendants to implement measures to ensure eligible North
Carolinians are able to vote absentee by mail, with respect to any election in the state during
the COVID-19 pandemic, including:
i. Expanding voter registration via online portals available through DHHS
services;
ii. Establishing contactless drop boxes for absentee ballots;
iii. Establishing mechanisms for requesting absentee ballots by phone, email,
and online;
iv. Permitting election officials to accept any proof of residency document
acceptable under the Help America Votes Act (HAVA) as acceptable forms
of identification with absentee ballot requests;
v. Establishing mechanisms to cure deficient absentee ballot requests and
absentee ballots; Establishing a mechanism for accepting FWAB ballots;
vi. Establishing a more accessible, centralized way in which voters and
advocates can monitor precinct consolidation; and
vii. Permitting voters who for reason of blindness, disability, or an inability to
read or write, require assistance to return an absentee ballot request form,
mark and complete an absentee ballot, and/or submit an absentee ballot, to
obtain assistance from anyone who is not their employer or union
representative.
(l) Order the SBE Defendants to permit mail-in absentee voters to cast a
downloadable Federal Write-in Absentee Ballot (“FWAB”), if and only if their timely-
78

requested absentee ballot has not arrived in time for the voter to timely cast that ballot so
that it will be counted;
(m) Order Defendants to implement a remedial plan to educate voters regarding
their options to register to vote and obtain and cast a ballot.
(n) Retain jurisdiction to monitor Defendants’ compliance with this Court’s
judgment;
(o) Grant Plaintiffs their reasonable costs and attorneys’ fees incurred in
bringing this action pursuant to 42 U.S.C. § 1988, 28 U.S.C. § 1920, and as otherwise
permitted by law; and
(p) Grant such other relief as this Court deems just and proper.
79

/s/ Jon Sherman /s/ Allison Riggs
Jon Sherman* Allison J. Riggs (State Bar #40028)
D.C. Bar No. 998271 Jeffrey Loperfido (State Bar #52939)
Michelle Kanter Cohen* Southern Coalition for Social Justice
D.C. Bar No. 989164 1415 West Highway 54, Suite 101
Cecilia Aguilera* Durham, NC 27707
D.C. Bar No. 1617884 Telephone: 919-323-3380
FAIR ELECTIONS CENTER Facsimile: 919-323-3942
1825 K St. NW, Ste. 450 Email: Allison@southerncoalition.org
Washington, D.C. 20006 jeff@southerncoalition.org
Telephone: (202) 331-0114
Email: jsherman@fairelectionscenter.org /s/ George P. Varghese
mkantercohen@fairelectionscenter.org George P. Varghese (Pa. Bar No. 94329)
caguilera@fairelectionscenter.org Joseph J. Yu (NY Bar No. 4765392)
Stephanie Lin (MA Bar No. 690909)
Rebecca Lee (DC Bar No. 229651)
Richard A. Ingram (DC Bar No. 1657532)
WILMER CUTLER PICKERING HALE AND
DORR LLP
60 State Street
Boston, MA 02109
Telephone: (617) 526-6000
Facsimile: (617) 526-5000
Email: george.varghese@wilmerhale.com
80

CERTIFICATE OF SERVICE
I certify that on the 5th day of June, 2020, the foregoing FIRST AMENDED COMPLAINT
was served by electronic mail to Defendants’ Counsel, Alec McC. Peters, Chief Deputy
Attorney General, at the address apeters@ncdoj.gov, with consent of counsel to accept
service in this manner.

Allison J. Riggs
81


ROBERT K. PRIDDY II, WALTER
HUTCHINS, AND SUSAN SCHAFFER,
Plaintiffs,
vs. Civil Action
THE NORTH CAROLINA STATE BOARD OF No. 20-cv-457

official capacity as CHAIR OF THE PLAINTIFFS’ MOTION
STATE BOARD OF ELECTIONS; STELLA FOR PRELIMINARY
ANDERSON, in her official capacity INJUNCTION
as SECRETARY OF THE STATE BOARD OF AND REQUEST TO
ELECTIONS; KEN RAYMOND, in his EXPEDITE
BOARD OF ELECTIONS; DAVID C. BLACK,
in his official capacity as MEMBER
OF THE STATE BOARD OF ELECTIONS;
KAREN BRINSON BELL, in her official
capacity as EXECUTIVE DIRECTOR OF
THE STATE BOARD OF ELECTIONS; THE
TRANSPORTATION; J. ERIC BOYETTE, in
his official capacity as
TRANSPORTATION SECRETARY; THE NORTH
CAROLINA DEPARTMENT OF HEALTH AND
HUMAN SERVICES; MANDY COHEN, in her
Defendants.

Plaintiffs Democracy North Carolina (“DemNC”) and the
League of Women Voters of North Carolina (“LWVNC” and,
together with DemNC, the “Organizational Plaintiffs”), as
well as Donna Permar, John P. Clark, Margaret B. Cates, Lelia
Bentley, Regina Whitney Edwards, Robert K. Priddy II, Walter
Hutchins, and Susan Schaffer (“Individual Plaintiffs”)
(together, with the Organizational Plaintiffs, the
“Plaintiffs”), hereby respectfully request, pursuant to
Federal Rule of Civil Procedure 65(a)(1), that the Court issue
a preliminary injunction preventing Defendants from enforcing
the challenged provisions of North Carolina’s election code,
Chapter 163 of the North Carolina General Statutes, and
requiring Defendants to provide additional accommodations to
safeguard voters’ rights during the November 3, 2020, general
election in light of the COVID-19 pandemic.
As set forth in Plaintiffs’ First Amended Complaint, ECF
No. 8, North Carolina’s current law and election
administration impose unconstitutional burdens on the right
to vote in violation of the First and Fourteenth Amendments,
violate the unconstitutional conditions doctrine, violate
Plaintiffs’ First Amendment associational rights, violate
Plaintiffs’ rights to procedural due process, violate Section

208 of the Voting Rights Act, and violate Title II of the
Americans with Disabilities Act (the “ADA”), 42 U.S.C.
§§ 12131, et seq., and Section 504 of the Rehabilitation Act,
29 U.S.C. § 794. The COVID-19 pandemic presents an
unprecedented challenge to the upcoming November 3, 2020,
general election. The experience of states that have already
conducted their primaries has shown that the pandemic has
deterred voters, strained election administrators’ finite
resources, and ultimately disenfranchised countless citizens.
Defendant the State Board of Elections anticipates an
unprecedented, ten-fold increase in the use of mail-in
absentee ballots relative to the 2016 general election and a
drastic shortfall in available poll workers that threatens
the operation of polling places. Yet, Defendants remain
unprepared to manage that level of absentee mail-in voting or
to adapt in-person voting to ensure both safety and equal
access. These and other statutory provisions pose a grave
threat to voters’ health and therefore severely burden the
most fundamental right of U.S. citizenship, no matter how
voters exercise it.
Preliminary injunctive relief is warranted—(1)
Plaintiffs are likely to succeed on the merits of their

claims; (2) they will likely suffer irreparable harm absent
an injunction; (3) the balance of hardships weighs in their
favor; and (4) the injunction is in the public interest. See
League of Women Voters of N.C. v. North Carolina, 769 F.3d
224, 236 (4th Cir. 2014). Absent relief from this Court,
voters will needlessly face great hardship and
disenfranchisement in the November 3, 2020, general election.
Accordingly, Plaintiffs request that the Court
preliminary enjoin Defendants from administering and
enforcing for the November 3, 2020, general election:
i. Gen. Stat. §§ 163-82.6(d) and 163-82.20(g), (h),
imposing 25-day voter registration deadlines;
ii. N.C. Gen. Stat. § 163-230.2(a), requiring requests
for absentee ballots be made by a form created by
the State Board of Elections;
iii. N.C. Gen. Stat. § 163-230.2(a)(4), (f), to the
extent that it limits the proof of residency
documents that voters must submit with their
absentee ballot request forms to only a North
Carolina driver’s license number, special
identification card number, or the last four digits
of his or her Social Security number, and instead

allow election officials to accept any proof of
residency document acceptable under the Help America
Votes Act (HAVA);
iv. N.C. Gen. Stat. §§ 163-226.3(a)(4)-(5), 163-
230.2(e)(4), 163-231(a), and 163-231(b)(1),
imposing restrictions on assistance for absentee
ballot request return, absentee ballot marking and
completion, and absentee ballot submission;
v. N.C. Gen. Stat. § 163-231(a), imposing the double-
witness certification requirement;
vi. N.C. Gen. Stat. § 163-227.6(c), requiring uniform
hours in precincts; and
vii. N.C. Gen. Stat. § 163-42(b), requiring a majority
of poll workers to come from the precinct in which
they serve.
Plaintiff further request that the Court preliminarily
enjoin Defendants from violating Plaintiffs’ constitutional
and federal statutory rights with respect to any election in
the state for the November 3, 2020, general election.
Plaintiffs further request that the Court issue an order
requiring the SBE Defendants to extend the voter registration
deadline in N.C. Gen. Stat. §§ 163-82.6(d) and 163-82.20(g),

(h), until 5:00 pm on the last Saturday of early voting and
the DOT and DHHS Defendants to process voter registrations
online and received in their offices up until and including
5:00 pm on the last Saturday of early voting for the November
3, 2020, general election, and further order Defendants to
implement measures to ensure eligible North Carolinians are
able to vote in the state during the COVID-19 pandemic,
including:
a. Expanding voter registration via online portals
available through DHHS services;
b. Establishing contactless drop boxes for absentee
ballots;
c. Establishing mechanisms for requesting absentee
ballots by phone, email, and online;
d. Permitting election officials to accept any proof
of residency document acceptable under the Help
America Votes Act (HAVA) as acceptable forms of
identification with absentee ballot requests;
e. Establishing mechanisms to cure deficient
absentee ballot requests and absentee ballots;
Establishing a mechanism for accepting FWAB
ballots;

f. Establishing a more accessible, centralized way
in which voters and advocates can monitor
precinct consolidation; and
g. Permitting voters who for reason of blindness,
disability, or an inability to read or write,
require assistance to return an absentee ballot
request form, mark and complete an absentee
ballot, and/or submit an absentee ballot, to
obtain assistance from anyone who is not their
employer or union representative.
Plaintiffs further request the Court order Defendants to
implement a remedial plan to educate voters regarding their
options to register to vote and obtain and cast a ballot.
Given the urgency of the relief sought, Plaintiffs
respectfully request expedited briefing and consideration of
this Motion, and that the Court shorten the requirements of
Local Civil Rule 7.3 to require Defendants’ response within
14 days of service of this Motion and Plaintiffs’ reply within
7 days of service of the response. Defendants, through
counsel, consent to the request to expedite briefing and
consideration. Finally, Plaintiffs respectfully request for
leave to present oral argument in support of this Motion.

This Motion is supported by the contemporaneously filed
Memorandum of Law, and accompanying declarations, and any
additional submissions that may be considered by the Court.

Jon Sherman* Allison J. Riggs (State Bar
D.C. Bar No. 998271 #40028)
Michelle Kanter Cohen* Jeffrey Loperfido (State
D.C. Bar No. 989164 Bar #52939)
Cecilia Aguilera* Southern Coalition for
D.C. Bar No. 1617884 Social Justice
FAIR ELECTIONS CENTER 1415 West Highway 54, Suite
1825 K St. NW, Ste. 450 101
Washington, D.C. 20006 Durham, NC 27707
Telephone: (202) 331-0114 Telephone: 919-323-3380
Email: Facsimile: 919-323-3942
jsherman@fairelectionsce Email:
nter.org Allison@southerncoalition.o
mkantercohen@fairelectionscen rg
ter.org jeff@southerncoalition.
caguilera@fairelectionscenter org
.org
/s/ George P. Varghese
George P. Varghese (Pa. Bar
No. 94329) Joseph J. Yu (NY
Bar No. 4765392)
Stephanie Lin (MA Bar No.
690909)
Rebecca Lee (DC Bar No.
229651)
Richard A. Ingram (DC Bar
No. 1657532)
DORR LLP
60 State Street
Boston, MA 02109
Telephone: (617) 526-6000
Facsimile: (617) 526-5000

Email:
george.varghese@wilmerh
ale.com
stephanie.lin@wilmerhale.co
m

I certify that on the 5th day of June, 2020, the
foregoing Motion for Preliminary Injunction and Request to
Expedite was served by electronic mail to Defendants’
Counsel, Alec McC. Peters, Chief Deputy Attorney General, at
the address apeters@ncdoj.gov, with consent of counsel to
accept service in this manner.

Allison J. Riggs
10

DEMOCRACY NORTH CAROLINA, THE LEAGUE
OF WOMEN VOTERS OF NORTH CAROLINA,
DONNA PERMAR, JOHN P. CLARK, MARGARET
B. CATES, LELIA BENTLEY, REGINA
WHITNEY EDWARDS, ROBERT K. PRIDDY
II, WALTER HUTCHINS, AND SUSAN
SCHAFFER,
Plaintiffs,
vs. Civil Action

STATE BOARD OF ELECTIONS; STELLA
ANDERSON, in her official capacity as PLAINTIFFS’
SECRETARY OF THE STATE BOARD OF MEMORANDUM IN SUPPORT
ELECTIONS; KEN RAYMOND, in his OF THEIR MOTION FOR
official capacity as MEMBER OF THE PRELIMINARY
STATE BOARD OF ELECTIONS; JEFF CARMON INJUNCTION AND
III, in his official capacity as REQUEST TO EXPEDITE*
ELECTIONS; DAVID C. BLACK, in his
STATE BOARD OF ELECTIONS; KAREN
BRINSON BELL, in her official
capacity as EXECUTIVE DIRECTOR OF THE
STATE BOARD OF ELECTIONS; THE NORTH
CAROLINA DEPARTMENT OF
Defendants.
* This memorandum exceeds the page limits set forth in

Local Rule 7.3. The parties have filed a motion to expand
the page limits for this memorandum. ECF No. 7.

TABLE OF CONTENTS
TABLE OF CONTENTS ....................................... ii
TABLE OF AUTHORITIES .................................... iv
INTRODUCTION ............................................. 1
STATEMENT OF FACTS ....................................... 6
I. The COVID-19 Pandemic ............................... 6
A. COVID-19 .......................................... 6
B. North Carolina’s Response to COVID-19............. 10
C. Election Administration Timing ................... 12
QUESTIONS PRESENTED ..................................... 14
LEGAL STANDARD .......................................... 15
ARGUMENT ................................................ 15
I. Plaintiffs are likely to succeed on the merits of their

claims. ............................................... 15
A. Undue Burdens on the Right to Vote ............... 15
i. Voter registration .............................. 17
ii. Absentee Ballot Requirements .................... 21
iii. In-Person Voting Restrictions.................. 39
B. Unconstitutional Condition on the Right to Vote ... 48
C. Violation of the Organizational Plaintiffs’ and

Plaintiff Schaffer’s First Amendment Rights to Free
Speech and Association ............................... 54
D. Procedural Due Process ........................... 59
E. Violation of Title II of the Americans with

Disabilities Act (42 U.S.C. §§ 12131 et seq.) and § 504
of the Rehabilitation Act (29 U.S.C. § 794) .......... 62
ii

F. Violation of Section 208 of the Voting Rights Act of
1965, 52 U.S.C. § 10508) ............................. 70
II. Absent injunctive relief, Plaintiffs will suffer

irreparable harm in the November general election. ..... 71
III. ... Given the dire circumstances of this deadly global

pandemic, the balance of hardships tips heavily in
Plaintiffs’ favor. .................................... 74
IV. The public interest strongly favors granting

Plaintiffs’ requested relief to facilitate participation
in the general election................................ 75
REQUEST FOR EXPEDITED CONSIDERATION ..................... 76
CONCLUSION .............................................. 77
iii

TABLE OF AUTHORITIES
Federal Cases
A Helping Hand, LLC v. Baltimore Cty.,

515 F.3d 356 (4th Cir. 2008)
Action NC v. Strach,
216 F. Supp. 3d 597 (M.D.N.C. 2016)
Anderson v. Celebrezze,
460 U.S. 780 (1983)
Ariz. Free Enter. Club’s Freedom Club PAC v.

Bennett,
564 U.S. 721 (2011)
United States v. Baker,
45 F.3d 837 (4th Cir. 1995)
Bourgeois v. Peters,
387 F.3d 1303 (11th Cir. 2004)
Bragdon v. Abbott,
524 U.S. 624 (1998) (HIV)
Buckley v. Am. Constitutional Law Found,

525 U.S. 182 (1999)
Burdick v. Takushi,
504 U.S. 428 (1992)
Cleveland Bd. of Educ. v. Loudermill,

470 U.S. 532 (1985)
Clingman v. Beaver,
544 U.S. 581 (2005) (O’Connor, J., concurring)
Common Cause Ga. v. Kemp,

347 F. Supp. 3d 1270 (N.D. Ga. 2018)
Common Cause Ind. v. Lawson,
327 F. Supp. 3d 1139 (S.D. Ind. 2018)
iv

Crawford v. Marion Cty. Election Bd.,
553 U.S. 181 (2008)
Cross v. Mokwa,
547 F.3d 890 (8th Cir. 2008) (Bye, J.,
concurring in part)
Davis v. Nat’l R.R. Passenger Corp.,

733 F. Supp. 2d 474 (D. Del. 2010)
Democratic Nat’l Comm. v. Republican Nat’l Comm.,

Nos. 20-1538 & 20-1546 (7th Cir. Apr. 3, 2020)
Fish v. Schwab,
957 F.3d 1105 (10th Cir. 2020)
Fusaro v. Cogan,
930 F.3d 241 (4th Cir. 2019)
Gill v. Whitford,
138 S. Ct. 1916 (2018)
Harman v. Forssenius,
380 U.S. 528 (1965)
Heiko v. Colombo Sav. Bank, F.S.B.,

434 F.3d 249 (4th Cir. 2006)
Kallstrom v. City of Columbus,
136 F.3d 1055 (6th Cir. 1998)
Kusper v. Pontikes,
414 U.S. 51 (1973)
League of Women Voters of N.C. v. North Carolina,

769 F.3d 224 (4th Cir. 2014)
League of Women Voters of Ohio v. Brunner,
548 F.3d 463 (6th Cir. 2008)
League of Women Voters of U.S. v. Newby,

838 F.3d 1 (D.C. Cir. 2016)
Lefkowitz v. Cunningham,
431 U.S. 801 (1977)

Libertarian Party of Ill. v. Pritzker,
No. 20-CV-2112, 2020 WL 1951687 (N.D. Ill. Apr.
23, 2020)
McCabe v. Sharrett,
12 F.3d 1558 (11th Cir. 1994)
Mem’l Hosp. v. Maricopa Cty.,

415 U.S. 250 (1974)
Meyer v. Grant,
486 U.S. 414 (1988)
Multi-Channel TV Cable Co. v. Charlottesville
Quality Cable Operating Co.,
22 F.3d 546 (4th Cir. 1994)
Myers v. Hose,
50 F.3d 278 (4th Cir. 1995)
N.C. State Conf. of NAACP v. Cooper,

430 F. Supp. 3d 15 (M.D.N.C. 2019)
Nat’l Fed’n of the Blind v. Lamone,

813 F.3d 494 (4th Cir. 2016)
Newsom ex rel. Newsom v. Albemarle Cty. Sch. Bd.,

354 F.3d 249 (4th Cir. 2003)
Norman v. Reed,
502 U.S. 279 (1992)
Saucedo v. Gardner,
335 F. Supp. 3d 202 (D.N.H. 2018) (applying
Mathews and concluding that the state’s scheme
“fails to guarantee basic fairness”)
Seremeth v. Bd. of Cty. Comm’rs Frederick Cty,

673 F.3d 333 (4th Cir. 2012)
Shapiro v. Thompson,
394 U.S. 618 (1969)
Simmons v. United States,
390 U.S. 377 (1968)
vi

Snider Int’l Corp. v. Town of Forest Heights,
739 F.3d 140 (4th Cir. 2014)
Thomas v. Andino,
No. 3:20-cv-01552-JMC, 2020 WL 2617329 (D.S.C.
May 25, 2020)
Ury v. Santee,
303 F. Supp. 119 (N.D. Ill. 1969)
Wilkinson v. Austin,
545 U.S. 209 (2005)
Williams v. Rhodes,
393 U.S. 23 (1968)
Winter v. Natural Res. Def. Council, Inc.,

555 U.S. 7 (2008)
Zessar v. Helander,
No. 05 C 1917, 2006 WL 642646 (N.D. Ill. Mar.
13, 2006)
State Cases
League of Women Voters of Okla. v. Ziriax,

No. 118765, 2020 WL 2111348 (Okla. May 4, 2020)
Federal Statutes
29 U.S.C. § 794(a)
42 U.S.C. § 1983
42 U.S.C. § 12132
52 U.S.C. §§ 20302(a)(3), 20303(a)(1)
52 U.S.C. § 20303(b)
Americans with Disabilities Act Title II (42

U.S.C. §§ 12131 et seq.)
Rehabilitation Act § 504 (29 U.S.C. § 794)
Uniformed and Overseas Citizens Absentee Voting

Act, 52 U.S.C. § 20301 et seq.
vii

State Statutes
An Act to Amend the Laws Governing Mail-In

Absentee Ballots, S.L. 2019-239
N.C. Gen. Stat. § 163-23.2
N.C. Gen. Stat. § 163-42(b)
N.C. Gen. Stat. § 163-82.6(c)
N.C. Gen. Stat. §§ 163-82.6(d), 163-82.20(g), (h)
N.C. Gen. Stat. § 163-128(a)
N.C. Gen. Stat. § 163-226(a)
N.C. Gen. Stat. §§ 163-226.3(a)(4) and 163-

237(b)(1)
N.C. Gen. Stat. §§ 163-226.3(a), 163-229(b)(4),

163-231(a)
N.C. Gen. Stat. § 163-227.2(b)

N.C. Gen. Stat. § 163-227.6(c)
N.C. Gen. Stat. § 163-228(c)
N.C. Gen. Stat. § 163-230.2(a)(4), (f)
N.C. Gen. Stat. § 163-230.2(a), (e)(1)
N.C. Gen. Stat. § 163-230.2(e)1
N.C. Gen. Stat. § 163-230.2 (e)(2)

N.C. Gen. Stat. § 163-231(a)
N.C. Gen. Stat. § 163-237
N.C. Gen. Stat. §§ 163-274, 163-275

Regulations
10 C.F.R. § 4.101
28 C.F.R. § 35.108(b)(2)
viii

28 C.F.R. § 35.164
28 C.F.R. § 36.105(c)(1)
Other Authorities
Local Civil Rule 7.3(f)
ix

INTRODUCTION
The COVID-19 pandemic has upended the normal functioning
of our democracy. State officials nationwide have attempted
to ensure that voters can cast their ballots safely. Some
states have postponed their elections, while others have
shifted to mail-in voting only. In states that have maintained
in-person voting in the face of the pandemic, thousands of
elderly poll workers have withdrawn from service, drastically
reducing the number of operational polling sites. The
experience of states that have already conducted their
primaries has shown that the pandemic has deterred voters,
strained election administrators’ finite resources, and
ultimately disenfranchised countless citizens.
In North Carolina, Defendant the North Carolina State
Board of Elections (“SBE”) anticipates an unprecedented, ten-
fold increase in the use of mail-in absentee ballots relative
to the 2016 general election as voters seek to maintain
physical distancing and limit their exposure to the novel
coronavirus that causes COVID-19. Yet Defendants remain
unprepared to manage that level of absentee mail-in voting or
to adapt in-person voting to ensure both safety and equal
access. North Carolina’s election code was not enacted with

a global pandemic in mind, let alone one of this ferocity.
And in the context of a pandemic caused by a highly contagious
and lethal virus, a number of statutory provisions pose a
grave threat to voters’ health and therefore severely burden
the most fundamental right of U.S. citizenship, no matter how
voters exercise it. Absent relief from this Court, voters
will needlessly face great hardship and disenfranchisement.
First, the 25-day deadline to register to vote must be
lifted to ensure adequate opportunities for voters to safely
complete the registration process. In a typical presidential
election year, voters register in robust and increasing
numbers. This year, however, registration rates have cratered
as in-person registration drives have been cancelled and
other in-person opportunities for registration have
disappeared. Normally, this fallout would be mitigated by the
opportunity to register at an early voting site within the
25-day window, but this option risks exposing voters and their
families to infection.
Second, in light of the pandemic, voting by mail should
theoretically be a safer option for many North Carolina
voters, but the absentee ballot laws require voters to take
unreasonable risks with their health. North Carolina’s

restrictions on requesting, completing, and submitting a
mail-in absentee ballot—including the requirement that voters
complete their ballot in the presence of two witnesses—have
already caused at-risk and quarantined voters to conclude
that they will not be able to participate in the November
election.
Third, restrictions on the administration of in-person
voting must be relaxed to safeguard voters’ rights, as well
as their health. For example, requiring that a majority of
poll workers reside in the precinct where they serve will
result in inadequate staffing; the risk of exposure to COVID-
19 is already causing dire shortfalls in poll worker
recruitment. The additional requirement under North Carolina
law that counties maintain uniform hours for early voting
sites will further reduce early voting capacity. Both of these
provisions will lead to long lines and large crowds, forcing
voters to violate social distancing directives to exercise
the right to vote.
Plaintiffs Donna Permar, John P. Clark, Margaret B.
Cates, Lelia Bentley, Regina Whitney Edwards, Robert K.
Priddy II, and Walter Hutchins, similar to many others in
North Carolina, live with underlying health conditions and/or

disabilities that heighten their risks of severe
complications and death from COVID-19. If this Court does not
relax the state’s unconstitutionally burdensome registration
and voting requirements for mail-in absentee and in-person
voting—relief that Plaintiffs request solely for the November
2020 general election—Plaintiffs and countless North Carolina
voters will not be able to vote in that election, or will
have to choose between forgoing this right and risking their
health and the health of their family members.
The time to act is now. Epidemiologists and infectious
disease specialists predict that COVID-19 infections will
surge in the fall. Election administration procedures follow
an inexorable timeline, and the necessary steps—to procure
equipment such as personal protective equipment (“PPE”),
designate polling places, print mail-in ballots with
instructions, educate the electorate about voting procedures,
and recruit and train poll workers—must begin well in advance
of Election Day. Absent timely intervention by this Court,
Plaintiffs will suffer irreparable injury.
Plaintiffs Democracy North Carolina (DemNC) and the
League of Women Voters of North Carolina (“LWVNC” and,
together with DemNC, the “Organizational Plaintiffs”), as

well as Donna Permar, John P. Clark, Margaret B. Cates, Lelia
Bentley, Regina Whitney Edwards, Robert K. Priddy II, Walter
Hutchins, and Susan Schaffer (“Individual Plaintiffs”)
(collectively, “Plaintiffs”), bring this civil rights action
under the First and Fourteenth Amendments, Title II of the
Americans with Disabilities Act (the “ADA”), 42 U.S.C. §§
12131 et seq., and Section 504 of the Rehabilitation Act (the
“RA”), 29 U.S.C. § 794, as enforced by 42 U.S.C. § 1983, for
preliminary declaratory and injunctive relief against
Defendants SBE; Damon Circosta, in his official capacity as
Chair of SBE; Stella Anderson, in her official capacity as
Secretary of SBE; Ken Raymond, Jeff Carmon III, and David C.
Black, all in their official capacities as Members of SBE;
Karen Brinson Bell, in her official capacity as Executive
Director of the State Board of Elections (collectively “SBE
Defendants”); Defendants the North Carolina Department of
Transportation (“DOT”) and J. Eric Boyette, in his official
capacity as Secretary of the Department of Transportation
(the “DOT Defendants”); and Defendants the North Carolina
Department of Health and Human Services (“DHHS”) and Dr. Mandy
Cohen, in her official capacity as Secretary of Health and
Human Services (“DHHS Defendants”). Plaintiffs seek an

injunction against the voting laws that will most interfere
with conducting a free and fair election in the fall, and
respectfully request that the Court expedite the briefing and
consideration of this issue.
STATEMENT OF FACTS
I. The COVID-19 Pandemic
A. COVID-19
“SARS-CoV-2 is a newly identified coronavirus that is
the causative agent involved in Coronavirus Disease 2019
(Covid-19).” Murray Decl. ¶ 6. The World Health Organization
(“WHO”) designated COVID-19 to be a Public Health Emergency
of International Concern on January 30, 2020, then declared
less than two months later that COVID-19 had become a
pandemic. Riggs Decl. ¶ 6.
The coronavirus continues to spread at an unprecedented
pace. As of June 4, 2020, there were 1,842,101 confirmed cases
and 107,029 deaths in the United States.1 This virus spreads
through respiratory droplets that are attached to the
surfaces of objects or are suspended in air and transmitted
1Coronavirus Disease 2019 (COVID-19), Cases in the U.S.,

CDC, https://www.cdc.gov/coronavirus/2019-ncov/cases-
updates/cases-in-us.html (last updated June 4, 2020).

via inhalation and “emitted during coughs, sneezes or even
talking.” Murray Decl. ¶¶ 8–9. Since it can be transmitted by
symptomatic and asymptomatic people alike, individuals can
spread the disease before realizing they are infected and
self-quarantining. Id. ¶ 9.
Though COVID-19 typically begins with “a flu-like illness
that starts out with fever, cough, sore throat and shortness
of breath,” some people “develop much more serious illness,
characterized by respiratory compromise due to pneumonia that
can be gradual or sudden.” Murray Decl. ¶¶ 14–15. The major
complication in patients with severe disease is acute
respiratory distress syndrome (“ARDS”), which commonly
requires patients to be put on a ventilator. Id. ¶ 16. People
who develop severe complications and require mechanical
ventilation to survive ARDS “are likely to develop lung
scarring that may permanently impair their pulmonary
function” or, in the case of stroke, “long term neurological
deficits from these events.” Id. ¶ 19. In critical cases,
COVID-19 can be fatal. Id. ¶ 16. Even young individuals,
including children, are at risk of severe complications and
death from COVID-19. Id. ¶¶ 16, 20.

According to the CDC, individuals are at higher risk of
severe complications and death from COVID-19 if they are 65
years of age or older, are immunocompromised, or have
underlying health conditions and diseases, including chronic
lung disease such as chronic obstructive pulmonary disease
(“COPD”), asthma, serious heart conditions, diabetes, and
severe obesity. Riggs Decl. ¶ 7; Murray Decl. ¶¶ 20–21.
The COVID-19 pandemic is expected to produce steady or
increased transmission in the United States through the fall,
as voters seek to cast their ballots on or before Election
Day. Dr. Megan Murray notes in her declaration that within
the range of different possible scenarios for COVID-19
epidemic trajectories, “all scenarios are similar in that
they predict that it is highly likely that Covid-19 will
continue to circulate at its current level or at an even
higher level than currently in October and November of 2020.”
Id. ¶ 33. Likewise, Dr. Anthony Fauci, Director of the
National Institute of Allergy and Infectious Diseases, has
said a second wave of infections in the United States is
“inevitable,” and CDC Director Robert Redfield has said that
wave may “be even more difficult than the one we just went
through.” Riggs Decl. ¶ 8.

Due to the relaxation of social distancing measures, the
corresponding increase in social contacts, and seasonal
changes, “it is reasonable to expect that, like other beta-
coronaviruses, [COVID-19] may transmit somewhat more
efficiently in fall and winter than summer.” Murray Decl. ¶¶
37–39. The projected persistent or increased risk of
transmission in the fall and winter is, in part, due to
seasonal factors, including “differences in the ways people
congregate,” as “people tend to spend more time indoors with
less ventilation and less personal space than they do in the
summer.” Id. ¶ 39. Based on studies of previous influenza
epidemics, Dr. Murray notes that the “most likely scenario”
is that “the current first wave of Covid-19 will be followed
by a larger wave in the fall or winter of 2020 and one or
more smaller subsequent waves in 2021,” and that “most
epidemiologists expect that incidence will increase in the
fall/winter months of 2020-2021.” Id. ¶¶ 41–42. “In the period
prior to the widespread use of an effective vaccine, this
spread will continue to lead to serious disease and death in
at-risk groups.” Id. ¶ 44. Finally, progress towards herd
immunity and vaccine development and production are unlikely

to advance sufficiently quickly to significantly alter the
trajectory of the COVID-19 outbreak. Id. ¶¶ 51.
B. North Carolina’s Response to COVID-19
As of June 4, 2020, the North Carolina Department of
Health and Human Services (“DHHS”) had confirmed 31,966
positive cases and 960 deaths in North Carolina, with 1,189
new cases reported in North Carolina on June 4, 2020 alone.2
Governor Cooper has announced a three-phase plan for
easing restrictions in North Carolina, and the timeline for
implementing the plan will depend on whether North Carolina
has successfully met key metrics regarding infection in the
state. Since May 20, 2020, North Carolina has been in “Phase
2,” which “very strongly encourage[s]” individuals at high
risk of severe illness, including those 65 years or older
and/or with underlying medical conditions, to stay home and
travel only for “absolutely essential purposes.” Id. It
maintains the prior guidance that individuals maintain at
least six feet of social distancing, and requires businesses
to limit occupancy and take other measures promoting social
2 COVID-19 Response, COVID-19 North Carolina Dashboard,

NCDHHS (last updated June 4, 2020).
10

distancing. Id. It also encourages individuals to wear face
coverings. Id. Mass gatherings of more than 10 people indoors
and 25 people outdoors remain prohibited. Id.3 Given the trend
of increasing transmission, similar measures will likely be
required for the remainder of 2020, and Governor Cooper has
stated that any spike in infections may require tightening
restrictions again. Riggs Decl. ¶ 10.
COVID-19 will have an unprecedented impact on the
upcoming general election on November 3, 2020. State and
county election officials have recently drawn attention to
the inadequacies of North Carolina’s election laws to
facilitate safe, free, and fair voting during a pandemic. On
March 26, 2020, Defendant Karen Brinson Bell wrote to Governor
Cooper and the General Assembly’s leadership requesting
statutory changes to address the anticipated impact of the
COVID-19 pandemic on the upcoming elections. Riggs Decl. ¶ 3.
In a follow-up letter, Defendant Bell emphasized that changes
were required immediately during the April 28 legislative
3 The DHHS Defendants similarly recommend that individuals

“put distance between yourself and other people” and
advise, “[t]he very best evidence on reducing the spread is
to maintain social distance and stay at home.” Riggs Decl.
¶ 22
11

session in order to be effective for North Carolina’s upcoming
general election. Riggs Decl. ¶ 4.
On April 27, 2020, dozens of county board of elections
officials from eleven counties in North Carolina’s 11th
Congressional District similarly issued an “urgent request”
of legislators to protect upcoming elections. Riggs Decl. ¶
5. They warned that regular poll workers were “reluctant to
serve” because a large percentage of them are elderly and at
higher risk of severe complications and death from COVID-19.
Id. These county officials requested that the legislators
eliminate the requirement that a majority of poll workers
reside in the precinct in which they serve and instead permit
officials to recruit poll workers from anywhere in the county.
C. Election Administration Timing
In her letter to Governor Cooper, Defendant Bell stated
the urgency of certain requested changes, particularly to
absentee voting by mail, noting that “[b]ecause of deadlines
associated with the 2020 General Election . . . there is an
immediate need to prepare for a coronavirus response.” Riggs
Decl. ¶ 4. She advised that expanding the options for absentee
requests needed to be made “as soon as possible as voters may
already request absentee ballots for the June 23 and November
12

3 elections,” that an online portal would need to be
established “immediately,” and that reducing or eliminating
the witness requirement needed to happen “now in order to
update the absentee instructions and return envelope, since
these will need to be redesigned by June and printed in early
July to ensure the counties can meet the start of absentee-
by-mail voting on September 4, 2020.” Id. She also noted that
modifying the uniform hours requirement would need to be made
“as soon as possible to allow time for county boards to locate
and procure appropriate sites, a process that has already
begun for the November 3 election.” Id.
Consistent with this, election expert Dr. Paul Gronke
states that “The experiences of Wisconsin, Pennsylvania, and
other states provide evidence that North Carolina will want
to prepare as soon as possible” for the November election.
Gronke Decl. ¶ 50; see also ¶¶ 39–49, 63–64. Former Executive
Director of the North Carolina State Board of Elections
likewise concurs with Defendant Bell’s assessment that
immediate action is required to prepare for the November
election. Bartlett Decl. ¶ 29.
13

QUESTIONS PRESENTED
A. Whether N.C. Gen. Stat. §§ 163-82.6(d), 163-82.20(g),
(h) , 163-230.2(a), (c), (e), (e1), 163-231(a), 163-
227.6(c), and 163-42(b) imposing restrictions on voter
registration, mail-in voting, and in-person voting, and
the Defendants’ failures to expand voter registration
establish contactless drop boxes for absentee ballots,
establish mechanisms for requesting absentee ballots by
phone, email, and online, establish mechanisms to cure
deficient absentee ballot requests and absentee ballots,
allow for submission of Federal Write-in Absentee Ballots
(“FWAB”), provide personal protective equipment (“PPE”)
to county boards of election for use during in-person
voting, and establish a more accessible, centralized way
in which voters and advocates can monitor precinct
consolidation, in the context of the pandemic violate
the First and Fourteenth Amendments, Title II of the
Americans with Disability Act, and Section 504 of the
Rehabilitation Act.
B. Whether Plaintiffs are entitled to preliminary
injunctive relief.
14

LEGAL STANDARD
To prevail on a motion for a preliminary injunction,
plaintiffs must demonstrate that (1) they are “likely to
succeed on the merits”; (2) they “will likely suffer
irreparable harm absent an injunction”; (3) “the balance of
hardships weighs in their favor”; and (4) “the injunction is
in the public interest.” League of Women Voters of N.C. v.
North Carolina, 769 F.3d 224, 236 (4th Cir. 2014). “In each
case, courts ‘must balance the competing claims of injury and
must consider the effect on each party of the granting or
withholding of the requested relief.’” Winter v. Natural Res.
Def. Council, Inc., 555 U.S. 7, 24 (2008) (citation omitted).
Plaintiffs readily meet these requirements.
ARGUMENT
I. Plaintiffs are likely to succeed on the merits of

their claims.
A. Undue Burdens on the Right to Vote
Under the First and Fourteenth Amendments to the U.S.
Constitution, any burden on the right to vote must be balanced
against a state’s legitimate interest in that requirement.
The Fourth Circuit has distilled governing Supreme Court
precedent into the following test:
15

When facing any constitutional challenge to a
state’s election laws, a court must first determine
whether protected rights are severely burdened. If
so, strict scrutiny applies. If not, the court must
balance the character and magnitude of the burdens
imposed against the extent to which the regulations
advance the state’s interests in ensuring that
‘order, rather than chaos, is to accompany the
democratic processes.’
Fusaro v. Cogan, 930 F.3d 241, 257–58 (4th Cir. 2019) (quoting
McLaughlin v. N.C. Bd. of Elections, 65 F.3d 1215, 1221 (4th
Cir. 1995)). To survive strict scrutiny, the regulation must
be “narrowly drawn to advance a state interest of compelling
importance.” Burdick v. Takushi, 504 U.S. 428, 434 (1992)
(quoting Norman v. Reed, 502 U.S. 279, 289 (1992)).
Even in the absence of a severe burden, the court must
still evaluate “the legitimacy and strength of each of [the
state’s] interests” and “consider the extent to which those
interests make it necessary to burden the plaintiff’s
rights.” Anderson v. Celebrezze, 460 U.S. 780, 789 (1983).
While states certainly have an interest in protecting against
voter fraud and ensuring voter integrity, the interest will
not suffice absent “concrete evidence” that “those interests
make it necessary to burden the plaintiff’s rights.” Fish v.
Schwab, 957 F.3d 1105, 1133 (10th Cir. 2020) (internal
quotation marks omitted).
16

Each of the laws challenged and other modifications
requested in this action, taken individually and as a
collective scheme, unduly burden Plaintiffs’ right to
register and vote. In the midst of this ongoing public health
crisis, the burdens on Plaintiffs’ right to vote imposed by
the challenged provisions and any refusal to provide the
requested modifications are neither justified by nor narrowly
drawn to advance a compelling state interest. Unless
Plaintiffs are granted the relief requested, thousands of
North Carolinians’ voting rights will be severely burdened,
or even denied completely, in the November general election.
i. Voter registration
In North Carolina, voters who register by mail, through
state agencies, or online through the Department of Motor
Vehicles (“DMV”) (a division of Defendant DOT), must do so at
least 25 days before the election in which the voter wishes
to cast a ballot. See N.C. Gen. Stat. §§ 163-82.6(d), 163-
82.20(g), (h); Registering to Vote in North Carolina, N.C.
State Bd. of Elections,
https://www.ncsbe.gov/Voters/Registering-to-Vote (last
visited June 3, 2020); see also N.C. Gen. Stat. § 163-82.6(c)
(voter registration via original form); id. §§ 163-82.20–
17

82.23 (agency registration); id. § 163-82.19 (DMV
registration). Online registration, moreover, is available
only to DMV customers, and until recently required voters to
complete a DMV transaction, such as a license renewal, at the
same time. See Riggs Decl. ¶ 21. The only alternative for
voters to register within 25 days of an election is same-day
registration during early in-person voting, which is
available until the last Saturday before the election. See
N.C. Gen. Stat. § 163-227.2(b).
In light of the COVID-19 pandemic North Carolina’s 25-
day registration deadline and failure to provide broader
online voter registration severely burden the right to vote.
The COVID-19 pandemic has limited voter registration
opportunities. Like other voter registration organizations,
LWVNC has reduced or canceled its in-person voter
registration initiatives, Nicholas Decl. ¶ 8, 13; Lopez Decl.
¶ 20–21, and the DMV and state agencies have closed or limited
in-person access. Riggs Decl. ¶ 11. These conditions have
prevented voters from registering for the November 2020
election, as indicated by the dramatic drop in voter
registration rates compared to the last presidential election
year. January 2020 started with a 162% increase in
18

registrations in comparison to 2016, but comparative rates
have fallen to -10% for February, -14% for March, and -50%
for April. Ketchie Decl. ¶ 4.
Plaintiff LWVNC anticipates that many voters will “seek[]
to register closer to the election because of limitations on
in-person voter registration efforts.” Nicholas Decl. ¶ 8. If
enforced, the 25-day registration deadline will seriously
hinder LWVNC’s purpose to promote voter registration,
especially given that the fail-safe option of registering
during early voting is no longer viable for voters at high
risk from COVID-19. Nicholas Decl. ¶ 8. Voters who could
register online through the DMV are generally unaware that
they no longer need to complete a “transaction,” and thus the
25-day deadline for DMV registration similarly hinders the
efforts of LWVNC to educate and help voters register leading
up to the election. Nicholas Decl. ¶ 9. DemNC also
traditionally receives many calls to its hotline during the
early voting period about voter registration, and
traditionally recommends same-day registration to voters,
which is not an option for many voters during the pandemic.
Lopez Decl. ¶ 21. Additionally, Defendants’ failure to
provide online registration through other agencies beyond the
19

DMV, such as agencies administered by Defendant DHHS,
likewise hinders LWVNC’s efforts to promote registration
online (in lieu of its in-person events) and renders DemNC’s
advising efforts more difficult. Nicholas Decl. ¶ 10; Lopez
Decl. ¶ 20.
The burdens discussed above are not justified by a
legitimate or important state interest while COVID-19
persists. North Carolina already allows for same-day
registration at one-stop early voting sites up until the
Saturday before Election Day, and if needed, supplemental
poll books can be printed for Election Day. Despite once
having online voter registration systems “ready to test and
roll out,” North Carolina still fails to offer broader online
registration—with no justification. Bartlett Decl. ¶ 15a. And
any purported state interest would pale in comparison to the
extremity of the situation, as demonstrated by the
unprecedented decline in registration numbers. Accordingly,
the voter registration deadline must be extended until the
Saturday before the election, and Defendants must offer
broader online registration through DHHS. These measures
will ensure that voters have adequate opportunities to
20

register this year and will reduce the demand for in-person
registration during early voting.
ii. Absentee Ballot Requirements
COVID-19 has caused Defendant SBE to anticipate a
dramatic increase in mail-in absentee voting in 2020. Riggs
Decl. ¶ 3. But North Carolina’s election laws contain
restrictions on absentee voting that will impermissibly force
voters to choose between voting and protecting their health.
The State also lacks crucial mechanisms for guaranteeing that
the mail-in absentee ballots of eligible voters will be
counted.
Burdens on Requesting and Submitting Absentee Ballots
North Carolina’s election code and administration
presents numerous burdens on mail-in absentee voting. These
include: (i) requiring voters to submit a completed State
Absentee Ballot Request Form to their county board of
elections in order to receive an absentee ballot, pursuant to
N.C. Gen. Stat. § 163-230.2(a), (e)(1), without allowing for
voters to request absentee ballots by phone, email, or online
(the “Form Requirement”); (ii) allowing only a “voter’s near
relative or verifiable legal guardian” or multi-partisan
assistance teams to help voters complete and deliver an
21

absentee ballot request form, pursuant to N.C. Gen. Stat. §
163-230.2 (e)(2) (the “Organizational Assistance Ban”);4
(iii) requiring individuals voting an absentee ballot to do
so either “[i]n the presence of two persons who are at least
18 years of age” (among other requirements),5 or in the
presence of a notary public, pursuant to N.C. Gen. Stat. §
163-231(a) (the “Two Witness Requirement”); and (iv) failing
to provide for contactless drop boxes for voters to deliver
absentee ballots.
In light of the COVID-19 pandemic, these requirements
each impose a severe, unjustified burden on Plaintiffs’ right
to vote because complying with these provisions would require
voters to risk their health by violating social-distancing
directives and self-quarantines. Specifically, the Form
4 Voters requiring assistance to complete the absentee

ballot request form due to blindness, disability, or
inability to read or write may request another person if
“there is not a near relative or legal guardian available
to assist that voter.” N.C. Gen. Stat. § 163-230.2(e)1.
However, there is no exception for those who require
assistance with returning the request form by reason of
their blindness, disability, or inability to read or write.
See id. § 163-230.2 (e)(4).
5 Other restrictions include prohibiting owners, managers,
directors, employees of any hospital, clinic, nursing home,
or rest home from witnessing for a voter who is a patient or
resident. See N.C. Gen. Stat. §§ 163-226.3(a)(4) and 163-
237(b)(1).
22

Requirement means that voters like Plaintiff Peggy Cates, who
lacks means to print the request form, will be unable to
request an absentee ballot while social distancing; they will
have to seek help from others, whereas they could make such
a request by alternative means if the form were not required.
Cates Decl. ¶ 8. Plaintiff LWVNC has already received similar
reports from members and others who have no way to download
and print the request form. Nicholas Decl. ¶ 14.
The Organizational Assistance Ban augments these
challenges, preventing organizations like LWVNC from helping
voters to correctly complete and deliver request forms. This
process can be “particularly difficult for those who are self-
quarantining and do not have access to envelopes, postage, or
secure USPS mail pick-up.” Nicholas Decl. ¶ 14. Recent
national polls indicate that a substantial number of voters
are not confident that they understand the process of voting
by mail. Gronke Decl. ¶ 53. Plaintiffs Clark, Cates, Edwards,
Priddy, and Bentley, who all intend to vote by mail-in
absentee ballot, will be restricted in terms of whom they can
receive assistance from. Clark Decl. ¶ 10; Cates Decl. ¶ 9–
10; Edwards Decl. ¶ 10; Priddy Decl. ¶ 5, 8; Bentley Decl. ¶
7. The Organizational Assistance Ban thus prevents voters
23

from receiving needed assistance to navigate the ballot
request process even though this assistance is crucial at
this time.
The Organizational Assistance Ban also severely hinders
the work of LWVNC and similar organizations to help those
wishing to vote by mail, a population that will dramatically
increase this year with an influx of voters who have never
voted by mail. Nicholas Decl. ¶¶ 13–14; see also Lopez Decl.
¶ 24. The Ban impedes LWVNC’s educational mission and message
of participation in voting, its ability to build
relationships and associate with voters, and most
importantly, its mission of promoting voter participation and
civic engagement. Nicholas Decl. ¶ 14. Additionally, the
multi-partisan assistance teams cannot remedy these barriers
in certain North Carolina counties, where their availability
has been inadequate under the best of circumstances. See Riggs
Decl. ¶ 12. For similar reasons, Susan Schaffer and others
who (separate from LWVNC) have previously assisted voters in
requesting and completing absentee ballots will be prevented
from doing so. Declaration of Susan Schaffer (“Schaffer
Decl.) ¶¶ 4–7.
24

The Two Witness Requirement also presents an
insurmountable barrier to voting by mail for many voters in
North Carolina. Plaintiffs Clark, Cates, Edwards, Priddy,
Bentley, and Hutchins are all eligible North Carolina voters
who are at high risk of developing severe complications from
COVID-19 and therefore need to vote by mail to safeguard their
lives and the health and well-being of their family members
or co-habitants. Clark Decl. ¶¶ 2, 4–6; Cates Decl. ¶¶ 2, 4;
Edwards Decl. ¶¶ 5–6; Priddy Decl. ¶¶ 4–5; Bentley Decl. ¶¶
2, 4–7; Hutchins ¶ 6. Following advice from medical
professionals or the CDC, these Plaintiffs have quarantined
themselves in their homes, either alone, Cates Decl. ¶¶ 6, 9–
10; Bentley Decl. ¶¶ 1, 4, or with one other individual, Clark
Decl. ¶¶ 6–7; Edwards Decl. ¶¶ 1, 6; Priddy Decl. ¶¶ 1, 5.
Plaintiff Hutchins is under quarantine in a nursing home due
to the pandemic and the residents’ vulnerability to COVID-
19. Hutchins Decl. ¶ 6. These Plaintiffs have no way to
safely comply with the two-witness requirement. As a result,
they will be forced to choose between exercising their right
to vote and risking their health by interacting with a
witness. Putting Plaintiffs to this choice constitutes a
severe burden on their right to vote.
25

These Plaintiffs are just a few among many in North
Carolina. According to the U.S. Census, there are 1,113,548
single-member households in North Carolina, 37% of which are
occupied by someone 65 or older, in addition to 1,388,442
two-person households (who would similarly be unable to meet
the Two Witness Requirement without contact with an adult
outside of their household).6 In addition to bringing the
voter in close proximity to others, the Two Witness exposes
them to the risks of surface contamination and transmission
of COVID-19 via the dispersion of respiratory droplets and
aerosolization. Murray Decl. ¶¶ 8, 24. The alternative of
obtaining a notary public’s signature does not alleviate this
issue since the recent remote-notarization provisions in
North Carolina’s COVID-19 response bill specifically exempted
absentee ballots. Riggs Decl. ¶ 13. For higher-risk voters,
this burden is especially severe and must be justified by and
narrowly drawn to a compelling interest and the law.
Finally, the SBE Defendants’ failure to provide
contactless drop boxes for absentee ballots creates an
6 Table S2501, Occupancy Characteristics, American Community

Survey 2014–2018, U.S. CENSUS BUREAU,
https://data.census.gov/cedsci/table?q=S2501&g=0400000US37&
tid=ACSST5Y2018.S2501.
26

additional burden on voters. Drop boxes would allow voters
without access to postage and USPS pick-up to securely deposit
their ballots without breaking social distancing guidelines,
and would further reduce the strain on North Carolina’s mail
infrastructure. The latter is not a merely theoretical
concern: mail-in ballots must be postmarked on or before
Election Day and delivered no later than 5:00 pm on Election
Day, or returned to the county board of elections (not a
polling location) no later than 5:00 pm on Election Day.
Voters such as Plaintiffs Clark, Cates, Edwards, Priddy,
Bentley, and Hutchins who intend to vote by mail will have to
rely on USPS to safely submit their ballots. North Carolina’s
failure to provide drop boxes will likewise strain Plaintiff
DemNC’s resources to “assist voters (in a legal way) to find
a way to return their ballots if they lack stamps or financial
resources.” Lopez Decl. ¶ 26. The anticipated influx of mail-
in ballots means that the USPS will have to handle an
unprecedented volume of absentee ballots unless contactless
drop boxes are provided. Furthermore, other states, including
Oregon, have successfully used drop boxes and North Carolina
can easily implement a similar program. Bartlett Decl. ¶ 24.
27

These Burdens Are Not Justified By The State’s Interest In
Fraud Prevention
In the midst of this public health crisis, no legitimate
or important state interest justifies the burdens placed on
Plaintiffs’ right to vote. To the extent the SBE Defendants
invoke an interest in election security and fraud prevention,
the challenged restrictions are neither justified by that
interest nor narrowly drawn to advance it.
The state’s lawyers will likely attempt to defend some
or all of these restrictions by citing the 2018 absentee
ballot fraud conspiracy in 9th Congressional District (the
“Dowless Scheme”). While states have an interest in ensuring
the legitimacy of their elections, see Crawford v. Marion
Cty. Election Bd., 553 U.S. 181, 196 (2008), the Anderson-
Burdick inquiry calls for a balancing of burdens against
interests, not merely the naming of a legitimate one. See,
e.g., Norman v. Reed, 502 U.S. 279, 289 (1992). The regulation
must be proportionate to the problem.
The COVID-19 pandemic has caused these provisions to
burden voters to an unprecedented degree, both in terms of
risk (given the severe impact COVID-19 can present to all
individuals and particularly those with underlying health
28

issues) and in scale (given the expected increase in infection
rates throughout the fall). The Form Requirement, failure to
provide alternative means to request absentee ballots by
phone, email, or online, and failure to provide contactless
drop boxes have no clear connection to preventing voter fraud
yet will significantly impair certain voters’ ability to vote
by mail during an election when more voters than ever before
will seek to do just that.
The Organizational Assistance Ban was passed in the wake
of the Dowless Scheme and therefore has some connection to
preventing voter fraud. See An Act to Amend the Laws Governing
Mail-In Absentee Ballots (“SB 683”), S.L. 2019-239, § 1 (Nov.
6, 2019). However, its restrictions are not narrowly drawn
nor necessary because the state still can—and already does—
achieve its anti-fraud goals in other, less burdensome ways
by: (i) requiring voters to submit one of their North Carolina
driver’s license or state ID number or the last four digits
of their Social Security Number to request an absentee ballot,
see N.C. Gen. Stat. § 163-230.2(a)(4), (f), (which could still
be required for requests made by phone, email, or online);
(ii) requiring the same as well as a certification under
penalty of perjury by the voter on the absentee ballot itself,
29

see, e.g., Riggs Decl. ¶ 14; (iii) making the identities of
absentee ballot requestors confidential until Election Day,
see N.C. Gen. Stat. § 163-228(c); and (iv) enhancing the
penalties for certain absentee-ballot-law violations and
criminalizing any receipt of payment, failure to deliver, or
copying of information from an absentee ballot request or
application. See N.C. Gen. Stat. § 163-237.
In particular, making absentee ballot requests
confidential (item (iii) above) prevents those trying to
commit fraud, such as Dowless, from targeting individuals who
have requested absentee ballots. As Mr. Tutor explains,
Mr. Dowless’ illegal mail-in absentee ballot fraud

enterprise was almost totally dependent on his daily
access to the names and addresses of those who requested
absentee ballots from the Bladen County Board of
Elections. Mr. Dowless was known to have had a very long
and cordial relationship with the staff at the Bladen
County Board of Elections. He would either call the
county board staff or come by on a daily basis to get
the list of absentee ballot requests. At that time, the
names and addresses of those requesting a mail-in
absentee ballot were public record.
Now that the law has been changed so that the identities
of voters requesting mail-in absentee ballots is not a
public record until Election Day, I do not believe anyone
can fraudulently manipulate the system as Mr. Dowless
did.
Tutor Decl. ¶¶ 6–7.
30

Although the Supreme Court has recognized fraud
prevention as a legitimate goal, it has twice struck down
voting requirements because oath requirements and other anti-
fraud measures already fulfilled the same purpose. In Dunn v.
Blumstein, the Court noted that Tennessee could prevent non-
residents from fraudulently voting in its elections by
imposing an oath requirement and implementing cross-checks.
405 U.S. 330, 346, 348 (1972). See also Mem’l Hosp. v.
Maricopa Cty., 415 U.S. 250, 267–68 (1974) (holding that state
agencies managed to prevent fraud without using durational
residency requirements); Harman v. Forssenius, 380 U.S. 528,
543 (1965) (rejecting Virginia’s argument that requiring
either a poll tax or a certificate of residence promoted
administrative efficiency in voting, in part because 46 other
states were able to verify voters’ addresses without these
requirements).
The Organizational Ban also imposes greater restrictions
on completing and submitting absentee ballot applications
than exist for returned, completed absentee ballots, for
which a voter may obtain assistance from a third party who is
not a near relative or legal guardian. See N.C. Gen. Stat.
§§ 163-226.3(a), 163-229(b)(4), 163-231(a). It is difficult
31

to ascertain how restrictions on application assistance could
be justified where restrictions on ballot assistance are not
necessary.
Similarly, the Two Witness Requirement does little to
prevent fraud while creating mass disenfranchisement. The
U.S. District Court for the District of South Carolina
recently considered a similar Anderson-Burdick undue burden
challenge to a single-witness requirement for mail-in voting
and concluded that plaintiffs were:
likely to prevail on their constitutional challenge to

the Witness Requirement under the Anderson-Burdick
balancing test because the character and magnitude of
the burdens imposed on [plaintiffs] in having to place
their health at risk during the COVID-19 pandemic likely
outweigh[s] the extent to which the Witness Requirement
advances the state’s interests of voter fraud and
integrity.
Thomas v. Andino, No. 3:20-cv-01552-JMC, 2020 WL 2617329, at
*21 (D.S.C. May 25, 2020). The court placed particular
emphasis on South Carolina Election Commission Executive
Director Marci Andino’s candid statement that “the witness
signature offers no benefit to election officials as they
have no ability to verify the witness signature.” Id. at *19–
20; see also League of Women Voters of Okla. v. Ziriax, No.
118765, 2020 WL 2111348, at *1 (Okla. May 4, 2020) (enjoining
absentee ballot notary requirement); Libertarian Party of

32

Ill. v. Pritzker, No. 20-CV-2112, 2020 WL 1951687, at *4 (N.D.
Ill. Apr. 23, 2020) (enjoining portions of signature
requirement for potential candidate ballot eligibility
because they presented “insurmountable hurdle” during
pandemic).
Any purported reliance by Defendants on the Dowless
Scheme to justify the Two Witness Requirement is unavailing:
the Two Witness Requirement was enacted in 2013, see 2013
N.C. HB 589 § 4.4 (enacted Aug. 12, 2013), years before the
Dowless Scheme and thus failed to prevent it. Former Lead
Investigator for Defendant SBE Marshall Tutor explains in his
declaration that the two-witness signature requirement is not
a particularly effective anti-fraud measure:
I do not believe a two-witness signature requirement

in any way prevents potential fraud such as that
conducted by Mr. Dowless’ illegal ballot fraud
activities. In my 15 years’ experience as an
investigator with the State Board of Elections, I
cannot think of a time or situation in which two
absentee ballot witness signatures would have
prevented absentee ballot fraud.
Declaration of Marshall Tutor (“Tutor Decl.”) ¶ 8. Former
Executive Director of the N.C. State Board of Elections
similarly explains:
Other measures, such as fining violators, suspending

voting rights and electioneering for a period of
time, or incarcerating violators, would be much more
33

effective in deterring voter fraud than imposing a
blanket two-witness requirement that will be an
unnecessary barrier to many eligible voters.
Bartlett Decl. ¶ 28. Similarly, DemNC is aware through
its research and advocacy that election fraud is “quite
rare, and that the issues raised by the 2018 case have
to do with enforcement of laws that were already in place
prior to 2018, and with enforcement, surveillance and
monitoring of election irregularities can suss out and
address these issues.” Lopez Decl. ¶ 30.
Even if it did advance an interest in preventing fraud,
the two-witness requirement is not narrowly tailored,
especially in light of the other anti-fraud measures in place
and listed above. As the court in League of Women Voters of
Virginia v. Virginia State Board of Elections recently
explained when considering a single witness requirement:
In ordinary times, Virginia’s witness signature

requirement may not be a significant burden on the right
to vote. But these are not ordinary times. In our current
era of social distancing-where not just Virginians, but
all Americans, have been instructed to maintain a minimum
of six feet from those outside their household-the burden
is substantial for a substantial and discrete class of
Virginia’s electorate. During this pandemic, the witness
requirement has become both too restrictive and not
restrictive enough to effectively prevent voter fraud.
On the one hand, the measure is too restrictive in that

it will force a large class of Virginians to face the
choice between adhering to guidance that is meant to
34

protect not only their own health, but the health of
those around them, and undertaking their fundamental
right-and, indeed, their civic duty-to vote in an
election. The Constitution does not permit a state to
force such a choice on its electorate.
No. 6:20-CV-000024, 2020 WL 2158249, at *8 (W.D. Va. May 5,
2020) (internal quotation marks and citations omitted).
Finally, the witness certifications themselves do not
call for the printed name of the witnesses, a glaring omission
that further undermines the certification’s use as an anti-
fraud tool. Accordingly, witness certifications function as
placebos. They have a psychological benefit, but recent
history has shown that they are not particularly effective
fraud deterrence, prevention, detection, or prosecution
tools. Accordingly, the Two Witness Requirement should be
suspended for the November election.7
7 Should the Court seek to craft a remedy tailored to voters

facing the most serious risks of severe illness, Plaintiffs
offer two alternatives to the Two Witness Requirement: (i)
permitting voters to submit a certification with their
absentee ballot affirming their inability to safely obtain
a witness requirement following reasonable efforts, and/or
(ii) permitting individuals to remotely witness absentee
ballots remotely (e.g., via videoconference), and requiring
only that voters record the name and address of the witness
without requiring the witness’s wet-ink signatures. See
Democratic Nat’l Comm. v. Republican Nat’l Comm., Nos. 20-
1538 & 20-1546, at *4 (7th Cir. Apr. 3, 2020), stayed in
part, No. 19A1016, 2020 WL 1672702 (U.S. Apr. 6, 2020). At
35

Additional Burdens To Absentee Voting
The failure by Defendants to ensure voters have an
opportunity to cure deficient absentee ballot requests or
ballots, or to submit a FWAB as an alternative of last resort
to cast their votes should they fail to receive absentee
ballots in time, present additional burdens to the right to
vote in North Carolina. In the March 2020 North Carolina
primary, almost 15 percent of submitted absentee mail-in
ballots were rejected. Ketchie Decl. ¶ 5. Plaintiffs Clark,
Cates, Edwards, Priddy, Bentley, and Hutchins all intend to
vote by mail-in absentee ballot, some for the first time, see
e.g., Cates Decl. ¶ 8, and may well make errors on their
absentee ballot request forms or absentee ballots and/or
their certificate envelopes. There is no guarantee they will
be notified or given the opportunity to cure these errors.
Plaintiff LWVNC will have to redirect its limited resources
toward ensuring that the voters it assists are following all
procedures precisely, all while navigating the Organizational
Assistance Ban. Nicholas Decl. ¶ 18. Plaintiff DemNC works in
bare minimum, Plaintiffs respectfully request the Court

enjoin the requirement for a second witness, thereby
requiring voters to only obtain one witness.
36

many of North Carolina’s 100 counties and, without a uniform
procedure for county boards to assist voters with curing their
absentee ballots or request forms, will require them to spend
more time helping individual voters from varying counties to
successfully vote by mail. Lopez Decl. ¶ 27. In light of the
anticipated dramatic increase in the use of absentee ballots
and the Organizational Assistance Ban, there is a heightened
risk that voters new to mail-in absentee voting will fail to
follow the proper procedures. By lacking a procedure for
voters to cure deficiencies, North Carolina’s election code
risks disenfranchising vast numbers of absentee voters.
Similarly, the importance of providing the FWAB as a
back-up is underscored by the recent evidence out of
Wisconsin, Ohio, and Pennsylvania, where state and local
election officials, as well as the USPS, failed to timely
deliver thousands of absentee ballots to voters in the mail
during a spring election with significantly lower-turnout
elections than the November presidential election will be.
Gronke Decl. ¶¶ 55, 60. Given the anticipated ten-fold
increase in use of absentee mail-in ballots, it is likely
that many North Carolina voters will likewise receive their
ballots too late to cast them. Those voters who timely request
37

an absentee ballot, such as Plaintiffs Clark, Cates, Edwards,
Priddy, Bentley, and Hutchins who all intend to vote by mail-
in absentee ballot, but do not receive their ballots in time
to vote and drop them off or mail them by Election Day will
be disenfranchised unless they are permitted to use the FWAB
as an alternative of last resort to cast their votes.
Plaintiff DemNC also anticipates a significant diversion of
resources to help voters get last-minute absentee request
submitted without the availability of the FWAB failsafe
measure. Lopez Decl. ¶ 27.
There are no legitimate state interests for Defendants’
failure to remedy these restrictions to absentee voting
during the ongoing health crisis. It’s not clear what, if
any, interest would be served in requiring counties to provide
voters with an opportunity to cure absentee ballots and
requests forms. As for FWABs, these are already available to
military and overseas citizens pursuant to the Uniformed and
Overseas Citizens Absentee Voting Act (“UOCAVA”), 52 U.S.C.
§ 20301 et seq. This law provides that military and overseas
voters must be permitted to cast FWABs as an “Official Backup
Ballot,” Riggs Decl. ¶ 15,or “back-up measure,” to vote in
federal races if they do not receive their regular absentee
38

ballot. 52 U.S.C. §§ 20302(a)(3), 20303(a)(1). FWABs are then
“submitted and processed in the manner provided by law for
absentee ballots in the State involved.” 52 U.S.C. § 20303(b).
Even if these burdens to voting did serve a legitimate state
interest, the need for these failsafe options during the
COVID-19 pandemic would far outweigh any such interest where
voting by mail is of paramount importance.
iii. In-Person Voting Restrictions
While use of mail-in absentee voting is projected to
increase ten-fold, a majority of voters are projected to still
rely on in-person voting options in the November election.
North Carolina’s electorate has expressed a clear preference
for in-person voting, with just 4 percent of voters casting
mail-in absentee ballots in the 2016 general election.
Ketchie Decl. ¶ 6; Gronke Rep. ¶ 15. As a result, North
Carolina has not built the infrastructure to accommodate such
a dramatic increase in voter demand for absentee mail-in
ballots without overloading current systems and causing mass
disenfranchisement. Gronke Decl. ¶¶ 15, 18. Accordingly, in-
person voting must be preserved as a safe alternative to mail-
in ballots.
39

The CDC has issued guidance recommending election
officials to “reduce crowd size at polling stations” and take
other action to ensure safe in-person voting options in light
of COVID-19. Riggs Decl. ¶ 16. Contrary to this guidance,
North Carolina’s election code has two provisions that have
already hindered—and will continue to hinder—county boards in
providing safe, free, and fair in-person voting options: (i)
the requirement pursuant to N.C. Gen. Stat. § 163-42(b) that
a majority of poll workers reside in the precinct where they
serve on Election Day under (the “Majority Precinct
Requirement”); and (ii) the requirement pursuant to N.C. Gen.
Stat. § 163-227.6(c) that all early voting sites must be open
during uniform hours and all sites other than the county board
office must be open 8:00 a.m. to 7:30 p.m. (the “Uniform Hours
Requirement”).
The burden of these provisions on the right to vote is
already apparent. As of May 14, 2020, eight county boards
have moved to eliminate 64 precincts for the upcoming
Congressional District 11 Second Republican Primary, with
several citing a lack of poll workers as the reason for
consolidation. Riggs Decl. ¶ 20. In a letter to General
Assembly leadership, county board members from Congressional
40

District 11 conveyed that eliminating the Majority Precinct
Requirement “would significantly help us staff polling places
in these challenging times.” Riggs Decl. ¶ 5. Eliminating the
Majority Precinct requirement is likewise required to prevent
the closure of polling locations in the November election in
light of the anticipated persistence of COVID-19 this fall
and the advanced age of poll workers. In the 2014 general
election, over 60 percent of North Carolina poll workers were
61 years of age or older and, as a result, a significant
portion of poll workers are in the 65-years-old-plus CDC risk
category. Riggs Decl. ¶ 17. Similarly, the Uniform Hours
Requirement has already proven to cause polling locations to
close. After North Carolina imposed this requirement in June
2018, the costs of implementing this measure caused 43
counties to reduce the number of early voting sites in the
2018 general election compared to 2014 and over two-thirds of
counties to reduce weekend hours. Lopez Decl. ¶ 7; Riggs Decl.
¶ 18—19.
The precinct consolidation that will result from
enforcement of the Majority Precinct and Uniform Hours
Requirements will cause a severe burden on the right to vote
in North Carolina. Gronke Decl. ¶ 28. Voters who need to vote
41

in person, like Plaintiff Permar, will be confronted with
confusion as to their voting location, increased travel time
to get there, as well as long lines and crowds that will put
them at greater risk of contracting COVID-19. Permar Decl.
¶ 7–10. Closures of polling places accessible by public
transportation will also jeopardize the ability of those who
rely on public transportation to reach polling locations,
like Plaintiff Permar. Id. at ¶ 7. Additionally, Plaintiff
LWVNC will have to divert its limited resources toward
recruiting poll workers from within precincts and to alerting
its members and those in their communities about precinct
closures, Nicholas Decl. ¶¶ 20–21, and Plaintiff DemNC will
have to spend more time advocating for early voting site sand
days if the Uniform Hours Restriction is enforced. Lopez
Decl. ¶ 28.
These anticipated barriers to voting are not speculative.
The reductions in polling place locations in the recent
Wisconsin primary caused voters to wait two to three hours to
cast a ballot in some locations. Gronke Decl. ¶ 46. In North
Carolina, there are over 200 precincts with over 5,000 voters,
Ketchie Decl. ¶ 7, and this number only stands to increase
with precinct closures. These precincts especially will
42

experience long lines. Bartlett Decl. ¶ 27. These factors—
inconvenient polling places, long lines, and less accessible
voting locations that require voters to travel longer
distances—already present obstacles to voting under ordinary
circumstances. Gronke ¶ 25; Lopez ¶ 14; Bartlett Decl. ¶ 17.
These obstacles will only be exacerbated during the current
pandemic, when social distancing is required for safe
election administration. Consistent with the anticipated
impact of these provisions, Defendant Bell requested a change
in state law to allow county boards to recruit and train poll
workers county-wide and to allow count boards of election
“flexibility to determine hours because they are affected
differently by, and respond differently to, the COVID-19
pandemic.” Riggs. Decl. ¶ 3.
Individuals accustomed to early voting may very well be
deterred by crowding and the inherent heightened risk of
infection; they will thus be forced to choose between risking
their health to cast a ballot or foregoing their right to
vote. Accordingly, these provisions present a severe burden
to these Plaintiffs and the rights of voters who rely on in-
person voting. See Ury v. Santee, 303 F. Supp. 119, 124 (N.D.
Ill. 1969) (finding that the defendant’s failure to provide
43

adequate voting facilities despite their foreknowledge of
precinct consolidations deprived voters of their
constitutional rights); League of Women Voters of Ohio v.
Brunner, 548 F.3d 463, 478 (6th Cir. 2008) (finding long lines
and inadequate voting machines severely burdened Ohio voters’
right to vote).
It is unclear what legitimate, let alone important, state
interest could be furthered by the Majority Precinct and
Uniform Hours Requirements, particularly when the shortage is
already dire. In the midst of this ongoing public health
crisis, there is no state interest in enforcing this
requirement that justifies these burdens placed on
Plaintiffs’ constitutional right to vote.
In addition to the above restrictions, the SBE Defendants
has imposed further burdens on the right to vote by failing
to provide an accessible, centralized way for voters and
advocates to monitor precinct consolidations, and failing to
require counties to provide poll workers and voters with PPE
for use during in-person voting for the 2020 general election.
These failures add cumulatively to the panoply of
restrictions on eligible voters wishing to cast a ballot in
person. See Clingman v. Beaver, 544 U.S. 581, 607–08 (2005)
44

(“A panoply of regulations, each apparently defensible when
considered alone, may nevertheless have the combined effect
of severely restricting participation and competition.”)
(O’Connor, J., concurring).
As for precinct consolidation, each county board must
give notice at least 45 days before the election when altering
or consolidating precincts by posting notice in a generally
circulated newspaper and on the door of the county courthouse
and county board, and mailed to the chairmen of every
political party in the county. See N.C. Gen. Stat. § 163-
128(a). However, voters only need to be notified of changes
in their particular precinct 30 days before an election. Id.
Accordingly, North Carolina’s failure to provide an
accessible, centralized way in which voters and advocates can
monitor precinct consolidation is a severe burden on the right
to vote in light of the expected volume of changes. Limited
access to this information will impede and confuse voters
trying to determine where and how best to vote in-person,
including voters like Plaintiff Permar, who must vote in
person and must ensure she is able to vote at a time that is
in line with her work schedule. Permar Decl. ¶¶ 1, 9. As a
central hub for voter information, Plaintiff DemNC will need
45

to redistribute resources in order to adequately and timely
inform voters about precinct consolidations absent a
centralized access to this information. Lopez Decl. ¶ 14–15.
In addition, the SBE Defendants must require counties to
provide PPE to ensure the safety of voters and poll workers.
Such PPE should include protective masks and gloves for poll
workers and/or voters, separation shields, antiseptic wipes
for equipment, and single-use pens, all of which will help
prevent voters such as Plaintiff Donna Permar, who must vote
in person, Permar Decl. ¶ 10, and poll workers from infection.
In conducting its Election Protection hotline and poll-
monitoring program, DemNC volunteers will almost certainly be
asked about PPE, who has it, and how to secure it if is not
provided. Lopez Decl. ¶ 24. In addition to presenting a risk
to voters’ health, the failure in the recent Wisconsin primary
to provide supplies to protect election workers caused poll
worker shortages and, as a result, localities to severely
limit or close early voting locations. Gronke Decl. ¶ 43. The
reductions in polling place locations also caused voters to
wait two to three hours to cast a ballot in some locations,
thus compounding issues of crowding and risks of infection.
Id. ¶ 46. Finally, the need for a requirement that counties
46

provide PPE can hardly be in dispute where Defendant Bell
stated that she intended already to order PPE for counties
holding the second Republican primary election. Riggs Decl.
¶ 23. The same measures should be taken for the November
election.
In the midst of this ongoing public health crisis and
the rapid changes to election plans it is forcing, there is
no state interest in denying easy access to precinct
consolidation information or failing to require counties to
provide PPE that justifies the burden placed on Plaintiffs’
constitutional right to vote.
As set forth above, Plaintiffs are likely to succeed on
the merits of proving that these various restrictions on voter
registration, absentee by-mail voting, and in-person voting,
present severe burdens to the right to vote in violation of
the First and Fourteenth Amendments that are not justified by
any state interests, compelling or otherwise, in light of
COVID-19. Even if purported to serve legitimate state
interests, such as preventing voter fraud, these measures are
not narrowly tailored in light of COVID-19. Although true
even when taken individually, even if these restrictions were
individually defensible they present a “panoply of
47

regulations” with the “combined effect of severely
restricting participation and competition.” Clingman, 544
U.S. at 607–08 (O’Connor, J., concurring).
B. Unconstitutional Condition on the Right to Vote
North Carolina’s election laws and procedures are not
designed to facilitate safe, fair, and free elections during
such a public health crisis, and the legislature has failed
to take action to remedy this situation. Given the rapidly
spreading infection, North Carolina’s current election laws
will force voters to choose between exposing themselves to
severe risks to their health and exercising their
constitutionally-protected right to vote. This forced choice
unlawfully compels North Carolina voters to forfeit their
constitutionally-protected right to bodily integrity in order
to exercise another constitutional right.
As the U.S. Constitution forbids undue burdens on the
right to vote, so does it prohibit states from forcing
individuals to choose between their rights. Defendants’
enforcement of restrictions on mail-in absentee voting
outlined in the sections above force mail-in absentee voters
to relinquish their Fourteenth Amendment right to bodily
integrity in order to exercise their First and Fourteenth
48

Amendment-protected right to vote. Forcing voters to forfeit
their right to bodily integrity violates the Fourteenth
Amendment.
Under the unconstitutional conditions doctrine, the
government may not require an individual to forfeit one
constitutional right in order to exercise another. See
Simmons v. United States, 390 U.S. 377, 394 (1968) (“[I]t
[is] intolerable that one constitutional right should have to
be surrendered in order to assert another.”). The doctrine
has also been invoked to prohibit the imposition of conditions
on First Amendment-protected activities that require the
forfeiture of other rights. See Lefkowitz v. Cunningham, 431
U.S. 801, 807–08 (1977) (finding New York law
unconstitutionally required political party leaders to
provide unimmunized testimony before a grand jury, forcing
leaders to choose between First Amendment right of
association and Fifth Amendment right against self-
incrimination); Bourgeois v. Peters, 387 F.3d 1303, 1324
(11th Cir. 2004) (“This case presents an especially malignant
unconstitutional condition because citizens are being
required to surrender a constitutional right—freedom from
unreasonable searches and seizures—not merely to receive a
49

discretionary benefit but to exercise two other fundamental
rights—freedom of speech and assembly.”).
Most relevant here, the Supreme Court has invalidated
voting requirements or conditions that require the forfeiture
of another fundamental right. In Dunn v. Blumstein, the Court
held that a one-year durational residency requirement for
voter registration placed an unconstitutional condition on
the fundamental right to interstate travel. 405 U.S. 330
(1972). The Court explained that “such laws force a person
who wishes to travel and change residences to choose between
travel and the basic right to vote.” Id. at 342. Notably,
when First Amendment-protected rights such as the right to
vote are at stake, it is irrelevant whether the government
intended to coerce the voter into forfeiting a constitutional
right. See Bourgeois, 387 F.3d at 1324–25 (“[T]he very purpose
of the unconstitutional conditions doctrine is to prevent the
Government from subtly pressuring citizens, whether purposely
or inadvertently, into surrendering their rights.” (emphasis
added)).
Courts evaluate these claims by looking to the
constitutional standard for the right that Plaintiffs are
coerced to surrender. “[W]hen a condition on a government
50

benefit burdens a constitutional right, it generally triggers
the same scrutiny as a direct penalty would.” McCabe v.
Sharrett, 12 F.3d 1558, 1562 (11th Cir. 1994). In Dunn, the
durational residency requirement for voter registration was
subjected to strict scrutiny because fundamental voting and
interstate travel rights were implicated: “In the present
case, whether we look to the benefit withheld by the
classification (the opportunity to vote) or the basis for the
classification (recent interstate travel) we conclude that
the State must show a substantial and compelling reason for
imposing durational residence requirements.” 405 U.S. at 335;
see also Shapiro v. Thompson, 394 U.S. 618, 634, 638 (1969)
(“Since the classification [for welfare eligibility] here
touches on the fundamental right of interstate movement, its
constitutionality must be judged by the stricter standard of
whether it promotes a compelling state interest.”).
This case implicates Plaintiffs’ rights to bodily
integrity, which is guaranteed by the Fourteenth Amendment’s
Due Process Clause. Government actions that threaten the
right to bodily integrity are subject to strict scrutiny. See
Kallstrom v. City of Columbus, 136 F.3d 1055, 1064 (6th Cir.
1998). In Guertin v. Michigan, which concerned the Flint water
51

crisis, the court recognized that the Sixth Circuit
articulated the following standard: “Involuntarily subjecting
nonconsenting individuals to foreign substances with no known
therapeutic value . . . is a classic example of invading the
core of the bodily integrity protection.” 912 F.3d 907, 919,
921–22 (6th Cir. 1998); cf. id. at 921 (“[A] government actor
violates individuals’ right to bodily integrity by knowingly
and intentionally introducing life-threatening substances
into individuals without their consent, especially when such
substances have zero therapeutic benefit.”).8
The Two-Witness Requirement forces voters who are at high
risk of developing severe complications from COVID-19, such
as Plaintiffs Cates, Clark, Edwards, Priddy, and Bentley, to
choose between their right to vote and the right to bodily
integrity. These voters, who have quarantined themselves in
their homes to protect their health, wish to vote by mail
8 Typically, these bodily integrity cases are about prior

misconduct in an action for damages, not, as here, an
action for prospective injunctive relief based upon the
argument that a law or policy will, in the future, violate
plaintiffs’ bodily integrity. But if anything, the right to
bodily integrity should be even more robust when the harm
to bodily integrity arises from the face of a law—it is a
small analytical hop to analogize from the cases about past
official misconduct.
52

because they cannot vote in person—but to do so, they must
risk their health by engaging two witnesses to observe their
completion of the ballot. Cates Decl. ¶¶ 10–11; Clark Decl.
¶¶ 9–11; Edwards Decl. ¶¶ 10–12; Priddy Decl. ¶¶ 8–10; Bentley
Decl. ¶¶ 7–10.
Further, voting in person is not a viable alternative to
mail-in voting for these at-risk Plaintiffs. See Thomas v.
Andino, No. 3:20-cv-01552-JMC, 2020 WL 2617329, at *17 n.20
(D.S.C. May 25, 2020) (holding that, in light of the COVID-
19 pandemic, restrictions on absentee voting effectively
impair and deny the right to vote because “it is relatively
difficult to vote in person without risking the possibility
of infection, especially for those who are more susceptible
to the ravaging harms of COVID-19” and “absentee voting is
the safest tool through [sic] which voters can use to
effectuate their fundamental right to vote”).
As discussed above, the Two Witness Requirement does not
clearly advance the state’s interest in preventing fraud, and
existing anti-fraud measures more than adequately protect
mail-in absentee voting, including requirements that voters
submit identifying information, that they and their witnesses
certify the ballot under penalty of perjury, and enhancing
53

the penalties for certain absentee-ballot-law violations. See
supra Section I.A.ii at pp. 1528–367; see also Dunn, 405 U.S.
at 346, 348 (striking down voting requirements after finding
Tennessee could prevent non-residents from fraudulently
voting in its elections by imposing an oath requirement and
implementing cross-checks); Mem’l Hosp. v. Maricopa Cty., 415
U.S. 250, 267–68 (1974) (holding that state agencies managed
to prevent fraud without using durational residency
requirements); Harman v. Forssenius, 380 U.S. 528, 543 (1965)
(rejecting Virginia’s argument that requiring either a poll
tax or a certificate of residence promoted administrative
efficiency in voting, in part because 46 other states were
able to verify voters’ addresses without these requirements).
Accordingly, Defendants’ enforcement of the challenged
restrictions on mail-in absentee voting forces Plaintiffs and
the Organizational Plaintiffs’ members to forfeit their right
to bodily integrity in order to exercise their right to vote
in violation of the Fourteenth Amendment.
C. Violation of the Organizational Plaintiffs’ and

Plaintiff Schaffer’s First Amendment Rights to
Free Speech and Association
Voter assistance is critical to Organizational
Plaintiffs’ speech, associational group activity and
54

organizational mission. SB 683’s restrictions on the
organization assisting its members and other voters with
completing and submitting absentee ballot request forms thus
impermissibly interferes with the Organizational Plaintiffs’
First Amendment rights to promote civic engagement and
associate with their members and other voters. SB 683’s
restrictions also interfere with Plaintiff Schaffer’s rights
to free speech and association because she is no longer able
to assist many voters who desperately need it. Schaffer Decl.
¶¶ 8–9.
There is no “doubt that freedom to associate with others
for the common advancement of political beliefs and ideas is
a form of orderly group activity protected by the First and
Fourteenth Amendments.” Kusper v. Pontikes, 414 U.S. 51, 56–
57 (1973) (internal quotation omitted). The restrictions on
who can assist voters with completing and returning mail-in
absentee ballot request forms stymie the Organizational
Plaintiffs and their members’ core political speech and
expressive conduct to engage potential voters and encourage
them to vote by assisting voters with requesting and
submitting absentee ballot requests. See Nicholas Decl. ¶ 6,
8, 12–14; Lopez Decl. ¶ 22.
55

The Supreme Court has recognized that petition-gathering
activity is “the type of interactive communication concerning
political change that is appropriately described as ‘core
political speech.’” Meyer v. Grant, 486 U.S. 414, 422–23
(1988). Whether a voter should apply for a ballot and
ultimately participate in an election is a “matter of societal
concern that [Plaintiffs] have a right to discuss publicly
without risking criminal sanctions.” Meyer v. Grant, 486 U.S.
414 at 421; see also Buckley v. Am. Constitutional Law Found,
525 U.S. 182, 186–87 (1999) (quoting Meyer, 486 U.S. at 422).
In Meyer, plaintiffs were engaged in direct outreach to fellow
citizens to engage them in the political process by gathering
petition signatures for inclusion of a ballot question. State
law burdened their signature-gathering activity by banning
payment of petition circulators. Applying “exacting
scrutiny,” the Supreme Court struck down this law as
“restrict[ing] political expression.” Meyer, 486 U.S. at
420–22.
As in Meyer, providing assistance to voters who need to
vote by mail to mitigate their risk of contracting COVID-19
and who are requesting a mail-in ballot for the first time
since SB 683’s enactment goes to the heart of Organizational
56

Plaintiffs’ core associational rights and missions to
increase civic participation and engagement, as well as
Plaintiff Schaffer’s individual free speech and associational
rights. Nicholas Decl. ¶¶ 6, 12–14; Lopez Decl. ¶¶ 2, 5, 10–
11; Schaffer Decl. ¶¶ 6, 9. Particularly in the pandemic
context, assisting voters with filling out request forms and
helping voters submit them, rather than simply pointing to
blank forms, would be an important part of the LWVNC’s
educational mission and the effectiveness of their message of
participation. Nicholas Decl. ¶¶ 13–14. Where the LWVNC
directly helps voters, this assistance has educational and
communicative value, and helps it build relationships with
members and other voters. Id. Voters who work with the LWVNC
to submit applications, many for the first time, would be
more likely to complete the process independently in the
future, and more likely to vote in the following election.
Id. ¶ 13. When voters cannot get needed assistance, DemNC
must expend more resources explaining the process to them,
including how to get a ballot. Lopez Decl ¶¶ 16, 22-24.
The restrictions on assisting voters with applying for
mail ballots prevent Organizational Plaintiffs from
associating with their members and other voters, limiting
57

Organizational Plaintiffs’ political expression, and
diminishing their ability to convey their message and further
it by engaging more individuals in the political process.
See Nicholas Decl. ¶¶ 12–13; Lopez Decl. ¶ 22. The speech in
question is “at the core of our electoral process and of the
First Amendment freedoms.” Williams v. Rhodes, 393 U.S. 23,
32 (1968). And because the restrictions interfere with core
political speech, they are “accordingly ‘subject to strict
scrutiny, which requires the Government to prove that the
restriction furthers a compelling interest and is narrowly
tailored to achieve that interest.’” Ariz. Free Enter. Club’s
Freedom Club PAC v. Bennett, 564 U.S. 721, 734 (2011) (quoting
Citizens United v. Fed. Election Comm’n, 558 U.S. 310, 340
(2010)).
By imposing a blanket ban on organizations like the
Organizational Plaintiffs and Plaintiff Schaffer, which
prevent them from assisting their members and/or voters with
completing and requesting absentee ballots, N.C. Gen. Stat.
§ 163-23.2 is not narrowly-tailored to serve a compelling
state interest. “[W]hen it comes to core First Amendment
speech…the government may not use a hatchet where
a scalpel will suffice.” Cross v. Mokwa, 547 F.3d 890, 903
58

(8th Cir. 2008) (Bye, J., concurring in part) (citing NAACP
v. Claiborne Hardware Co., 458 U.S. 886, 908 (1982)).
Examples of more targeted provisions include the prohibition
on falsification of papers with respect to fraudulent voter
qualification, and on false representations to blind or
illiterate voters regarding their ballots. N.C. Gen. Stat. §§
163-274, 163-275. Accordingly, Organizational Plaintiffs and
Plaintiff Schaffer are likely to succeed on their First
Amendment speech and association claim.9
D. Procedural Due Process
“Where the government seeks to deprive someone of a
liberty interest protected by due process, due process
demands that certain procedural safeguards be provided.”
United States v. Baker, 45 F.3d 837, 843 (4th Cir. 1995). A
liberty interest that is governed by due process can be
created by the U.S. Constitution or “may arise from an
9 Even if the Court were to review this restriction on

Plaintiffs’ associational rights under the Anderson-Burdick
framework for regulations of the election process, there is
little difference between the exacting scrutiny of Meyer
and the close scrutiny applied under Anderson-Burdick when
considering regulations on core political speech, which are
necessarily severe. Buckley v. Am. Constitutional Law
Found., 525 U.S. 182, 208 (1999) (Thomas, J., concurring);
see id. at 192 n.12. See infra Section 1.A.
59

expectation or interest created by state laws or policies.”
Wilkinson v. Austin, 545 U.S. 209, 221 (2005).
“[P]rocedural due process requires fair notice of
impending state action and an opportunity to be heard.” Snider
Int’l Corp. v. Town of Forest Heights, 739 F.3d 140, 146 (4th
Cir. 2014) (citing Mathews v. Eldridge, 424 U.S. 319, 333
(1976)). Absent exigent circumstances, due process requires
pre-deprivation procedures. See Cleveland Bd. of Educ. v.
Loudermill, 470 U.S. 532, 542 (1985). The Mathews test “set
forth the familiar three-step inquiry for determining the
adequacy of the opportunity to be heard,” Snider Int’l, 739
F.3d at 146, but here state and county election officials
afford no process whatsoever.
Courts have held that the failure to provide voters
adequate notice and an opportunity to cure amounts to a
violation of voters’ procedural due process rights. Saucedo
v. Gardner, 335 F. Supp. 3d 202, 217–22 (D.N.H. 2018)
(applying Mathews and concluding that the state’s scheme
“fails to guarantee basic fairness”). North Carolina law
gives all registered North Carolina voters statutory rights
to request and cast a mail-in absentee ballot that will be
processed and counted, thereby vesting them with liberty
60

interests. N.C. Gen. Stat. § 163-226(a). Eligible, registered
voters enjoy an “individual and personal” right to vote under
North Carolina law. Gill v. Whitford, 138 S. Ct. 1916, 1929
(2018) (quoting Reynolds v. Sims, 377 U.S. 533, 561 (1964)).
“The right to vote by absentee ballot is not, in and of
itself, a fundamental right. But once the State permits voters
to vote absentee, it must afford appropriate due process
protections, including notice and a hearing, before rejecting
an absentee ballot.” Zessar v. Helander, No. 05 C 1917, 2006
WL 642646, at *5 (N.D. Ill. Mar. 13, 2006).
As enforced by Defendants, the state’s election laws do
not afford mail-in absentee voters any notice of or
opportunities to cure material defects in their absentee
ballot request form or the absentee ballots themselves. Such
material defects will result in the rejection of their request
forms or absentee ballots, thereby depriving Individual
Plaintiffs and the Organizational Plaintiffs’ members of
their right to vote by mail. Furthermore, the lack of any
uniform mechanism to cure will require LWVNC and DemNC to
devote additional resources towards identifying which
counties are voluntarily providing some sort of process to
cure absentee ballot request forms and absentee ballots,
61

educating voters on those processes, and assisting them.
Nicholas Decl. ¶ 18; Lopez Decl. ¶¶ 23, 27.
Plaintiffs Clark, Cates, Edwards, Priddy, Bentley, and
Hutchins all intend to vote by mail-in absentee ballot, some
for the first time, see e.g., Cates Decl. ¶ 8, and may well
make errors on their absentee ballot request forms or absentee
ballots and/or the certificate envelopes. Procedural due
process requires a cure procedure for these defects.
Defendants have deprived Plaintiffs of their protected
interest in casting an absentee ballot by failing to provide
notice and an opportunity to cure deficiencies in the request
forms and ballots.
E. Violation of Title II of the Americans with

Disabilities Act (42 U.S.C. §§ 12131 et seq.) and
§ 504 of the Rehabilitation Act (29 U.S.C. § 794)
Title II of the ADA provides that “[n]o qualified
individual with a disability shall, by reason of such
disability, be excluded from participation in or be denied
the benefits of the services, programs, or activities of a
public entity” such as voting. 42 U.S.C. § 12132. Similarly,
section 504 of the RA requires that “[n]o otherwise qualified
individual with a disability . . . shall, solely by reason of
her or his disability, be excluded from the participation in,
62

be denied the benefits of, or be subjected to discrimination
under any program or activity receiving Federal financial
assistance.” 29 U.S.C. § 794(a). The ADA and RA protect
individuals with disabilities from being excluded from voting
on the basis of their disabilities. See Nat’l Fed’n of the
Blind v. Lamone, 813 F.3d 494, 510 (4th Cir. 2016).
Accordingly, Defendants are obligated to provide Plaintiffs
Clark, Edwards, and Priddy with the reasonable modifications
so they are afforded the same opportunity to vote as other
individuals who do not have disabilities.
The SBE, which received federal funding to conduct
elections, must make reasonable modifications in policies,
practices, or procedures when the modifications are necessary
to avoid discrimination on the basis of disability. See 29
U.S.C. § 794(a). By failing to waive the two-witness
requirement for absentee ballots for voters whose
disabilities limit their ability to have contact with others
during this pandemic, the SBE Defendants are violating the
ADA and RA. Without action by this Court, vulnerable voters
like Plaintiffs Clark, Edwards, Priddy, and Hutchins (the
“ADA/RA Plaintiffs”) will not be able to vote this November.
63

To prove a violation of Title II of the ADA and Section
504 of the RA,10 plaintiffs must show
(1) they have a disability; (2) they are otherwise

qualified to receive the benefits of a public service,
program, or activity; and (3) they were denied the
benefits of such service, program, or activity, or
otherwise discriminated against, on the basis of their
disability.
Lamone, 813 F.3d at 503. First, there is no question that the
ADA/RA Plaintiffs have disabilities under the ADA and RA. An
individual is considered disabled if he can show “(1) that he
has a physical or mental impairment, (2) that this impairment
implicates at least one major life activity, and (3) that the
limitation is substantial.” Heiko v. Colombo Sav. Bank,
F.S.B., 434 F.3d 249, 254 (4th Cir. 2006).
ADA/RA Plaintiffs’ preexisting conditions qualify as
physical impairments. Physical impairments include lung
disease and diabetes, see 28 C.F.R. § 35.108(b)(2); 10 C.F.R.
§ 4.101, and both conditions impose a greater risk of severe
illness from COVID-19. Courts around the country have also
routinely held that conditions like COPD, diabetes,
10The Fourth Circuit analyzes the ADA and RA together

because “the analysis is substantially the same.” Seremeth
v. Bd. of Cty. Comm’rs Frederick Cty, 673 F.3d 333, 336 n.1
(4th Cir. 2012) (internal quotation marks omitted).
64

blindness, and immunodeficiency can qualify as disabilities
under the ADA and RA. See, e.g., Davis v. Nat’l R.R. Passenger
Corp., 733 F. Supp. 2d 474, 494 (D. Del. 2010) (COPD); Myers
v. Hose, 50 F.3d 278, 282 (4th Cir. 1995) (diabetes); Lamone,
813 F.3d 494 (blindness); Bragdon v. Abbott, 524 U.S. 624
(1998) (HIV). Moreover, the CDC has deemed that individuals
who have impairments such as COPD, diabetes, and organ
transplants (requiring immunosuppressant medication), or are
of advanced age (65 or older), such as the ADA/RA Plaintiffs,
are “at higher risk for severe illness from COVID-19.” Riggs
Decl. ¶ 7.
These physical impairments, in combination with the
pandemic, also substantially affect ADA/RA Plaintiffs by
restricting their enjoyment of at least one major life
activity. Major life activities include breathing, standing,
sleeping, reading, writing, walking, as well as the operation
of a major bodily function, such as “function of the immune
system” and respiratory and endocrine systems. 28 C.F.R. §
36.105(c)(1). Plaintiff Clark suffers from severe COPD, which
interferes with several major life activities, including
breathing. Clark Decl. ¶ 5. Plaintiff Edwards possesses type
1 Diabetes, a physical impairment that substantially affects
65

her major bodily function through her endocrine system.
Edwards Decl. ¶ 5. Plaintiff Priddy’s pre-existing conditions
are physical impairments that substantially influences his
major life activities because the function of his immune
system is directly affected. Priddy Decl. ¶ 4. Plaintiff
Hutchin’s blindness is a physical impairment that
substantially influences many major life activities, such as
reading, writing, and walking. Hutchins Decl. ¶¶ 4, 12.
Accordingly, the ADA/RA Plaintiffs have disabilities as
defined by the ADA and RA.
Second, the ADA/RA Plaintiffs are otherwise qualified to
receive the benefits of a public service, program, or
activity—namely, voting. Each ADA/RA Plaintiff is registered
to vote this November. Clark Decl. ¶ 3; Priddy Decl. ¶ 2;
Edwards Decl. ¶ 2; Hutchins Decl. ¶ 3. However, whether the
ADA/RA Plaintiffs can vote in light of this pandemic will
depend on whether this Court grants relief and suspends the
two-witness requirement.
Third, the ADA/RA Plaintiffs are excluded from
participation in and denied the benefits of voting, or are
otherwise discriminated against, on the basis of their
disability. Due to their conditions, the Plaintiffs Clark,
66

Edwards, and Priddy cannot vote safely in person and must
vote by mail. However, they are unable to safely obtain two
witness signatures without ignoring the CDC’s guidance and
putting themselves at unreasonable risk of contracting COVID-
19 and suffering serious health consequences, including
death. Furthermore, Plaintiff Hutchins would like to vote by
mail because his age puts him at risk of serious illness or
death from COVID-19. Hutchins Decl. ¶ 6. Due to his
disability, he cannot fill out and return his absentee ballot
himself and needs assistance. His nursing home is closed to
visitors in light of the COVID-19 pandemic and he is not able
to receive assistance from his wife. Thus, he would like his
nursing home staff to help him. Id. ¶¶ 10–12. However, under
North Carolina law, the nursing home staff and nurses are not
allowed to assist him with returning an absentee ballot
request form, marking and completing an absentee ballot, and
submitting an absentee ballot. See N.C. Gen. State. §§ 163-
226.3(a)(4)-(6), 163-230.2(e)(4); 163-231(b)(1); see also
Lamone, 813 F.3d at 504 (because Maryland allowed no-excuse
absentee voting, defendants violated the ADA by failing to
make reasonable accommodations to allow individuals who were
blind to vote by mail).
67

Thus, unless this Court grants relief, by omitting the
Two Witnesses Requirement and by allowing nursing home staff
to assist voters fill out and submit absentee ballots, voters
like the ADA/RA Plaintiffs will confront a dilemma that they
should never have to face: vote and risk exposure to a highly-
contagious and deadly disease, or forego voting. Indeed, it
was out of concern for the pandemic that Defendant Director
Bell recommended that the witness requirement be reduced or
eliminated “[i]n light of social distancing requirements to
prevent the spread of COVID-19.” Even if Defendants are not
intentionally discriminating against individuals with
disabilities, Defendants are nevertheless violating the ADA
and RA because reasonable modification or accommodation
claims do not require discriminatory intent. See Lamone, 813
F.3d at 510 (Maryland violated ADA for “failure to make
reasonable accommodations” for visually-impaired voters even
though “the record is devoid of any evidence that the
defendants acted with discriminatory animus”). Furthermore,
no discriminatory intent is necessary because Defendants’
policies have a disparate impact on vulnerable voters like
the ADA/RA Plaintiffs. See A Helping Hand, LLC v. Baltimore
Cty., 515 F.3d 356, 362 (4th Cir. 2008).
68

Finally, Defendants will not succeed in arguing that
eliminating the two-witness requirement or the prohibition on
nursing staff assistance pose an undue burden. Under ADA
regulations, a public entity is not required to take any
action “that it can demonstrate would result in a fundamental
alteration in the nature of a service, program, or activity
or in undue financial and administrative burdens.” 28 C.F.R.
§ 35.164. Defendants bear the burden of proving this undue
burden. See id. (“[A] public entity has the burden of proving
that compliance with this subpart would result in such
alteration or burdens”). Eliminating the two-witness
requirement is clearly not burdensome, as it merely requires
Defendants to cease disqualifying absentee ballots lacking
two witness signatures, make minor modifications to the
ballots, and include instructions regarding the rule change.
See Lamone, 813 F.3d at 508 (proposed online ballot marking
tool for absentee voting for visually impaired did not pose
undue burden). There can be no serious argument that
eliminating the two-witness “results in a fundamental
alteration in the nature” of voting. Furthermore, allowing
nursing home staff to assist voters complete and submit
absentee ballots cannot pose burdens on the Defendants.
69

Accordingly, the ADA/RA Plaintiffs are likely to prevail
on their ADA and RA claims. Defendants’ failure to accommodate
these voters constitutes a condition on access to the ballot
box that has the effect of screening out individuals from
participating in the November general election because of
their disabilities, in violations of Title II of the ADA and
Section 504 of the RA.
F. Violation of Section 208 of the Voting Rights Act

of 1965, 52 U.S.C. § 10508)
Under Section 208, a voter who needs assistance for
reason of blindness, disability, or inability to read or write
(“208-covered voter”) possesses the right to choose any
person other than their employer/union representative—
regardless of whether the person is a near relative, legal
guardian, or nursing home staff—to assist them with the voting
process, including the steps necessary to obtain, cast, and
submit an absentee ballot. 52 U.S.C. § 10508; OCA-Greater
Houston v. Texas, 867 F.3d 604, 614–15 (5th Cir. 2017).
Defendants are violating Section 208 of the VRA by preventing
208-covered voters from selecting their assistor of choice
who is not their employer or union representative to assist
them with submitting their absentee ballot request form (N.C.
Gen. Stat. § 163-230.2(e)(4)), or with marking, completing

70

and submitting their absentee ballot (N.C. Gen. Stat. §§ 163-
226.3, 163-231(b)(1)). States cannot “deny the assistance at
some stages of the voting process during which assistance
[is] needed.” S. Rep. 97-417. For Plaintiff Hutchins,
applying for a mail ballot is a prerequisite to safely voting,
and he requires assistance with submitting his request for a
ballot, marking and completing the ballot, and delivering it.
Hutchins Decl. ¶¶ 4–12. Defendants provide an exception to
208-covered voters only for completing the request form. N.C.
Gen. Stat. § 163-230.2(e1). Plaintiff Hutchins is entitled to
any assistor of choice other than an employer/union
representative at all stages of the absentee voting process.
See OCA-Greater Houston v. Texas, 867 F.3d 604, 614–15 (5th
Cir. 2017).
II. Absent injunctive relief, Plaintiffs will suffer

irreparable harm in the November general election.
Absent an injunction suspending or modifying the
challenged restrictions, voters will suffer irreparable
injuries in the November general election. “[O]nce [an]
election occurs, there can be no do-over and no redress.”
League of Women Voters of N.C. v. North Carolina, 769 F.3d
224, 247 (4th Cir. 2014). For that reason, “[c]ourts routinely
71

deem restrictions on fundamental voting rights irreparable
injury.” Id. (collecting cases).
To demonstrate irreparable harm, a party must establish
that (1) the harm is “certain and great, actual and not
theoretical, and so imminen[t] that there is a clear and
present need for equitable relief”; and (2) that, once
incurred, the threatened harm would be “beyond remediation.”
League of Women Voters of U.S. v. Newby, 838 F.3d 1, 7–8 (D.C.
Cir. 2016) (internal quotation marks omitted) (alteration in
original). Dr. Murray’s report demonstrates that this fall
the pandemic’s transmission dynamics and the corresponding
risk to voters are highly likely to be equal to or worse than
the current situation. Murray Decl. ¶¶ 33, 42, 44. Absent
relief from this Court, in-person and mail-in absentee voters
alike will face severe risks and severe burdens in casting
their ballots in person or by mail. Some may overcome these
obstacles; many others will not. But these unconstitutional
hardships will remain without an injunction.
Further, denial or abridgment of the right to vote in a
particular election is the archetypal irreparable injury. See
N.C. State Conf. of NAACP v. Cooper, 430 F. Supp. 3d 15, 51
(M.D.N.C. 2019) (“By their very nature, laws impacting the
72

right to vote create the potential for irreparable harm . .
. .”). Once the burdens cause a denial or undue burdening of
the right to vote, this injury cannot be undone. Once the
results are certified, it is nearly impossible to set aside
the results of an election, and voters deprived of their voice
cannot be made whole. An injury is typically deemed
irreparable if monetary damages are inadequate or difficult
to ascertain and, typically, there are no damages in voting
rights cases. See Multi-Channel TV Cable Co. v.
Charlottesville Quality Cable Operating Co., 22 F.3d 546, 551
(4th Cir. 1994), abrogated on other grounds by Winter v.
Natural Res. Def. Council, Inc., 555 U.S. 7, 22 (2008).
Just as individual voters face irreparable harm in
November, so do organizations engaged in voter engagement
like LWVNC and DemNC, as Defendants’ “actions ‘perceptibly
impair[ ]’ the organization’s programs, making it more
difficult to carry out its mission.” Action NC v. Strach, 216
F. Supp. 3d 597, 642 (M.D.N.C. 2016) (quoting Lane v. Holder,
703 F.3d 668, 674–75 (4th Cir. 2012)); Newby, 838 F.3d at 9
(holding that plaintiffs suffered an irreparable harm when
newly enacted barriers to registering voters “ma[de] it more
73

difficult for [them] to accomplish their primary mission of
registering voters”).
A voter engagement and advocacy organization is also
irreparably harmed when its members’ constitutional and
statutory rights related to voting are unlawfully burdened
and otherwise infringed. See Common Cause Ga. v. Kemp, 347 F.
Supp. 3d 1270, 1295 (N.D. Ga. 2018) (holding that harm
organizational plaintiff suffered was “coterminous” with harm
its members would suffer if voting was made more difficult);
Common Cause Ind. v. Lawson, 327 F. Supp. 3d 1139, 1154 (S.D.
Ind. 2018) (holding that organizational plaintiff would
suffer irreparable harm if voters were wrongfully
disenfranchised), aff’d, 937 F.3d 944 (7th Cir. 2019).
III. Given the dire circumstances of this deadly global

pandemic, the balance of hardships tips heavily in
Plaintiffs’ favor.
Many of the challenged laws in this case are quite
burdensome even in normal times. As voters are now facing a
virus that transmits extremely easily from person to person
and can cause severe complications, lasting physical injury,
and death in a wide range of people, the harm to voters far
outweighs any harm to the state from the requested injunction.
The injunctive relief requested seeks to strike a balance,
74

and Plaintiffs have herein proposed alternative solutions
that safeguard election integrity while advancing voter
participation and safety. For example, Plaintiffs seek the
invalidation of the double-witness requirement but have
suggested no fewer than three alternative remedies that would
mitigate, if not eliminate, the constitutional harm. Further,
Plaintiffs also do not seek invalidation or noncompliance
with other requirements of the absentee ballot envelope;
rather, they seek only an option for voters to cure
deficiencies. In light of the pandemic’s severe disruption to
the normal course of voting and the threat it poses to every
manner of voting, Plaintiffs have demonstrated why it is
necessary to enjoin or modify the targeted restrictions, and
how this will facilitate safe and equal participation and can
be achieved without undermining the general election’s
integrity.
IV. The public interest strongly favors granting

Plaintiffs’ requested relief to facilitate
participation in the general election.
Entering a preliminary injunction would serve the public
interest as well, as non-parties to this action will stand to
benefit from the requested injunction. Election integrity is
not only served by effective anti-fraud measures but equally,
75

if not more so, by ensuring that all eligible, registered
voters can make their voices heard. Indeed, courts have often
said that the public interest “favors permitting as many
qualified voters to vote as possible.” League of Women Voters
of N.C., 769 F.3d at 247 (quoting Obama for Am. v. Husted,
697 F.3d 423, 437 (6th Cir. 2012)). As this Court recently
put it, “electoral integrity is enhanced, not diminished,
when all eligible voters are allowed to exercise their right
to vote free from interference and burden unnecessarily
imposed by others.” N.C. State Conf. of NAACP, 430 F. Supp.
3d at 53. The public interest is also served by “upholding
constitutional rights.” Newsom ex rel. Newsom v. Albemarle
Cty. Sch. Bd., 354 F.3d 249, 261 (4th Cir. 2003).
REQUEST FOR EXPEDITED CONSIDERATION
Plaintiffs respectfully request expedited briefing and
consideration of this motion. As discussed supra p. 12
(Election Administration Timing), any changes to election
administration must be made immediately to avoid irreparable
harm, and specifically to allow for ordering and printing of
election-related materials, recruitment of poll workers, and
voter education regarding voting processes and election-day
location information and other logistics. As Director Bell
76

stated in her April 22, 2020 letter, “[b]ecause of deadlines
associated with the 2020 General Election . . . there is an
immediate need to prepare for a coronavirus response.” Riggs
Decl. ¶ 4. Accordingly, there is good cause to expedite
briefing and consideration here, and Plaintiffs respectfully
request that the Court shorten the requirements of Local Civil
Rule 7.3(f) to require Defendants’ response within 14 days of
service of this Motion and Plaintiffs’ reply within 7 days of
service of the response, and thereafter that the Court provide
expedited consideration of a hearing date and decision on
Plaintiffs’ motion.
CONCLUSION
For the reasons set forth above, Plaintiffs respectfully
request that this Court grant their Motion for a Preliminary
Injunction.
Dated: June 5, 2020.

Respectfully submitted,
Jon Sherman Allison J. Riggs (State Bar
D.C. Bar No. 998271 #40028)
Michelle Kanter Cohen Jeffrey Loperfido (State
D.C. Bar No. 989164 Bar #52939)
Cecilia Aguilera Southern Coalition for
D.C. Bar No. 1617884 Social Justice
FAIR ELECTIONS CENTER 1415 West Highway 54, Suite
1825 K St. NW, Ste. 450 101
Washington, D.C. 20006 Durham, NC 27707
77

Telephone: (202) 331-0114 Telephone: 919-323-3380
Email: Facsimile: 919-323-3942
jsherman@fairelectionsce Email:
nter.org Allison@southerncoalition.o
mkantercohen@fairelectionscen rg
ter.org jeff@southerncoalition.
caguilera@fairelectionscenter org
.org
/s/ George Varghese
George P. Varghese (Pa. Bar
No. 94329)
Joseph J. Yu (NY Bar No.
4765392)
Stephanie Lin (MA Bar No.
690909)
Rebecca Lee (DC Bar No.
229651)
Richard A. Ingram (DC Bar
No. 1657532)
DORR LLP
60 State Street
Boston, MA 02109
Telephone: (617) 526-6000
Facsimile: (617) 526-5000
Email:
george.varghese@wilmerh
ale.com
stephanie.lin@wilmerhale.co
m
78

CERTIFICATE OF WORD COUNT
Pursuant to Local Rule 7.3(d)(1), the undersigned counsel
hereby certified that the foregoing Memorandum in Support of
Plaintiffs’ Motion for Preliminary Injunction and to Expedite
contains 14973 words (including headings and footnotes) as
measured by Microsoft Word.

Allison J. Riggs
79

I certify that on the 5th day of June, 2020, the
foregoing Memorandum in Support for Plaintiffs’ Motion for
Preliminary Injunction and Request to Expedite, and all
Declarations and Exhibits thereto, was served by electronic
mail to Defendants’ Counsel, Alec McC. Peters, Chief Deputy
Attorney General, at the address apeters@ncdoj.gov, with
consent of counsel to accept service in this manner.

Allison J. Riggs
80


Plaintiffs,
vs. Civil Action

ANDERSON, in her official capacity
as SECRETARY OF THE STATE BOARD OF
Defendants.

INDEX OF PLAINTIFF DECLARATIONS
1. Declaration of Tomas Lopez, Executive Director of

Democracy North Carolina
2. Declaration of Jo Nicholas, President of the League
of Women Voters of North Carolina
3. Declaration of Donna Permar
4. Declaration of John P. Clark
5. Declaration of Margaret B. Cates
6. Declaration of Lelia Bentley
7. Declaration of Regina Whitney Edwards
8. Declaration of Robert K. Priddy II
9. Declaration of Walter Hutchins
10. Declaration of Susan Schaffer


LEAGE OF WOMEN VOTERS OF NORTH
CLARK, MARGARET B. CATES, LEILIA
ROBERT K. PRIDDY II, WALTER HUTCHINS,
AND SUSAN SCHAFFER. Civil Action No. 20-cv-457
Plaintiffs,
vs.

ELECTIONS; DAMON CIRCOSTA, in his official
capacity as CHAIR OF THE STATE BOARD OF
ELECTIONS; STELLA ANDERSON, in her
official capacity as SECRETARY OF THE STATE
BOARD OF ELECTIONS; KEN RAYMOND, in
BOARD OF ELECTIONS; JEFF CARMON III, in
BOARD OF ELECTIONS; DAVID C. BLACK, in
BOARD OF ELECTIONS; KAREN BRINSON
BELL, in her official capacity as EXECUTIVE
ERIC BOYETTE, in his official capacity as
HEALTH AND HUMAN SERVICES; MANDY
COHEN, in her official capacity as SECRETARY
OF HEALTH AND HUMAN SERVICES.
DECLARATION OF TOMAS LOPEZ

I, Tomas Lopez, hereby declare as follows:
I. Background
1. I am a U.S. citizen and a resident of North Carolina. I am a registered voter in
Durham County, and have resided in Durham County since 2018.
2. I have served as Executive Director of Democracy North Carolina (“DemNC”) since
January 2018. DemNC is a nonpartisan, nonprofit organization that works to,
among other goals, protect the right to vote in our state. As part of this work, we
seek to bring North Carolinians – especially historically underrepresented
communities and communities of color – into the political process and encourage
their participation and leadership through voting, monitoring the election process,
and issue advocacy. We also author original research on election administration,
help coordinate a statewide nonpartisan poll monitoring and voter assistance
network, and advocate for policies and practices that we believe will increase voter
access and participation.
3. In my role as Executive Director of DemNC, I am responsible for the organization’s
overall operations, from serving as the chief executive official at the organization,
to overseeing both operational and programmatic leaders and staff. I work with our
staff and board to set strategic priorities, but I am also directly involved in
programmatic work, interfacing with organizational allies and democracy
advocates. I am also involved in shaping our policy advocacy and research.
Additionally, I interface with election officials on a frequent basis (state more than
local), but I oversee a sizable organizing and advocacy staff that interfaces with all

levels of election officials (state and county). My involvement in programmatic
work has afforded me direct knowledge of many of the voter protection issues that
arise in this state. Since I joined the organization, I have been present at every
Election Day voter assistance hotline staffing site that we and other nonpartisan
organizations have collaborated to operate, and we have conducted early voting
voter assistance hotline staffing out of our offices at DemNC, allowing me to see
the issues faces voters and to, myself, advocate with election officials to remedy
these issues.
4. Before assuming the Executive Director role at DemNC, I was a voting rights
attorney at the Brennan Center for Justice at New York University, where I was
involved in state and federal court litigation over election law matters, legislative
advocacy on the same, and subject matter research on these topics. Prior to that, I
was an attorney litigating constitutional civil rights issues affecting immigrant
communities. I received my Juris Doctor from Yale in 2010.
5. DemNC has existed for nearly 30 years, and in that time has been deeply engaged
in election policy issues, redistricting and campaign finance. On election and voting
issues, the organization played a leadership role in the development and
implementation of same-day registration, preregistration for 16- and 17-year-olds,
and judicial public financing in the 2000s. Since 2010, DemNC has played a
leadership role in non-partisan voter protection efforts, including poll monitoring
and providing voter assistance via phone, email and text. The organization has
developed a reputation for subject matter expertise in the election realm, and to this

day, continues to release original research on election issues. Since at least 2000,
DemNC has employed organizers whose job was to cultivate grassroots support for
democracy reform, mobilize around political participation (both voting and
otherwise), and educate and assist voters across the state. In the late 2000s, DemNC
moved those regional organizers from being based out of Durham to being located
in the regions in which they worked. We currently employ seven regional, full-time
organizers.
II. DemNC’s Work to Educate and Support Voters
A. Advocacy and Research
6. As mentioned above, DemNC devotes substantial time to advocating for election
reform and urging pro-voter policies at the North Carolina General Assembly, the
State Board of Elections, and at many county boards of elections. It is critical to
our mission that every voter be able to have easy access to the ballot box. In
particular, we know the importance of in-person voting opportunities, especially for
underserved communities across our state, and we recently successfully advocated
for the restoration of the last Saturday of early voting.
7. Based on our original research, we have also documented the negative impact that
reducing early voting opportunities can have on North Carolina’s electorate, and
specifically communities of color. For example, after North Carolina enacted S325
in June 2018 mandating uniform hours across all early voting sites within each

county,1 the costs of implementing this measure caused 43 counties to reduce the
number of early voting cites in the 2018 election compared to 2014 and over two
thirds of counties to reduce weekend hours. This disproportionately impacts Back
voters, who in 2018 made up approximately 22% of registered voters but 27% of
those who cast ballots on the last Saturday of Early Voting.
8. Our regular advocacy work also includes urging counties to adopt as expansive early
voting plans as possible and mobilizing our advocates to turnout to county boards
of election meetings to support expansive early voting plans. Before an election,
we commonly submit letters to county boards of election with data and maps
documenting the usage of early voting sites and days, in order to ensure that those
boards understand how their decisions can make voting easier and more accessible
for voters in their counties. In particular, we have been leaders in efforts to expand
weekend voting in counties, including Sunday voting so that our church partners
can conduct “Souls to the Polls” efforts. We planned to do this advocacy this year,
before COVID-19, and still plan to do so.
B. Election Protection, and Voter Assistance and Voter Education
9. Since 2010, we have devoted substantial time and staffing to voter protection
efforts, including developing a statewide poll monitoring program and providing
voter assistance via a non-partisan election protection hotline. We escalated those
efforts even more starting in 2013, after the loss of Section 5 of the Voting Rights
1
S.L. 2018-112. As originally written, the statute removed the final Saturday of early
voting beginning in 2018; this was subsequently postponed.
5

Act and the passage of House Bill 589, a law passed by the North Carolina General
Assembly that rolled back many of the voting reforms for which we had advocated.
Over the last approximately seven years, we have worked with other non-partisan
groups to fully staff a national election protection hotline with in-state North
Carolina election experts. We help to recruit and train these hotline experts, and
during early voting, we host them in our offices. The hotline (which we recently
extended to offering text message services) is heavily staffed by DemNC staff, and
that work specifically has represented a significant expenditure in both staff time
and resources.
10. In the course of our hotline work, our staff are often contacted by voters with various
physical impediments or health conditions that may make voting more difficult. We
frequently have to assist voters in understand how to access curbside voting or, more
commonly, when curbside voting is not working as intended, notify county elections
officials and advocate for a solution.
11. We have also answered questions about how voters can use absentee voting by mail,
a process that is cumbersome and hard to understand, especially for voters who have
never used it before. We also get calls about voters inquiring as to the status of their
absentee ballots, and many times we have dealt with situations where absentee mail
ballots not getting to the voters that requested them, even before COVID-19.
12. DemNC staff answers hotline calls, emails and texts at times outside of normal
voting days and hours, and our staff collectively spends many hours answering voter
questions about where and how to vote, getting registered, and other aspects of the

voting process. We are already receiving more calls than we would normally expect
in June from voters asking about absentee voting in the fall election.
13. In addition to staffing the hotline, DemNC runs an extensive poll monitoring
program, deploying volunteers to polling places across the state. DemNC recruits,
trains and places volunteers to be stationed outside polling places on Election Day
and during heavily-used early voting days. The purpose of putting DemNC
volunteers at polling places is to provide direct assistance to voters who have issues
voting and identify the issues at polling places that require additional attention. We
train our volunteers on what it means to be a non-partisan poll monitor, how to
provide assistance to voters, how to refer people to the hotline so that we can better
gather information to use in real time to address issues that may affect other voters.
In 2018, we placed 800 monitors at approximately 260 sites, which represented
about 10% of all sites statewide.
14. In January 2018, DemNC issued a report, From the Voter’s View: Lessons from the
2016 Election, documenting the many issues North Carolina voters face when they
go to the polls, including long lines, machine malfunctions, disability access
challenges, and poll worker conduct.2 In that report, we made many findings
relevant to this case. For example, we consistently found that voters who showed
up to the incorrect precinct on Election Day were not afforded the opportunity to
cast an “out of precinct” provisional ballot and were instead told they had to go to
2
This report is available at https://democracync.org/wp-
content/uploads/2018/01/PostElectionReport_DemNC_web.pdf
7

another site. We also documented widespread problems with curbside voting – both
in inadequate signage and long wait times due to inadequate staffing. In more than
a dozen counties, we documented excessively long lines and wait times for voters
on popular early voting days and on Election Day.
15. On voter education more broadly, we devote considerable staff time to voter
education and mobilization. Through these efforts, we seek to explain the voting
rules to the public, through in person trainings and through print and digital
resources. We distribute these resources directly ourselves or through partners like
state or regional partners, like churches. We also mobilize volunteers to contact
voters, typically members of historically underrepresented communities, to
encourage participation and to answer questions re: election rules.
16. In past elections, DemNC also produced a voter guide in collaboration with partner
organizations, mailed to over one million North Carolina homes, with information
about election rules and candidates. For example, in the 2018 general election, we
printed 1.8 million of these non-partisan voter guides, which were distributed
through direct mail, our organizing networks, and the efforts of partner
organizations. We have limited funds with which to pay for these guides, so space
is at a premium because of printing and mailing costs. When voting laws are
changed or voting becomes more complicated, we will have to devote more space
in the guides to explaining how to register and vote, for example, and less space
providing voters non-partisan information about the candidates that will be on their
ballots.

17. DemNC has, from time to time, including in the March 2020 primary, conducted a
rides-to-the-poll program.
III. COVID-19: Reforms Needed and the Impact On DemNC’s Work
18. Absent changes to make voting in a pandemic easier, DemNC is going to have to
divert significant resources to help voters problem-solve complying with existing
rules: from registering to vote, to successfully requesting and submitting a valid
absentee ballot, to finding a place and time to vote safely in-person.
A. Voter Registration
19. DemNC has both advocated and litigated for expanded opportunities to register to
vote. DemNC successfully negotiated a settlement to an action under the National
Voter Registration Act filed in North Carolina in 2015, which opened the door to
DMV customers who were updating their drivers’ licenses to be able to also update
their voter registration both in-person and online. The success of that settlement
process was followed recently by DMV allowing all of its customers to register to
vote online, not just those customers executing a DMV transaction. DemNC has
long recognized that easier online registration options are good for democratic
participation.
20. Voter registration rates in North Carolina are falling compared to the last
presidential election, and the only thing halting that precipitous decline in voter
registrations is the availability of online voter registration through DMV. North
Carolina Department of Health and Human Services agencies should also be
offering online voter registration, and having that option available to voters would

make our job easier, when voters call our hotline and ask how they can register to
vote.
21. We traditionally receive many calls to the election protection hotline during the
early voting period about voter registration. That is when many voters may think
about their registration status for the first time. Those voters either may not know
that they needed to register or re-register (if they had moved or been removed from
the voter rolls). We would normally recommend same-day registration to these
voters, but we anticipate that many voters will not be comfortable voting in person.
Right now, the statutory cut-off for regular registration is 25 days before the
election, but in advance of the deadline for requesting absentee ballots. An
extension of the deadline for voter registration would impose minimal burdens on
election officials, but offer more opportunities for registration by mail.
B. Absentee by Mail
22. In addition to issues we identified in the primary and would see in a “normal”
election, given the expected increase in demand in absentee voting, we expect to
have to spend more time helping voters new to the process navigate absentee voting
by mail. We will have to do so with the same amount of capacity that we had before
this. Absent significant changes to state laws governing the requesting and
submitting an absentee ballot, making it easier for voters so that they do not need to
seek our assistance, we will have reduced capacity to do some of our other planned
advocacy—for example, efforts to improve curbside voting or engage in broad-
based civics education (a part of our long-term organizing model) to explain
10

importance of voting and its positive impact. We will also have less time and fewer
resources to devote to “what’s on the ballot” training.
23. Without making it much easier to request an absentee ballot and cast it without
exposing others to the virus, we also anticipate having to devote valuable space in
our printed voter guides to proactive problem-solving and recommendations for
voters who may have trouble requesting absentee ballots or finding a witness. This
is space we would devote to other topics. Importantly, that voter guide is a key part
of both our voter education and mobilization efforts, and we partner with
community groups (including churches and local civic groups) and other
nonpartisan organizing and mobilizing groups, often led by and serving people of
color, to distribute the guides both digitally and through direct in-person contact.
Because of the loss of direct contact opportunities and that these partners might have
constituents that have low digital use rates (i.e., older voters, lower income), we
may have to spend more on direct mail to try to explain complicated rules to voters.
24. DemNC also works with numerous civic engagement groups, and we know from
those partnerships that the ban on assisting voters with completing and returning
absentee ballot request forms is hindering their work. Where there are fewer
volunteers on the ground able to assist voters with requesting and completing an
absentee ballot, we know that we will get more inquiries to the hotline about how
to get an absentee ballot or why a voter’s absentee ballot never arrived. This ban
strains our resources in a time we need to be putting those efforts elsewhere.
11

25. Voters who cannot provide their driver’s license number, special identification card
number, or last four digits of their social security number are not currently allowed,
under Sec. 163-230.2, to request an absentee ballot. In her March 26, 2020, letter
to the General Assembly, State Board of Elections Executive Director Karen
Brinson Bell recommended that voters also be allowed to submit a copy of a Help
America Vote Act (HAVA) document, as counties have reported to her problems
with elderly voters who do not drive and cannot remember their social security
number are having their absentee ballot requests rejected. Based on her
recommendation and an expected increase in absentee by mail voting by a
vulnerable population, we expect to get many more calls about this issue to the
election protection hotline, and without substantial assistance from my staff and our
volunteers, which again will undermine our efforts to do voter education or other
advocacy, that statutory barrier will be insurmountable for voters.
26. Given that high volume of people will be voting by mail for the first time, we
anticipate that voters will be calling with questions about postage and processes for
returning absentee ballots. The state’s failure to provide contactless drop-boxes will
likely strain our resources in assisting voters (in a legal way) to find a way to return
their ballots if they lack stamps or financial resources.
27. Likewise, the amount of time-intensive research it takes to help a voter find out what
happened to his/her absentee ballot is a substantial drain on our staff time and
resources. The failure to provide uniform measures for an opportunity to cure a
deficient absentee ballot will certainly require that we spend more time with
12

individual voters helping them to figure out if their counties will allow them an
opportunity to correct their ballot and how they can go about doing so. We work in
so many different counties, and right now, most counties have different practices on
whether they even let voters cure their absentee ballot, and if they do, those curative
measures may vary wildly. We could spend thousands of hours researching the
intricacies of each North Carolina county’s process without some uniform rule in
place. Likewise, without some sort of failsafe measure in place for absentee ballot
requests forms that get lost in transmission, like the state equivalent of Federal
Write-in Absentee Ballot, we anticipate a significant diversion of a resources as we
help voters try to get last minute absentee requests submitted.
C. In-Person Voting
28. As mentioned before, DemNC’s advocacy for expansive early voting has been a key
part of its work for years. Without relief from the law that requires counties to have
uniform early voting hours (that is, if one site is open, all sites must be open),
particularly in light of the challenge in recruiting poll workers and the revenue
shortfall that many counties are experiencing, we expect that without increased
advocacy from us, many counties will reduce their number of early voting sites.
This loss of early voting sites and days already happened as a result of S.B. 683, and
is certain to be exacerbated by a decrease in expected in-person voting. But we will
need to explain to county boards (and forcefully advocate) that respecting social
distancing guidelines and allowing time for cleaning materials between voters
actually means that counties need to provide more voting sites and days. That is the
13

only way to space out voters appropriately. If counties were allowed the flexibility
to open sites when they were available and when they could secure poll workers,
we would have to spend less time advocating for early voting sites and days and
could devote our resources to other activities pertinent to our mission.
29. Likewise, we are fielding requests from election officials and others to help them
recruit poll workers because of an anticipated shortage. Recognizing the importance
of securing these workers, we are striving to incorporate recruitment into our current
mobilization efforts, even though we have never done that kind of work before. But
this strains our capacity and resources, and will only do more so as we get closer to
the election. Right now, the law requires that a majority of poll workers on Election
Day be registered voters in the precinct in which they work. Lifting that
requirement, and, indeed, lifting the requirement that poll workers be residents of
the county, would allow counties with older and more vulnerable populations to cast
a broader net to find workers who could safely help conduct the election.
D. Concerns about Election Security
30. Recently, the North Carolina General Assembly justified imposing new restrictions
and criminal penalties regarding who can assist voters with requesting absentee
ballots due to the voter fraud discovered in the 2018 Campaign by Republican
congressional candidate Mark Harris in the 2018 Congressional District 9 election.
What we know from our research and advocacy is that fraud is quite rare, and that
the issues raised by the 2018 case have to do with enforcement of laws that were
already in place prior to 2018, and with enforcement, surveillance and monitoring
14

of election irregularities can suss out and address these issues. Eliminating the
witness requirement would not open up North Carolina elections to interference, but
instead would allow vulnerable communities—including many communities of
color—to receive the help they need in order to participate in our democracy during
a global pandemic.
31. As recent litigation has illustrated, the purported state interests that legislatures have
used to implement voting restrictions in North Carolina are often red herrings and
bear no relationship to the needs of conducting an election and create
insurmountable burdens on the right to vote.
IV. Legislative Activity on Elections and COVID-19
32. On March 19, DemNC and its partners sent a letter to the State Board of Elections
urging expansive and first-step reforms to ease the burden of voting during a global
pandemic.3 Shortly thereafter, NC State Board of Elections Executive Director
Karen Brinson Bell sent a series of letters to the North Carolina General Assembly
urging legislative action to ensure that fully participatory and safe elections could
be conducted this fall. DemNC supported these recommendations.
33. My organization’s position is that two bills filed in the legislature represent the best
efforts to address the myriad of needs arising from the challenges of conducting an
election during this COVID-19 pandemic: House Bill 1184, introduced by
Representatives Morey, Hawkins, Autry, and Butler, and Senate Bill 861,
3
This letter is available at https://democracync.org/wp-content/uploads/2020/03/Letter-
to-SBOE-re-COVID-19-response-3-19-2020.pdf.
15

introduced by Senators Marcus, Chaudhuri, and Foushee. DemNC has urged its
supporters and partners, in particular, to raise up Senate Bill 861 as an example of
comprehensive electoral reform that would make voting safer and more accessible
in November. However, the legislature has failed to take action on either of those
bills.
34. DemNC understands that HB 1169, a compromise bill, seems to be the only
legislation that stands any chance of moving, and it is, at the time of the signing of
this declaration, still being heard in Senate committees. While HB 1169 might have
represented a decent start to addressing the broad scope of election-related needs
arising out of the COVID-19 pandemic had it been passed two months ago, when
DemNC’s and the State Board of Elections recommendations first came out, this
bill does far too little now. It does nothing to ease the burden on voter registration
during the pandemic, and it is grossly inadequate in addressing the challenges that
will face those organizations like mine trying to preserve safe, in-person voting. It
does not do nearly enough to ensure that voters will have an easier time using
absentee mail-in voting, particularly given North Carolinians lack of familiarity
with the process. Even if this bill emerges as is out of the legislature, DemNC still
asserts that, absent judicial intervention, participation in this year’s general election
will be severely hindered and our resources will be significantly taxed and diverted
trying to help voters in these unprecedented times.
16

I declare under penalty of perjury under the laws of the United States of America
that the foregoing Declaration is true and correct to the best of my knowledge.
Executed on the 4th day of June, 2020.
____________________
Tomas Lopez
17


LEAGUE OF WOMEN VOTERS OF
NORTH CAROLINA, DONNA PERMAR,
JOHN P. CLARK, MARGARET B. CATES,
LELIA BENTLEY, REGINA WHITNEY
EDWARDS, ROBERT K. PRIDDY II,
WALTER HUTCHINS, AND SUSAN
SCHAFFER.
Plaintiffs,
vs.
THE NORTH CAROLINA STATE BOARD
OF ELECTIONS; DAMON CIRCOSTA, in
his official capacity as CHAIR OF THE
ANDERSON, in her official capacity as
SECRETARY OF THE STATE BOARD OF
CARMON III, in his official capacity as
STATE BOARD OF ELECTIONS; THE
TRANSPORTATION; J. ERIC BOYETTE,
in his official capacity as
HEALTH AND HUMAN SERVICES;
MANDY COHEN, in her official capacity as
SECRETARY OF HEALTH AND HUMAN
SERVICES,
Defendants.
DECLARATION OF JO NICHOLAS IN SUPPORT OF PLAINTIFFS’

MOTION FOR PRELIMINARY INJUNCTION

I, Jo Nicholas, hereby declare as follows:
1. I am a U.S. citizen and a resident of North Carolina. I am a registered voter
in Moore County, and have resided in Moore County since 2003.
2. I have served as President of the League of Women Voters of North Carolina
(“LWVNC”) since July 2019. In this role, I preside at all meetings of the organization and
board of directors and represent the organization to the public at an assembly. In the
absence of the treasurer, I may sign or endorse checks, drafts and notes. I am an ex officio
member of all committees except the nominating committee, and I manage and supervise
the overall organization and perform other duties as may be designated by the Board. I first
became involved with the LWVNC in 2011 and since then have served as Past President
and Board Director in addition to my current role.
3. The LWVNC is a state affiliate of the League of Women Voters of the United
States (“the League”). The League is a nonpartisan, community-based organization that
encourages Americans to participate actively in government and the electoral process.
Founded in 1920 as an outgrowth of the struggle to win voting rights for women, the
League now has more than 140,000 members and supporters, and is organized in
approximately 750 communities and in every state.
4. For over ninety years, the League has led efforts to remove barriers that
Americans face in registering to vote and casting a ballot. The League was also deeply
involved in crafting the National Voter Registration Act of 1993 (“NVRA”), having
provided substantial testimony and input over the course of the NVRA’s legislative history,

specifically on the topic of purges for failure to vote. See, e.g., Voter Registration: Hearing
Before the Subcomm. on Elections of the Comm. on H. Admin., 101st Cong. 149 (1989)
(testimony of Nancy M. Neuman, President, League of Women Voters); Voter
Registration: Hearing Before the Subcomm. on Elections of the Comm. on H. Admin.,
103d Cong. 140 (1993) (testimony of Becky Cain, President, League of Women Voters).
5. The LWVNC is a nonpartisan political grassroots organization with
seventeen local chapters throughout North Carolina. The LWVNC currently has
approximately 1,912 members.
The LWVNC’s Work to Help Voters Register
6. The LWVNC conducts voter registration and education initiatives
throughout North Carolina, including voter registration drives, distribution of voter
education materials, and voting-day assistance to help individuals exercise their right to
vote. For example, in the 2016 election cycle, the LWVNC assisted several thousands of
voters to register and hundreds of voters to enroll to receive absentee or by-mail ballots.
In our Piedmont Triad chapter alone, which operates in Guilford County, we held 46 voter
registration events as well as voter registration drives following Naturalization Ceremonies
and registered over 550 voters between July 1, 2016 and June 30, 2017. Our other local
chapters have engaged in similar efforts.
7. The LWVNC has expended significant resources to conduct these voter
registration and education initiatives, including the time and effort of our members. We
expect to engage in similar efforts for the upcoming general election cycle, and have

already started our voter education initiatives, releasing a nonpartisan voter guide ahead of
the March primary.
8. The COVID-19 pandemic has already significantly hindered the LWVNC’s
work, requiring us to modify in-person initiatives and meetings to remote platforms. The
LWVNC is becoming increasingly concerned that the COVID-19 pandemic is likely to
interfere with the upcoming 2020 election, and I anticipate that without additional voter
registration and support initiatives we may experience a significantly lower voter turnout.
As a result, the LWVNC is currently working on initiatives to facilitate voter registration
to mitigate the effects of the COVID-19 pandemic on voter turnout this fall. We expect that
many voters will be seeking to register closer to the election because of the limitations on
in-person voter registration efforts by LWVNC and similar groups. As a result, we expect
many voters will try to register and be unable to due to the 25-day registration deadline,
and if this deadline remains in force it will have the effect of frustrating our purpose in
promoting voter registration. In addition, voters who need to update their registration and
were previously able to do so during one-stop voting, including LWVNC members, will
now be unable to do so because they are unable to vote in person due to the risk to their
health. We will have to devote more resources to make sure voters, including our members,
can update their information in time to apply for and vote an absentee ballot.
9. Online voter registration will be particularly important to the LWVNC’s
registration work given the limits on our in-person initiatives. The North Carolina
Department of Motor Vehicle (“DMV”) offers online registration, but previously this was

only available to individuals who were also making a “transaction” with DMV. This was
recently changed in March 2020 so that voters with a DMV account can register to vote
online even if they are not doing an online transaction. Since this function is very new,
most voters are not aware that they can use this online feature to safely register to vote.
The LWVNC intends to publicize this option, and include this in our online voter services
guide, “VOTE411”, within our communities, but we need time to do so. The current
requirement that voters register with the DMV at least 25 days before the election will
hinder these efforts and require us to devote resources to helping voters register that we
would otherwise use in other initiatives leading up to the election.
10. Similarly, the failure of North Carolina to offer any other method of online
voter registration, especially for individuals without DMV accounts, will significantly
hinder and impact our efforts to conduct voter registration during the COVID-19 pandemic.
Many voters we assist do not have DMV accounts and cannot register online currently. We
would ordinarily assist citizens without DMV accounts using paper registration forms
during our community voter registration activities, but cannot do so during the pandemic.
The time needed to educate voters in a format that many are not familiar with – online
resources – is crucial and these changes are needed now so that voters can be made aware
and register to vote. The absence of an online option frustrates the mission of the LWVNC
to ensure that all eligible voters can register safely in the current environment.

The LWVNC’s Work to Help North Carolinians Vote By Mail
11. As noted above, the LWVNC engages in voter education through its local
chapters and this includes educating voters, including our members, on their options for
how to vote. We are developing educational materials for voters to use in order to help
them navigate this process, and our members have already started to receive questions
about this process. LWVNC is acutely aware that many voters will want to vote absentee
by mail this year. We will therefore focus on educating our members and their communities
about voting absentee by-mail because it will likely be the safest option for many
individuals to exercise their right to vote.
12. We also expect that many of these voters will seek to vote by mail for the
first time. A survey of our members indicated that most had either never voted by mail, or
had not voted in North Carolina recently by mail. We recognize that significant resources
need to be devoted to voter education, and particularly to absentee by mail voting,
throughout the state. As a result, helping voters navigate the application process and
understand the requirements of voting by mail will be an essential part of our work,
including providing them with resources, application forms, and accessible ways to submit
forms.
13. Before the enactment of SB 683, LWVNC members assisted voters who
needed help with completing and submitting absentee ballot request forms. The new
restrictions on what assistance we can provide voters to complete and submit absentee
ballot request forms will naturally impair these efforts and limit the types of initiatives we

can undertake to help voters. Specifically, LWVNC and its members are unable to assist
voters with correctly completing absentee ballot request forms and will be severely
constrained in how we can help voters ensure they have filled these forms out correctly.
Given the dramatic increase in voters wishing to vote by mail this year and the number we
expect to do so for the first time, helping voters to request absentee ballots is particularly
critical to our mission at this time in light of COVID-19. Assisting voters with filling out
request forms is an important part of our educational mission and message of participation
because once we assist voters with this process for the first time, they are more likely to do
so on their own the next time and more likely to vote in the next election. Directly assisting
voters is also an essential means of how we build relationships and associate with voters,
including our members. In the absence of SB 683, we would be able to associate with our
members and other voters to assist them with completing and submitting absentee ballot
applications, which would allow us to further associate and build such relationships as a
trusted messenger.
14. The LWVNC also views the lack of any method to request absentee ballots
by phone, email, or online as problematic. We have already heard from people, including
members, who have limited access to a computer and no access to a printer to download
the absentee ballot request form. Other options need to be created to allow the many voters
who will be looking to vote safely and vote absentee by mail to do so. We are also unable
to help voters deliver absentee ballot request forms to the county board of elections, and
this step can be particularly difficult for those who are self-quarantining and do not have

access to envelopes, postage, or secure USPS mail pick-up. Developing the kind of
relationship where voters trust us to turn in their forms (much like the voter registration
assistance we provide) is key to our relationship and association with voters and the
purpose of our members in their respective communities. With these restrictions in place,
LWVNC will have to redirect a significant amount of its limited resources to helping
eligible voters access absentee ballot request forms on their own and are severely limited
in the assistance we can provide to help voters actually submit those forms. Helping voters
submit forms and ensuring they are delivered to election officials would also make our
message of promoting participation and civic engagement more effective. It is less effective
and creates less of a relationship with members and other voters to simply point to a blank
form and no more.
15. As for the requirement that two witnesses or a notary certify each mail-in
ballot, the LWVNC is very concerned that this requirement will seriously affect voting
behavior this year. Many LWVNC members fall into the population of voters that need to
practice strong social distancing behaviors to protect their health. For these members,
getting two witnesses to observe ballot marking and complete the application envelope will
be difficult and force them to choose whether to break social distancing guidelines.
Additionally, many have stated that this requirement discouraged their voting absentee by
mail in the past. If the two witness requirement remains in effect, the LWVNC will have
to divert its limited resources towards educating voters on how to vote safely, if even
possible, with this restriction in place.

16. Furthermore, we have great respect for all the workers with the U.S. Postal
Service, but we recognize that they are likely to be overloaded this year and alternative,
safe and secure delivery systems will be required to make absentee by mail voting an
effective option for every voter who cannot vote in person. Contactless drop boxes are a
safe and secure option for many voters. Without this option, the LWVNC’s work to assist
voters to vote by mail will be limited because we will have concerns as the election gets
closer that mailed absentee ballots may not be postmarked or delivered in time and will
have to redirect more of its limited resources towards mitigating this concern.
17. The LWVNC recognizes that many counties make a significant effort to
review completed absentee ballot envelopes and flag errors so that voters can offer more
information, or have an opportunity to re-do their ballot. This has been observed by League
members at many local county board of elections meetings. However, we also are aware
that there is no uniform standard that is followed by every county board of elections, and
that not all counties undertake these efforts. All voters in North Carolina should have the
same opportunity to make sure their ballot is counted in this election. Because so many
voters will be submitting absentee by mail ballots for the first time this year, we expect this
to be a significant issue.
18. Without uniform and adequate methods for allowing voters to cure absentee
ballot application forms or absentee ballots, the LWVNC will have to redirect its limited
resources to ensuring that the voters it assists are following all procedures precisely, in
addition to its general educational efforts.

The LWVNC’s Work to Support In-Person Voting
19. The LWVNC recognizes that North Carolina will need to have a robust in-
person voting system in place. Many voters prefer to vote in person. In fact, if we follow
the estimates of the State Board of Elections that 40% of voters will opt to vote absentee
by mail this election cycle, millions of North Carolina voters will still want to vote in
person. For example, people who lack a fixed long-term address, who rely on the ADA-
ballot marking devices, or who prefer the security of seeing their ballot enter the tabulator,
will still want to go to an in-person polling location.
20. Local county boards of elections must have as much flexibility as possible to
operate as many polling sites as possible in what is expected to be a very challenging early
voting environment. Local boards of elections will be scrambling to find locations that
offer the space to provide social distancing, not only for voters, but for precinct workers.
In addition, it is expected that some sites usually available for voting may become
unavailable if the proprietors are uncomfortable giving the public broad access to their
facilities. Allowing different sites to be open at different times will give more voters access
to safe in-person voting options, reducing the possibility of long lines. If the uniform hours
requirement remains in place and precincts are consolidated as a result, the LWVNC will
have to divert its limited resources in its voter education efforts to alert its members and
those in their communities about the changes.
21. As with in-person polling sites, local county boards of election will need
flexibility in recruiting workers to staff the polls. COVID-19 has reduced the population of
10

registered voters who will feel comfortable interacting with large numbers of the public. I
understand that Wisconsin had such a crisis during their recent primary, and that they called
in their National Guard to staff some precincts where insufficient numbers of poll workers
would have prevented some counties and townships from having any polling places. Many
LWVNC members work as precinct officials both during early voting and on election day.
Some have reported that they will not work this year because of the pandemic. We will
work hard to get the word out to the community to find poll workers, but they may no
longer be within the precinct. If the requirement that the majority of poll workers must
come from a precinct remains in place, the LWVNC will have to redirect more of our
additional resources to recruit poll workers, whereas these efforts would be much easier
with this restriction lifted.
The Urgency of Preparing for the 2020 General Election
22. The LWVNC recognizes that this will be a unique election and our usual
voter education will be under greater constraints. Voters have already communicated to us
their concerns and their confusion. In order to effectively undertake our voter education
and assistance initiatives, we need the ability now to give voters the information and
reassurance that they will be able to vote safely in November. It is crucial for us to convey
to our members and the voters in their communities that this most critical election will be
handled by our government with the professional confidence that other elections have had
in North Carolina, and that their votes will be received at their boards of elections and will
be counted.
11

that the foregoing Declaration is true and correct to the best of my knowledge.
·~f°
Executed on the £ day of June, 2020.
12


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF DONNA PERMAR IN SUPPORT OF PLAINTIFFS’


I, Donna Permar, hereby declare as follows:
1. I am a Durham County resident, and I work at the Duke Hospital as a staff
assistant.
2. I am a United States Citizen and a registered North Carolina voter who is eligible
to vote in the November 2020 General Election.
3. I am completely blind and I live with my spouse who is also completely blind.
4. I plan on voting in-person this election cycle.
5. In-person voting via an ADA compliant voting machine is the only way that I
am confident in casting my ballot. Due to my blindness, voting absentee by mail
is not an option for me because I cannot complete an absentee ballot without
assistance from another individual, thereby compromising the privacy of my
ballot.
6. Utilizing an ADA compliant machine is also the only way that I can cast my own
ballot without assistance from others, and I trust it more than I do another person
helping me to cast my ballot. I also trust the machine because it will read my
choices back to me before I actually submit my vote.
7. I utilize public transportation in order to travel, thus it is important that my
polling place for the November 2020 General Election is accessible by public
transportation. If precincts are consolidated in a manner in which I would not
have access to my polling place via public transportation, it would place a severe
burden on my ability to cast my vote in-person.

8. I also don't believe I, or any other voter should have to stand in long lines
because of excessive precinct consolidation.
9. Additionally, it is important that the location and hours of the early voting sites
in Durham are widely publicized, and that I am able to request information about
early voting sites from the North Carolina State Board of Elections or the
Durham County Board of Elections in order to know my options as to where to
vote. It is also important that the early voting site hours are at times that are
accessible via public transportation.
10. Further, I don't believe I or any other voter should be subject to excessive risk
of infection with COVID-19 because polling places are not adequately sanitized
and because poll workers were not provided with personal protective equipment.
I declare under penalty of perjury that the foregoing is true and correct to the best of my
knowledge.
Executed this 19 of May, 2020.
Isl


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF JOHN P. CLARK IN SUPPORT OF PLAINTIFFS’


I, John P. Clark, hereby declare as follows:
1. I am a U.S. citizen and a resident of the town of Apex in Wake County, North
Carolina.
2. I am 79 years old. I was a high school teacher before I retired.
3. I am a registered North Carolina voter who is eligible to vote in the November
2020 general election.
4. I have severe chronic obstructive pulmonary disease ("COPD") and have lived
with this disease for the last 12 years. It limits my activities. Whenever I'm active
at all, walking around or working a little bit in the yard, I carry an oxygen tank.
I can walk only two blocks, even with oxygen. I'm more susceptible to
pneumonia and have had pneumonia four times in the last six years or so. Each
time I have had pneumonia, the COPD was exacerbated by it. The most recent
episode was in January 2020, which has caused a further deterioration of my
respiratory condition.
5. COPD makes me more vulnerable to severe complications or even death from
COVID-19. For me, the coronavirus is a death sentence. It is absolutely way too
high a risk for me to vote in person. It is a necessity that I vote by absentee ballot
in the November general election. To the best of my recollection, this is the first
time in my life that I will not be voting in person and will be voting by mail.
6. To avoid any risk of contracting COVID-19, I have been quarantining myself
during the pandemic, for the last eight weeks approximately. Because I can only

walk about two blocks usmg an oxygen tank, my life has been quite
circumscribed during this pandemic.
7. I live only with my wife. The only people who have entered our house during
the lockdown have been three service people. I made sure I was never in the
same room with them. My wife has limited her grocery shopping to no more
than once a week. Because of the risk to me, she wears a mask and gloves when
she goes inside and she uses sanitizing wipes as well. My wife's grocery trips
are her only travel outside the house except for accompanying me on my short
walks in the neighborhood and an occasional drive. We never go over to
neighbors' houses or yards. We never leave our property except for necessary
medical appointments, short walks, and an occasional drive.
8. I have voted in every presidential election since 1968, and I vote regularly in
state and local elections.
9. I want to vote in the November 2020 general election and have already applied
for my mail-in absentee ballot.
10. My wife could serve as one witness for my absentee ballot, but I could not safely
get a second witness for the ballot. Given my COPD and the very serious risk it
poses to my life if I catch COVID-19, I simply cannot ask someone to come to
to my house to serve as a second witness or go to theirs. Each additional person
I interact with poses an additional risk to my life. COVID-19 creates a much
greater risk for someone like me because of my serious respiratory illness.

Therefore, the only way I can safely vote is by mail, and without getting a second
witness for my ballot.
11. Given the current rules in North Carolina, I am unable to figure out how I will
safely cast a ballot by mail, with the current requirement of two witness
signatures, that will be counted in the upcoming election.
that the foregoing is true and correct to the best of my knowledge.
Executed this·.,,; of May, 2020.
,./John P. Clark


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF MARGARET B. CATES IN SUPPORT OF PLAINTIFFS’


I, Margaret B. Cates, hereby declare as follows :
1. I am a U.S. citizen and a resident of the Town ofFaison in Duplin County, North
Carolina.
2. I am 85 years old. I taught piano for a living but have since retired.
2020 general election.
4. I have had chronic fatigue syndrome for the last 27 years since 1993. When I
first came down with it, I was totally bedridden. Gradually, over a period of a
few years, I was able to get up, dress and function somewhat. I could go out but
not very far. I also could go to my children' s house but not often. I would have
some recovery periods but then crashes. I was able to rehabilitate to about half
my original function. Right now, I am not in good health. I have had several falls
and have had a urinary tract infection coming and going for this past year which
has been very debilitating. As a result, I have been pretty weak and have been
using a walker in the house. I have not been able to function in a normal way. I
am in bed twelve hours at night a nd two in the afternoon. I seldom get up and
get dressed. There is no treatment for this syndrome.
5. I have also psoriasis and am being treated for that, and I also have had cancer
though it is not active now though.
6. For the last six months, after the tlu·ee falls and infection, I have had someone
who comes over to the house for a couple hours every day except Sunday to help

with household chores, like cleaning, getting food , and doing laundry. She goes
for grocery shopping and occasionally cooks. Since the coronavirus pandemic
started, we have been following social distancing, and wc stay far apart. I have
not left the house in 3 months, except to go to a doctor's appointment right before
March began and before the social distancing guidelines were put in place. She
only goes out to go to the grocery store for me and her family. She is very
cautious, wears a mask, and keeps her distance. I could not live in this home by
myself without her help.
7. I have voted in every presidential election since the 1956 presidential election.
I also vote in many state and local elections.
8. I want to vote in the November 2020 general election. I do not have a computer
or printer. I do have a tablet and a smart phone. I have never voted by mail, but
from what I understand there is no way for me to request an absentee ballot
online. If this option were available, I could (with some assistance) and would
request a ballot that way. I could also request one by phone call. I have not yet
requested an absentee ballot for the November election.
9. My nearest family member is my son, who lives a two-hours ' drive away in
Southern Pines, North Carolina. Without an online or phone option to request an
absentee ballot, I would not be able to request an absentee ballot on my own and
would depend on others to mail or otherwise provide it to me.
I O.Ifl were able to get an absentee ballot, I understand there is a requirement that I
either get two witnesses or a notary public for it to be counted. My assistant who

comes to the house to help with daily tasks could serve as one witness for my
absentee ballot, but I would be taking a risk in getting a second witness for the
ballot. Given my poor health and debilitated state, I would have to ask someone
to come into my house to serve as a second witness , and no one has been here
besides my assistant. I am reluctant to ask someone to come in because of the
coronavirus. Each additional person I interact with poses a risk to my life. I will
not be able to get a second witness without breaking the social distancing rules
that T am following to protect my health .
11 . Voting in person is not an option for me, and I believe it would pose too much
of a risk to me. Given the current rules for voting by mail , I am unable to figure
out how I will safely cast a ballot by mail in the upcoming election.
Executed this ~O ofMay, 2020.
Isl
Margaret B) Cates


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF LELIA BENTLEY IN SUPPORT OF PLAINTIFFS’


I, Lelia Bentley, hereby declare as follows:
1. I am a U.S. citizen and a resident of the town of Wilkesboro in Wilkes County,
North Carolina. I live on my own.
2. I am 62 years old and registered to vote in Wilkes County. I regularly vote in local,
state, and federal elections.
3. I have been diagnosed with hypertension, which I control through diet, exercise,
and activities like meditation. Additionally, about once a year, I usually get a cold that develops
into respiratory issues. Typically when this happens, I get congested in my sinuses and lungs,
develop a hacking cough, experience shortness of breath, and cannot leave my bed. Because
of these issues and because it has been reported that COVID-19 attacks the lungs, I am terrified
of getting COVID-19. I believe it could kill me.
4. I started self-isolating to protect my health on March 10. The last time I went to the
grocery store was on March 15. Since then, if I have needed groceries, I order them online and
have them delivered.
5. My city has been working to connect water lines in my area. City employees have
come to my home to provide me with updates about this work, but I have made them stand on
the sidewalk and cleaned my door and doorbell with Clorox wipes after they left.
6. I am following the stay-at-home order as best as I can. If I do not need to leave my
home, then I don’t.
7. I do not have any support network, including relatives, in Wilkes County and would
have to ask my neighbors to serve as witnesses to request and cast a mail-in ballot. However,
I believe this would put me at risk of catching COVID-19 or put others at risk. The neighbors
who live on either side of my house continue to leave their homes and even host gatherings.

Other neighbors are self-isolating because they have elderly relatives, and I worry that despite
all of the precautions I take, I could accidentally spread the virus to them. As for my other
neighbors, I do not know what precautions, if any, they are taking, and cannot trust that they
are not infected or otherwise carrying the virus as a result.
8. I will not feel safe leaving my home again until there are safe treatments available
if I get sick or a vaccine.
9. It is incredibly important to me to vote in the General Election. I believe every vote
will count. But I do not know that I will be able to find witnesses, or who I would ask. Even if
I could find witnesses, I do not know that I would move forward with requesting a mail-in
ballot or sending in a ballot by mail because of the risk of catching COVID-19 through the
witnessing process. I will not vote in person because I believe it would be too much of a risk
to my health.
10. I am very frustrated by these laws. I do not understand why they are required. Other
states have been voting by mail for years. This situation is extremely unfair to voters like me.
I declare under penalty of perjury under the laws of the United States of America that the
foregoing is true and correct to the best of my knowledge.
Executed this 19 of May, 2020.
/s/ Lelia Bentley

Lelia Bentley


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF REGINA WHITNEY EDWARDS IN SUPPORT OF

PLAINTIFFS’ MOTION FOR PRELIMINARY INJUNCTION

I, Regina Whitney Edwards, hereby declare as follows:
1. I am a U.S. citizen and a resident of Durham County, North Carolina. My
address is 3231 Sparger Road, Durham, North Carolina 27705. I live in a single-
family home with my partner.
2020 General Election.
3. I am 30 years old.
4. I am a Program Manager at the Duke Human Vaccine Institute. My
responsibilities include managing grants, including awards from the National
Institutes of Health, and overseeing a training and mentorship program for
students and researchers who are affiliated with the Institute. Because
immunologists and vaccine specialists at the Institute are actively working on
COVID-19, I am familiar with the health risks posed by COVID-19. I am also
an advocate for the American Diabetes Association.
5. I learned from the website of the Centers for Disease Control that I am at very
high risk of developing severe illness from the novel coronavirus because I have
a serious pre-existing medical condition, type 1 diabetes. I have had type 1
diabetes for 21 years.
6. Numerous medical professionals with whom I work at the Institute have warned
me about the impact of COVID-19 on high-risk individuals like myself. To
protect my health, I have remained at home since mid-March and have not seen

another person other than my partner. I work from home and avoid public
spaces. I rely on my partner to shop for groceries and run other errands. In light
of the advice of the medical professionals with whom I work, I am
uncomfortable leaving my home or being in close proximity to people other than
my partner.
7. Because of the nature of my work for the Duke Human Vaccine Institute and my
advocacy with the American Diabetes Association, I understand that these
measures are necessary to safeguard my physical wellbeing in light of the
COVID-19 pandemic.
8. I have voted in multiple elections in North Carolina, including the most recent
primary election in March 2020. I almost always vote in person. But for the
threat of COVID-19, I would vote in the 2020 General Election in person.
9. Because of the pandemic and the health risks posed by in-person voting, I am
not willing to vote in person during the 2020 General Election.
10. To protect my health, I would like to vote by mail-in absentee ballot. But I
cannot safely comply with North Carolina's two-witness requirement. Although
my partner is available to serve as the first witness, I am not willing to jeopardize
my physical wellbeing by asking another person to serve as the second witness.
11. The two-witness requirement thus forces me to choose between my health and
my right to vote.
12. Although I strongly wish to vote in this election, I will not do so if the two-
witness requirement remains in effect.

Executed this ~day of May, 2020.
Regina Whitney Edwards


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF ROBERT K. PRIDDY II IN SUPPORT OF PLAINTIFFS’


I, Robert K. Priddy II, hereby declare as follows:
1. I am a U.S. citizen and a resident of Brunswick County, North Carolina. I live
at 2 Kings Grant Court, Shallotte, North Carolina 28470, with my wife.
2020 General Election.
3. I am 70 years old. Before I retired, I worked in nuclear safety.
4. My doctor has informed me that I am at very high risk of developing severe
illness from the novel coronavirus because I have several serious pre-existing
health conditions and because of my age . In 2010, I received a kidney
transplant. To ensure that my body does not reject the transplant, I take
medication that suppresses my immune system. The medication also causes
borderline diabetic issues, so I receive treatment for diabetes.
5. To protect my health, my doctor has advised me to stay home and avoid
contact with people outside my household. Accordingly, I have remained at
home since mid-March. I rely on my wife to shop for groceries and mn other
errands. The only time I have gone outside is to pick up prescriptions from a
drive-thru pharmacy, where I remain in my vehicle and do not directly interact
with the pharmacist. In light of my doctor's advice, I am uncomfortable
leaving my home or being in close proximity to people other than my wife.

6. I have voted in numerous elections in North Carolina. Although I usually vote
in person, I have also voted by absentee ballot on occasion. But for the threat
of COVID-19, I would vote in the 2020 General Election in person.
7. Because of the pandemic and the health risks posted by in-person voting, I am
not willing to vote in person for the 2020 General Election.
8. I would like to vote by mail-in absentee ballot, but I cannot safely comply with
North Carolina's two-witness requirement. Although my wife is available to
serve as·the first witness, I am not sure whether I am willing to jeopardize my
physical wellbeing by asking another person to serve as the second witness.
9. The two-witness requirement thus forces me to choose between my health and
my right to vote.
10. Although I strongly wish to vote, I do not expect the risks to my physical
health to abate in the months leading up to the election. As a result, if the two-
witness requirement remains in effect, I am not sure whether I will be able to
vote in the 2020 General Election.
Executed this// day of May, 2020.
Robert K. Priddy II


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF WALTER HUTCHINS IN SUPPORT OF PLAINTIFFS’


I, Walter Hutchins, hereby declare as follows:
I . I am a U.S. citizen and a resident of Wilmington County, North Carolina. I have
been living at The Davis Community, a nursing home in Wilmington, for about
a year and a half.
2. I am 91 years old and a veteran of the U.S. Army Air Forces and U.S. Air Force.
I served from 1946 to 1949.
2020 general election. The first election I voted in was in 1952, and the last
election I voted in was the 2018 general election. I voted in person at a polling
location in Plantation Village, a senior citizen living facility in Wilmington,
North Carolina, where I used to live. My wife, Reverend Margaret Hutchins, is
still residing there.
4. In 2018, I was not completely visually impaired. Now, I am legally blind.
5. My wife assisted me with casting my ballot in 2018. She recited the candidates
and when I informed her of my choice, she would position my hand so that I
could mark my ballot.
6. Due to my age, I am at very high risk of developing severe illness from the novel
coronavirus. To protect my health, and the health of others similarly situated to
me, The Davis Community has been on lockdown since mid-March. No visitors,
including family members, are allowed. My wife has not been allowed to see
me during this time.
-2-

7. The residents at Davis community are told to maintain at least 6 feet of distance
from each other, due to the coronavirus. We are kept at least 6 feet apart at meals,
and we are given hand sanitizer.
8. I would like to vote by absentee ballot in November. However, I have never
voted by mail before and am unfamiliar with the absentee ballot process. I do
not know how I will be able to request and cast an absentee ballot without my
wife's assistance.
9. I asked the staff at The Davis Community how blind residents have been able to
vote in the past, and no one could provide an answer. As far as I know, there has
been no preparation at The Davis Community for residents to vote. I have not
been given any information about how to participate in the upcoming November
election.
10. I do not know how I can vote with the current restrictions in place. I am unable
to fill out an absentee ballot request by mail, since I am legally blind, and would
like to be able to do so by phone. I have a phone in my room, which I am able
to use without assistance. Ifl were provided the number for the county board of
elections-as well as the necessary information, such as the last four digits of
my Social Security Number- by my wife or The Davis Community staff, I could
make this request on my own.
11 . Since The Davis Community is under lockdown and my wife cannot assist me
with my absentee ballot, I would like The Davis Community staff members to
-3-

be permitted to assist me in voting and returning my absentee ballot, and only if
necessary, to serve as my witnesses.
12. Otherwise, my blindness will prevent me from completing and returning my
absentee ballot and voting in the upcoming November election.
13. This declaration has been read to me by my attorneys, and a copy for me to sign
was provided by courier.
Executed this 4th day of June, 2020.
Waite
-4-


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF SUSAN SCHAFFER IN SUPPORT OF PLAINTIFFS’


I, Susan Schaffer, hereby declare as follows:
1. I am a Durham County resident, and I am a retired attorney.
2. I am a United States Citizen.
3. I am a volunteer with You Can Vote, an organization that does voter registration
and, in the past, has helped people request absentee ballots.
4. In the past couple of years, I have assisted numerous voters in registering to vote
and requesting absentee ballots, as well as assisting voters with completing their
absentee ballots.
5. Additionally, in the past I have assisted voters at Senior living facilities and
nursing homes that are now off limits to people who are seeking to assist voters
with requesting an absentee ballot, but do not have a family member in that
specific facility and/or are not a part of a Multi-Partisan Assistance Team.
6. The assistance prohibitions set forth in N.C. Gen. Stat. §§ 163-230.2 as amended
by North Carolina Senate Bill 683 (“SB 683”) have stifled persons such as
myself from assisting voters who need help requesting an absentee ballot. Such
as elderly voters, first-time absentee voters who are not familiar with the
absentee voting rules in North Carolina, or voters who may not otherwise qualify
for assistance.
7. Since the passage of SB 683, organizations like You Can Vote and its volunteer
base (of which I am a part) have not been able to assist voters with requesting
absentee ballots.

8. I want to ensure that I am following the letter of the law, and as not to
potentially be in violation of the law I have been prevented from assisting
voters in requesting an absentee ballot which may be their only way to vote
this year given the Covid- 19 pandemic.
9. Without having the ability to assist voters with requesting their absentee
ballots, my ability to help voters who may require assistance is impaired.
I declare under penalty of perjury that the foregoing is true and correct to the best of my
knowledge.
Executed this 4th of June, 2020.
Isl


Plaintiffs,
vs. Civil Action No. 20-
THE NORTH CAROLINA STATE BOARD OF cv-457

ANDERSON, in her official capacity
as SECRETARY OF THE STATE BOARD OF
Defendants.

INDEX OF ADDITIONAL DECLARATIONS
1. Declaration of Dr. Meghan Murry, Professor of Global

Health, Harvard Medical School
2. Declaration of Dr. Paul Gronke, Professor of Political
Science, Reed College
3. Declaration of Gary Bartlett, former Executive Director
of the North Carolina Board of Elections
4. Declaration of Marshall Tutor, former Lead Investigator
for the North Carolina State Board of Elections
5. Declaration of Christopher Ketchie, demographer and
data analyst, Southern Coalition for Social Justice
6. Declaration of Allison J. Riggs, Counsel for Plaintiffs
and Interim Executive Director and Chief Counsel for
Voting Rights, Southern Coalition for Social Justice
7. Exhibits 1-10 to Riggs Declaration


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF MEGHAN MURRAY IN SUPPORT OF PLAINTIFFS’


1. I am the Ronda Stryker and William Johnston Professor of Global Health in
the Department of Global Health and Social Medicine at the Harvard Medical School, a
Professor of Epidemiology at the Harvard Chan School of Public Health, a faculty member
of the Center for Communicable Disease Dynamics at the Harvard Chan School of Public
Health and an associate Professor of Medicine at the Harvard Medical School and the
Brigham and Women’s Hospital. I obtained my BA from Dartmouth College in 1980, after
which I worked for the Intergovernmental Committee for Migration (now IOM) heading
up a public health screening program for refugees being resettled from refugee camps in
Thailand. I obtained my MD from Harvard Medical School in 1990 and my ScD (doctorate
in science) in Epidemiology from the Harvard School of Public Health in 2001. I completed
a residency in internal medicine in 1993 and a fellowship in the sub-specialty of Infectious
Diseases in 1995, both at the Massachusetts General Hospital in Boston.
2. Over the past 20 years, I have worked in the field of infectious disease
dynamics and epidemiology, teaching and conducting research in emerging infectious
diseases and in tuberculosis epidemiology and control. At the Harvard Chan SPH, I taught
the basic epidemiology course Infectious Disease Dynamics between 2000 and 2016, and
I have directly supervised the research of over 40 graduate students and post-doctoral
fellows in these fields. Attached here as Exhibit A and incorporated by reference to this
declaration is a copy of my curriculum vitae.
3. I have conducted research and have published on the transmission dynamics
of SARS-CoV-1 in 2003, the 2010 cholera epidemic in Haiti, and on the 2015 Ebola

outbreak, although most of my research is in the field of tuberculosis. I have published over
200 research articles. My work includes dynamic modeling of epidemics (TB, Cholera,
Ebola, SARS-CoV-1, SARS-CoV-2); cohort studies on host and pathogen specific
determinants of disease transmission and the development of novel diagnostic tools for the
diagnosis of infectious diseases. I have been funded by the National Institute of Infectious
Disease and Allergy since 1995 and have led, and currently lead, several major consortium
projects on tuberculosis funded by this agency.
4. At the Harvard Medical School, I lead the Global Health Research Core of
the Harvard Medical School, which conducts research in more than ten countries on a range
of topics including emerging infectious diseases. I head up research at the Division of
Global Health Equity at the Brigham and Women’s Hospital and also direct research at the
non-governmental organization, Partners in Health. I have served as an associate editor of
the European Journal of Epidemiology, the Journal of the International Union against TB
and Lung Disease and of PLoS (Public Library of Science) Medicine. I am the co-lead of
the Epidemiology working group of the Massachusetts Consortium for Pathogen
Readiness.
5. I am currently collaborating on research concerning SARS-CoV-2 and its
incidence, as well as serving on Covid-19 advisory groups for multiple organizations,
including the State of Massachusetts and Harvard University. My research in this area
includes, but is not limited to, modeling and estimating the number of hospital beds that
will be required in the US and elsewhere, developing methods on syndromic surveillance

for Covid-19 for low and middle-income countries, identification of risk factors for poor
outcomes and the use of the vaccine, BCG, to prevent Covid-19 disease. To date (May 11,
2020), I have published two papers in this area and have three others under review.
OVERVIEW
6. SARS-CoV-2 is a newly identified coronavirus that is the causative agent
involved in Coronavirus Disease 2019 (Covid-19). SARS-CoV-2 infection can result
in an asymptomatic infection or in symptomatic disease which ranges from mild to
severe. Most people who develop symptomatic Covid-19 have a flu-like illness that starts
out with fever, cough, sore throat and shortness of breath. A subset of people who are
infected will go on to develop much more serious illness, characterized by respiratory
compromise and acute respiratory distress syndrome (ARDS). Other serious
manifestations of Covid-19 have included cardiac problems: arrhythmias, acute cardiac
injury, and shock.
7. Because Covid-19 is a new disease, it is too early to know the full extent of
long-term medical consequences of the infection. However, some information can be
inferred from the courses of diseases with similar manifestations. Patients who develop
ARDS and/or are mechanically ventilated are likely to develop lung scarring that may
permanently impair their pulmonary function [1]. Patients who end up in ICUs or on
mechanical ventilation for extended periods often develop post-ICU syndrome which
prolonged physical debilitation, muscle atrophy, neurocognitive impairments and
emotional/psychiatric responses that are similar to post-traumatic stress syndrome.

Although Covid-19 has been reported in people of all ages, older people and those with co-
morbidities (concurrent illnesses) are most likely to develop severe disease.
8. Covid-19 is a respiratory virus which is spread by symptomatic and
asymptomatic people through respiratory droplets, meaning drops of fluid from the
nose or mouth that are emitted during coughs, sneezes or even talking. Some of the
viral particles emitted this way end up on surfaces (door handles, coins) where they can
remain viable. It has also been shown that Covid-19 can be transmitted as an aerosol – in
other words, through the airborne route, i.e., direct inhalation of virus suspended in the air.
9. Control of SARS-CoV-2 spread is particularly difficult relative to some
other viral infections because people can transmit the infection even when they do not
have symptoms of the disease. This means that the practice of isolating patients with
symptomatic disease will not be enough by itself to control epidemic spread. In contrast,
infections like smallpox and SARS-CoV-1 were not infectious until symptoms had
developed so isolation of ill people had a substantial impact on epidemic control. In the
absence of a vaccine or pharmaceutical interventions that interrupt transmission, infection
control can only be achieved by reducing the number of contacts between infectious
individuals (including those who are asymptomatic) and susceptible people.
10. Infectious disease epidemiologists have developed projections of the future
trajectory of Covid-19 incidence based on modeling the epidemic and possible
interventions. Although these models differ in terms of specifics, they consistently show
that it is highly likely that the relaxation of social distancing measures that will occur with

the end of “lock-down” will increase the number of social contacts that people make and
that the incidence of infection will increase accordingly In particular, these models predict
that transmission of SARS-CoV-2 will continue or increase in the fall and winter, leading
to further morbidity and mortality from this disease.
11. There is a substantial risk that an infection with Covid-19 acquired during
voting at a poll booth in North Carolina in the fall of 2020 could result in symptomatic
disease, hospitalization or death. The risk of an individual being infected during voting at
a polling booth in fall 2020 depends on the number of infectious people in that community
at that time point and the number of physical, fomite-mediated and near contacts one makes
during that process. To the extent that polling places are crowded, require people to wait
in lines, involve interacting with polling staff or other voters at a close distance, move
people through the process slowly, are poorly ventilated, and/or involve people touching
objects like pens, paper, or surfaces within the voting booth, they constitute a risk to voters.
Similarly, if voters or poll workers use toilets that are also used by others, they can be put
at risk. North Carolina has relatively high rates of the co-morbidities that predispose people
to poor outcomes from Covid-19.
12. I was asked to describe the novel coronavirus that causes Covid-19. SARS-
CoV-2 is a newly identified coronavirus that is the causative agent involved in Coronavirus
Disease 2019 (Covid-19) [1]. It is a single-stranded RNA virus of the Coronavirus family.
Previously identified coronaviruses are known to infect a wide range of hosts including
wild and domestic animals and birds as well as humans. Six human coronaviruses have

been identified over the past 60 years; four of them (OC43, 229E, NL63, and HKU1) cause
mild cold-like symptoms and/or gastrointestinal tract infections. Two that have caused
more serious illness include the severe acute respiratory syndrome coronavirus (SARS-
CoV-1) that emerged in China in 2003 and the Middle East respiratory syndrome
coronavirus (MERS-CoV) that was first identified in humans in Saudi Arabia in 2012.
SARS- and MERS-CoVs are believed to have originated in bats and transferred to humans
through intermediary hosts, possibly palm civets for SARS or dromedary camels for
MERS. The coronaviruses that are most similar to SARS-CoV-2 are those identified in
horseshoe bats – these share 96 percent of their genetic material with SARS-CoV-2 while
the earlier SARS virus shared 80 percent and cold viruses mentioned above share about 50
percent [2].
13. Like SARS-CoV-1, SARS-CoV-2 infiltrates human cells by binding to the
receptor for ACE2 (angiotensin converting enzyme) and then being taken up by these cells,
where it directs the production of new virus particles (virions) using the host’s genetic
machinery [3]. Like other viruses, SARS-CoV-2 virions consist of a “core” which contains
the genetic material, a “capsid” which is a protein coat and a lipid envelope. Upon assembly
in the host cell, newly-produced virions are released from the host cell and go on to infect
new host cells. To some extent, the clinical manifestations of the disease are related to the
types of cells that have the receptor to which the virus binds and to the inflammatory
responses that are induced by the host immune response to the infection. While ACE2
receptors were well-known to be present on vascular endothelial cells (blood vessels) and

renal tubular cells (kidney), they have also been found to be abundant on alveolar epithelial
cells (lung), enterocytes (gut), heart cells, brain cells and in cells in the inner lining of the
nose [4]. This diverse distribution helps explain the wide constellation of symptoms and
syndromes that are increasingly being recognized as part of Covid-19 disease.
14. I was asked to characterize clinical features of Covid-19. SARS-CoV-2
infection can result in an asymptomatic infection or in symptomatic disease which ranges
from mild to severe. The term Covid-19 refers to the illness that is caused by SARS-CoV-
2. Most people who develop symptomatic Covid-19 have a flu-like illness that starts out
with fever, cough, sore throat and shortness of breath. As clinicians have gained more
experience with the disease, it is now becoming clear that the initial presentation of the
disease can also include a variety of other symptoms including gastrointestinal issues such
as nausea, vomiting and diarrhea, loss of a sense of taste and/or smell, headache and muscle
pain and in some cases, particularly in the elderly, altered neurological states such as
confusion, lethargy and reduced responsiveness. The Centers for Disease Control and
Prevention (CDC) have recently expanded their list of symptoms associated with Covid-
19 from fever, shortness of breath and cough to include chills, muscle pain, headache, sore
throat and new loss of taste or smell [5]. On average, among those who present with these
symptoms, fever persists for around 12 days, shortness of breath for 13 days and cough for
about 19 days. According to the World Health Organization (WHO), recovery time appears
to be around two weeks for mild infections and three to six weeks for severe disease [6].

15. A subset of people who are infected will go on to develop much more serious
illness, characterized by respiratory compromise due to pneumonia that can be gradual or
sudden. Some patients who initially reported only mild symptoms may progress to severe
disease over the course of a week. In one study of 138 patients hospitalized in Wuhan,
China, for pneumonia due to SARS-CoV-2, dyspnea (severe shortness of breath) developed
approximately five days after the onset of symptoms, and hospital admission occurred after
around seven days after the onset of symptoms [7].
16. Acute respiratory distress syndrome (ARDS) is the major complication in
patients with severe disease. In the study cited above, ARDS developed in 20 percent of
hospitalized patients around eight days after the onset of symptoms and 12.3 percent of this
group required mechanical ventilation [7]. In another study of 201 hospitalized patients
with Covid-19 in Wuhan, 41 percent developed ARDS [8]. Some patients with severe
Covid-19 have an overactive inflammatory response, sometimes termed a “cytokine
storm,” which is characterized by persistent fevers and laboratory abnormalities including
high levels of inflammatory markers and elevated proinflammatory cytokines. People with
these types of laboratory abnormalities are those most likely to have critical or fatal illness.
17. Other serious manifestations of Covid-19 have included cardiac problems:
arrhythmias, acute cardiac injury, and shock [9-11] which occurred in 17, 7, and 9 percent
of hospitalized patients, respectively [7]. In a case series of 21 severely ill patients admitted
to a US ICU, one-third developed cardiomyopathy (injury to the heart muscle) [12]. An
alarming recent finding has been the association of Covid-19 with thromboembolic

complications (pulmonary embolism and stroke) that have been reported among patients
in younger age groups and without known risk factors [13-15]. In one US-based case
series, a single health facility reported on five Covid-19 patients with acute stroke who
were seen over a two-week period; all of these people were under 50 years of age [14].
This incidence is more than seven times the rate reported in that age group prior to the
pandemic. In one series of ICU patients, ischemic stroke was also noted observed in 3.7
percent of the patients [15].
18. Other rarer manifestations of Covid-19 include Guillain-Barré syndrome
which can occur five to ten days after initial symptoms [16]. Guillain-Barré syndrome is a
rare neurological syndrome characterized by an inflammation of nerve cells outside the
brain. In serious cases, it can lead to paralysis which usually resolves after six months but
which can be permanent in some cases. Another rare inflammatory syndrome that has been
reported in Covid-19 occurs in children who have developed symptoms consistent with
toxic shock syndrome and Kawasaki disease [17].
19. Because Covid-19 is a new disease, it is too early to know the full extent of
long-term medical consequences of the infection. However, some information is already
available, and some can be inferred from the courses of diseases with similar
manifestations. Patients who develop ARDS and/or are mechanically ventilated are likely
to develop lung scarring that may permanently impair their pulmonary function. [18]. In
addition, patients who end up in ICUs or on mechanical ventilation for extended periods
often develop post-ICU syndrome which includes a constellation of findings such as
10

prolonged physical debilitation, muscle atrophy, neurocognitive impairments and
emotional/psychiatric responses that are similar to post-traumatic stress syndrome [19].
Patients that suffer strokes in the context of Covid-19 are very likely to experience long-
term neurological deficits from these events.
20. Although Covid-19 has been reported in people of all ages, older people and
those with co-morbidities (concurrent illnesses) are most likely to develop severe disease.
Accurate case fatality rates are hard to obtain in the context of limited testing since we do
not always know who actually has the infection. However, a compilation of the death rates
across countries shows that older people are consistently more likely to die if they have
detectable Covid-19 disease than are younger people [20]. The table below shows that the
risk of death rises with each additional decade after age 50.
Table 1. Case Fatality rate by age groups. From Onder G, Rezza G, Brusaferro S. Case-
Fatality Rate and Characteristics of Patients Dying in Relation to Covid-19 in
Italy. JAMA. 2020;323 [18].
21. In addition to age, other risk factors for severe disease and death include
hypertension, heart disease, lung diseases (e.g., asthma, chronic obstructive pulmonary
11

disease (COPD)), diabetes mellitus, obesity, and chronic kidney disease. In one recent
study of 5700 Covid-19 patients identified in New York City, 56.6 percent had pre-existing
hypertension, 41.7 percent were obese (body mass index > 30) and 33.8 percent had
diabetes mellitus [21]. Risk factors for death among patients with Covid-19 were recently
ascertained in another study of 5,683 Covid-19 deaths in the United Kingdom [22]. In this
report, men were twice as likely to die as women; people with obesity 2.3 times as likely
to die as those of normal weight; people with uncontrolled diabetes 2.36 times than non-
diabetics, people with organ transplants 4.3 times than their healthy counterparts. In both
Britain and the US, there are marked disparities in deaths by race: 33 to 42 percent of deaths
in the US have reportedly occurred in African Americans, while only 12 to 13 percent of
the total US population is African American [23]. Figure 2 provides comparative death
rates from Covid-19 from the APM research lab (https://www.apmresearchlab.org/).
Table 2 Covid-19 Death Rate by ethnic group. (From APM Research Lab)
https://www.apmresearchlab.org/
12

22. Although the Covid-19 case fatality rates are low in young individuals, it is
important to note that multiple seroprevalence studies (studies that detect previous
infection in people) in several countries show that infection (as distinct from severe
disease) is more common in people younger than 50, probably because they have more
frequent social contacts than older people. Furthermore, the proportion of people in the US
population under 50 years of age is 66%, meaning that even though the absolute risk for a
young person is lower than for someone over 50, deaths among people under 50 will not
be uncommon as the epidemic progresses over time.
23. I was asked to explain how Covid-19 is transmitted and to describe
interventions that could interrupt transmission. SARS-CoV-2 can be transmitted in
multiple ways, through respiratory droplets emitted during talking, singing, sneezing and
coughing, via objects on which viral particles have been deposited, and through air.
Importantly, the virus can be transmitted by people who are asymptomatic as well as by
those who are demonstrably ill.
24. Covid-19 is a respiratory virus which is spread through respiratory droplets,
meaning drops of fluid from the nose or mouth that are emitted during coughs, sneezes or
even talking [52]. Some of the viral particles emitted this way end up on surfaces (door
handles, coins) where they can remain viable. These objects then become “fomites,”
defined as inanimate objects that can transfer infection between people. A recent study
documented the stability of SARS-CoV-2 on a series of different surfaces over time [24].
The virus was found to be more stable on plastic and stainless steel than on copper and
13

cardboard with viable virus detectable for up to 72 hours after application to these surfaces
although the virus titer was steadily reduced over those periods. On cardboard, viable
SARS-CoV-2 was measured for 24 hours. Notably, this study also evaluated the stability
of SARS-CoV-1 – the causative virus of the 2003 SARS epidemic – and found that it was
very similar to SARS-CoV-2 despite the fact that SARS-CoV-2 has much more capacity
to spread widely than SARS-CoV-1. The authors conclude that the “differences in the
epidemiologic characteristics of these viruses probably arise from other factors, including
high viral loads in the upper respiratory tract and the potential for persons infected with
SARS-CoV-2 to shed and transmit the virus while asymptomatic.” [24]
25. It is also possible that Covid-19 is transmitted as an aerosol – in other words,
through the airborne route, i.e., direct inhalation of virus suspended in the air. The study
cited above also assessed the stability of aerosolized SARS-CoV-2 over time. To do this,
they used a nebulizer to generate aerosols that would be similar to those observed in
samples obtained from the upper and lower respiratory tract in humans. SARS-CoV-2
remained viable in aerosols throughout the duration of the three-hour experiment,
suggesting that aerosol spread of SARS-CoV-2 is indeed possible. These findings are
consistent with case reports of Covid-19 patients who were infected in settings in which
they did not have direct contact with others. In one case, 45 people were diagnosed with
Covid-19 after attending a choir practice in Washington State in early March although they
had no direct physical contact with each other [25]. The findings are also consistent with a
report in the journal, Nature, where researchers found viral RNA in aerosols sampled in
14

February and March at two hospitals in Wuhan, China. The levels of airborne viral RNA
in well-ventilated patient rooms were relatively low but there were higher levels in some
of the patients’ toilet areas, presumably aerosolized by the flushing mechanism.
26. High levels of viral RNA were also found in areas where medical workers
remove their protective equipment and in locations near the hospitals where people tended
to congregate. The authors concluded: “Our study and several other studies proved the
existence of SARS-CoV-2 aerosols and implied that SARS-CoV-2 aerosol transmission
might be a non-negligible route from infected carriers to someone nearby.”
27. The transmissibility of any infectious agent depends on several things: the
probability of an infection event given a contact between a susceptible person and an
infectious person; the duration of infectiousness – or number of days that a person can
transmit – and the number of contacts that an infectious person has per unit time. This
means that the transmissibility can vary in different settings and will depend on things like
crowding, which increases the number of contacts. Based on a summary of multiple
studies, each infectious person with Covid-19 is expected to infect between 2 and 3 people
on average [26]. But this term – “on average” – obscures the substantial variability
observed in different people. Some people are much more infectious than others and other
people do not transmit at all. Like many other respiratory infections, SARS-CoV-2 follows
the 20/80 rule – meaning that most transmission is associated with 20 percent of the
infectious people while the other 80 percent infect relatively few people. The factors that
15

lead to this kind of “super-spreading” are not clear and it is thus not possible to identify in
advance those people who are likely to infect a large number of other people.
28. Control of SARS-CoV-2 spread is also made more difficult because people
can transmit the infection even when they do not have symptoms of the disease. This can
happen in two ways. Many people with SARS-CoV-2 infection have few if any symptoms
– as more and more seroprevalence studies are being conducted to identify who has been
infected, it is estimated that 50-60 percent of infected people never develop symptoms of
the disease. Seroprevalence surveys are studies that look for the presence of antibodies to
an infection in a blood sample; these are only present in people who have been exposed to
the infection and have mounted an immune response. Secondly, people who develop
Covid-19 disease experience a “pre-symptomatic” period during which they are infected
but do not yet have symptoms. A recent study in the New England Journal of Medicine
found that quantitative SARS-CoV-2 viral loads were similarly high in four different
symptom groups; people with typical symptoms of Covid-19, people with atypical
symptoms, people who were pre-symptomatic, and those who remained asymptomatic
[27]. Notably, 71 percent of the samples taken from pre-symptomatic persons had viable
virus for one to six days before the development of symptoms. Because viral load is an
accepted proxy for infectiousness, these data imply that a significant proportion of
transmission events originate from persons who do not have detectable infection.
29. What kinds of interventions are currently available that could interrupt or
reduce transmission of SARS-CoV-2? In the absence of a vaccine or pharmaceutical
16

interventions that reduce the probability of transmission, there are a limited number of
approaches to infection control, all of which involve restricting people’s physical and social
interactions. One can isolate people with symptomatic disease to try to prevent them from
infecting others, but this will only be completely effective if people are diagnosed with the
disease at or before the time that they become infectious. As noted above, in people who
are infectious before they have symptoms or in infectious people who never develop
symptoms at all, transmission can take place in the absence of symptoms. For diseases like
this one, with significant asymptomatic spread, quarantine is used to separate and restrict
the movements of people without signs of illness who may have been exposed to an
infectious case so that they do not infect others during that period. Another approach is
social distancing – this can range from asking people to stay at home or to avoid congregate
settings such as schools, workplaces, or large gatherings. The purpose of social distancing
is to reduce the number of person-to-person contacts one makes so that one is less likely to
encounter an infectious person. Polls show that US adults practicing social distancing have
90% fewer contacts per day than those who are not social distancing. Those who
completely or mostly isolate themselves generate about five contacts per day, compared
with an average of 52 for those not attempting to isolate themselves [28].
30. It is challenging to directly measure the actual efficacy of the non-
pharmacological interventions to reduce the spread of an infection because these
interventions are not randomly assigned to individuals and then evaluated in a head-to-
head comparison of what happens to people in intervention and non-intervention groups.
17

One approach to estimating the impact of social distancing measures is to conduct studies
that screen entire communities to determine who is actively infected at the time of
screening. The researchers then correlate various characteristics of the people screened
with the likelihood that they have been infected. Few such studies have been conducted to
date but one that is informative was conducted in the Mission District of San Francisco.
The research team offered free Covid-19 testing to all persons ages four years and older in
an area that includes approximately 5,700 people (29). Of nearly 3,000 residents and
workers in a Mission District census tract who were tested in late April for active infection
with the novel coronavirus, 62 individuals (2.1 percent) have tested positive.
Table 3 Viral test positivity in Mission District of San Francisco [29]
31. The question of the efficacy of quarantine, isolation and social distancing
depends on when in the course of the infection most transmission is taking place. If most
transmission occurs during the asymptomatic period – as it does, say, for HIV – isolation
18

of patients with disease will have little impact. If on the other hand, most transmission takes
place when people have identified themselves as ill (as it did for SARS-CoV-1 in 2002),
isolation can be a very effective way to reduce spread. The benefits of quarantine –
restricting the movements of people who are known to be in contact with an infectious case
– depend on how effectively one can identify all contacts and prevent them from mixing
with the general public. For obvious reasons, this can be very challenging and can have
unintended consequences if quarantined people are housed together and become infected
in that setting. Social distancing cannot prevent all transmission but could have a
substantial impact on delaying transmission since contact rates are often much higher in
congregate settings such as schools, prisons and other residential facilities. None of these
measures is likely to lead to complete control of an epidemic since transmission is expected
to resume once these are discontinued. But they may delay spread and give health systems
time to develop better responses to the disease, whether those are new drugs, vaccines or
simply improved efficiency of supportive care.
32. I was asked to address the likelihood that voting at polling stations could
lead to SARS-CoV-2 transmission and Covid-19 disease. Because voting takes place in
public buildings where people congregate and because the risks of infection and disease in
the North Carolina population are high due to the high prevalence of comorbidities, voting
at a polling station in November entails a substantial risk of infection with Covid-19 that
could result in symptomatic disease, hospitalization or death. The risk of an individual
being infected during a community event in a public place depends on the number of
19

infectious people in that community at any particular time point and the number of
physical, fomite-mediated and near contacts one makes during that process. To the extent
that polling places are crowded, require people to wait in lines, involve interacting with
polling staff or other voters at a close distance, move people through the process slowly,
are poorly ventilated and/or involve people touching objects like pens, paper, or surfaces
within the voting booth, they constitute a risk to voters. Similarly, if voters or poll workers
use toilets that are also used by others, they can be put at risk. The data supporting some
aerosol transmission of Covid-19 provides evidence that poorly ventilated areas where
crowding may take place pose risk to those using these facilities. The probability that a
person who is exposed to Covid-19 in this setting will go on to develop severe Covid-19
disease or to die depends on the age of that person and his/her underlying health status.
Given the relatively high prevalence of relevant co-morbidities (obesity, hypertension,
diabetes), the proportion of the population over 60, and the fact that older people are more
likely to vote than younger people (on a nationwide basis, 66 percent of over 65 years
compared to 35.6 percent of 18-29 years in the 2018 national mid-term elections [54]),
there is a substantial risk that an infection with Covid-19 in North Carolina could result in
symptomatic disease, hospitalization or death.
33. I was asked to address the likelihood of a persistent or increased risk of
transmission of Covid-19 in the fall in the weeks/months leading up to November 3, 2020.
Epidemiologists have projected a number of future Covid-19 epidemic trajectories based
on a range of different possible scenarios but all of these scenarios are similar in that they
20

predict that it is highly likely that Covid-19 will continue to circulate at its current level or
at an even higher level than currently in October and November of 2020. The likelihood of
continued transmission of Covid-19 in the fall 2020 can be estimated by modeling the
epidemic process. Mathematical models simulate epidemics under a variety of scenarios
using “parameters” obtained from empirical (data-driven) studies. Typically, a model uses
estimates of the relative transmissibility of an infectious agent, the average number of
contacts people in different age groups make and the duration of infectiousness of the virus
to reproduce the epidemic trajectory that has been observed. Then modelers introduce
assumptions about the impact of interventions, for example, the number of social contacts
that occur when social distancing measures are in place and re-run the model with these
hypothetical parameters to determine what effect these changes will have. Over the past
several months, multiple modeling teams have developed these kinds of models, and while
they often obtain different results depending on various differences in the assumptions
made, all show that reducing the number of social contacts, especially in the presence of
asymptomatic infection, will “flatten” or reduce the epidemic curve. For example, one such
model, reported in Emerging Infectious Diseases this week, investigated the effectiveness
of social distancing interventions in a mid-sized city. Modeled interventions included
reducing the number of contacts made by adults greater than 60 years of age, adults 20–59
years of age, and children under 19 years of age for six weeks. The modelers found that
these interventions delay or flatten the epidemic curve and that even modest reductions of
21

contacts could reduce the number of new cases and deaths by 20 percent. Notably,
however, when interventions ended, the epidemic rebounded [53].
34. The expected future trajectory of Covid-19 depends on a number of factors
including the level of “herd immunity” that has already been achieved by the circulating of
the infection, the extent of social mixing that occurs, and the possibility that SARS-CoV-
2 will be more transmissible in cooler, drier weather.
35. First, herd immunity is achieved when enough people in a population have
been infected and developed immunity so that the likelihood that an infectious person will
come into contact with a susceptible person is low. This concept is illustrated in the graphic
below. When an infectious person encounters only susceptible people, he or she can infect
all of them but when most of the people an infectious person encounters are immune,
relatively few people will be infected by that infectious case.
Table 4 Herd Immunity (From

https://www.technologyreview.com/2020/03/17/905244/what-is-herd-immunity-and-can-
it-stop-the-coronavirus/)
36. A general rule of thumb is that herd immunity can only be achieved when
the proportion of people in a population who are immune is equal to 1-(1/R0), where R0
22

refers to the basic reproductive number of an infectious disease. This term is defined as the
number of people who, on average, will be infected by a single infectious person in an
entirely susceptible population. The basic reproductive number of SARS-CoV-2 is
estimated between two and three, with an average of about 2.6. This means that about 60
percent of the population would need to be immune before we see Covid-19 cases level out
(in the absence of interventions such as social distancing). At present, it is unclear what
proportion of the US population is seropositive (in other words, has evidence of an immune
response to the infection), but no study conducted in the US to date has suggested that more
than 20-30 percent of any specific community is immune and most studies suggest that the
number is closer to 2-3 percent. A recent study from Spain, one of the countries that has
been most affected by the epidemic, found that only 2 percent of the population was
immune [30]. Therefore, it is highly unlikely that, short of a catastrophic increase in
circulating virus, herd immunity will be achieved by November 2020. Furthermore, the
lack of herd immunity is in part due to social distancing that has taken place to date and
this means that as a population, we remain highly vulnerable to epidemic spread.
37. Secondly, it is highly likely that with the relaxation of social distancing
measures and the end of “lock-down” the number of social contacts that people make will
increase and that, therefore, the incidence of infection will increase accordingly. There is
a linear relationship between the average number of social contacts individuals make and
the reproductive number of the infection; as social contacts increase, the incidence of
infection will increase proportionately.
23

38. Third, epidemic spread in the fall and winter could be driven by potential
worsening of the epidemic due to changes in temperature or humidity that may be
associated with higher viral stability with cooler and drier conditions, seasonal changes in
host immunity and/or changes in human behavior (e.g., spending more time indoors). In
the fall and winter, the outdoor air is colder, and the air is drier both indoors and out. For
influenza, laboratory experiments have shown that absolute humidity — the amount of
water vapor in the air — strongly affects viral transmission, with drier conditions being
more favorable [31]. Lab studies on SAR-CoV-1 have also confirmed that viruses are
stable for longer periods in cooler, drier environments [32]. However, multiple recent
studies have suggested that SARS-CoV-2 transmission is possible in many different
climates [33, 34].
39. Seasonal differences in transmission are also affected by differences in the
ways people congregate in different seasons. In the fall and winter, people tend to spend
more time indoors with less ventilation and less personal space than they do in the summer.
Schools have been identified as the sites of much transmission of respiratory viruses
including those that cause measles, chicken pox and influenza. [35, 36]. However, to date,
the role of children in the transmission of SARS-CoV-2 is not clear and the relevance of
the timing of school openings is not known. Finally, it is likely that host immunity is
affected by seasonal changes. One hypothesis has focused on melatonin which has some
immune effects and is modulated by the photoperiod [37], which varies seasonally.
Vitamin D levels have also been associated with improved human immune responses -
24

these levels depend in part on ultraviolet light exposure which is higher in summer. There
is strong evidence for the possible role of vitamin D supplementation in reducing the
incidence of acute respiratory infection, as documented in a meta-analysis of randomized
trials [38]. To summarize the evidence for seasonal trends in SARS-CoV-2, it is reasonable
to expect that, like other beta-coronaviruses (a family of viruses with shared genetic
characteristics), it may transmit somewhat more efficiently in fall and winter than summer.
Table 5 Possible Covid-19 scenarios [38]
25

40. These considerations have guided most of the modeling projections on the
expected future trajectory of SARS-CoV-2 spread. The Center for Infectious Disease
Research and Policy (CIDRAP) recently published a document where they drew lessons
from previous influenza pandemics to predict the future trajectory of Covid-19 [39]. They
summarize three different possible scenarios as illustrated in the above figure. In the first
scenario, the first spring wave of Covid-19 that is currently underway will be followed by
a series of repetitive smaller waves that occur through the summer and then consistently
over a one- to two-year period, gradually diminishing sometime in 2021. These waves
would be expected to vary geographically depending on what interventions are in place
and how and when they are relaxed. Depending on the height of the peaks, this could lead
to periodic re-implementation and interruption of social distancing measures over the next
one to two years.
41. In the second and most likely scenario, the current first wave of Covid-19
will be followed by a larger wave in the fall or winter of 2020 and one or more smaller
subsequent waves in 2021.
42. This pattern is what was seen with the 1918-19 influenza pandemic in which
a small wave began in March 1918 but transmission leveled off during the summer months.
This was followed by a much larger peak which occurred in the fall of 1918 and a third
peak which occurred during the winter and spring of 1919. The 1957-58 and 2009-2010
influenza pandemics followed a similar pattern, with a smaller spring wave followed by a
much larger fall wave [40]. Given the many similarities between how SARS-CoV-2 and
26

influenza are spread, it is expected that Covid-19 will behave in a similar way, and most
epidemiologists expect that incidence will increase in the fall and winter months of 2020-
2021.
43. In the third scenario proposed by the CIDRAP team, the first wave of Covid-
19 in spring 2020 would be followed by persistent ongoing transmission and disease
incidence without a clear wave pattern. This third scenario might not lead to the
reinstitution of mitigation measures, although cases and deaths will continue to occur
especially in areas where risk factors for disease and death are common.
44. Whichever scenario the pandemic follows, it is highly likely that Covid-19
activity will continue for at least another 18 to 24 months, with hot spots arising
periodically in diverse geographic areas. In the period prior to the widespread use of an
effective vaccine, this spread will continue to lead to serious disease and death in at-risk
groups As the pandemic wanes, it is likely that SARS-CoV-2 will continue to circulate at
lower levels in the human population and will synchronize to a seasonal pattern with
diminished severity over time, as other coronaviruses, such as the beta-coronaviruses OC43
and HKU1, [41] and past pandemic influenza viruses have done.
27

45. I was asked to describe the Covid-19 situation in North Carolina.
Table 6 County-specific Covid-19 prevalence for North Carolina by May 21, 2020. (from
https://covid19.ncdhhs.gov/)
46. To assess the risk of serious disease given a Covid-19 infection, we can turn
to the existing data on the prevalence of specific risk factors in the state. The CDC has
documented that 33 percent of North Carolinians are obese and an additional 35 percent
are overweight; 35 percent have a diagnosis of high blood pressure and 13.1 percent have
diagnosed diabetes mellitus [45, 46, 47]. 16.3 percent of the state’s population is 65 years
old or over [48]. It is useful to compare the prevalence of different co-morbidities
associated with poor outcomes in North Carolina to other states. The figures below give
county-level rates of hospitalizations for coronary heart disease and hypertension
demonstrating that North Carolina has comparatively high rates of these diseases and the
age distribution of the population.
47. It is useful to compare the prevalence of different co-morbidities associated
with poor outcomes in North Carolina to other states. The figures below give county-level
rates of hospitalizations for coronary heart disease and hypertension demonstrating that
28

North Carolina has comparatively high rates of these diseases and the age distribution of
the population.
Table 7. Rates of hypertension and Coronary Heart Disease Nationally. From

(https://www.medrxiv.org/content/10.1101/2020.04.08.20058248v1)
48. The Kaiser Family Foundation has developed a method to estimate the
proportion of a state’s population at elevated risk for serious Covid-19 illness [49]. Using
data from the CDC’s 2018 Behavioral Risk Factor Surveillance System (BRFSS), they
estimated the total number of at-risk adults by state—based on the revised definition from
the CDC—of adults who are at higher risk of serious illness if they get infected with
coronavirus. The relevant factors include ages 65 or older, heart disease, chronic
obstructive pulmonary disease (COPD), uncontrolled asthma, diabetes, or a BMI greater
than 40. Based on this analysis, 39% of adults over age 18 in North Carolina are at risk for
serious disease with older adults making up 54.2% of those at high risk.
29

Table 8 CCVI Score components [48]
49. In another nation-wide assessment of risk, the Surgo Foundation has
developed a Covid-19 community vulnerability index (the CCVI) to identify communities
at especially high risk of being affected by Covid-19 [50]. The CCVI combines indicators
specific to Covid-19 with the CDC’s social vulnerability index, which measures the
expected negative impact of any type of disaster. The indicators are based on the themes
listed below.
50. On this scale, North Carolina scored a 98 out of 100 with 100 being the most
vulnerable. It ranked second among the states on this measure, mostly because its high
(poor) score in the area of healthcare system factors. These data suggest that in the event
of further spread of Covid-19, North Carolina may experience higher levels of disease,
disability and death than other states experiencing the same amount of transmission.
51. I was asked if herd immunity, progress in vaccine development or the
development of drugs to treat Covid-19 will alter the expected course of the Covid-19
30

pandemic in the United States and specifically North Carolina. To date, the proportion
of the population that is likely to be immune is far less than that that required to achieve
herd immunity. This is unlikely to change significantly before November. Although recent
studies of the temporal trajectories of the appearance of SARS-CoV-2 antibodies show that
most people who are infected with the virus do develop an antibody-mediated immune
response, it is not yet clear whether this response is adequate to protect people from future
infection or for how long it might be protective. Other coronaviruses, such as those that
cause colds, are known to provide protection for periods of approximately one year and
this experience has led most Covid-19 experts to accept the “educated guess” that after
being infected with SARS-CoV-2, most individuals will have an immune response which
will offer some protection over the medium term — at least a year — and then its
effectiveness might decline. Until there is empirical evidence of how well-protected
previously infected people are in the future, there is no way to confirm or deny the existence
of long-term immunity.
52. An effective vaccine is extremely unlikely to have been developed, tested
and widely distributed before November. Vaccine development has proceeded at an
unprecedented pace. More than 110 candidate vaccines are under development. A number
of companies and research teams already have candidate vaccines that are either in human
trials (eight have started) or close to ready to trial in humans. The most advanced of these
seems to be the ChAdOx1 nCoV-19 vaccine being developed by a group in Oxford,
England. The speed with which these vaccines are being developed is partly due to the fact
31

that a great deal of work was done on a SARS-CoV-1 vaccine after the 2002 epidemic and
some of that work can be applied to this organism.
53. Despite this extraordinarily rapid progress, it is important to realize that the
usual time frame from development to widespread use of a vaccine is over ten years. New
vaccines require a complex set of trials to establish safety, immunogenicity, optimal
dosing, etc. Phase 1 trials are usually conducted in small groups of healthy volunteers and
are designed to establish whether serious adverse effects occur with escalating doses of the
agent and whether the vaccine produces the expected immune response. Phase 2 trials are
designed to replicate Phase 1 results in a more diverse population of volunteers, to assess
whether the expected immune response is generated, and to test different vaccine
schedules. Once safety, immunogenicity and optimal dosing are established, Phase 3
studies are conducted to determine vaccine efficacy. Phase 3 studies are usually much
larger than phase 1 or 2 studies and are conducted in people at risk for the infection in
question. So the time frame of these trials depends on the actual incidence of infection and
is expected to be shorter in regions with very high rates of disease. The completion of all
three steps is required for a vaccine to be approved by the FDA. Once a vaccine is
approved, it must then be manufactured at a scale that will provide adequate coverage for
a large population.
54. The White House has recently announced an initiative, “Operation Warp
Speed,” to expedite the development of a vaccine that will be available to the US
population. Although many scientists question the timeline proposed by the project, the
32

goal is to speed up the development and production of a vaccine so that 100 million doses
are available in November of 2020 and the remaining 200 million doses needed to
vaccinate the US population are ready by early 2021. Thus, even in the most optimistic
scenario, it is highly unlikely that a vaccine will have been distributed and had time to
induce an immune response in a significant number of Americans by November 3, 2020.
55. Although new and repurposed drugs are being tested and some may be found
to be helpful in treating severe Covid-19, this is unlikely to have a major impact on the
transmission of the virus and the risk of severe disease or death by November 2020. A
number of antiviral drugs are currently being developed and other existing drugs are being
“repurposed” as potential therapies for Covid-19. The hope is that these drugs will reduce
the rate of death and severe disease in people who are treated with them. As of mid-April,
the FDA website had listed 72 active and 211 planned Covid-19 drug trials and almost
1000 drug-development proposals have been submitted to the agency. To date, only
Remdesivir has been shown in a major, randomized control trial to reduce the duration of
illness in Covid-19 patients. In that study, Remdesivir reduced the median time to recovery
in hospitalized patients with advanced Covid-19 disease and lung involvement from 15
days for those who received placebo to 11 days for patients treated with Remdesivir [51].
The researchers also noted a survival benefit (which was not “statistically significant”) with
the Remdesivir group experiencing an 8.0 percent mortality rate compared to 11.6 percent
for the placebo group. This suggests that even with the approval of the drugs that have been
33

found to be effective in clinical trials, people with severe Covid-19 are at risk for death as
well as the long-term effects of lung damage and other sequelae of infection detailed above.
I declare under penalty of perjury that the foregoing is true and correct.
Executed this 2nd day of June, 2020.
Megan Murray, MD, MPH, ScD
34

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38

Harvard Medical School/Harvard School of Dental Medicine
Curriculum Vitae
Date May 2020

Prepared:
Name: MEGAN MURRAY
Office Harvard Medical School
Address:
641 Huntington Avenue, 4A07
Boston, MA 02115
Home 21 Prince Street
Address:
Cambridge, MA 02139
Work Phone: (617) 432-2781
Work Email: megan_murray@hms.harvard.edu
Work FAX: (617) 432-2565
Place of Birth: Minnesota
Education
1980 AB Philosophy Dartmouth College,

Magna cum laude Dartmouth, NH
1990 MD Medicine Harvard Medical School,

Boston, MA
1997 MPH Public Health Harvard School of Public

Health, Boston, MA
2001 ScD Epidemiology (James Robins) Harvard School of Public

Health, Boston, MA
Postdoctoral Training
1990-1991 Internship Internal Medicine Massachusetts General

Hospital, Harvard Medical
School, Boston, MA
1991-1993 Residency Internal Medicine Massachusetts General

School, Boston, MA
39

1993-1997 Fellowship Infectious Disease Massachusetts General
School, Boston, MA
Faculty Academic Appointments
1997-2006 Instructor in Medicine Medicine Harvard Medical School
1999-2000 Research Associate Epidemiology Harvard School of Public

Health
2001-2007 Assistant Professor Epidemiology Harvard School of Public

Health
2004- Associate Broad Institute,

Cambridge, MA
2006-2009 Assistant Professor Medicine Harvard Medical School
2007-2013 Associate Professor Epidemiology Harvard School of Public

Health
2009-2012 Associate Professor Medicine Harvard Medical School
2012- Professor Global Health and Social Harvard Medical School

Medicine
2013- Professor Epidemiology Harvard T.H. Chan School

of Public Health
2017- Ronda Stryker and Global Health and Social Harvard Medical School
William Johnston Medicine
Professor of Global
Health
Appointments at Hospitals/Affiliated Institutions
01/98-09/02 Clinical Assistant in Dept. of Internal Medicine Massachusetts General

Medicine Hospital
09/02-09/06 Assistant in Medicine Dept. of Internal Medicine Massachusetts General

Hospital
40

09/06-02/08 Assistant Physician Dept. of Internal Medicine Massachusetts General
Hospital
02/08-09/10 Consultant (Medicine Dept. of Internal Medicine Massachusetts General

Services) Hospital
41

Other Professional Positions
Year Position Title Institution Level of effort

1980-1984 Refugee Camp Coordinator Intergovernmental Committee for
Migration, Phanat Nikhom, Thailand
1984 Public Health Educator Matanyok Rural Training Project,

Rift Valley, Kenya
2004- Research Director Partners In Health, Boston 36 days per year
Major Administrative Leadership Positions

Local
2007- Director of Research Division of Global Health Equity, Brigham
and Women’s Hospital and Partners In
Health, Boston, MA
2010- Director Research Core, Department of Global
Health and Social Medicine, Harvard
Medical School, Boston, MA
2012-2013 Member Executive Leadership Team, Global Health
Delivery Partnership, Harvard Medical
School, Brigham and Women’s Hospital
and Partners In Health, Boston, MA
Committee Service
Local
1986-1990 Curriculum Committee Harvard Medical School
Member
2001- Infectious Disease-Epidemiology Graduate Harvard School of Public Health

Admissions Committee Member
2003-2005 Faculty Council Harvard School of Public Health

Member
2004- Steering Committee for the Residency in Brigham and Women’s Hospital
Global Health Member
2005- Human Subjects Committee Harvard School of Public Health

Member
2005 Task Force on Women in Sciences and Harvard University, Cambridge, MA

Engineering Member
42

2006 President’s Task Force on Avian Influenza Harvard University
Member
2006 Search Committee for Dean of Educational Harvard School of Public Health
Programs Member
2007 Epidemiology Curriculum Committee Harvard School of Public Health

Member
2007 Search Committee for Compliance Officer Harvard School of Public Health
Member
2007 Search Committee for Assistant Professor in Brigham and Women’s Hospital
the Division of Social Medicine and Health Member
Inequalities
2008 Search Committee for Assistant Professor in Harvard School of Public Health
Infectious Disease Epidemiology Member
2009 Search Committee for Assistant Professor in Harvard School of Public Health
Infectious Disease Epidemiology Chair
2010 Global Health Epidemiology Committee Harvard School of Public Health

Member
2010-2011 Strategic Leadership Team Brigham and Women’s Hospital

Member (Co-Chair Community
Engagement Mission Area)
2012 Ad Hoc Committee to Evaluate Professorial Harvard Medical School

Candidate Member
2012-2016 Professor of Population Medicine Search Harvard Pilgrim Health Care Institute
Committee Member
2012 Ad Hoc Evaluation of Professorial Harvard Medical School

Appointment Committee Member
2012 Global Health Instructor Search Committee Harvard Medical School

Co-chair
2014-2016 Pershing Square Professorship in Global Harvard Medical School

Health Search Committee Chair
2015 Search Committee for Professor of Harvard Medical School

Biomedical Informatics Member
43

2016- Department of Biomedical Informatics Harvard Medical School
Executive Committee Member
2016- Committee on Promotions, Reappointments, Harvard Medical School

and Appointments (P&R) Member
2018-2019 Dean’s Innovation Grants Review Harvard Medical School

Committee Member
2018-2019 Therapeutics Planning Foundry Committee Harvard Medical School

Member
2019- Center for Computational Biomedicine Harvard Medical School

(CCB) Advisory Committee Member
2019- Faculty Council Harvard Medical School/Harvard School of

Dental Medicine
Member
2020- Ariadne Spark Grant Review Committee Harvard Medical School

Member
2020- Massachusetts Consortium on Pathogen Harvard Medical School

Readiness (MassCPR) Working Group on Co-Lead
Epidemiology
National and International

2005-2007 Committee on Infectious Diseases among Institute of Medicine, Washington, DC
Gulf War Veterans Member
2006-2010 IHR Roster of Experts in Modeling World Health Organization, Geneva,

Analytical Epidemiology Switzerland
2007-2009 Global Task on XDR Tuberculosis World Health Organization
2007 External Review Committee for TB Program Montreal Chest Institute, McGill University
Montreal, Canada
Member
2008-2011 STAG (Strategic and technical advisory World Health Organization

group) TB Member
44

2008 39th Union World Conference 2008 International Union TB and Lung Disease
Drug Resistance /MDR-TB management II Paris, France, Coordinator
2009 Panel to Review the DST/NRF Centre of National Research Foundation, Pretoria,
Excellence for Biomedical TB Research South Africa, Convener
2009-2010 Expert Panel on Tuberculosis and Diabetes Union of TB and Lung Disease and World
Diabetes Federation
Member
2010-2015 Advisory Group to Fogarty Grant Member

Public Health Research Institute
New Jersey
2010- Working Group on New Diagnostics Member,

Stop TB Partnership
Geneva, Switzerland
2013-2014 Millennium Villages Project Independent Member

Expert Group Meetings Earth Institute, Columbia University
Millennium Development Goals Centre
West and Central Africa
Dakar, Senegal
2013-2014 External Advisory Committee on Member

Tuberculosis Gates Foundation
New York City, NY
2016- Critical Path to TB Drug Regimens (CPTR) Member

Initiative
Professional Societies
1995- Infectious Disease Society of America Member
1997- Society for Epidemiologic Research Member
2007- International Union of TB and Lung Member

Disease
2007- Global Health Council Member
2009- American Society for Tropical Medicine Member
45

Grant Review Activities
2004 Fogarty International Center/NIH Study NIH, Bethesda, MD
Section ZRG1 ICP-3(03) Member
2005 Improving Tuberculosis Control in Africa; Wellcome Trust Review

Mathematical Modeling of Intervention London, England
Trials Member
2008 Postdoctoral Program Review for Royal Netherlands Academy of Arts and
Indonesian PhDs Sciences (KNAW), Amsterdam, Holland
Referee
2008 Center for AIDS Research Scholar and Harvard School of Public Health
Feasibility Scientific Reviewer Committee Member
2009, 2010 Center for Scientific Review/NIH study NIH

section l ZRG1 IDM-P 50 R Ad hoc Member
2009-2016 Center for Scientific Review/NIH Study NIH

Section on Clinical Research and Field Permanent Member
Studies of Infectious Diseases (CRFS)
2009 Wellcome Trust Ad hoc Reviewer

London, England
2010 National Science Foundation Ad hoc Reviewer

South Africa
2012 Center for Scientific Review/NIH Study NIH

Section ZRG1 AARR-K (52) Ad-hoc Member
Section ZRG1 IMST-K (50)S Ad-hoc Member
Section ZAI1 LG-M (M1) Ad-hoc Member
NIAID Clinical Trial Implementation
Cooperative Agreement (U01/R01)
2018 Center for Scientific Review/NIH Clinical NIH

Research and Field Studies of Infectious Ad-hoc Member
Diseases [CRFS] Study Section ZRG1 IDM-R
(02)
46

Section ZRG1 IDM-R (50) Ad-hoc Member
Editorial Activities
Ad hoc Reviewer
Science
Nature Medicine
New England Journal Medicine
Lancet
Lancet Infectious Diseases
Lancet Pulmonary Medicine
Epidemiology
American Journal of Epidemiology
International Journal of Tuberculosis and Lung Diseases
British Medical Journal
British Medical Journal, Global Health
Emerging Infectious Diseases
PLoS Medicine
PLoS Pathogens
PLoS One
Scandinavian Journal of Infectious Disease
Journal of the American Medical Association
American Journal Respiratory and Critical Care Medicine
Journal of Clinical Microbiology
Antimicrobial Agents and Chemotherapy
PNAS (Proceedings of the National Academy of Sciences)
Bulletin of the World Health Organization
Clinical Infectious Disease
Journal Infectious Disease
Annals of Internal Medicine
American Journal of Tropical Medicine and Hygiene
Royal Society Proceedings B
BMC Medicine
BMC Genomics
BMC Public Health
BMC Biology
BMC Health Services
Interface
Epidemics
Royal Society Open Science
47

mBio
Other Editorial Roles

2004- Member of Editorial Board European Journal of Epidemiology
2005-2012 Associate Editor International Journal of TB and Lung

Disease
2009- Associate Editor PLOS Medicine
Honors and Prizes

1980 Dartmouth General Dartmouth College
Fellowship
1990 Aesculupian Society Harvard Medical School
1990 Paul Dudley White Harvard Medical School

Fellowship
1996 Howard Hughes Post- Howard Hughes Medical

Doctoral Research Institute
Fellowship
1997 Tapplin Fellowship Award Harvard School of Public

Health
2001 Teaching Award School of Public Health,

Boston University
2002 Teaching Award Harvard School of Public

Health
2004 Ellison Senior Scholar Ellison Medical Foundation
2008 Recognition Award Harvard School of Public

Health
2010 Nominated for Mentorship Harvard Medical School

Award
2010-11 Landolt Chair Ecole Polytechnique

Federale de Lausanne
Report of Funded and Unfunded Projects

48

Funding Information
Past
1997-2003 Molecular epidemiology of tuberculosis

NIH/NIAID 1K08AI001430-01
PI
This study explored the use of molecular epidemiologic data for epidemiologic inference
and evolutionary studies of M. tuberculosis.
2000-2003 Population-based investigations of tuberculosis

NIH R01AI046669
Co-investigator
In this project, population-based genetic studies of human specimens were used to
determine the clinical consequences of mutations in genes associated with bacterial
antibiotic resistance and virulence.
2002-2005 Transmissibility and fitness of drug-resistant TB, Sverdlovsk

WHO T9-181-270
PI
This project assessed epidemiologic risk factors for TB drug resistance, identified locally
prevalent drug-resistance profiles, used molecular epidemiological analyses to measure
association between clustering and specific drug-resistance mutations, and assessed
demographic distribution of drug resistance in prison and local community, evaluating
extent of transmission between the two groups.
2003-2005 INH resistance in Beijing/W Isolates of M. tuberculosis

NIH R21 AI055800
Co-investigator
This project sought to identify risk factors associated with Isoniazid resistance which may
be pathogen and/or host- specific and which may lead to acquisition of MDR-TB, after
controlling for compliance.
2003-2005 Decision analysis for TB control

Bill Melinda Gates Foundation
Co-investigator
This project developed a decision-analytic model that could be used with data from
different countries to assess the potential benefits, costs, and cost-effectiveness of the full
range of policy options for dealing with MDR-TB, including preventive therapy, active
case finding, diagnostic testing and treatment.
2004-2009 Curriculum in Emerging Infectious Diseases

NIH/NIGMS K073000-04
PI ($363,933)
49

This project aimed to develop and implement a core course in transmission dynamics of
emerging infectious diseases, taking an interdisciplinary approach that incorporates case-
based seminars and short courses.
2005-2007 Evaluation of a community based HIV-TB adherence support program in a government

ARV-rollout site in KwaZulu-Natal, South Africa
Harvard University Center for AIDS Research
Co-investigator
This study evaluated the feasibility of community-based adherence support program
designed to improve HIV/AIDS and TB outcomes among a cohort of HIV patients in a
government ARV treatment program.
2006-2007 Ferroportin Polymorphisms and Tuberculosis Susceptibility

William F. Milton Fund/Harvard Medical School
PI
This study assessed the association between Ferroportin (FPN1) mutations, iron intake and
TB susceptibility in South Africa.
2006-2010 Macrophage Iron Metabolism and Tuberculosis Infection

NIH/NIAID R21 AI068077-01
PI ($271,375)
We elucidated the role of host macrophage iron status on the growth of M. tuberculosis
and explored the impact of iron and ferroportin status on cellular immune function.
2006-2011 Epidemiology of Multidrug-Resistant Tuberculosis in Peru

NIH/NIAID R01 A1057786-01A2
Co-investigator
The goal of this project is to provide new knowledge about the transmission dynamics of
multidrug-resistant tuberculosis in a high TB-burden area in Peru and will measure within-
household transmission of various strains of TB, assess the impact of socio-demographic
and clinical confounders and risk modifiers, and measure associations between specific
resistance mutations and phenotypes.
2007-2009 A Postmortem Study of the Burden of MDR and XDR Tuberculosis Among Adult
Inpatient in KZN Deaths Occurring at Edendale Hospital Kwazulu-Natal South Africa
Massachusetts General Hospital
PI ($60,050)
This study estimated the burden of tuberculosis among seriously ill individuals in KZN and
measured the proportion of TB among these patients which is drug-resistant by conducting
postmortem tests at Edendale Hospital KZN.
2007-2014 Epidemiology and Transmission Dynamics of MDR/XDR Tuberculosis

NIH/NIAID U19 A1076217
PI ($13,422,751)
We conducted a series of linked interdisciplinary research projects focused on the
emergence and transmission of multidrug and extensively drug resistant TB: a cohort
50

study of host and microbial factors associated with MDR and XDR TB in Lima, Peru; a
study characterizing M. tuberculosis strain diversity and its contribution to the emergence
and spread of MDR; and a study using epidemic and individual predictive models to
support public health policy and clinical decision-making for MDR and XDR TB.
2009 Systematic Reviews of Diabetes and Tuberculosis Interactions

PI ($25,000)
International Union of TB and Lung Disease
We evaluated the links between TB and diabetes by conducting a series of systematic
reviews and meta-analyses.
2009-2012 Bioaerosols Production and Influenza Study

Pulmatrix Inc.
PI ($348,393)
The project measured the particle production in persons diagnosed with active influenza,
measured the quantity and size distribution of influenza virus particles generated and
exhaled by persons infected with influenza during normal tidal breathing, and measured
the secondary attack rate of influenza within their households.
2009-2013 Treat TB: Technology, Research, Education and Technical Assistance for TB
USAID (subcontract through International Union against TB and Lung Disease)
Co-investigator
The subproject aims were to develop a modeling tool to assist national policy-makers in
selecting the appropriate tests and strategies for the diagnosis of tuberculosis in specific
types of epidemiological settings, with an emphasis on low- and middle-income countries,
taking into account a variety of modifying factors including drug resistance and HIV.
2009-2014 Strengthening and Studying Community Based Integrated Primary Health Care Systems in
Rural Rwanda
Doris Duke Foundation
Co-investigator
The PHIT Partnership strengthened integrated primary health care delivery in Rwanda. The
Partnership deployed a care-based intervention, conduct implementation research to
generate data for ongoing monitoring, evaluation, and quality improvement of the
intervention.
2009-2014 MIDAS Center for Communicable Disease Dynamics

NIH/NIGMS U54 GM088558-01
Co-investigator
This project advanced the quantitative study of communicable diseases through
training/education, transdisciplinary research, and public health policy and will develop
statistical and novel modeling methods, train mathematical modelers, perform outreach,
and develop software for the analysis of communicable disease data.
2012-2013 Identification of GyrA/B Mutations that Predict Fluoroquinolone Resistant TB

51

Harvard University Center for AIDS Research
Co-investigator
This project evaluated the correlation between newly-developed molecular genetic
probes that can detect mutations in the gryA and gryB genes of tuberculosis which may
render them more resistant to first and later generation quinolones.
2013-2014 African Health Facility Capacity to Roll Out Technological Interventions

Gates Foundation
PI ($17,232)
This project summarized the following outcomes across Rwanda health facilities: the
percent and number of health facilities with electricity currently; estimate percent of
health clinics with electricity within five years; percent and number of facilities with rapid
HIV testing available; and the distribution of HIV testing staffing.
Current
2014-2020 Integrated discovery and development of innovative TB Diagnostics

NIH/NIAID CETR U19AI109755
PI ($29,218,333)
This multi-disciplinary collaboration is designed to enable the discovery of new
biomarkers of Mycobacterium tuberculosis drug resistance, identify optimal clinical
sampling strategies directed toward detection of Mtb DNA and develop and test a
sensitive micro-array based rapid diagnostic. Our long-term goal is to develop a diagnostic
strategy that will improve the diagnosis of childhood and DR TB and stem the further
spread of the disease. This grant is in a no cost extension phase.
2015-2022 Metabolic Factors that Control the Spectrum of Human Tuberculosis

NIH/NIAID TBRU U19AI111224
Co-PI ($19,815,180)
This consortium project focuses on the link between host immune and metabolic factors
and their impact on progression and persistence of tuberculosis. Teams focusing on
human subjects, bio-informatics, and metabolomics work in parallel to identify targets
including pathways linking human metabolism and immune response, T cells involved in
Mtb response, pathogen determinants of drug resistance and pathogen-shed markers of
clinical TB phenotypes. Each project includes validation of these targets in the guinea pig
model.
2018- Metabolic Factors that Control the Spectrum of Human Tuberculosis

NIH/NIAID TBRU U19AI111224-04 Supplement
Co-PI ($200,000)
This supplement to the TBRU consortium project is a new collaborative, multi-disciplinary
effort that conducted a genome-to-genome approach aimed at the identification of
52

interacting molecular patterns in Mtb and the human host. The same approach and new
methods will be adaptable and easily applicable to other populations being studied within
the TBRU program.
2019-2024 Bacterial Determinants of Treatment Response in Mycobacteria Tuberculosis

NIH/NIAID U19AI142793-01
PI ($14,633,712)
This study will focus on the discovery of the genetic determinants of drug tolerance and
resistance in mycobacteria tuberculosis both through mechanistic bench studies and
through a genome wide association study of treatment failure in TB patients.
2019-2021 Randomised trial of an intervention to increase tuberculosis notifications by private

practitioners in Indonesia, plus sequencing and susceptibility sub studies
CRDF Global u/d USDA (59-0210-06-004) DAA3-19-64909-2
United States Research Leader ($99,917)
This study will evaluate whether a tailored intervention package increases notifications of
tuberculosis (TB) by private practitioners in Bandung, Indonesia.
2020-2023 Are TB neighbourhoods a high risk population for active intervention?

CRDF Global u/d NIAID
United States Research Leader ($99,999)
This study will confirm whether neighborhoods around known, routinely diagnosed TB
index cases are high risk sub-populations which may warrant active intervention to
enhance TB control.
Unfunded Projects
2003 Transmission dynamics of SARS (Co-leader)

I co-led a team that developed a mathematical model of the transmission dynamics of
SARS. (Lipsitch et al. Science 2003)
2005-2011 TB Genome Project (Collaborator)

Whole genome sequencing of sets of drug resistant M. tuberculosis isolates.
I led a collaboration with the Broad Institute to identify, sequence and analyze
progressively resistant isolates of M. tuberculosis to identify drug resistance mutations and
to characterize compensatory or enabling mutations. We currently have one manuscript
under review and several in preparation.
2006 Cost-effectiveness of testing the blood supply for West Nile Virus (Supervisor)
I supervised a doctoral student in the development of a combined transmission/cost-
effectiveness model on West Nile Virus. (Korves et al. PLoS Med 2006; Korves et al. Clin
Infect Dis 2006)
53

2006-2010 Determinants of tuberculosis (Advisor)
I supervised two doctoral students to carry out epidemiologic studies and meta-analyses of
the associations between determinants (smoking and diabetes mellitus) and tuberculosis
and to use the parameters thus obtained to construct mathematical models assessing the
impact interventions directed at these determinants. (Jeon et al. PLoS Med 2008; Jeon et al,
Trop Med and Int Health 2010; Lin et al. Lancet 2008; Lin et al. Am J Respir Crit Care
Med 2009, Murray M et al, IJTLD 2010, Baker M et al. BMC Medicine 2011, Lin et al.
IJTLD 2011). I supervised Dr. Olivia Oxlade on work that is a further extension of this
project.
2007-2009 Timing of ART in patients co-infected with HIV and TB in Rwanda: an observational
approach (Initiator)
I initiated this project and supervised a doctoral student in the collection and analysis of the
data. This work led to a paper published in PLoS Medicine (Franke M et al. PLoS Med
2011).
2007-2009 Metabolic modeling of M. tuberculosis (Collaborator)

I collaborated with a team of bio-informaticists on a project to fit a metabolic flux model to
M. tuberculosis expression data to mycolic acid production. (Colijn et al. PLoS
Computational Biology, 2009)
2008-2009 Structural analysis of M. tuberculosis “resistome” (Collaborator)

I collaborated with George Church on a project to define the structural basis of drug
resistance in M. tuberculosis using sequence data. We published one paper together
(Sandgren et al. PLoS Med 2009).
2008-2010 M. tuberculosis isoniazid and quinolone mono-resistance in South Africa (Mentor)

I supervised two trainees who are investigating the frequency and outcomes of mono-
resistance in M. tuberculosis in South Africa. We published two papers in this area. (Jeon
C et al, 2010, Jacobson K et al, 2011).
2008-2010 ART Outcomes in Rwanda for 1000 HIV patients (Co-investigator)

I provided technical support and supervised the data collection and analysis team. We have
published a paper on this topic (Rich et al, 2011).
2009-2010 Within host dynamics of TB and the evolution of drug resistance. (Initiator)
I collaborated with my former trainees, Ted Cohen and Caroline Colijn, on a project to
model the within-host evolution of drug resistance (Colijn C et al, PLoS One, 2011).
2009-2011 Sex trafficking and HIV transmission in India (Advisor)

I supervised a doctoral student in the analysis of data and construction of a mathematical
model of HIV transmission among trafficked sex workers in India. We published several
papers together.
54

2010-2012 Cholera transmission in the Democratic Republic of the Congo and Haiti. (Collaborator
and Adviser). I worked with a team including hydraulogists and infectious disease
modelers on the transmission routes by which cholera spreads. We published three papers
(Rinaldo et al, Proc Natl Acad Sci, 2012; Bompangue et al, PLoS Curr 2012; Bompangue
et al, Lancet, 2012).
2012- Poverty traps in under-resourced settings (Collaborator)

I collaborate with Matthew Bonds on a range of studies to understand the role of infectious
diseases in creating poverty traps in Rwanda and other under-resourced settings.
2014-2015 MDR TB in India

I worked with a Fulbright fellow to assess the burden of MDR TB in India.
2013-2016 Ebola Diagnostics, Asymptomatic Infection and Modeling (Initiator and Collaborator)
I worked with the Partners in Health clinical teams in Sierra Leone to evaluate two point of
care diagnostic tests and supervised Gene Richardson in a study of asymptomatic Ebola
infections and Ibrahim Diakite on a study of dynamic modeling of Ebola vaccination
strategies.
2012- Impact of Health Research Capacity Building (Team Leader)

I lead a team focused on the implementation and assessment of Health Research Capacity
Building in Africa.
2014- Yaws epidemiology and impact of mass drug administration (Collaborator)

I work with my former student, Eric Mooring, on the evaluation of data collected during a
mass drug administration campaign in Papua, New Guinea.
2014- Health System Strengthening in Madagascar (Collaborator)

I work on developing methods to evaluate the impact of health system strengthening in
Madagascar and other implementation sites.
2018-2019 Investigation of Services delivered for TB by External care system – especially the Private
sector (INSTEP) (Collaborator)
I worked on quantitative measure of health seeking pathways and delays, diagnostic and
treatment behaviors of private providers and qualitative (or mixed methods) analysis of
provider behaviors and the reasons behind them as assessed via direct interviews.
Training Grants and Mentored Trainee Grants
1990-2011 Multidisciplinary AIDS Training Grant

NIH NIAID T32AI007387
Mentor (PI: Martin Hirsch)
55

The major goal was to provide in depth laboratory experience in a specific research area
of virology, immunology, molecular biology, oncology, epidemiology molecular genetics,
or molecular therapeutics to selected postdoctoral candidates.
1992-2022 Program for AIDS Clinical Research Training (PACRT)

NIH NIAID T32 AI007433
Mentor (PI: Kenneth Freedberg)
The major goal is to provide training in quantitative research methodologies with a focus
on HIV clinical research to pre-doctoral PhD students and physicians at formative stages
in their careers.
1998-2020 Epidemiology of Infectious Diseases

NIH NIAID T32 AI007535
Mentor (PI: George Seage)
The major goal is to increase the number of graduates who will be capable of drawing on
diverse tools – including sophisticated approaches to causal inference, transmission-
dynamic modeling, model fitting, population genomics and phylogenetics – in a
knowledgeable way to meet the infectious disease threats of a new generation.
2004-2009 Molecular Approaches for Understanding TB Dynamics

NIH NIAID K08 5K08AI055985
Co-Mentor to Ted Cohen
The major goal of this five-year training program K award focused on the development of
new analytic tools to evaluate molecular data from tuberculosis patients.
2009 AMSTH Postdoctoral Fellowship in Tropical Infectious Diseases

Mentor to Karen Jacobson
The major goal was to fund to conduct research focused on infectious diseases of low and
low-middle income countries.
2010-2013 Predicting the impact and cost-effectiveness of technical and non-technical approaches to
TB control in low and middle income countries
CIHR (Canadian Institute for Health Research) Fellowship MFE106987
Mentor to Olivia Oxlade
The goal was to predict, in 3 low and middle income countries, the epidemiologic impact
and cost effectiveness of a technical approach to TB control (using improved diagnostic
tests for earlier diagnosis of active TB disease) versus a non-technical population level
intervention designed to reduce tobacco use and alcohol consumption.
2010-2014 The Economic Impacts of Community-Based Integrated Health Care Systems in Rural
Rwanda
NIH Fogarty K01 TW008773
Mentor to Matthew Bonds
56

The major goal of this K award was to measure the specific economic consequences of
expanded community-based integrated primary healthcare in Rwanda by measuring the
partial effects of malnutrition, disease, schooling and socioeconomic status on each
other.
2011 Modifiable risk factors for tuberculosis disease in children

Parker B. Francis Fellowship in Pulmonary Research
Mentor to Molly Franke
The major goal was to identify modifiable risk factors for TB in children.
2011-2016 Geospatial Clustering and Molecular and Social Epidemiology of Drug Resistant TB
NIH Fogarty K01 5K01TW009213
Co-Mentor to Karen Jacobson
The major goal of this K award was to estimate the burden of drug resistant TB and assess
the heterogeneity of disease burden in different geographic locations, to examine the
association of host risk factors and population determinants with regions of high drug
resistant TB burden, and to describe the spatial and molecular clustering of strains of drug
resistant TB in this province. My role was to mentor Karen Jacobson in research in
molecular and social epidemiology of TB.
2012-2013 US-Italy Fulbright Scholarship

Mentor to Anna Odone
2012-2016 The Role of Development Assistance for Health in Reducing Child Mortality
NIH NICHD 4K01HD071929-05
Epidemiology mentor to Chunling Lu
The major goal of this K award was to obtain background knowledge of epidemiology so
as to understand the disease profiles of under-five children of different age groups in
developing countries.
2013-2014 Controlling Drug Resistant Tuberculosis (TB): A Review of Literature and an Attempt for
Designing Innovative Approaches in Indian Setting
Core Fulbright Visiting Scholar Research Grant
Mentor to Sachin Atre
2013-2015 Gene Mutations and Tuberculosis Resistance

American Lung Association Research Award
Mentor to Maha Farhat
The major goal was to investigate the genetic sequences of known and candidate
resistant genes for a large panel of TB drugs, to determine which mutations predict the
extent of resistance, and if specific combinations of mutations interact to affect this
resistance level. The information will be used to guide the development of a much
needed rapid diagnostic test for drug resistant TB.
57

2014 Genetic determinants of drug resistance in mycobacterium tuberculosis
Parker B. Francis Fellowship in Pulmonary Research
Mentor to Maha Farhat
The major goal was to investigate the genetic sequences of known and candidate
resistance genes for a large panel of TB drugs to determine which mutations predict the
extent of resistance and use this information to guide the development of improved
diagnostic tests for resistance.
2014-2017 Integrating Pediatric Care Delivery in Rural Healthcare Systems

NIH NICHD 5DP5OD019894
Mentor (PI: Duncan Maru)
The major goal was to increase the timely engagement in acute care for children to
receive evidence-based World Health Organization protocols aimed at reducing child
mortality and to implement a Chronic Care Model for pediatric patients under the age of
twenty suffering from a chronic disease.
2014-2019 Infectious Disease and Basic Microbiological Mechanisms

NIH NIAID T32 2T32AI007061
Mentor (PI: Marcia Goldberg)
The major goal is to train scientists who have a career goal of solving medically relevant
problems and who elect rigorous laboratory or epidemiologic training in any of the
Harvard adult infectious disease programs or other Harvard-based institutions
participating in this program.
2015-2017 New Tools for the Interpretation of Pathogen Genomic Data with a Focus on
Mycobacterium Tuberculosis
NIH Fogarty K01 5K01ES026835
Principal Mentor to Maha Farhat
The major goal of this K award was to develop a web-based public interface to several
analysis tools, to develop and study an MTB gene-gene network, and to study the
performance of methods in current use for the association of genotype and phenotype in
pathogens, and develop a generalizable power calculator for the best performing
method.
2016-2017 Genetic Determinants of Drug Resistance in Mycobacterium Tuberculosis

NIH URM Supplement U19AI109755-03S1
PI & Mentor to Ibrahim Diakite (Total direct costs $82,633)
The major goal of this supplement was to develop and validate a prediction model that
will define the optimal set of mutations to be assessed to improve the performance of
rapid molecular diagnostics.
Report of Local Teaching and Training

58

Teaching of Students in Courses
Boston University
1998-2001 SPH EB755: Infectious Disease Boston University School of Public Health
Epidemiology 2.5-hr sessions per week for 15 weeks
34 students of public health
Harvard School of Public Health
2001-2003 ID293: Inference in Infectious Disease Harvard School of Public Health

Epidemiology 4-hr sessions per week for 8 weeks
2001-2004 EPI225: Infectious Disease Dynamics Harvard School of Public Health

5 medical students, 50 students of public 4-hr sessions per week for 8 weeks
health
2002 ID267: Infectious Disease Harvard School of Public Health

Epidemiology Seminar 2-hr sessions per week for 16 weeks
2 medical students, 8 students of public
health
2002-2003 ID229: Epidemiology of Infectious Disease Harvard School of Public Health

Developing Countries 2-hr session
2002 EPI269: Epidemiological Research in Harvard School of Public Health

Obstetrics and Gynecology 1-hr session
30 advanced students of public health
2003-2006 IMI202: Tuberculosis Harvard School of Public Health

10 medical students, 10 students of public 2-hr sessions
health
2003-2004 ID287: Bioterrorism: Public Health Harvard School of Public Health

Preparedness and Response 1-hr session
2004-2007 EPI285: Infectious Disease Dynamics Harvard School of Public Health

50 graduate students of public health 5-hr per week for 16 weeks
2008-2015 EPI501: Dynamics of Infectious Diseases Harvard School of Public Health

50 graduate students of public health 4-hr sessions per week for 8 weeks
59

2008-2010 GHP539: The Social, Political and Harvard School of Public Health
Economic Dimensions of Infectious 2-hr session
Diseases in Developing Countries
20 medical and graduate students of public
health
2008 IMI 227: Genetics and Genomics of Harvard School of Public Health
Infectious Diseases: Tuberculosis, Malaria 2-hr session
25 graduate students of public health
2008-2015 ID269: Respiratory Epidemiology Harvard School of Public

18 medical and graduate students of public 2-hr sessions
health
2009-2011 IMI202: Tuberculosis the Host, the Harvard School of Public Health
Organism and the Global 2-hr session
2015, 2017, Epi225 Harvard School of Public Health

2019 Epidemiology of HIV 2-hr session
2016 - Epi502: Biology and Epidemiology of Harvard School of Public Health

Antibiotic Resistance 2-hr session
Harvard University/FAS
2004 FAS Freshman Seminar 24p: How Harvard College, Cambridge, MA
Epidemics Happen 3-hr sessions per week for 16 weeks
12 undergraduate students
2005-2006 FAS Freshman Seminar 25m: Epidemics as Harvard College

a Metaphor 2-hr sessions per week for 16 weeks
2006-2007 FAS Freshman Seminar 25m: What Harvard College

Epidemics Mean: Infectious Disease in a 2-hr sessions per week for 16 weeks
Social Context
Formal Teaching of Residents, Clinical Fellows and Research Fellows (post-docs)

2003 The Transmission Dynamics of M. Research Seminar
tuberculosis: Models and Molecular Department of Epidemiology
Epidemiology Harvard School of Public Health
60

One-hour lecture
2004 Transmission of TB in the Community Infectious Disease Society of America

Invited Lecture Boston, MA
One-hour lecture
2007 Genetic Heterogeneity in M. tuberculosis Department of Genetics and Complex

Diseases
One-hour lecture
Clinical Supervisory and Training Responsibilities

1996-2007 Attending and supervision of clinical Daily supervision for 6 weeks per year
infectious disease
fellows/Massachusetts General Hospital
Laboratory and Other Research Supervisory and Training Responsibilities

2002-2004 Supervision of Julia E. Aledort, doctoral Weekly mentorship for 18 months
research fellow/Harvard School of
Public Health
2002-2006 Supervision of Stephen Resch, doctoral Weekly mentorship for 18 months

research fellow/Harvard School of
Public Health
2004-2006 Supervision of Johanna Daily, Master's Monthly mentorship for 24 months

student /Harvard School of Public
Health
2007-2008 Supervision of Preetika Muthukrishnan, Weekly mentorship for 24 months

Master’s student/Harvard School of
Public Health
2009 Supervision of Daniel Pletzer, Daily laboratory mentorship for 3

Undergraduate intern/Upper Austria months
University of Applied Sciences,
Hagenberg, Austria
2010 Supervision of Matsie Mphahlele, Weekly mentorship for 3 months

doctoral candidate at Stellenbosch
University, Visiting Fogarty scholar
61

2010 Supervision of Laurence Laser, visiting Weekly mentorship for 9 months
Master’s student from Ecole
Polytechnique Federale de Lausanne
2018 Supervision of Junkun Ren, Master’s Mentorship for 3 months

student in epidemiology, Harvard T.H.
Chan School of Public Health
Formally Supervised Trainees and Faculty

1999-2004 Caroline Korves, ScD / Epidemiologist, Analysis Group, Inc.
I was Dr. Korves’s doctoral supervisor at the Harvard School of Public Health.
Published two research papers together, one in PLoS Medicine and Clinical Infectious
Disease.
2001-2006 Theodore Cohen, MD, MPH, DPH / Professor, Department of Epidemiology, School of
Public Health, Yale University
I was Dr. Cohen's DPH advisor at the Harvard School of Public Health and his primary
mentor on his NIH K08 grant. Published 36 research papers together, including one in
Science, one in Nature Medicine, and one in PNAS.
2003-2005 Anson Wright, MSc / WASH Advisor, Millennium Villages Project

I supervised Ms. Wright’s master’s thesis on preparedness for a Yersinia pestis
bioterrorism attack.
2004-2006 Kristina Wallengren, PhD, MPH / Executive Director and Founder, THINK (Tuberculosis
and HIV Investigative Network)
I was Dr. Wallengren's post-doctoral advisor at Harvard School of Public Health. We
published three papers together.
2004-2010 Molly Franke, ScD / Assistant Professor, Department of Global Health and Social
Medicine, Harvard Medical School
I was Dr. Franke's doctoral advisor at Harvard School of Public Health and continue to
mentor her in her role at HMS. We have published 18 research papers together.
2005-2010 Erin Johnson, PhD / Associate Professor, Department of Biology, John Carroll University
I was Dr. Johnson’s post-doctoral advisor at Harvard School of Public Health. Published
two papers together in FEMS Immunology and Medical Microbiology and Infection and
Immunity.
2005-2009 Hsien-Ho Lin, MD, MPH, ScD / Associate Professor in Epidemiology, Institute of
Epidemiology and Preventive Medicine, National Taiwan University College of Public
Health
62

I was Dr. Lin's advisor at Harvard School of Public Health. Published nine research papers
together, including in PLoS Medicine, the Lancet, and American Journal Respiratory
Critical Care Medicine.
2005-2011 Meghan Baker, MD / Instructor, Department of Population Medicine, Harvard Medical

School and Harvard Pilgrim Health Care Institute
I was Dr. Baker's advisor at the Harvard School of Public Health, Boston, MA. We have
published five papers together.
2006-2009 Andreas Sandgren, MSc, PhD / Deputy Head, ReAct Europe

I was Dr. Sandgren’s post-doctoral research advisor at Harvard School of Public Health.
We published three research papers together, including one in PLoS Medicine.
2006-2010 Christie Jeon, MSc, ScD / Assistant Professor, Cedars-Sinai Division of

Hematology/Oncology and Department of Epidemiology, UCLA Fielding School of Public
Health
I was Dr. Jeon’s doctoral advisor at the Harvard School of Public Health. We published
ten research papers together including one in PLoS Medicine.
2006-2011 Kathleen Wirth, ScD / Research Scientist, Department of Biostatistics, Harvard School of
Public Health
I was Dr. Wirth’s doctoral advisor at the Harvard School of Public Health. We published
two papers together, including one in Epidemiology.
2006-2008 Caroline Colijn, PhD / Professor, Department of Mathematics, Simon Fraser University
I was Dr. Colijn’s post-doctoral advisor at Harvard School of Public Health. Published
twelve research papers together, including one in American Journal Respiratory Critical
Care Medicine and one in PLoS Computational Biology.
2007-2009 Gape Machao, MSc / Monitoring and Evaluation Officer, UNICEF Botswana
I supervised Mr. Machao’s master’s thesis on rapid diagnostic testing for TB in Botswana.
2008-2010 Ellen Brooks-Pollock, MSc, PhD / Lecturer, Veterinary Public Health, Bristol Veterinary
School
I was Dr. Pollock’s post-doctoral research advisor at Harvard School of Public Health. We
published two papers together.
2008-2013 Karen Jacobson, MD / Assistant Professor of Medicine, Section of Infectious Diseases,

Boston University School of Medicine
I was Dr. Jacobson’s research mentor for her infectious disease post-doctoral research
fellowship. We published nine papers together.
2008-2010 Tsering Pema Lama, MSc. Postdoctoral Fellow / Consultant, The George Washington
University Milken Institute School of Public Health
63

I supervised Ms. Lama’s master’s thesis.
2009-2015 Matthew Bonds, PhD / Assistant Professor, Department of Global Health and Social
Medicine, Harvard Medical School
I was Dr. Bonds’ mentor on his K award on poverty traps and currently mentor him in his
role in my department. We have published five papers and two book chapters together.
2009-2012 Razvan Sultana, MD, PhD / Computational Biologist, University of Hawaii John A. Burns
School of Medicine
I co-supervised Dr. Sultana’s doctoral thesis in Bio-informatics at Boston University on
genomic analysis of drug resistant TB. We have published three papers together.
2010-2016 Hanna Guimaraes, MA, PhD / Postdoctoral Researcher, RIVM National Institute for
Public Health and the Environment
I was Ms. Guimaraes’ doctoral adviser while she conducted research for her degree from
Portugal. We published four papers together.
2010-2016 Maha Farhat, MD, MSc / Assistant Professor of Biomedical Informatics, Harvard Medical
School
I was Dr. Farhat’s postdoctoral mentor and supervised her analysis of whole genome
sequence data on M. tuberculosis for the identification of novel mutations associated with
drug resistance. We have published 12 papers together.
2010 Joanne Salmon, MD, MPH / Clinical Instructor, Division of Infectious Diseases,
Department of Medicine, The University of British Columbia
I supervised Dr. Salmon’s master’s thesis on community health workers and impact on TB
treatment outcomes: a multi-country proposal.
2010-2014 Chuan-Chin Huang, MS, ScD / Instructor in Medicine, Harvard Medical School
I was Dr. Huang’s doctoral adviser. We have published eight papers together.
2010-2014 Olivia Oxlade, PhD / Epidemiologist and Modeler, McGill International TB Centre
I was Dr. Oxlade’s postdoctoral research supervisor in her work on modeling the
determinants of TB. We published three papers together.
2010-2016 MaryCatherine Arbour, MD / Assistant Professor of Medicine, Department of Global

Health and Social Medicine, Harvard Medical School
I mentored this junior faculty member at the Division of Global Health Equity, Brigham
and Women’s Hospital in her work on education and health outcomes in a cluster
randomized trial of school-based interventions in Santiago, Chile. We published two
papers together.
64

2011 Devra Barter, MS / Emerging Infections Epidemiologist, Colorado Department of
Public Health & Environment
I co-supervised Ms. Barter’s master’s thesis on out-of-pocket expenses during TB
treatment which is published in BMC Public Health.
2011-2013 Silvan Vesenbeckh, MD / Senior Registrar, Infectious Diseases, Groote Schuur Hospital
I supervised Dr. Vesenbeckh’s postdoctoral work on cholera transmission in the DRC and
Haiti. We published three papers together.
2011-2015 Philips Loh, MS / Doctoral candidate, Department of Epidemiology, Harvard School of

Public Health
I supervised Mr. Loh’s master’s thesis and served as his doctoral adviser.
2012-2013 Alexis Krumme, MS, ScD / Research Specialist, Division of Pharmacoepidemiology and
Pharmacoeconomics, Brigham and Women's Hospital
I supervised Ms. Krumme’s master’s thesis. We published one paper together.
2012-2015 Xeno Acharya, MPH / Senior Consultant, Healthcare AI, PA Consulting

I was Mr. Acharya’s doctoral adviser. We have published one paper.
2013-2014 Anna Odone, MD, MPH, PhD / Associate Professor of Public Health, Università Vita-
Salute San Raffaele
I was Ms. Odone’s postdoctoral research supervisor for her work on socioeconomic risk
factors for acquired and primary MDR-TB in Lima, Peru. We published one paper
together.
2013-2014 Sachin Atre, PhD / Study Coordinator, Johns Hopkins Center for Clinical Global Health
Education
I supervised Dr. Atre’s work on MDR-TB management and policy in India, and the
effective use of information technology in TB control. We published one paper together.
2013-2015 Emilia Ling, MS / Medical Student, Stanford University

I supervised Ms. Ling’s master’s thesis at HSPH. We published one paper together.
2013-2016 Assumpta Mukabutera, PhD / Instructor, University of Rwanda School of Public Health
I supervised Dr. Mukabutera’s doctoral thesis on rainfall and child health outcomes. We
published three papers together.
2014-2016 Rebecca Butler, MS / Biostatistician, Kaiser Permanente

I supervised Ms. Butler’s master’s thesis.
2014-2016 Gustavo Velasquez, MD, MPH / Research Associate, Department of Global Health and
Social Medicine, Harvard Medical School
65

I supervised Dr. Velasquez’s postdoctoral work examining the relationship between
phenotypic pyrazinamide resistance and multidrug-resistant tuberculosis (MDR-TB)
treatment outcomes. We published four papers together.
2014-2017 Ibrahim Diakite, PhD / Associate Scientist in Modeling & Meta-Analysis, Pharmerit
International
I supervised Dr. Diakite’s postdoctoral project that aimed to advance the quantitative
study of communicable diseases especially the Mycobacterium Tuberculosis by using a
combination of different mathematical techniques such as differential equations,
stochastic process, branching process, and mathematical game theory. We published two
papers together.
2014-2018 Omowunmi Aibana, MD, MPH / Assistant Professor, General Internal Medicine, University
of Texas McGovern Medical School
I supervised Dr. Aibana’s work on Tuberculosis in Ukraine through a T32 mechanism
based at Brown Medical School. We published five papers together.
2014-2019 Eric Mooring, MPhil, ScD / Epidemic Intelligence Service, Centers for Disease Control and
Prevention
I was Dr. Mooring’s doctoral adviser. We have published three papers together.
2014-2020 Ruoran Li, MPhil / Doctoral Student, Department of Epidemiology, Harvard T.H. Chan
School of Public Health. I was Dr. Li’s doctoral adviser. We have published one paper
together.
2016-2018 Silvia Chiang, MD / Assistant Professor of Pediatrics, Brown Alpert Medical School
I supervised Dr. Chiang in her postdoctoral study of adolescent tuberculosis. We have
published two papers together and have one under review.
2017-2018 Katrin Sadigh, MD / Fogarty Global Health Fellow, Harvard T.H. Chan School of Public
Health
I supervised Dr. Sadigh in her clinical research as part of the Department of Infectious
Disease, Brigham and Women’s Hospital/Massachusetts General Hospital combined
program.
2017-2019 Taylor Chin, BA / Master’s student, Department of Epidemiology, Harvard T.H. Chan
School of Public Health
I supervised Ms. Chin’s master’s thesis.
2017-2019 Tori Cowger, MPH / Doctoral Student, Department of Epidemiology, Harvard T.H. Chan
School of Public Health
I was Ms. Cowger’s doctoral adviser.
66

2017- Alexander Chu, MPH / Post-baccalaureate premedical candidate, Harvard Extension
School.
2017- Annelies Mesman, PhD / Postdoctoral Research fellow, Department of Global Health and
Social Medicine, Harvard Medical School. I supervised Annelies Mesman in her
postdoctoral study of tuberculosis. We have published two papers together.
2019 Gerson Galdos Cardenas, PhD / Postdoctoral Research fellow, Department of Global
Health and Social Medicine, Harvard Medical School.
2019- Kamela Ng, PhD / Postdoctoral Research fellow, Department of Global Health and Social
Medicine, Harvard Medical School.
2019- Qi Tan, MD, PhD / Postdoctoral Research fellow, Department of Global Health and Social
Medicine, Harvard Medical School.
Presentations
Invited Presentations and Courses
Local, Regional, National, and International Invited Presentations and Courses
Local Invited Presentations

No presentations below were sponsored by outside entities
2001 Styblo's Rule revisited
Freeman Symposium Research Seminar
Department of Epidemiology
2002-2003 Molecular epidemiology of tuberculosis

Invited Lecture
Hot Topics Series
2003 The transmission dynamics of M. Tuberculosis: Models and Molecular Epidemiology

Research Seminar
2003 Inferring the evolution of M. Tuberculosis from comparative genomics

Research Seminar
Infectious Disease Unit
Harvard Medical School
2003 The epidemiology of Severe Acute Respiratory Syndrome (SARS)

Invited lecture
67

Kennedy School of Government
Harvard University
2003 Transmission dynamics, epidemiology and SARS

Research Seminar
2003 Modeling the molecular epidemiology of TB

2003 Molecular epidemiology and the transmission dynamics of tuberculosis

Research Seminar
The Broad Institute
2004 The epidemiology of SARS

Hot Topic Series
2005 Epidemiology of multi-drug resistant tuberculosis

Grand Rounds
2006 Iron metabolism and M. Tuberculosis

Research Seminar
The Broad Institute
2006 Natural variation in M. Tuberculosis

Research Seminar
The Broad Institute
2006 Avian influenza

Department of Environmental Health
2006 Three epidemics and how they happened

Department of Epidemiology Seminar
2006 Transmission dynamics of drug sensitive and resistant tuberculosis infectious disease
Research Seminar
Partners Infectious Disease
Boston, MA
68

2007 Genetic heterogeneity in M. Tuberculosis
Department of Genetics and Complex Diseases
2007 Epidemiology of HIV and tuberculosis

Department of Epidemiology Seminar
2008 A multi-disciplinary approach to MDR and XDR tuberculosis

Department of Epidemiology Seminar Series
2008 Making multidisciplinary research work: the example of MDR tuberculosis

Seminar Series
Department of Social Medicine and Health Inequalities
Brigham and Women’s Hospital
2008 Conducting research in international settings

Best Practices in International Scientific Collaboration (Panel discussion)
2nd annual New England Tuberculosis Retreat
Harvard Initiative for Global Health
2009 Genomic epidemiology of MDR and XDR tuberculosis

The Broad Institute
2009 A multi-disciplinary approach to XDR tuberculosis

Grand Rounds
Department of Medicine
Brigham and Women’s Hospital
2009 Social justice and the effort to address MDR TB

Symposium on an Idea of Justice
Harvard University and the China Research Council
2010 The evolution of drug resistant tuberculosis

Grand Rounds
2010 Overview of Murray research team

69

2011 Deans’ Research Update
2011 Innovation in global health

Massachusetts General Hospital Department of Medicine Bicentennial Reunion
2013 TB in the 21st century: the convergence of the infectious and metabolic diseases
Seventh Annual New England Tuberculosis Symposium
The Broad Institute
2014 Ebola and the research equity agenda

Global Health Advisory Council
Boston, MA
2015 Ebola Update

Global Health Advisory Council
Boston, MA
2015 HIV and TB co-infection

Harvard T.H. Chan School of Public Health
Boston, MA
2015 Burke Global Health Fellowship Symposium

Harvard Global Health Institute
Cambridge, MA
2017 Host and bacterial determinants of TB infection and disease: a longitudinal cohort study
Spring Seminar
Center for Communicable Disease Dynamics
Harvard T.H. Chan School of Public Health, Boston, MA
2017 Host and bacterial determinants of TB infection and disease: insights from a large cohort
study
IDMP Seminar
Broad Institute of MIT and Harvard, Cambridge, MA
2017 Tuberculosis and the vitamin A connection

Talks at 12
2018 How to write an NIH grant

Training to Teachers Mongolia
70

2020 SARS-CoV-2: Assessing the risks

Environmental Health Risk: Analysis and Applications (RISK0320)
Harvard T.H. Chan School of Public Health
2020 The epidemiology of COVID-19: Evaluation of Treatment and Response

GHSM Seminar - Social Medicine: Response to COVID-19
2020 The Epidemiology of COVID-19

MassCPR webinar
2020 BCG and innate immune responses

Pathogenesis Working group
MassCPR webinar
2020 The transmission dynamics of COVID-19

BCMP Seminar
Regional
2001 Genetics and phenotypic variability within M. Tuberculosis
Invited lecture
Boston University
2001 Problems in the molecular epidemiology of tuberculosis

Research Seminar
Massachusetts State Laboratory Institute (MSLI), Boston, MA
2006 Three epidemics

Kay Stratton Lecture
Massachusetts Institute of Technology, Cambridge, MA
2015 Converging epidemics: tuberculosis and diabetes

Oxford Immunotec
Marlborough, MA
National
2004 Transmission of TB in the community
Infectious Disease Society of America, Boston, MA
71

2006 Modeling MDR tuberculosis
National Partners Meeting on MDR Tuberculosis, Atlanta, GA
2006 Transmission dynamics of Drug Resistant tuberculosis

Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, CA
2008 Host iron metabolism genes

Workshop on Biofilms, Iron and Drug Refractory TB
Colorado State University, Fort Collins, CO
2008 The impact of strains diversity and mechanisms of strains competition

on the Potential Performance of New TB Vaccines
Microbial Diseases Lecture Series
Yale School of Public Health, Hartford, CT
2008 The role of mathematical modeling in evaluating interventions to control epidemics: the
example of tuberculosis
Howard Hughes Medical Institute
California Institute of Technology, Pasadena, CA
2008 An interdisciplinary approach to extensively drug resistant tuberculosis

Howard Hughes Medical Institute
California Institute of Technology, Pasadena, CA
2008 Number of MDR-TB and XDR-TB patients receiving treatment today:

Successes/Failures/Consequences
Forum on Drug Discovery, Development and Translation
Institute of Medicine of the National Academies, Washington, DC
2009 The evolution of XDR-TB in M. tuberculosis

Seminar Series Biology Department
Williams College, Williamstown, MA
2009 The evolution of XDR-TB in M. tuberculosis: a multidisciplinary approach

Grand Rounds Presentation
Division of Infectious Diseases
Hennepin County Medical Center, Minneapolis, MN
2009 Mathematical modeling

Infectious Diseases Clinical Cases Conference
Division of Infectious Diseases
Hennepin County Medical Center, Minneapolis, MN
2009 The evolution of XDR-TB: a multidisciplinary approach

2009 National TB Conference-TB Elimination-“It Takes a Village”
Centers for Disease Control and Prevention, Atlanta, GA
72

2009 The Gates Project overview
Mycobacteriology Laboratory Branch (MLB)
Division of Tuberculosis Elimination Seminar
Centers for Disease Control and Prevention, Atlanta, GA
2010 Social, economic and biological determinants of tuberculosis

Taskforce for Disease Eradication
Carter Center
Atlanta, Georgia
2010 Estimating the impact of social and biological determinants on TB and modeling their
modification
Texas School of Public Health
Brownsville, Texas
2010 The evolution of XDR tuberculosis

Mary Hitchcock Hospital
Hanover, New Hampshire
2011 Molecular methods to detect drug resistance in M. tuberculosis

Workshop on TB and HIV Diagnostics in Adult and Pediatric Populations
National Institutes of Health
Washington, DC
2011 Understanding the transmission dynamics of drug resistant tuberculosis: a

multidisciplinary approach
Annual Biomedical Research Conference for Minority Students
St. Louis, Missouri
2012 Evolution of drug resistance

World TB Day Symposium
Boston University
Boston, Massachusetts
2012 High throughput sequencing of drug resistance targets for Mycobacterium tuberculosis
National Institute of Allergy and Infectious Diseases
Sponsored meeting
Washington, DC
2013 Genetic determinants of drug resistance in Mtb

World TB Day Symposium
Weill Cornell Medical College
New York City, New York
73

2015 Tuberculosis and diabetes
The Comstock Lecture
Johns Hopkins School of Public Health
Baltimore, Maryland
2016 Tuberculosis and diabetes

20th Annual Conference of Union-North America Region/National TB Controllers
Association Joint Meeting
Denver, Colorado
2017 Risk factors for TB disease progression: evidence from a cohort study in Peru
9th Annual CEND (Center for Emerging and Neglected Diseases) Symposium:
Deconstructing TB: Insights from Fundamental Research
University of California, Berkeley, California
2017 Public health and the environment: interdisciplinary research and emerging infectious
disease
Ecology & Evolution of Infectious Diseases
UC Santa Barbara, California
2018 Women in science

2018 Women in Science Symposium
Colorado State University
Fort Collins, Colorado
2019 Who gets TB infection and disease in Lima, Peru

Epidemiology Grand Rounds
Columbia University Mailman School of Public Health
New York, New York
2019 Who gets TB infection and disease in Lima, Peru

UPGG Tuesday Seminar Series
Duke University
Durham, North Carolina
International
2001 Determinants of cluster distribution in M. tuberculosis

Research Seminar
University of Warwick, Coventry, United Kingdom
74

2002 Pathogenesis of tuberculosis
Invited Lecture
Peruvian Thoracic Society, Lima, Peru
2002 Problems in the molecular epidemiology of tuberculosis

Research Seminar
Karolinski Institutet, Stockholm, Sweden
2003 The fitness of MDR-TB: what do we know

Invited Lecture
World Health Organization, Tallin, Estonia
2004 Molecular epidemiology of TB in Sverdlosk, Russia

Invited Lecture
International Union Against Tuberculosis and Lung Disease (IUTLD) Meeting
Moscow, Russia
2005 The fitness of MDR-TB strains

Invited Lecture
Desmond Tutu Center for Tuberculosis Research
University of Stellenbosch, Matieland, South Africa
2005 The current and future status of Multi-Drug Resistant TB

Invited Lecture
Novartis Symposium on TB Drug Development, Bagamoyo, Tanzania
2006 XDR-TB surveillance

Task Force on XDR-TB
World Health Organization, Geneva, Switzerland
2007 Mathematical models of population effects of potential TB vaccines

Keystone Symposium of Challenges of Global Vaccine Development
Cape Town, South Africa
2007 Modeling vaccine effects

Modeling Symposium at the 38th Union World Conference on Lung Health
2007 Genomic epidemiology of infectious diseases: a new science

US-Japan Meeting
Hainan, China
2008 The molecular evolution of extensively drug resistant tuberculosis

Keystone Symposium of Pathogenesis and Control of Emerging
Infections and Drug-Resistant Organisms
75

Bangkok, Thailand
2008 TB Drug Resistance Mutation Database

39th Union World Conference 2008
Paris, France
2009 The evolution of multi-drug resistance in M. tuberculosis

Engineering and Physical Sciences Research Council Workshop
on the Evolution of Antibiotic Resistance
Imperial College, London, England
2009 The evolution of multi-drug resistance in M. tuberculosis

School of Biosciences Seminar Series
University of Birmingham, Birmingham, England
2009 Diagnosis of drug resistant TB

Fondation Mérieux International Scientific Conference on Latest Approaches to HIV
Infection Management: A Focus on HIV, TB and HIV/Hepatitis Co-Infection
New Delhi, India
2009 Tuberculosis and diabetes: interactions between two epidemics

TB/DM Expert Meeting
Paris, France
2009 Differences between epidemiology of TB in rich and poor countries

Union World Conference of Lung Health
Cancun, Mexico
2009 Modeling the potential impact of changing risk factors and social determinants
Union World Conference of Lung Health
Cancun, Mexico
2010 The evolution of drug resistance in TB

Ecole Polytechnique Federale de Lausanne
Lausanne, Switzerland
2010 Identification of drug resistance mutations in M. tuberculosis

Fondation Mérieux
Annecy, France
2010 Guidelines for management of tuberculosis and diabetes

World Health Organization
Geneva, Switzerland
76

2010 Data for developing diagnostics for MDR TB
Christian Medical College
Vellore, India
2010 Beyond labs and pills for improved tuberculosis control: what role for TB programmes?
41st Union World Conference on Lung Health
Berlin, Germany
2011 Iron transport polymorphisms and TB susceptibility

Ecole Polytechnique Federale de Lausanne
Lausanne, Switzerland
2011 Evaluating health interventions using DHS oversamples

Doris Duke Charitable Foundation Population Health Implementation Training Partnership
Grantee Meeting
Ifakara, Tanzania
2012 Overview: Transmission dynamics and epidemiology of drug resistant TB

Lima, Peru
2012 The transmission dynamics of drug resistant TB

Harvard China Fund
Shanghai, China
2012 Understanding the epidemic dynamics of drug resistant TB

Keystone Symposia Conference – Drug Resistance and Persistence in Tuberculosis
Kampala, Uganda
2012 The social, environmental and biologic determinants of tuberculosis

TB Day in Braga: From the hospital to the bench and back.
Braga, Portugal
2012 Studying the link between nutrition and TB Risk: problems and strategies
International Conference of the Union for TB and Lung Disease
Kuala Lumpur, Malaysia
2012 TB and diabetes: what we know, what we don’t know

Kuala Lumpur, Malaysia
2013 Genetic diversity of DR TB: implication for future diagnostics

Institute of Medicine and Chinese Academy of Sciences Workshop
77

The Global Crisis of Drug-Resistant Tuberculosis and the Leadership of the BRICS
Countries: Challenges and Opportunities
Beijing, China
2013 Evolution of drug-resistance in TB genomes

Paris, France
2014 The genetics and pathogenesis of MDR and XDR TB drug resistance
Conference on Retroviruses and Opportunistic Infections (CROI)
Boston, MA
2014 Genetic basis for transmission of MDR-TB

9th International Conference on the Pathogenesis of Mycobacterial Infections
Stockholm, Sweden
2015 Issues in the management and prevention of drug resistant and sensitive TB
Invited Lecture
Bogomolets National Medical University
Kiev, Ukraine
2015 TB and diabetes mellitus outcomes

19th Annual Conference of the Union-North America Region
Vancouver, BC, Canada
2015 The transmissibility of drug resistant TB

RePort Consortium Meeting
Boston University
Boston, Massachusetts
2015 The TB drug resistance database

46th Union World Conference on Lung Health
2016 Diabetes and environmental co-morbidities with TB

Keystone Symposia Conference - Tuberculosis Co-Morbidities and Immunopathogenesis
Keystone, Colorado
2016 Enabling next generation whole genome sequencing readouts directly from sputum
samples and in the clinic: hype or hope?
Liverpool, United Kingdom
78

2017 Infectiousness and transmission of tuberculosis
American Thoracic Society 2017 International Meeting
Washington, DC
2017 Recent insights in the meaning of latency in tuberculosis

30th Annual Doctor Dorothy Wiselberg Seminar
McGill University
Montreal, QC, Canada
2017 Next generation whole genome sequencing for tuberculosis: ready for clinical practice?
Guadalajara, Mexico
2017 Estimating the adolescent tuberculosis burden in the 30 high-TB burden countries
Guadalajara, Mexico
2017 Insights into TB from a longitudinal cohort study in Lima, Peru

National TB program
Lima, Peru
2018 Insights into TB from a longitudinal cohort study in Lima, Peru

Otago University
Dunedin, New Zealand
2018 Grant Writing

Mongolian National University of Medical Sciences
Ulaanbaatar, Mongolia
2019 Bacterial determinants of TB progression

Hyderabad, India
2019 Genetic variations of mycobacterium tuberculosis that are associated with tuberculosis
transmission
Hyderabad, India
2020 The COVID-19 Research Agenda

Partners in Health
2020 SARS-CoV-2
Partners in Health
79

Report of Clinical Activities and Innovations
Current Licensure and Certification
1996 Licensed in Medicine in Massachusetts
1996 Board Certified in Internal Medicine
1997 Board Certified in Infectious Disease
Practice Activities
Infectious Disease 3-5 new consults, 20-

1998 – 2007 Attending Physician Consult Services, 30 follow-ups per day
MGH, Boston, MA 3-6 weeks per year
The unit provides consults on infectious disease issues to all medical, surgical and other specialty
wards. I saw patients referred to the specialty unit in conjunction with a team that includes an
infectious disease fellow and rotating medical students and residents. In addition to this bedside
clinical teaching, I also participated in weekly clinical conferences and seminars that are
designed to maximize teaching.
Report of Scholarship
Peer reviewed publications in print or other media
Research investigations
1. Murray MJ, Murray NJ, Murray AB, Murray MB. Refeeding-malaria and hyperferraemia.
Lancet 1975;1:653-4.
2. Murray MJ, Murray AB, Murray MB, Murray CJ. Somali food shelters in the Ogaden famine
and their impact on health. Lancet 1976 Jun 12;1:1283-5.
3. Murray MJ, Murray AB, Murray MB, Murray CJ. Parotid enlargement, forehead edema, and
suppression of malaria as nutritional consequences of ascariasis. Am J Clin Nutr. 1977
Dec;30(12):2117-21.
4. Murray MJ, Murray AB, Murray NJ, Murray MB. Diet and cerebral malaria: the effect of
famine and refeeding. Am J Clin Nutr. 1978 Jan;31(1):57-61.
5. Murray MJ, Murray AB, Murray NJ, Murray MB. Serum cholesterol, triglycerides and heart
disease of nomadic and sedentary tribesmen consuming isoenergetic diets of high and low
fat content. Br J Nutr. 1978 Jan;39(1):159-63.
80

6. Murray MJ, Murray AB, Murray NJ, Murray MB. The effect of iron status of Nigerien
mothers on that of their infants at birth and 6 months, and on the concentration of Fe in
breast milk. Br J Nutr. 1978 May;39(3):627-30.
7. Murray MJ, Murray AB, Murray MB, Murray CJ. The adverse effect of iron repletion on the
course of certain infections. Br Med J 1978 Oct 21;2:1113-5.
8. Murray MJ, Murray AB, Murray NJ, Murray MB, Murray CJ. Molluscum contagiosum and
herpes simplex in Maasai pastoralists; refeeding activation of virus infection following
famine? Trans R Soc Trop Med Hyg. 1980;74(3):371-4.
9. Murray JM, Murray AB, Murray MB, Murray CJ. Rarity of planar warts in Cushite nomads:
antiviral effect of milk? Lancet. 1980 Jul 19;2(8186):143-4.
10. Murray MJ, Murray AB, Murray NJ, Murray MB. Infections during severe primary
undernutrition and subsequent refeeding: paradoxical findings. Aust N Z J Med. 1995
Oct;25(5):507-11.
11. Murray M, Rasmussen Z. Measles Outbreak in a Northern Pakistani village: epidemiology
and vaccine effectiveness. Am J Epidemiology 2000;1:811-9.
12. Piatek A, Telenti A, Murray M, El-Hajj H, Jacobs WR Jr, Kramer FR, Alland D. Genotypic
analysis of M. tuberculosis in two distinct populations using molecular beacons: implications
for rapid susceptibility testing. Antimicrob Agents Chemother 2000;1:103-10.
13. Murray MB, Determinants of cluster distribution in the molecular epidemiology of
tuberculosis. Proc Natl Acad Sci U S A 2002 Feb; 99:1538-43.
14. Murray MB, Alland D. Methodological problems in the molecular epidemiology of
tuberculosis. Am. J. Epidemiology 2002;155: 565-71.
15. Murray MB. Sampling bias in the molecular epidemiology of tuberculosis. Emerg Infect Dis
2002 Apr; 4:363-9.
16. Hughes A, Friedman R, Murray M. Genomewide pattern of synonymous nucleotide
substitution in two complete genomes of Mycobacterium tuberculosis. Emerg Infect Dis
2002 Nov;8:1342-6.
17. Murray MB. Molecular epidemiology and the dynamics of tuberculosis transmission among
foreign-born people. CMAJ 2002;167:355-6.
18. Lipsitch M, Murray MB. Multiple equilibria: Tuberculosis transmission require unrealistic
assumptions. Theor Popul Biol 2003 Mar; 63:169-7.
19. Alland D, Whittam T, Murray M, Cave DM, Hazbon M, Dix K, Kokoris M, Duesterhoeft A,
Eisen JA, Fraser CM, Fleischmann RD. Modeling bacterial evolution with comparative-
genome based marker systems. Application to M. tuberculosis evolution and pathogenesis. J
Bacteriol 2003;185:3392-9.
20. Lipsitch M, Cohen T, Cooper B, Robins JM, Ma S, James L, Gopalakrishna G, Chew SK, Tan
CC, Fisman D, Samore M, Murray M. Transmission dynamics and control of severe acute
respiratory syndrome. Science 2003; 300:1966-70.
21. Kudva IT, Griffin RW, Murray M, John M, Perna NT, Barrett TJ, and Calderwood SB.
Insertions, deletions and single nucleotide polymorphisms at rare restriction enzyme sites
enhance discriminatory power of polymorphic amplified typing sequences, a novel strain
typing system for escherichia coli O157:H7. J Clin Microbiol 2004 Jun;42:2388-97.
81

22. Cohen T**, Becerra MC, Murray MB. Isoniazid resistance and the future of drug-resistant
tuberculosis. Microb Drug Resist 2004;10:280-5.
23. Cohen T**, Murray M. Modeling epidemics of multidrug-resistant M. tuberculosis of
heterogeneous fitness. Nat Med 2004 Oct;10:1117-21.
24. Becerra MC, Pachao-Torreblanca IF, Bayona J, Celi R, Shin S, Kim JY, Farmer P, Murray M.
Expanding tuberculosis case detection by screening household contacts. Public Health Rep
2005;120:271-7.
25. Cohen T**, Murray M. Incident tuberculosis among recent US immigrants and exogenous
reinfection. Emerg Infect Dis 2005;11:725-8.
26. Korves C**, Goldie S, Murray M. Cost-effectiveness of alternative blood screening strategies
for West Nile Virus in the United States. PLoS Med 2006; 3:0211-21.
27. Louw GE, Warren RM, Donald PR, Murray MB, Bosman M, Van Helden PD, Young D, Victor
TC. Frequency and implications of pyrazinamide resistance in managing previously treated
tuberculosis patients. Int J Tuberc Lung Dis 2006 Jul;10:802-7.
28. Cohen T**, Lipsitch M, Walensky R, Murray M. Beneficial and perverse effects of isoniazid
preventive therapy for latent tuberculosis infection in HIV-TB co-infected populations. Proc
Natl Acad Sci U S A 2006 May 2;103:7042-7.
29. Resch S, Salomon J, Murray M, Weinstein M. Cost-effectiveness of treating multidrug-
resistant tuberculosis. PLoS Med 2006 Jul;3:1302-9.
30. Mathew TA, Shin SS, Ovsynakova TN, Gelmanova I, Balbuena D, Atwood S, Peremetin GG,
Strelis AK, Murray M. Causes of death during TB treatment in Tomsk Oblast, Russia. Int J
Tuberc Lung Dis 2006; 10:857-63.
31. Korves C**, Goldie S, Murray M. Blood screening for the West Nile virus: the cost-
effectiveness of a real-time trigger-based strategy. Clin Infect Dis 2006 Aug 15;43:490-3.
32. Hazbón MH, Brimacombe M, Bobadilla del Valle M, Cavatore M, Guerrer MI, Varma-Basil M,
Billman-Jacobe H, Lavender B, Fyfe J, García-García L, León C, Bose M, Chaves G, Murray M,
Eisenach KD, Sifuentes-Osornio J, Cave MD, Ponce de León A, Alland D. Population genetics
study of isoniazid resistance mutations and evolution of multidrug-resistant Mycobacterium
tuberculosis. Antimicrob Agents Chemother 2006;50:2640-9.
33. Johnson R, Warren R, Strauss OJ, Jordaan AM, Falmer AA, Beyers N, Schaaf HS, Cloete K,
Murray M, van Helden PD, Victor TC. An outbreak of drug resistant tuberculosis caused by a
Beijing strain in the Western Cape, South Africa. Int J Tuberc Lung Dis 2006;10:1412-4.
34. Lipsitch M, Cohen T, Murray M, Levin BR. Antiviral resistance and the control of pandemic
influenza. PLoS Med 2007 Jan;4:0111-21.
35. Lin HH**, Ezzati M, Murray M. Tobacco smoke, indoor air pollution and tuberculosis – A
systematic review and meta-analysis. PLoS Med 2007: 0173-89.
36. Gelmanova I, Keshavjee S, Golubchikova VT, Berezina VI, Sterlis AK, Yanova GV, Atwood S,
Murray M. Barriers to successful tuberculosis treatment in Tomsk, Russia: Non-adherence,
default and the acquisition of multi-drug resistance. Bull WHO 2007;85:703-11.
37. Victor TC, Streicher EM, Kewley C, Jordaan AM, van der Spuy GD, Bosman M, Louw H,
Murray M, Young D, van Helden PD, Warren RM. Spread of an emerging Mycobacterium
tuberculosis drug-resistant strain in the Western Cape of South Africa. Int J Tuberc Lung Dis
2007;11:195-201.
82

38. Colijn C**, Cohen T, Murray M. Emergent heterogeneity in tuberculosis epidemics. J Theor
Biol 2007 Aug 21;247:765-74.
39. Cohen T**, Colijn C, Wright A, Zignol M, Pym A, Murray M. Challenges in estimating the
total burden of drug resistant tuberculosis. Am J Respir Crit Care Med 2008 Jun 15;
177:1302-6.
40. Cohen T**, Colijn C, Finklea B, Murray M. Exogenous re-infection and the dynamics of
tuberculosis epidemics: local effects in a network model of transmission. J R Soc Interface
2007 Jun 22;4:523-31.
41. Franke MF**, Appleton SC, Bayona J, Arteaga F, Palacios E, Llaro K, Shin SS, Becerra MC,
Murray MB, Mitnick CD. Risk factors and mortality associated with default from multidrug-
resistant tuberculosis treatment. Clin Infect Dis 2008 June 15;46:1844-51.
42. Cohen T**, Colijn C, Finklea B, Wright A, Zignol M, Pym A, Murray M. Are survey based
estimates of the burden of drug resistant TB too low?: Insight from a simulation study. PLoS
One 2008;3:e2363.
43. Jeon CY**, Murray M. Diabetes mellitus increases the risk of active tuberculosis: A
systematic review of 13 observational studies. PLoS Med 2008; 5:e152.
44. Cohen T**, Colijn C, Murray M. Modeling the effects of strain diversity and mechanisms of
strain competition on the potential performance of new tuberculosis vaccines. Proc Natl
Acad Sci U S A. 2008 Oct 21;105(42):16302-7.
45. Lin HH**, Murray M, Cohen T, Colijn C, Ezzati M. Integrated analysis of respiratory diseases
and risk factors in China: The effects of smoking and solid fuel use on COPD, lung cancer,
and tuberculosis. Lancet 2008; 372:1473-83.
46. Cohen T**, Colijn C, Murray M. Latent coinfection and maintenance of strain diversity. Bull
Math Biol 2009;71:247-63.
47. Sandgren A**, Strong M, Muthukrishnan P, Weiner BK, Church GM, MB Murray.
Tuberculosis drug resistance mutation database. PLoS Med 2009;6:e2.
48. Uys PW, Warren R, van Helden PD, Murray M, Victor TC. Potential of rapid diagnosis for
controlling drug-susceptible and drug-resistant tuberculosis in communities where
Mycobacterium tuberculosis infections are highly prevalent. J Clin Microbiol 2009;47:1484-
90.
49. Lin HH**, Ezzati M, Chang HY, Murray M. Association between tobacco smoking and active
tuberculosis in Taiwan: prospective cohort study. Am J Respir Crit Care Med 2009 Sep
1;180(5):475-80.
50. Colijn C**, Brandes A, Zucker J, Lun DS, Weiner B, Farhat MR, Cheng TY, Moody DB, Murray
M, Galagan JE. Interpreting expression data with metabolic flux models: predicting
Mycobacterium tuberculosis mycolic acid production. PLoS Comput Biol.
2009;5(8):e1000489.
51. Brooks-Pollock E**, Cohen T, Murray M. The impact of realistic age structure in simple
models of tuberculosis transmission. PLoS One. 2010 Jan 7;5(1):e8479.
52. Johnson EE**, Srikanth C, Sandgren A, Harrington L, Trebicka E, Wang L, Borregaard N,
Murray M, Cherayil B. Siderocalin inhibits the intracellular replication of Mycobacterium
tuberculosis in macrophages. FEMS Immunol Med Microbiol. 2010 Feb;58(1):138-45.
83

53. Harries AD, Murray MB, Jeon CY, Ottmani S, Lonnroth K, Barreto, ML, Billo N, Brostron R,
Bygbjerg IC, Fisher-Hock S, Mori T, Ramaiya K, Roglic G, Stransgaard H, Unwin N,
Viswanathan V, Whiting D, Kapur A. Defining the research agenda to reduce the joint
burden of disease from Diabetes Mellitus and Tuberculosis. Trop Med Int Health.
2010;15(6):659-63.
54. Calver AD, Falmer AA, Murray M, Strauss OJ, Streicher EM, Hanekom M, Liversage M, Masibi
M, van Helden PD, Warren RM, Victor TC. Emergence of increased resistance and
extensively drug-resistant tuberculosis despite treatment adherence, South Africa. Emerg
Infect Dis. 2010 Feb;16(2):264-71.
55. Cohen T**, Murray M, Wallengren K, Samuel L, Wilson D. The prevalence of drug sensitive
and drug resistant tuberculosis among patients dying in hospital in KwaZulu-Natal, South
Africa: a postmortem study. PLoS Med. 2010;7(6):e1000296.
56. Jacobson KR**, Tierney DB, Jeon CY, Mitnick CD, Murray M. Treatment outcomes among
patients with extensively drug-resistant tuberculosis: systematic review and meta-analysis.
Clin Infect Dis. 2010 Jul 1;51(1):6-14.
57. Becerra MC, Appleton SC, Franke MF, Chalco K, Bayona J, Murray M, Mitnick CD. Recurrence
after treatment for pulmonary multidrug-resistant tuberculosis. Clin Infect Dis. 2010 Sep
15;51(6):709-11.
58. Wirth KE**, Tchetgen Tchetgen EJ, Murray M. Adjustment for missing data in complex
surveys using doubly robust estimation: Application to commercial sexual contact among
Indian men. Epidemiology. 2010 Nov;21(6):863-71.
59. Jeon CY**, Harries AD, Baker MA, Hart JA, Gooneskera S, Murray MB. Bi-directional
screening for tuberculosis and diabetes: a systematic review. Trop Med Int Health. 2010
Nov;15(11):1300-14.
60. Ottmani S, Murray MB, Jeon CY**, Baker MA**, Kapur A, Lonnroth K, Harries AD.
Consultation: Meeting on Tuberculosis and Diabetes Mellitus: Meeting summary and
recommendations. Int J Tuberc Lung Dis. 2010 Dec;14(12):1513-7.
61. Johnson EE**, Sandgren A, Cherayil BJ, Murray M, Wessling-Resnick M. The role of
ferroportin in macrophage-mediated immunity. Infect Immun. 2010 Dec;78(12):5099-106.
62. Jeon CY**, Calver AD, Victor TC, Warren RM, Shin SS, Murray MB. Use of fluoroquinolone
antibiotics leads to tuberculosis treatment delay in a South African gold mining community.
Int J Tuberc Lung Dis. 2011 Jan;15(1):77-83.
63. Cohen T**, Wilson D, Wallengren K, Samuel EY, Murray M. Mixed strain M. tuberculosis
infections among patients dying in hospital in KwaZulu-Natal, South Africa. J Clin
Microbiol. 2011;49(1):385-8.
64. Becerra MC, Appleton SC, Franke MF, Chalco F, Arteaga F, Bayona J, Murray M, Atwood SS,
Mitnick CD. Tuberculosis burden in households of patients with multi-drug resistant
tuberculosis and extensively drug resistant tuberculosis. Lancet. 2011 Jan 8;377(9760):147-
52.
65. Colijn C**, Cohen T, Ganesh A, Murray M. Spontaneous emergence of multiple drug
resistance in TB before and during therapy. PLoS One. 2011 Mar 30;6(3):e18327.
84

66. Goldhaber-Fiebert JD, Jeon CY, Cohen T, Murray MB. Diabetes mellitus and tuberculosis in
countries with high tuberculosis burdens: individual risks and social determinants. Int J
Epidemiol. 2011 Apr;40(2):417-28.
67. Franke MF**, Robins JM, Mugabo J, Kaigamba F, Cain LE, Fleming JG, Murray M.
Effectiveness of early Antiretroviral Therapy initiation to improve survival among HIV-
infected adults with tuberculosis: a retrospective study. PLoS Med. 2011
May;8(5):e1001029.
68. Murray M, Oxlade O, Lin HH. Modeling social, environmental, and biological determinants
of tuberculosis. Int J Tuberc Lung Dis. 2011 Jun;15 S 2:64-70.
69. Brooks-Pollock E**, Becerra M, Goldstein E, Cohen T, Murray M. Epidemiological inference
from the distribution of tuberculosis cases in households in Lima, Peru. J Infect Dis. 2011 Jun
1;203(11):1582-9.
70. Cohen T**, Murray M, Abubakaar I, Zhang A, Sloutsky A, Arteaga F, Chalco K, Franke F,
Becerra MC. Multiple introductions of multidrug resistant tuberculosis into households.
Emerg Infect Dis. 2011 Jun;17(6):969-75.
71. Baker MA**, Harries A, Lonnroth K, Murray M. The impact of diabetes on tuberculosis
treatment outcome: A systematic review. BMC Med. 2011 Jul 1;9(1):81.
72. Louw GE, Warren RM, Gey van Pittius NC, Leon R, Jimenez A, Pando RH, McEvoy CR,
Grobbelaar M, Murray M, van Helden PD, Victor TC. Rifampicin Reduces Susceptibility to
Ofloxacin in Rifampicin Resistant Mycobacterium tuberculosis through Efflux. Am J Respir
Crit Care Med. 2011 Jul 15;184(2):269-76.
73. Lin H**, Langley I, Mwenda R, Doulla B, Egwaga S, Millington KA, Mann GH, Murray M,
Squire SB, Cohen T. A modelling framework to support the selection and implementation of
new tuberculosis diagnostic tools. Int J Tuberc Lung Dis. 2011 Aug;15(8):996-1004.
74. Jacobson KR**, Theron D, Victor TC, Streicher EM, Warren R, Murray M. Treatment
outcomes of Isoniazid-Resistant Tuberculosis patients, Western Cape Province, South Africa.
Clin Infect Dis. 2011 Aug;53(4):369-72.
75. Izu A, Mitnick C, Cohen T, Murray M, DeGruttola V. Bayesian methods of identifying and
comparing branching tree structures: An application to development of resistant TB strains.
Stat Med. 2011 Sep 30;30(22):2708-20.
76. Franke MF**, Murray MB, Muñoz M, Hernández-Díaz S, Sebastián JL, Atwood S, Caldas A,
Bayona J, Shin S. Food insufficiency is a risk factor for suboptimal Antiretroviral Therapy
adherence among HIV-Infected adults in urban Peru. AIDS Behav. 2011 Oct;15(7):1483-9.
77. Harries AD, Lin Y, Satyanarayana S, Lönnroth K, Li L, Wilson N, Chauhan LS, Zachariah
R, Baker MA, Jeon CY**, Murray MB, Maher D, Bygbjerg IC, Enarson DA, Billo NE, Kapur A.
The looming epidemic of diabetes-associated tuberculosis - learning lessons from HIV-
associated tuberculosis. Int J Tuberc Lung Dis. 2011 Nov;15(11):1436-44.
78. Jeon CY**, Kang H, Kim M, Murray MB, Kim H, Cho EH, Park YK. Clustering of
Mycobacterium tuberculosis strains from foreign-born patients in Korea. J Med Microbiol.
2011 Dec;60(Pt 12):1835-40.
79. Layre E, Sweet L, Hong S, Madigan CA, Desjardins D, Young DC, Cheng TY, Annand JW, Kim K,
Shamputa IC, McConnell MJ, Debono CA, Behar SM, Minnaard, AJ, Murray M, Barry CE 3rd,
85

Matsunaga I, Moody BD. A comparative lipidomics platform for chemotaxonomic analysis of
Mycobacterium tuberculosis. Chem Biol. 2011 Dec 23;18(12):1537-49.
80. Weiner B, Gomez J, Victor TC, Warren RB, Sloustky A, Plikyatis BB, Posey J, van Helden P,
van Pittius, NG, Koerhsen M, Sisk P, Stolte C, While J, Gagneux S, Birren B, Hung D, Murray
M, Galagan J. Independent Large Scale Duplications in Multiple M. tuberculosis Lineages
Overlapping the Same Genomic Region. PLoS One. 2012;7(2):e26038.
81. Rich M, Miller AC, Niyigena, P, Franke M, Niyonzima JB, Socci A, Drobac P, Hakizamungu,
Mayfield A, Ruhayisah R, Epino H, Stulac S, Cancedda C, Karamaga A, Niyonzima S,
Yarbrough C Fleming J, Amoroso C, Mukherjee J, Murray M, Farmer P, Binagwaho A.
Excellent Clinical Outcomes and High Retention in Care Among Adults in a Community-
based HIV Treatment Program in Rural Rwanda. J Acquir Immune Defic Syndr. 2012 Mar
1;59(3):e35-42.
82. Baker M**, Lin HH, Chang HY, Murray M. The risk of tuberculosis disease among people
with diabetes, a prospective cohort study. Clin Infect Dis. 2012 Mar;54(6):818-25.
83. Baker MA**, Wilson D, Wallengren K, Sandgren A, Iartchouk O, Broodie N, Goonesekera S,
Sabeti P, Murray M. Polymorphisms in the gene encoding the iron transport protein
ferroportin 1 influence susceptibility to tuberculosis. J Infect Dis. 2012 Apr;205(7):1043-7.
84. Bompangue D, Vesenbeckh SM, Giraudoux P, Castro M, Muyembe Tamfun J, Kebela Ilunga
B, Murray M. Cholera ante portas – The re-emergence of cholera in Kinshasa after a ten-
year hiatus. Version 2. PLoS Curr. 2012 Feb 17 [revised 2012 Mar 12];4:RRN1310.
85. Rinaldo A, Bertuzzo E, Mari L, Righetto L, Blokesch M, Gatto M, Casagrandi R, Murray M,
Vesenbeckh S, Rodriguez-Iturbe I. Reassessment of the 2010-2011 Haiti cholera outbreak
and multi-season projections. Proc Natl Acad Sci U S A. 2012 Apr 24;109(17):6602-7.
86. Lu C**, Chin B, Lewandowski JL, Basinga P, Hirschhorn LR, Hill K, Murray M, Binagwaho A.
Towards universal health coverage: an evaluation of Rwanda Mutuelles in its first eight
years. PLoS One. 2012;7(6):e39282.
87. Sergeev R, Colijn C, Murray M, Cohen T. Modeling the dynamic relationship between HIV
and the risk of drug-resistant tuberculosis. Sci Transl Med. 2012 May 23;4(135):135ra67.
88. Jeon CY, Murray MB, Baker MA. Managing tuberculosis in patients with diabetes
mellitus: why we care and what we know. Expert Rev Anti Infect Ther. 2012 Aug;10(8):863-
8.
89. Arbour M**, Murray KA, Atwood SS, Murray M, Angel Cordero Vega M. Choosing the Best
Child Assessment Instrument for a Specific Context: A Methodology for Engaging Local
Experts Applied in Chile. J Dev Behav Pediatr. 2012 Oct;33(8):666-675.
90. Lin HH**, Dowdy D, Dye C, Murray M, Cohen T. The impact of new tuberculosis diagnostics
on transmission: why context matters. Bull World Health Organ. 2012 Oct 1;90(10):739-
747A.
91. Oxlade O**, Murray M. Tuberculosis and Poverty: Why Are the Poor at Greater Risk in
India? PLoS One 2012; 7(11): e47533.
92. Kudva I. Griffin RW, Murray M, John M, Hovda CJ, Calderwood SB. Polymorphic Amplified
Typing Sequences and Pulsed-Field Gel Electrophoresis Yield Comparable Results in the
Strain Typing of a Diverse Set of Bovine Escherichia coli O157:H7 Isolates. Int J Microbiol.
2012;2012:140105.
86

93. Menzies NA, Cohen T, Lin H-H, Murray M, Salomon JA. Population Health Impact and Cost-
Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and
Economic Evaluation. PLoS Med 2012; 9(11): e1001347.
94. Fraser HS, Thomas D, Tomaylla J, Garcia N, Lecca L, Murray M, Becerra MC. Adaptation of
a web-based, open source electronic medical record system platform to support a large
study of tuberculosis epidemiology. BMC Med Inform Decis Mak. 2012 Nov 7;12:125.
95. Barter DM**, Agboola SO, Murray MB, Bärnighausen T. Tuberculosis and poverty: the
contribution of patient costs in sub-Saharan Africa—a systematic review. BMC Public
Health. 2012 Nov 14; 12(1):980.
96. Jacobson KR**, Theron D, Kendall EA, Franke MF, Barnard M, van Helden PD, Victor TC,
Streicher EM, Murray MB, Warren RM. Implementation of GenoType MTBDRplus Reduces
Time to Multidrug-Resistant Tuberculosis Therapy Initiation in South Africa. Clin Infect Dis.
2013 Feb;56(4):503-8.
97. Wirth KE**, Tchetgen Tchetgen EJ, Silverman JG, Murray MB. How does sex trafficking
increase the risk of HIV Infection? An observational study from Southern India. Am J
Epidemiol. 2013 Feb 1;177(3):232-41.
98. Franke MF**, Appleton SC, Mitnick CD, Furin JJ, Bayona J, Chalco K, Shin SS, Murray MB,
Becerra MC. Aggressive Regimens for Multidrug-Resistant Tuberculosis Reduce Recurrence.
Clin Infect Dis. 2013 Mar;56(6):770-6.
99. Kato-Maeda M, Ho C, Passarelli B, Banaei N, Grinsdale J, Flores L, Anderson J, Murray M,
Rose G, Kawamura LM, Pourmand N, Tariq MA, Gagneux S, Hopewell PC. Use of Whole
Genome Sequencing to Determine the Microevolution of Mycobacterium tuberculosis
during an Outbreak. PLoS One. 2013 Mar 15;8(3): e58235.
100.Reeves AZ, Campbell PJ, Sultana R, Malik S, Murray M, Plikaytis BB, Shinnick TM, Posey JE.
Aminoglycoside Cross-Resistance in Mycobacterium tuberculosis Due to Mutations in the 5'
Untranslated Region of whiB7. Antimicrob Agents Chemother. 2013 Apr;57(4):1857-65.
101.Drobac PC, Basinga P, Condo J, Farmer PE, Finnegan KE, Hamon JK, Amoroso C, Hirschhorn
LR, Kakoma JB, Lu C, Murangwa Y, Murray M, Ngabo F, Rich M, Thomson D, Binagwaho A.
Comprehensive and integrated district health systems strengthening: the Rwanda
Population Health Implementation and Training (PHIT) Partnership. BMC Health Serv Res.
2013;13 Suppl 2:S5.
102.Galea JT, Contreras C, Lecca L, Shin S, Lobatón R, Zhang Z, Calderón R, Murray M, Becerra
MC. Rapid home-based HIV testing to reduce costs in a large tuberculosis cohort study.
Public Health Action. 2013 Jun 21;3(2):172-174.
103.Ford CB, Shah RR, Maeda MK, Gagneux S, Murray MB, Cohen T, Johnston JC, Gardy J,
Lipsitch M, Fortune SM. Mycobacterium tuberculosis mutation rate estimates from
different lineages predict substantial differences in the emergence of drug-resistant
tuberculosis. Nat Genet. 2013 Jul;45(7):784-90.
104.Farhat MR**, Shapiro BJ, Kieser KJ, Sultana R, Jacobson KR, Victor TC, Warren RM, Streicher
EM, Calver A, Sloutsky A, Kaur D, Posey JE, Plikaytis B, Oggioni MR, Gardy JL, Johnston JC,
Rodrigues M, Tang PK, Kato-Maeda M, Borowsky ML, Muddukrishna B, Kreiswirth BN,
Kurepina N, Galagan J, Gagneux S, Birren B, Rubin EJ, Lander ES, Sabeti PC, Murray M.
87

Genomic analysis identifies targets of convergent positive selection in drug-resistant
Mycobacterium tuberculosis. Nat Genet. 2013 Oct; 45(10):1183-9.
105.Lin HH**, Chiang YT, Chuang JH, Yang SL, Chang HY, Ezzati M, Murray M. Exposure to
secondhand smoke and risk of tuberculosis: prospective cohort study. PLoS One. 2013 Oct
25;8(10):e77333.
106.Kudva IT, Smole S, Griffin RW, Garren J, Kalia N, Murray M, John M, Timperi R, Calderwood
SB. Polymorphic Amplified Typing Sequences (PATS) Strain Typing System Accurately
Discriminates a Set of Temporally and Spatially Disparate Escherichia coli O157 Isolates
Associated with Human Infection. Open Microbiol J. 2013 Oct 31;7:123-9.
107.Kendall EA, Theron D, Franke MF, van Helden P, Victor TC, Murray MB, Warren RM,
Jacobson KR. Alcohol, hospital discharge, and socioeconomic risk factors for default from
multidrug resistant tuberculosis treatment in rural South Africa: a retrospective cohort
study. PLoS One. 2013 Dec 13;8(12):e83480.
108.Johnson AD, Thomson DR, Atwood S, Alley I, Beckerman JL, Koné I, Diakité D, Diallo H,
Traoré B, Traoré K, Farmer PE, Murray M, Mukherjee J. Assessing Early Access to Care and
Child Survival during a Health System Strengthening Intervention in Mali: A Repeated Cross
Sectional Survey. PLoS One. 2013 Dec 11;8(12):e81304.
109.Franke MF, Del Castillo H, Pereda Y, Lecca L, Cárdenas L, Fuertes J, Murray MB, Bayona J,
Becerra MC. Modifiable Factors Associated with Tuberculosis Disease in Children: A Case-
Control Study. Pediatr Infect Dis J. 2014 Jan;33(1):109-11.
110.Franke MF, Del Castillo H, Pereda Y, Lecca L, Fuertes J, Cárdenas L, Becerra MC, Bayona J,
Murray M. Parasite Infection and Tuberculosis Disease among Children: A Case-Control
Study.
Am J Trop Med Hyg. 2014 Feb;90(2):279-82.
111.Nebenzahl-Guimaraes H**, Jacobson KR, Farhat MR, Murray MB. Systematic review of
allelic exchange experiments aimed at identifying mutations that confer drug resistance in
Mycobacterium tuberculosis. J Antimicrob Chemother. 2014 Feb;69(2):331-42.
112.Huang CC**, Tchetgen ET, Becerra M, Cohen T, Hughes KC, Zhang Z, Calderon R, Yataco R,
Contreras C, Galea J, Lecca L, Murray M. The effect of HIV-related immunosuppression on
the risk of tuberculosis transmission to household contacts. Clin Infect Dis. 2014
Mar;58(6):765-74.
113.Zelner JL, Murray MB, Becerra MC, Galea J, Lecca L, Calderon R, Yataco R, Contreras C,
Zhang Z, Grenfell BT, Cohen T. Bacillus Calmette-Guérin and isoniazid preventive therapy
protect contacts of tuberculosis patients. Am J Respir Crit Care Med. 2014 Apr 1;189(7):853-
9.
114.Ngonghala CN, Pluciński MM, Murray MB, Farmer PE, Barrett CB, Keenan DC, Bonds MH.
Poverty, disease, and the ecology of complex systems. PLoS Biol. 2014 Apr
1;12(4):e1001827.
115.Nebenzahl-Guimaraes H**, Borgdorff MW, Murray MB, van Soolingen D. A Novel Approach
- The Propensity to Propagate (PTP) Method for Controlling for Host Factors in Studying the
Transmission of Mycobacterium Tuberculosis. PLoS One. 2014 May 21;9(5):e97816.
Zhang Z, Grenfell BT, Cohen T. Age-Specific Risks of Tuberculosis Infection from Household
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and Community Exposures and Opportunities for Interventions in a High-Burden Setting.
Am J Epidemiol. 2014 Oct 15;180(8):853-61.
117.Langley I, Lin HH, Egwaga S, Doulla B, Ku CC, Murray M, Cohen T, Squire SB. Assessment of
the patient, health system, and population effects of Xpert MTB/RIF and alternative
diagnostics for tuberculosis in Tanzania: an integrated modelling approach. Lancet Glob
Health. 2014 Oct;2 (10):e581-91.
118.Farhat MR**, Shapiro BJ, Sheppard SK, Colijn C, Murray M. A phylogeny-based sampling
strategy and power calculator informs genome-wide associations study design for microbial
pathogens. Genome Med. 2014 Nov 15;6(11):101.
119.Menzies NA, Cohen T, Murray M, Salomon JA. Effect of empirical treatment on outcomes of
clinical trials of diagnostic assays for tuberculosis. Lancet Infect Dis. 2015 Jan;15(1):16-7.
120.Krumme AA, Kaigamba F, Binagwaho A, Murray MB, Rich ML, Franke MF. Depression,
adherence and attrition from care in HIV-infected adults receiving antiretroviral therapy. J
Epidemiol Community Health. 2015 Mar;69(3):284-9.
121.Ivers LC, Hilaire IJ, Teng JE, Almazor CP, Jerome JG, Ternier R, Boncy J, Buteau J, Murray MB,
Harris JB, Franke MF. Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-
control study and bias-indicator analysis. Lancet Glob Health. 2015 Mar;3(3):e162-8. doi:
10.1016/S2214-109X(14)70368-7.
122.Farhat MR**, Mitnick CD, Franke MF, Kaur D, Sloutsky A, Murray M, Jacobson KR.
Concordance of Mycobacterium tuberculosis fluoroquinolone resistance testing:
implications for treatment. Int J Tuberc Lung Dis. 2015 Mar;19(3):339-41.
123.Childs LM, Abuelezam NN, Dye C, Gupta S, Murray MB, Williams BG, Buckee CO. Modelling
challenges in context: lessons from malaria, HIV, and tuberculosis. Epidemics. 2015
Mar;10:102-7.
124.Oxlade O**, Huang CC, Murray M. Estimating the impact of reducing under-nutrition on the
tuberculosis epidemic in the central eastern states of India: a dynamic modeling study. PLoS
One. 2015 Jun 5;10(6):e0128187.
125.Broadhurst MJ, Kelly JD, Miller A, Semper A, Bailey D, Groppelli E, Simpson A, Brooks T, Hula
S, Nyoni W, Sankoh AB, Kanu S, Jalloh A, Ton Q, Sarchet N, George P, Perkins MD, Wonderly
B, Murray M, Pollock NR. ReEBOV Antigen Rapid Test kit for point-of-care and laboratory-
based testing for Ebola virus disease: a field validation study. Lancet. 2015 Aug
29;386(9996):867-74.
126.Odone A**, Calderon R, Becerra MC, Zhang Z, Contreras CC, Yataco R, Galea J, Lecca L,
Bonds, MH, Mitnick CD, Murray MB. Acquired and Transmitted Multidrug Resistant
Tuberculosis: The Role of Social Determinants. PLoS One. 2016 Jan 14;11(1):e0146642.
Zhang Z, Manjourides J, Grenfell BT, Cohen T. Identifying Hotspots of Multidrug-Resistant
Tuberculosis Transmission Using Spatial and Molecular Genetic Data. J Infect Dis. 2016 Jan
15;213(2):287-94.
128.Velásquez GE, Cegielski JP, Murray MB, Yagui MJ, Asencios LL, Bayona JN, Bonilla CA, Jave
HO, Yale G, Suárez CZ, Sanchez E, Rojas C, Atwood SS, Contreras CC, Santa Cruz J, Shin
SS. Impact of HIV on mortality among patients treated for tuberculosis in Lima, Peru: a
prospective cohort study. BMC Infect Dis. 2016 Feb 1;16:45.
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129.Farhat MR**, Jacobson KR, Franke MF, Kaur D, Sloutsky A, Mitnick CD, Murray M. Gyrase
mutations are associated with variable levels of Fluoroquinolone resistance in
Mycobacterium tuberculosis. J Clin Microbiol. 2016 Mar;54(3):727-33.
130.Semper AE, Broadhurst MJ, Richards J, Foster GM, Simpson AJ, Logue CH, Kelly JD, Miller A,
Brooks TJ, Murray M, Pollock NR. Performance of the GeneXpert Ebola assay for diagnosis
of Ebola virus disease in Sierra Leone: a field evaluation study. PLoS Med. 2016
Mar;13(3):e1001980.
131.Miller AC, Murray MB, Thomson DR, Arbour MC. How consistent are associations between
stunting and child development? Evidence from a meta-analysis of associations between
stunting and multidimensional child development in fifteen low- and middle-income
countries. Public Health Nutr. 2016 Jun;19(8):1339-47.
132.Lahiri N, Shah RR, Layre E, Young D, Ford C, Murray MB, Fortune SM, Moody DB. Rifampin
Resistance mutations are associated with broad chemical remodeling of Mycobacterium
tuberculosis. J Biol Chem. 2016 Jul 1;291(27):14248-56.
133.Atre SR**, Murray MB. Management and control of multidrug-resistant tuberculosis (MDR-
TB): Addressing policy needs for India. J Public Health Policy. 2016 Aug 37:277-299.
134.Mukabutera A**, Thomson D, Murray M, Basinga P, Nyirazinyoye L, Atwood S, Savage KP,
Ngirimana A, Hedt-Gauthier BL. Rainfall variation and child health: effect of rainfall on
diarrhea among under 5 children in Rwanda, 2010. BMC Public Health. 2016 Aug 5;16:731.
135.Diakite I**, Mooring EQ, Velasquez GE, Murray MB. Novel Ordered Stepped-Wedge Cluster
Trial Designs for Detecting Ebola Vaccine Efficacy Using a Spatially Structured Mathematical
Model. PLoS Negl Trop Dis. 2016 Aug 10;10(8):e0004866.
136.Farhat MR**, Sultana R, Iartchouk O, Bozeman S, Galagan J, Sisk P, Stolte C, Nebenzahl-
Guimaraes H, Jacobson K, Sloutsky A, Kaur D, Posey J, Kreiswirth BN, Kurepina N, Rigouts L,
Streicher EM, Victor TC, Warren RM, van Soolingen D, Murray M. Genetic Determinants of
Drug Resistance in Mycobacterium tuberculosis and Their Diagnostic Value. Am J Respir Crit
Care Med. 2016 Sep 1;194(5):621-30.
137.Thomson DR, Semakula M, Hirschhorn LR, Murray M, Ndahindwa V, Manzi A, Mukabutera
A, Karema C, Condo J, Hedt-Gauthier B. Applied statistical training to strengthen analysis
and health research capacity in Rwanda. Health Res Policy Syst. 2016 Sep 29;14(1):73.
138.Cancedda C, Davis SM, Dierberg KL, Lascher J, Kelly JD, Barrie MB, Koroma AP, George P,
Kamara AA, Marsh R, Sumbuya MS, Nutt CT, Scott KW, Thomas E, Bollbach K, Sesay A, Barrie
A, Barrera E, Barron K, Welch J, Bhadelia N, Frankfurter RG, Dahl OM, Das S, Rollins RE,
Eustis B, Schwartz A, Pertile P, Pavlopoulos I, Mayfield A, Marsh RH, Dibba Y, Kloepper D,
Hall A, Huster K, Grady M, Spray K, Walton DA, Daboh F, Nally C, James S, Warren GS, Chang
J, Drasher M, Lamin G, Bangura S, Miller AC, Michaelis AP, McBain R, Broadhurst MJ,
Murray M, Richardson ET, Philip T, Gottlieb GL, Mukherjee JS, Farmer PE. Strengthening
Health Systems While Responding to a Health Crisis: Lessons Learned by a
Nongovernmental Organization During the Ebola Virus Disease Epidemic in Sierra Leone. J
Infect Dis. 2016 Oct 15;214(suppl 3):S153-S163.
139.Velasquez GE**, Calderon RI, Mitnick CD, Becerra MC, Huang CC, Zhang Z, Contreras CC,
Yataco RM, Galea JT, Lecca LW, Murray MB. Pyrazinamide Resistance Assays and Two-
90

Month Sputum Culture Status in MDR-TB Patients. Antimicrob Agents Chemother. 2016
Nov;60(11):6766-6773.
140.Aibana O**, Acharya X, Huang CC, Becerra MC, Galea JT, Chiang SS, Contreras C, Calderon R,
Yataco R, Velasquez GE, Tintaya K, Jimenez J, Lecca L, Murray MB. Nutritional Status and
Tuberculosis Risk in Adult and Pediatric Household Contacts. PLoS One. 2016 Nov
11;11(11):e0166333.
141.Richardson ET**, Kelly JD, Barrie MB, Mesman AW, Karku S, Quiwa K, Marsh RH,
Koedoyoma S, Daboh F, Barron KP, Grady M, Tucker E, Dierberg KL, Rutherford GW, Barry
M, Jones JH, Murray MB, Farmer PE. Minimally Symptomatic Infection in an Ebola
'Hotspot': A Cross-Sectional Serosurvey. PLoS Negl Trop Dis. 2016 Nov 15;10(11):e0005087.
142.Miller AC, Ramananjato RH, Garchitorena A, Rabeza VR, Gikic D, Cripps A, Cordier L,
Rahaniraka Razanadrakato HT, Randriamanambintsoa M, Hall L, Murray M, Safara
Razanavololo F, Rich ML, Bonds MH. Baseline population health conditions ahead of a
health system strengthening program in rural Madagascar. Glob Health Action.
2017;10(1):1329961.
143.Aibana O**, Bachmaha M, Krasiuk V, Rybak N, Flanigan TP, Petrenko V, Murray MB. Risk
factors for poor multidrug-resistant tuberculosis treatment outcomes in Kyiv Oblast,
Ukraine. BMC Infect Dis. 2017 Feb 7;17(1):129.
144.Nebenzahl-Guimaraes H**, van Laarhoven A, Farhat MR, Koeken VACM, Mandemakers JJ,
Zomer A, van Hijum SAFT, Netea MG, Murray M, van Crevel R, van Soolingen D.
Transmissible Mycobacterium tuberculosis strains share genetic markers and immune
phenotypes. Am J Respir Crit Care Med. 2017 Jun 1;195(11):1519-1527.
145.Garchitorena A, Miller AC, Cordier LF, Ramananjato R, Rabeza VR, Murray M, Cripps A, Hall
L, Farmer P, Rich M, Orlan AV, Rabemampionona A, Rakotozafy G, Randriantsimaniry D,
Gikic D, Bonds MH. In Madagascar, use of health care services increased when fees were
removed: lessons for universal health coverage. Health Aff (Millwood). 2017 Aug
1;36(8):1443-1451.
146.Aibana O**, Franke MF, Huang CC, Galea JT, Calderon R, Zhang Z, Becerra MC, Smith ER,
Ronnenberg AG, Contreras C, Yataco R, Lecca L, Murray MB. Impact of Vitamin A and
Carotenoids on the Risk of Tuberculosis Progression. Clin Infect Dis. 2017 Sep 15;65(6):900-
909.
147.Rodriguez CA, Smith ER, Villamor E, Zaveleta N, Respicio-Torres G, Contreras C, Perea S,
Jimenez J, Tintaya K, Lecca L, Murray MB, Franke MF. Development and validation of a food
frequency questionnaire to estimate intake among children and adolescents in urban Peru.
Nutrients. 2017 Oct 14;9(10).
148.Farhat MR**, Jacobson KR, Franke MF, Kaur D, Murray M, Mitnick CD. Fluoroquinolone
resistance mutation detection is equivalent to culture-based drug sensitivity testing for
predicting multidrug-resistant tuberculosis treatment outcome: a retrospective cohort
study. Clin Infect Dis. 2017 Oct 15;65(8):1364-1370.
149. Aibana O, Slavuckij A, Bachmaha M, Krasiuk V, Rybak N, Flanigan TP, Petrenko
V, Murray MB. Patient predictors of poor drug sensitive tuberculosis treatment outcomes
in Kyiv Oblast, Ukraine. F1000Research 2017 Oct 23;6:1873.
91

150.Nathavitharana RR, Shi CX, Chindelevitch L, Calderon R, Zhang Z, Galea JT, Contreras C,
Yataco R, Lecca L, Becerra MC, Murray MB, Cohen T. Polyclonal Pulmonary Tuberculosis
Infections and Risk for Multidrug Resistance, Lima, Peru. Emerg Infect Dis 2017
Nov;11:1883-86.
151.Mukabutera A, Thomson DR, Hedt-Gauthier BL, Atwood S, Basinga P, Nyirazinyoye L, Savage
KP, Habimana M, Murray M. Exogenous factors matter when interpreting the results of an
impact evaluation: a case study of rainfall and child health programme intervention in
Rwanda. Trop Med Int Health. 2017 Dec;22(12):1505-1513.
152.Miotto P, Tessema B, Tagliani E, Chindelevitch L, Starks AM, Emerson C, Hanna D, Kim PS,
Liwski R, Zignol M, Gilpin C, Niemann S, Denkinger CM, Fleming J, Warren RM, Crook D,
Posey J, Gagneux S, Hoffner S, Rodrigues C, Comas I, Engelthaler DM, Murray M, Alland D,
Rigouts L, Lange C, Dheda K, Hasan R , Ranganathan UDK, McNerney R, Ezewudo M, Cirillo
DM, Schito M, Köser CU, Rodwell TC. A standardised method for interpreting the
association between mutations and phenotypic drug-resistance in Mycobacterium
tuberculosis. Eur Respir J. 2017 Dec 28;50(6).
153.Aibana O**, Franke MF, Huang CC, Galea JT, Calderon R, Zhang Z, Becerra MC, Smith ER,
Contreras C, Yataco R, Lecca L, Murray MB. Vitamin E Status is inversely associated with
risk of incident tuberculosis disease among household contacts. J Nutr. 2018 Jan
1;148(1):56-62.
154. Zelner J, Murray M, Becerra M, Galea J, Lecca L, Calderon R, Yataco R, Zhang Z, Cohen
T. Protective effects of household-based TB interventions are robust to neighbourhood-level
variation in exposure risk in Lima, Peru: a model-based analysis. Int J Epidemiol. 2018 Feb
1;47(1):185-192.
155. Linger Y, Knickerbocker C, Sipes D, Golova J, Franke M, Calderon R, Lecca L, Thakore N,
Holmberg R, Qu P, Kukhtin A, Murray MB, Cooney CG, Chandler DP. Genotyping
Multidrug-Resistant Mycobacterium tuberculosis from Primary Sputum and Decontaminated
Sediment with an Integrated Microfluidic Amplification Microarray Test. J Clin Microbiol.
2018 Feb 22;56(3). Print 2018 Mar.
156.Wun KS, Reijneveld JF, Cheng TY, Ladell K, Uldrich AP, Le Nours J, Miners KL, McLaren JE,
Grant EJ, Haigh OL, Watkins TS, Suliman S, Iwany S, Jimenez J, Calderon R, Tamara KL, Leon
SR, Murray MB, Mayfield JA, Altman JD, Purcell AW, Miles JJ, Godfrey DI, Gras S, Price DA,
Van Rhijn I, Moody DB, Rossjohn J. T cell autoreactivity directed toward CD1c itself rather
than toward carried self lipids. Nat Immunol. 2018 Apr;19(4):397-406.
157.Thomson DR, Amoroso C, Atwood S, Bonds MH, Rwabukwisi FC, Drobac P, Finnegan KE,
Farmer DB, Farmer PE, Habinshuti A, Hirschhorn LR, Manzi A, Niyigena P, Rich ML, Stulac S,
Murray MB, Binagwaho A. Impact of a health system strengthening intervention on
maternal and child health outputs and outcomes in rural Rwanda 2005-2010. BMJ Glob
Health. 2018 Apr 9;3(2):e000674.
158. Garchitorena A, Miller AC, Cordier L, Rabeza VR, Randriamanambintsoa M, Razanadrakato
HR, Hall L, Haruna J, Randrianambinina A, Thomson DR, Atwood S, Murray MB,
Ratsirarson J, Ouenzar MA, Bonds MH. Early changes in intervention coverage and
mortality rates following the implementation of an integrated health system intervention in
Madagascar: a cohort study. BMJ Glob Health. 2018 Jun 4;3(3):e000762.
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159. Thakore N, Norville R, Franke M, Calderon R, Lecca L, Villanueva M, Murray MB,
Cooney CG, Chandler DP, Holmberg RC. Automated TruTip nucleic acid extraction and
purification from raw sputum. PLoS One. 2018 Jul 5;13(7):e0199869.
160. McIntosh AI, Jenkins HE, White LF, Barnard M, Thomson DR, Dolby T, Simpson J,
Streicher EM, Kleinman MB, Ragan EJ, van Helden PD, Murray MB, Warren RM,
Jacobson KR. Using routinely collected laboratory data to identify high rifampicin-resistant
tuberculosis burden communities in the Western Cape Province, South Africa: A
retrospective spatiotemporal analysis. PLOS Med. 2018 Aug 21;15(8):e1002638.
eCollection 2018 Aug.
161. Miller AC, Garchitorena A, Rabeza V, Randriamanambintsoa M, Rahaniraka Razanadrakato
HT, Cordier L, Ouenzar MA, Murray MB, Thomson DR, Bonds MH. Cohort Profile:
Ifanadiana Health Outcomes and Prosperity longitudinal Evaluation (IHOPE). Int J
Epidemiol. 2018 Oct 1;47(5):1394-1395e.
162. CRyPTIC Consortium and the 100,000 Genomes Project, Allix-Béguec C, Arandjelovic I, Bi
L, Beckert P, Bonnet M, Bradley P, Cabibbe AM, Cancino-Muñoz I, Caulfield MJ,
Chaiprasert A, Cirillo DM, Clifton DA, Comas I, Crook DW, De Filippo MR, de Neeling H,
Diel R, Drobniewski FA, Faksri K, Farhat MR, Fleming J, Fowler P, Fowler TA, Gao Q,
Gardy J, Gascoyne-Binzi D, Gibertoni-Cruz AL, Gil-Brusola A, Golubchik T, Gonzalo X,
Grandjean L, He G, Guthrie JL, Hoosdally S, Hunt M, Iqbal Z, Ismail N, Johnston J,
Khanzada FM, Khor CC, Kohl TA, Kong C, Lipworth S, Liu Q, Maphalala G, Martinez E,
Mathys V, Merker M, Miotto P, Mistry N, Moore DAJ, Murray M, Niemann S, Omar SV,
Ong RT, Peto TEA, Posey JE, Prammananan T, Pym A, Rodrigues C, Rodrigues M, Rodwell
T, Rossolini GM, Sánchez Padilla E, Schito M, Shen X, Shendure J, Sintchenko V, Sloutsky
A, Smith EG, Snyder M, Soetaert K, Starks AM, Supply P, Suriyapol P, Tahseen S, Tang P,
Teo YY, Thuong TNT, Thwaites G, Tortoli E, van Soolingen D, Walker AS, Walker TM,
Wilcox M, Wilson DJ, Wyllie D, Yang Y, Zhang H, Zhao Y, Zhu B. Prediction of
Susceptibility to First-Line Tuberculosis Drugs by DNA Sequencing. N Engl J Med. 2018
Oct 11;379(15):1403-1415.
163. Mooring EQ**, Mitjà O, Murray MB. Spatial-temporal clustering analysis of yaws on
Lihir Island, Papua New Guinea to enhance planning and implementation of eradication
programs. PLoS Negl Trop Dis. 2018 Oct 29;12(10):e0006840.
164. Hedt-Gauthier B, Airhihenbuwa CO, Bawah AA, Burke KS, Cherian T, Connelly MT,
Hibberd PL, Ivers LC, Jerome JG, Kateera F, Manabe YC, Maru D, Murray M, Shankar
AH, Shuchman M, Volmink J. Academic promotion policies and equity in global health
collaborations. Lancet. 2018 Nov 3;392(10158):1607-1609.
165. Gupta N, Hirschhorn LR, Rwabukwisi FC, Drobac P, Sayinzoga F, Mugeni C, Nkikabahizi
F, Bucyana T, Magge H, Kagabo DM, Nahimana E, Rouleau D, VanderZanden A, Murray
M, Amoroso C. Causes of death and predictors of childhood mortality in Rwanda: a
matched case-control study using verbal social autopsy. BMC Public Health. 2018 Dec
17;18(1):1378.
166. Farhat MR, Freschi L, Calderon R, Ioerger T, Snyder M, Meehan CJ, de Jong B, Rigouts L,
Sloutsky A, Kaur D, Sunyaev S, van Soolingen D, Shendure J, Sacchettini J, Murray M.
GWAS for quantitative resistance phenotypes in Mycobacterium tuberculosis reveals
resistance genes and regulatory regions. Nat Commun. 2019 May 13;10(1):2128.
93

167. Farhat MR, Sixsmith J, Calderon R, Hicks ND, Fortune SM, Murray M. Rifampicin and
rifabutin resistance in 1003 Mycobacterium tuberculosis clinical isolates. J Antimicrob
Chemother. 2019 Jun 1;74(6):1477-1483.
168. Mesman AW**, Soto M, Coit J, Calderon R, Aliaga J, Pollock NR, Mendoza M, Mestanza
FM, Mendoza CJ, Murray MB, Lecca L, Holmberg R, Franke MF. Detection of
Mycobacterium tuberculosis in pediatric stool samples using TruTip technology. BMC Infect
Dis. 2019 Jun 27;19(1):563.
169. Bellerose M, Baek SH, Huang CC, Moss C, Koh EI, Proulx M, Smith C, Baker R, Lee J,
Eum S, Shin SJ, Cho SN, Murray M, Sassetti C. Common variants in the glycerol kinase
gene reduce tuberculosis drug efficacy. mBio. 2019 Jul 30;10(4).
170. Ezran C, Bonds MH, Miller AC, Cordier LF, Haruna J, Mwanawabenea D,
Randriamanambintsoa M, Razanadrakato HR, Ouenzar MA, Razafinjato BR, Murray M,
Garchitorena A. Assessing trends in the content of maternal and child care following a
health system strengthening initiative in rural Madagascar: a longitudinal cohort study. PLoS
Med. 2019 Aug 20;16(8):e1002869.
171. Luo Y, Suliman S, Asgari S, Amariuta T, Calderon R, Lecca L, León SR, Jimenez J, Yataco
R, Contreras C, Galea JT, Becerra M, Nejentsev S, Martínez-Bonet M, Nigrovic PA, Moody
DB, Murray MB, Raychaudhuri S. Early progression to active tuberculosis is a highly
heritable trait driven by 3q23 in Peruvians. Nat Commun. 2019 Aug 21;10(1):3765.
172. Buter J, Cheng TY, Ghanem M, Grootemaat AE, Raman S, Feng X, Plantijn AR, Ennis T,
Wang J, Cotton RN, Layre E, Ramnarine AK, Mayfield J, Young DC, Martinot A, Siddiqi N,
Wakabayashi S, Botella H, Calderon R, Murray M, Ehrt S, Snider BB, Reed MB, Oldfield
E, Tan S, Rubin EJ, Behr MA, van der Wel NN, Minnaard AJ, Moody DB. Mycobacterium
tuberculosis releases an antacid that remodels phagosomes. Nat Chem Biol. 2019
Sep;15(9):889-899.
173. Aibana O, Huang CC, Aboud S, Arnedo-Pena A, Becerra MC, Bellido-Blasco JB, Bhosale R,
Calderon R, Chiang S, Contreras C, Davaasambuu G, Fawzi WW, Franke MF, Galea JT,
Garcia-Ferrer D, Gil-Fortuño M, Gomila-Sard B, Gupta A, Gupte N, Hussain R, Iborra-
Millet J, Iqbal NT, Juan-Cerdán JV, Kinikar A, Lecca L, Mave V, Meseguer-Ferrer N,
Montepiedra G, Mugusi FM, Owolabi OA, Parsonnet J, Roach-Poblete F, Romeu-García
MA, Spector SA, Sudfeld CR, Tenforde MW, Togun TO, Yataco R, Zhang Z, Murray MB.
Vitamin D status and risk of incident tuberculosis disease: A nested case-control study,
systematic review, and individual-participant data meta-analysis. PLoS Med. 2019 Sep
11;16(9):e1002907.
174. Becerra MC, Huang CC, Lecca L, Bayona J, Contreras C, Calderon R, Yataco R, Galea J,
Zhang Z, Atwood S, Cohen T, Mitnick CD, Farmer P, Murray M. Transmissibility and
potential for disease progression of drug resistant Mycobacterium tuberculosis: prospective
cohort study. BMJ. 2019 Oct 24;367:l5894.
175. Reinink P, Shahine A, Gras S, Cheng TY, Farquhar R, Lopez K, Suliman SA, Reijneveld JF,
Le Nours J, Tan LL, León SR, Jimenez J, Calderon R, Lecca L, Murray MB, Rossjohn J,
Moody DB, Van Rhijn I. A TCR β-Chain Motif Biases toward Recognition of Human CD1
Proteins. J Immunol. 2019 Dec 15;203(12):3395-3406.
176. Li R**, Nordio F, Huang CC, Contreras C, Calderon R, Yataco R, Galea JT, Zhang Z,
Becerra MC, Lecca L, Murray MB. Two clinical prediction tools to improve tuberculosis
contact investigation. Clin Infect Dis. 2020 Jan 6. [Epub ahead of print]
94

177. Aibana O, Dauria E, Kiriazova T, Makarenko O, Bachmaha M, Rybak N, Flanigan TP,
Petrenko V, Becker AE, Murray MB. Patients' perspectives of tuberculosis treatment
challenges and barriers to treatment adherence in Ukraine: a qualitative study. BMJ Open.
2020 Feb 2;10(1):e032027.
178. Lopez K, Iwany SK, Suliman S, Reijneveld JF, Ocampo TA, Jimenez J, Calderon R, Lecca
L, Murray MB, Moody DB, Van Rhijn I. CD1b tetramers broadly detect T cells that
correlate with mycobacterial exposure but not tuberculosis disease state. Front
Immunol. 2020 Feb 14;11:199.
179. Huang CC, Chu AL, Becerra MC, Galea JT, Calderon R, Contreras C, Yataco R, Zhang Z,
Lecca L, Murray MB. Mycobacterium tuberculosis Beijing lineage and the risk of
tuberculosis in child household contacts. Emerg Infect Dis. 2020 Mar;26(3):568-578.
180. Martinez L, Cords O, Horsburgh CR, Andrews JR; Pediatric TB Contact Studies Consortium.
The risk of tuberculosis in children after close exposure: a systematic review and individual-
participant meta-analysis. Lancet. 2020 Mar 21;395(10228):973-984.
181. Kukhtin A, Norville R; Bueno A, Qu P, Parrish N, Murray M, Chandler D, Holmberg R,
Cooney C. A benchtop automated sputum-to-genotype system using a Lab-on-a-Film
assembly for detection of multidrug-resistant Mycobacterium tuberculosis. Anal Chem. 2020
Apr 7;92(7):5311-5318.
182. Suliman S, Gela A, Mendelsohn SC, Iwany SK, Tamara KL, Mabwe S, Bilek N, Darboe F,
Fisher M, Corbett AJ, Kjer-Nielsen L, Eckle SBG, Huang CC, Zhang Z, Lewinsohn DM,
McCluskey J, Rossjohn J, Hatherill M, León SR, Calderon RI, Lecca L, Murray M, Scriba
TJ, Van Rhijn I, Moody DB; South African Tuberculosis Vaccine Initiative (SATVI) Clinical
Immunology Team. Peripheral blood mucosal-associated invariant T (MAIT) cells in
tuberculosis patients and healthy Mycobacterium tuberculosis-exposed controls. J Infect Dis.
2020 Apr 8. [Epub ahead of print]
183. Penn-Nicholson A, Mbandi SK, Thompson E, Mendelsohn SC, Suliman S, Chegou NN,
Malherbe ST, Darboe F, Erasmus M, Hanekom WA, Bilek N, Fisher M, Kaufmann SHE,
Winter J, Murphy M , Wood R, Morrow C, Van Rhijn I, Moody DB, Murray M, Andrade
BB, Sterling TR, Sutherland J, Naidoo K, Padayatchi N, Walzl G, Hatherill M, Zak D, Scriba
TJ, and the Adolescent Cohort Study team, GC6-74 Consortium, the SATVI Clinical and
Laboratory Team, The ScreenTB and AE-TBC teams, CAPRISA IMPRESS team, RePORT
Brazil Consortium and Peruvian Household Contacts Cohort study group. RISK6, a 6-gene
transcriptomic signature of TB disease risk, diagnosis and treatment response. Sci Rep.
2020. In press.
184. Li R**, Rivers C, Tan Q, Murray MB, Toner E, Lipsitch M. Estimated Demand for US
Hospital Inpatient and Intensive Care Unit Beds for Patients With COVID-19 Based on
Comparisons with Wuhan and Guangzhou, China. JAMA Netw Open. 2020 May
6;3(5):e208297.
185. Sonenthal PD, Masiye J, Kasomekera N, Marsh RH, Wroe EB, Scott KW, Li R, Murray
MB, Bukhman A, Connolly E, Minyaliwa T, Katete M, Banda G, Nyirenda M, Rouhani SA.
SARS-CoV-2 preparedness in Malawi: results of a national facility-based critical care
assessment. Lancet Glob Health. 2020. In press.
186. Asgari, S., Luo, Y., Akbari, A, Belbin GM, Li X, Harris DN, Selig M, Bartell E, Calderon
R, Slowikowski K, Contreras C, Yataco R, Galea JT, Jimenez J, Coit JM, Farroñay
C, Nazarian RM, O’Connor TD, Dietz HC, Hirschhorn JN, Guio H, Lecca L, Kenny
95

EE, Freeman EE, Murray MB, Raychaudhuri S. A positively selected FBN1 missense
variant reduces height in Peruvian individuals. Nature. 2020 May 13.
(** = mentee)
Other peer-reviewed publications
1. Logigian EL, Murray MB. Case 42-1994— A 19-year-old man with rapidly progressive lower-
extremity weakness and dysesthesias after a respiratory tract infection. NEJM
1994;331:1437-44.
2. Murray M, Nardell E. Molecular epidemiology of tuberculosis: achievements and challenges
to current knowledge. Bull World Health Organ. 2002;80(6):477-82.
3. Brickner PW, Vincent RL, First M, Nardell E, Murray M, Kaufman W. The application of
ultraviolet germicidal irradiation to control transmission of airborne disease: bioterrorism
countermeasure. Public Health Rep 2003;118:99-114.
4. Cohen T**, Sommers B, Murray M. The effect of drug resistance on the fitness of
Mycobacterium tuberculosis. Lancet Infect Dis 2003;3:13-21.
5. Gessler D, Dye C, Farmer P, Murray M, Navin T, Reves R, Shinnick T, Small PM, Yates T,
Simpson G. Public health. A national tuberculosis archive. Science 2006 Mar 3;311:1245-6.
6. Murray M. The epidemiology of SARS. In: Kleinman A, Watson JL, editors. SARS in China;
prelude to pandemic? Stanford, CA: Stanford University Press; 2006. p. 17-30.
7. Colijn C, Cohen T, Murray M. Mathematical models of tuberculosis: accomplishments and
future challenges. Proceedings of BIOMAT 2006 - International Symposium on
Mathematical and Computational Biology; 2006 Nov 27-30, Manaus, Brazil. World Scientific
Publishing Co. 2007.
8. Cohen T, Colijn C, Murray M. Mathematical modeling of tuberculosis transmission
dynamics. In: Handbook of Tuberculosis: Clinics, Diagnostics, Therapy, and Epidemiology.
Kaufman SH, van Helden P, eds. Weinheim: Wiley-VCH; 2008.
9. Cohen T**, Dye C, Colijn C, Williams B, Murray M. Mathematical models of the
epidemiology and control of drug-resistant TB. Expert Rev Resp Med. 2009;3:67-9.
10. Harries AD, Murray MB, Jeon CY, Ottmani SE, Lonnroth K, Kapur A. Response to letter from
Sarah Bailey and Peter Godfrey-Faussett. Trop Med Int Health. 2010 Jul 15(11):1402.
11. Boulle A, Clayden P, Cohen K, Cohen T, Conradie F, Dong K, Gelfen N, Grimwood A, Hurtado
R, Kenyon C, Lawn S, Maartens G, Meindjes G, Mandelson M, Murray M, Sanne I, Spencer
D, Taljaand J, Vanieva E, Venter F, Wilson D. Prolonged deferral of antiretroviral therapy in
the SAPIT trial: did we need a clinical trial to tell us that this would increase mortality? S Afr
Med J. 2010 Sep 7;100(9):566, 568, 570-1.
12. Rinaldo A, Blokesch M, Bertuzzo E, Mari L, Righetto L, Murray M, Gatto M, Casagrandi
R, Rodriguez-Iturbe I. A transmission model of the 2010 cholera epidemic in Haiti. Ann
Intern Med. 2011 Sep 20;155(6):403-4.
13. Nahid P, Kim PS, Evans CA, Alland D, Barer M, Diefenbach J, Ellner J, Hafner R, Hamilton CD,
Iademarco M, Ireton B, Kimerling M, Lienhardt C, Mackenzie W, Murray M, Perkins MD,
Posey J, Roberts T, Sizemore S, Stevens WS, Via L, Williams SD, Yew WW, Swindells S.
96

Clinical research and development of tuberculosis diagnostics: moving from silos to
synergy. J Infect Dis. 2012 May 15; 205(Suppl 2): S159–S168.
14. Dheda K, Gumbo T, Gandhi NR, Murray M, Theron G, Udwadia Z, Migliori GB, Warren R.
Global control of tuberculosis: from extensively drug-resistant to untreatable tuberculosis.
Lancet Respir Med. 2014 Apr;2(4):321-338.
15. Ferrara G, Murray M, Winthrop K, Centis K, Sotgiu G, Migliori GB, Maeurer M, Zumla A. Risk
factors associated with pulmonary tuberculosis: smoking, diabetes and anti-TNF-α drugs.
Curr Opin Pulm Med. 2012 May;18(3):233-40.
16. Jeon CY**, Murray MB, Baker MA. Managing tuberculosis in patients with diabetes mellitus:
why we care and what we know. Expert Rev Anti Infect Ther. 2012 Aug;10(8):863-8.
17. Andrews JR., Basu S, Dowdy DW, Murray MB. The epidemiological advantage of preferential
targeting of tuberculosis control at the poor. Int J Tuberc Lung Dis. 2015 Apr;19(4):375-80.
Review. Erratum in: Int J Tuberc Lung Dis. 2015 Aug;19(8):1000.
18. Velasquez GE**, Aibana O, Ling EJ, Diakite I, Mooring EQ, Murray MB. Time from infection
to disease and infectiousness for Ebola virus disease, a systematic review. Clin Infect Dis.
2015 Oct 1;61(7):1135-40.
19. Dheda K, Gumbo T, Maartens G, Dooley KE, McNerney R, Murray M, Furin J, Nardell EA,
London L, Lessem E, Theron G, van Helden P, Niemann S, Merker M, Dowdy D, Van Rie A,
Siu GK, Pasipanodya JG, Rodrigues C, Clark TG, Sirgel FA, Esmail A, Lin HH, Atre SR, Schaaf
HS, Chang KC, Lange C, Nahid P, Udwadia ZF, Horsburgh CR Jr, Churchyard GJ, Menzies D,
Hesseling AC, Nuermberger E, McIlleron H, Fennelly KP, Goemaere E, Jaramillo E, Low M,
Jara CM, Padayatchi N, Warren RM. The epidemiology, pathogenesis, transmission,
diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable
tuberculosis. Lancet Respir Med. 2017 Mar 15. pii: S2213-2600(17)30079-6. Review.
20. Dheda K, Gumbo T, Maartens G, Dooley KE, Murray M, Furin J, Nardell EA, Warren RM;
Lancet Respiratory Medicine drug-resistant tuberculosis Commission group. The Lancet
Respiratory Medicine Commission: 2019 update: epidemiology, pathogenesis, transmission,
diagnosis, and management of multidrug-resistant and incurable tuberculosis. Lancet Respir
Med. 2019 Sep;7(9):820-826.
(** = mentee)
Research publications without authorship
1. TB Sequencing Consortium, A first for tuberculosis research in South Africa: whole genome
sequence of the South African Mycobacterium tuberculosis strain F11 released. South
African Journal of Science 2005;101:393-5. (*Principal Investigator)
Non-peer reviewed scientific or medical publications/materials in print or other media
1. Kim JY, Mitnick C, Bayona J, Blank R, Nardell E, Mukherjee J, Rich M, Farmer P, Becerra M,
Murray M. Examining assumptions about multi-drug resistant TB control : round table
discussion / Jim Yong Kim ...[et al.]. Bull WHO 2002; 80:498.
97

2. Ryan ET, Murray M. Epidemiology and biostatistics. In: Guerrant RL, Walker DH, Weller PF,
editors. Tropical Infectious Diseases: Principles, Pathogens, and Practice. Second Edition.
New York: Elsevier; 2005. p. 11-16.
3. Cave DM, Nardell E, Murray M. Molecular epidemiology of Mycobacterium tuberculosis. In:
Jacobs W, Cole ST, editors. Tuberculosis. Washington DC: ASM Press 2005.
4. Murray M and King G. The effects of International Monetary Fund loans on health
outcomes.
PLoS Med 2008;5:e162.
5. Murray M and Cohen T. Extensively drug resistant tuberculosis and HIV/AIDS. In:
Kaufmann, SHE, Walker, BD, editors. AIDS-TB: A Deadly Liaison, Weinheim. Wiley-VCH;
2009.
6. Murray M. Epidemiology of tuberculosis. In: Raviglione, MC, editor. Tuberculosis: Fourth
Edition, The Essentials. New York: Informa Healthcare USA, Inc. 2009. p. 23-59.
7. Murray M, How Epidemics Happen. Nature Medicine 2010:16: 159. Book review.
8. Farmer PE, Murray M, Hedt-Gauthier B. Clinical Trials and Global Health Equity. The Lancet
Global Health Blog; 8 July 2013. Available at:
http://globalhealth.thelancet.com/2013/07/08/clinical-trials-and-global-health-equity
9. Bonds MH, Garchitorena A, Cordier L, Miller AC, McCarty M, Andriamihaja B, Ratsirarson J,
Randrianambinina A, Rabeza VR, Finnegan K, Gillespie T, Wright PA, Farmer PE, Loyd T,
Murray MB, Herrnstein RM, Herrnstein JR, PIVOT Impact Team, Gikic D, Ouenzar MA, Hall L,
Rich ML. Advancing a Science for Sustaining Health: Establishing a Model Health District in
Madagascar. BioRxiv [Preprint]. [posted 2017 May 30]. Available from:
https://www.biorxiv.org/content/early/2017/05/30/141549
10. Bloom BR, Atun R, Cohen T, Dye C, Fraser H, Gomez GB, Knight G, Murray M, Nardell E,
Rubin E, Salomon J, Vassall A, Volchenkov G, White R, Wilson D, Yadav P. Tuberculosis. In:
Holmes KK, Bertozzi S, Bloom BR, Jha P, editors. Major Infectious Diseases. 3rd edition.
Washington (DC): The International Bank for Reconstruction and Development / The World
Bank; 2017 Nov 3.
11. Buckee C, Hedt-Gauthier B, Mahmud A, Martinez P, Tedijanto C, Murray M, Khan R, Menkir
T, Suliman S, Fosdick B, Cobey S, Rasmussen A, Popescu S, Cevik M, Dada S, Fowkes F,
Clapham H, Mordecai E, Hampson K, Majumder M, Wesolowski A, Kuppalli K, Rodriguez
Barraquer I, Smith TC, Hodcroft E, Christofferson RC, Cormier SA, Gerardin J, Cowley L,
Childs L, Keegan LT, Pitzer V, Oldenburg C. Women in science are battling COVID-19 and
patriarchy at the same time. Times Higher Ed. 15 May 2020.
Thesis
Murray, MB. Problems in the Molecular Epidemiology of Tuberculosis [Dissertation]. Boston

(MA): Harvard School of Public Health; 2001.
Narrative
98

To date, my career has focused on two main areas: advancing progress in tuberculosis
management and control and developing research capacity in low and middle-income
countries.
My work on tuberculosis has shifted over the past twenty years from a focus on dynamical
modeling of TB epidemics to field studies on the bacterial and host determinants of TB infection
and disease. Between 2008-2013, I led a multi-disciplinary consortium that studied the impact
of drug resistance of the transmission dynamics of tuberculosis in Lima, Peru. This project
followed over 18000 people for TB-associated outcomes and has generated data that has
allowed my team to also address a range of host and environmental factors that contribute to
the transmission and disease burden of TB. More recently, our work in this area has centered
on the links between host metabolic and immune function as determinants of the outcome of
TB infection. This work, which is funded through an NIH consortium grant which I co-lead with
Dr. Branch Moody, is another multi-disciplinary collaboration, this time among immunologists,
epidemiologists, geneticists and veterinary pathologists.
My work on drug resistant tuberculosis has also led me to use targeted and whole genome
sequencing to study “genomic epidemiology” and to elucidate the genetic basis of drug
resistance phenotypes. To date, we have sequenced over 1500 TB strains and have created an
innovative data interface tool that allows us to use whole genome data in epidemiologic
studies. Currently, we are funded by NIH to identify, collect, archive, sequence and analyze the
drug resistance genes in M. tuberculosis strains from around the world. These data are then
passed to our collaborators who attempt to validate our findings by generating and
phenotyping Mtb variants and to our industry partners who are developing point of care
diagnostic tests to detect drug resistance. I am the PI of this collaborative project which is
funded through an NIH Center for Excellence in Translational Research.
In addition to my roles on my grant-funded projects, I am the research director for the Division
of Global Health Equity in the Department of Medicine at the Brigham and Women’s Hospital
and the non-governmental organization, Partners In Health (PIH). In that capacity, I support the
research mission of the Global Health Delivery Partnership by building research infrastructure
and mentoring junior faculty interested in research careers. At HMS, I lead the Department of
Global Health and Social Medicine’s “research core,” a team of eight epidemiologists,
biostatisticians and programmers in the task of identifying and developing research
opportunities in affiliation with PIH and other NGO’s clinical field sites. Much of this work
focuses on developing methods to evaluate the health interventions implemented in these sites
and in designing and carrying out studies to conduct such evaluations. Increasingly, our mission
has encompassed the training and development of independent researchers from the countries
in which we work.
Almost all my academic work has been conducted in the context of training graduate students
and post-doctoral fellows. I have directly supervised 39 graduate students or post-doctoral
fellows, almost all of whom have published with me. Fourteen of my former trainees have gone
99

on to tenure track faculty positions and six have joined international and non-governmental
organizations focused on global health. Among many committee assignments, I am particularly
proud of my contribution to the Task Force on Women in Science and Engineering which made
recommendations that I believe have improved the working lives of many women in science at
Harvard. I have served on the Human Subjects Committee at HSPH, co-chaired the Community
Engagement Mission of the Strategic Leadership Team at the Brigham and Women’s Hospital
and led a number of junior and senior faculty searches.
100


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF PAUL GRONKE IN SUPPORT OF PLAINTIFFS’


1. I am a Professor of Political Science at Reed College and Director of
the Early Voting Information Center. I received a BA in Political
Science from the University of Chicago, a Master’s Degree in Western
European Politics from the University of Essex, Colchester UK, and a
PhD in Political Science from the University of Michigan. I have
written scientific research publications on voting by mail, early voting,
voter turnout, and election administration that have appeared in peer-
reviewed journals and university press edited volumes. I have written
and collaborated on policy reports on public opinion and the opinions
of local election officials (LEOs) about elections and election
administration. The principal focus of my research and writing since
2006 has been early voting, election administration, local election
officials, and public opinion about elections, election reform, and
electoral integrity.
2. I created the Early Voting Information Center (EVIC) in 2006 as a non-

partisan center for the study of non-precinct place voting in the United
States. EVIC has attracted more than $1,000,000 in funding from
public charities, non-profits, state governments, and federal agencies.
As the Director of EVIC, I regularly consult with election officials at
the local and state level to help them anticipate and plan for the
changes wrought by the growth in early in-person, no-excuse absentee,
and vote by mail voting. I worked as a contractor and subcontractor
in 2006 and 2008 for the federal Election Assistance Commission,
helping to oversee the collection, analysis, and reporting of election
administration data pertaining to the National Voter Registration Act,
the Uniformed Overseas and Citizens Abroad Voting Act, and the
Election Administration and Voting Survey. I helped develop the
section of the Election Assistance Commission’s Election

Administration and Voting Survey (EAVS) that asks for information
about early in-person and absentee ballots. I designed the survey
questions for early voting used by two highly regarded academic
election surveys, the Cooperative Congressional Election Study
(CCES) and the American National Election Study.
3. I have published a number of articles that contain statistical analyses

of national, regional, and state trends in voting by mail, early voting,
and the demographic and attitudinal characteristics of individual early
in-person and no-excuse absentee voters. These publications include
peer-reviewed articles in American Politics Research (2012), the
Annual Review of Political Science (2008), the Journal of Social
Issues (2008), and PS: Political Science and Politics (2007). Other
published works that discuss the legal and administrative changes to
early voting and the public response include a 2015 Electoral Studies
article, a 2014 chapter in Measure of American Elections, a 2008
William and Mary Law Review article, a 2008 chapter in Democracy
in the States, and 2019, 2016, and 2008 chapters in editions of
America Votes! A Guide to Election Law and Voting Rights. A
complete list of my publications is included in my curriculum vitae,
attached to this document.
4. In light of my scientific expertise, I was retained to give expert

testimony in League of Women Voters v. State of North Carolina
(Civil Action No. 1:13-CV-660, 2014-2015) and provided an expert
report in Ohio State Conference of the NAACP, et al. vs. John Husted
et al. (Case No. 2:14-cv-00404, Summer 2014).
5. I have been retained to opine on the impact of the COVID-19

pandemic on administering the November 3, 2020, general election in
North Carolina. Specifically, I have been asked to opine on (1) the

impact of the COVID-19 pandemic on administering in-person voting
(early and on Election Day); (2) the impact of the COVID-19
pandemic on by-mail voting; (3) the evidence accumulated so far in
2020 regarding the best mix of in-person and by-mail voting options;
and (4) when and how state and local election administrators in North
Carolina need to act in order to assure a safe, secure, and accessible
election this fall.
6. My expert opinion is that the State of North Carolina needs to act

immediately to assure a safe, secure, and accessible election in
November. The state should encourage county boards to immediately
identify sufficient in-person voting locations for early voting and
precinct place voting, and require that this information be publicly
released at the earliest possible instance. The state should suspend the
uniform hours requirement for satellite early in-person voting
locations and should suspend the requirement that a majority of poll
workers reside within an election precinct. The state should allow for
electronic requests of absentee ballots and suspend the requirement
for two witness signatures on the returned ballot materials. Finally, the
state should assure that sufficient resources are available to every
county board to implement these changes.
I. Background on Voting By Mail

A. National Trends
7. Voting by mail is a method of balloting in which a ballot is produced
by a local election official, transmitted to an eligible voter using the
United States Postal Service (in most cases 1 ); an eligible citizen
1
The Federal Military and Overseas Voter Empowerment Act (MOVE) requires states to provide blank absentee
ballots to UOCAVA (Uniformed and Overseas Citizens Absentee Voting Act) voters in at least on electronic format
– email, fax, or an online delivery system – at least 45 days before an election.
https://www.fvap.gov/uploads/FVAP/Policies/moveact.pdf

completes the ballot and provides additional validating information
(in most cases, a signature, although 12 states require additional or
alternate verifying information, such as a notary or witness signature,
copy of a valid identification, or copy of an identification and a
witness or notary signature 2 ); and the ballot is returned using the
United States Postal Service or is returned to a designated drop box or
elections office.
8. The terminology used to describe voting by mail can be a point of

confusion. Historically, this method of voting has been called
“absentee voting” because the assumption is made that an eligible
voter is sent and casts a ballot outside of an elections office or polling
place on Election Day because the voter is “absent” and unable to
appear on Election Day. Absentee voting was first made available in
nineteen of twenty-five states in the 1864 election so that soldiers in
the field could exercise the franchise.3 By the end of World War II,
most states provided for some sort of civilian access to an absentee
ballot for a variety of reasons: business travelers, railroad workers,
and citizens who were sick and infirm. With the ratification of the 26th
Amendment and the addition of many college students to the voting
rolls, many states extended absentee balloting rights to students. In
1975, the passage of the Overseas Citizens Voting Rights Act (Pub. L.
No. 94-203, 89 Stat. 1142 (1976)) extended absentee balloting to
citizens living overseas. In all of these cases, the voter is presumed to
have a legally specified reason for being “absent” on Election Day.
9. I will refer in this document to this method of balloting as “excuse-
2
State requirements for verifying absentee ballots are documented by the National Conference of State Legislatures.
https://www.ncsl.org/research/elections-and-campaigns/verification-of-absentee-ballots.aspx.
3
Fortier, John C. 2006. Absentee and Early Voting: Trends, Promises, and Perils. Washington, D.C.: AEI Press.

required absentee voting.” As of the time of this writing, sixteen states
require an excuse for requesting an absentee ballot.
10. In the late 1980s, beginning with California in 1978, and followed by
a number of additional states in the 1980s and 1990s, many states
removed the need for a designated excuse to request an absentee ballot,
thus giving rise to a second method, most commonly referred to as
“no-excuse absentee voting.” 4 Today, thirty-four states and the
District of Columbia, including North Carolina, do not require an
excuse to vote absentee by mail.5
11. Finally, five states among those thirty-four are “fully vote by mail,”
sometimes referred to as “universal ballot delivery” states. This
method was first put in place in Oregon in 2000, and is also used by
Colorado, Hawaii, Utah, and Washington. In a fully vote by mail
system, every valid registered voter on the registration rolls is sent a
ballot without the need to file a request. These fully vote by mail states
do not operate precinct polling places, although states continue to
provide in-person voting services at county offices and, in some cases,
designated voting centers in addition to county offices.
4
John Fortier, 2006, Absentee and Early Voting: Trends, Promises, and Perils. Washington, DC: AEI Press.
5
N.C. Gen. Stat. § 163-226(a)

12. The following figure, reproduced from the National Conference of
State Legislatures, 6 provides a visual representation of these three
different “voting by mail” voting regimes. As the figure makes clear,
no-excuse absentee voting is available in every region of the country.
No Excuse Required to Vote

AK ME
Absentee (or by Mail)
VT NH
WA MT ND MN WI MI NY MA RI *
ID WY SD IA IL IN OH PA NJ CT
OR NV CO NE MO KY WV MD DE DC
CA AZ UT KS AR TN VA NC
Legend
NC
NM OK LA MS AL SC No excuse absentee/mail
ballot voting
TX GA VA
All-mail elections
*Rhode Island lists a
HI FL number of excuses to vote
absentee, including "no
AS GU MP PR VI specific reason
necessary."
Figure 1: Vote By Mail Options as of May 2020
13. For the purposes of this report, I will rely on the umbrella term “voting
by mail” to refer to the no-excuse absentee election administration
system that is currently in place in North Carolina and other states.
When I refer to a citizen “voting by mail,” I refer to the individual act
of casting the absentee ballot, regardless of the state in which they live.
14. The use of voting by mail and early in person voting has grown as
these methods became more widely available across the country. The
Census Bureau has conducted the Current Population Survey (CPS)
Voting and Registration Supplement in November of federal election
years since 1960.7 The CPS is a large random sample survey that is an
6
Source: https://www.ncsl.org/research/elections-and-campaigns/absentee-and-early-voting.aspx
7
https://www.census.gov/topics/public-sector/voting.html

authoritative source to compare registration and voting in the United
States. The following figure displays the percentage of respondents
nationwide who report voting on Election Day, voting early in-person,
and voting by mail from 1996-2018 (prior to these years, the CPS did
not ask about when the ballot was cast). According to the CPS survey
data, Election Day voting comprised more than 90% of ballots cast in
1996, and just over 5% of the survey respondents said that they cast a
ballot by mail. Twenty-two years later, according to the CPS survey
conducted after the November 2018 election, 23.1% of CPS
respondents said they cast a ballot by mail.8
8
2018 Current Population Survey Voting and Registration Supplement, Table 14, “Method of Voting by Selected
Characteristics: November 2018.” https://www.census.gov/data/tables/time-series/demo/voting-and-
registration/p20-583.html

Figure 2: Election Day, Early In Person, and Voting By Mail from 1996-
2018
B. North Carolina
15. North Carolina removed the need for an excuse to request an absentee
ballot in 2001.9 Figure 3 details the percentage of voters in North Carolina
who report casting a ballot on Election Day, Early In Person, and By Mail
from 1996-2018, using data from the CPS Voting and Registration
Supplement. 10 Official voter turnout statistics from the State of North
Carolina indicate that 5.5% of ballots were cast absentee by mail in 201611
9
N.C. Gen. Stat. § 163-226(a).
10
Calculated by the author using the CPS Voting and Registration Supplement survey datasets.
11
Source: NC Board of Elections,
https://s3.amazonaws.com/dl.ncsbe.gov/ENRS/2016_11_08/absentee_stats_20161108.pdf

and 2.4% of ballots were cast absentee by mail in 2018.12
Figure 3: Use of Election Day, Early In Person, and

Voting By Mail In North Carolina
16. Usage of voting by mail remains very low in North Carolina,

something that distinguishes the state from other states that do not
require an excuse to request an absentee ballot. According to data
reported by the Federal Election Assistance Commission’s Election
Administration and Voting Survey, in 2016 North Carolina has the
seventh lowest percentage of ballots that were cast absentee by-mail.
12
Calculated by the author from the 2018 absentee ballot (https://dl.ncsbe.gov/?prefix=ENRS/2018_11_06/) and the
total ballots cast in 2018 (https://er.ncsbe.gov/?election_dt=11/06/2018&county_id=0&office=FED&contest=0).
10

Among the states that did not require an excuse for casting an absentee
ballot, North Carolina ranked lowest in terms of the percentage of
ballots cast absentee by-mail.13
17. One possible reason for this is that North Carolina rejects many
absentee ballots. In Figure 4, I report the average percentage of
absentee ballots rejected in 2012, 2014, 2016, and 2018 among four
kinds of states: states with all vote by mail, states with high vote by
mail usage (50% and higher), states with mid-tier vote by mail usage
(20-50%), and states with mostly polling places. Thirty-one states,
including North Carolina, fall into the “mostly polling places”
category.14 As shown in the figure, mail ballot rejection rates in states
that mainly use polling places are substantially higher than in states
with more extensive by-mail balloting. North Carolina stands out as
having a rejection rate higher than the average in the “mostly polling
place” (less than 20% by mail ballots) in 2014, 2016, and 2018.
13
Comparisons calculated by the author. Percentages were calculated by dividing the number of absentee ballots
counted by turnout, from Pg. 23-25, Table 2, of the Election Assistance Commission, The Election Administration
and Voting Survey: 2016 Comprehensive Report.
https://www.eac.gov/sites/default/files/eac_assets/1/6/2016_EAVS_Comprehensive_Report.pdf.
State absentee ballot laws in 2016 were taken from the National Conference of State Legislatures. As of October
2018, the NCSL reported that Alabama, Arkansas, Connecticut, Delaware, Indiana, Kentucky, Louisiana,
Massachusetts, Michigan, Mississippi, Missouri, New Hampshire, New York, Pennsylvania, Rhode Island, South
Carolina, Tennessee, Texas, Virginia, and West Virginia were the states that required an excuse to cast an absentee
ballot. http://www.ncsl.org/research/elections-and-campaigns/absentee-and-early-voting.aspx.
14
Calculations were made by the author. State absentee usage categories are determined by the 2018 absentee ballot
rate, calculated using the 2018 EAVS, as described in Footnote 13. .
11

Figure 4: Mail Ballot Rejection Rates in the 2014 – 2018 Elections
18. Voters in North Carolina have shown a strong preference to continue

to cast a ballot at a precinct place or at an early in-person voting
location, even though no-excuse absentee balloting has been available
for nearly two decades. In the following sections of the report, I
examine how COVID-19 impacts the administration of in-person and
by-mail voting.
II. The Impact of the COVID-19 Pandemic On Administering Elections
A. In-Person Voting
19. The Centers for Disease Control and Prevention (CDC) has issued
interim guidance for election polling locations to prevent the spread
of the novel coronavirus that causes COVID-19. The
recommendations include: encouraging mail-in voting, encouraging
early voting, relocating polling places from locations that would put
certain populations at risk (e.g. nursing homes and senior living
residences), and adding social distancing measures to protect
12

individuals during voting.15
20. Expert reports that have been issued since the onset of the pandemic
recommend that election officials “develop techniques to spread out
arrivals to polling places so that they are more even throughout the
day.” 16 Election officials are urged to obtain and provide personal
protective equipment and other supplies to assure the safety of poll
workers and voters.17
21. Election officials may need to identify additional polling sites in order
to provide a safe voting environment. The Ad Hoc Committee for
2020 Election Fairness and Legitimacy at the University of California-
Irvine argues that additional in-person voting locations may be
necessary:
To the extent [election officials]have discretion, they can

increase the number of polling places and decline to
consolidate polling places. By minimizing the number of voters
assigned to each location, election officials can reduce crowd
size, shorten lines, and promote social distancing.18
North Carolina laws and policies need to be adjusted in order to allow
election officials to implement these recommendations, find new
polling locations, and communicate these changes to voters.
22. Some areas may need to consolidate polling places because some
15
Centers for Disease Control, “Recommendations for Election Polling Locations.” March 27, 2020.
https://www.cdc.gov/coronavirus/2019-ncov/community/election-polling-locations.html Accessed May 21, 2020.
16
Nathaniel Persily and Charles Stewart, III, March 19, 2020, “Ten Recommendations To Ensure A Healthy and
Trustworthy 2020 Election,” Lawfare, https://www.lawfareblog.com/ten-recommendations-ensure-healthy-and-
trustworthy-2020-election Accessed May 20, 2020.
17
Christopher R. Deluzio, Elizabeth Howard, David Levine, Paul Rosenzweig, and Derek Tisler. April 20, 2020.
“Ensuring Safe Elections.” Report of the Brennan Center for Justice.
https://www.brennancenter.org/sites/default/files/2020-04/2020_04_5StateCostAnalysis_FINAL.pdf Accessed May
20, 2020; Ad Hoc Committee for 2020 Election Fairness and Legitimacy. April 2020. “Fair Elections During A
Crisis.” Irvine, CA: University of California, Irvine Law School. https://www.law.uci.edu/faculty/full-
time/hasen/2020ElectionReport.pdf. Pg. 7.
18
UCI Ad Hoc Committee Report, pg. 7
13

locations that have traditionally been used (e.g. schools, long-term
care facilities, retirement homes) are no longer available. As the
National Conference of State Legislature’s “Covid-19 and Elections”
website notes:19
Poll workers may not be as willing to serve due to health risks,

which can make running an election more challenging. Moving
to consolidated polling places—in which several precincts vote
at the same location—or moving to vote centers—in which any
voter from a jurisdiction can vote at any polling place, usually
a larger facility—can reduce the total number of poll workers
required.
23. But precinct consolidation sometimes comes with dire consequences,

including longer lines and longer distances to polling sites, which can
have a negative effect on voter turnout, as reported below. The state
needs to do what it can to mitigate poll worker shortages, such as
removing the requirement that a majority of poll workers be residents
of the local precinct.
24. Identifying new polling locations, whether as part of a process of

consolidation or adding new locations (and reassigning voters) takes
time, resources, and expertise. For example, in California, the
California Civic Engagement Project (CCEP) was engaged in 201720
to provide assistance to counties that sought to locate vote centers,
which are required by the California Voters Choice Act 21 for any
county that moved to a universal absentee ballot delivery system,
starting with the 2018 election. The CCEP developed a sophisticated
19
National Conference of State Legislature, 5/21/2020, “COVID-19 And Elections.”
https://www.ncsl.org/research/elections-and-campaigns/state-action-on-covid-19-and-elections.aspx, accessed May
25, 2020.
20
Personal communication with Dr. Mindy Romero, June 2, 2020.
21
The Voters Choice Act was passed and signed into law in 2016. https://elections.cdn.sos.ca.gov/vca/sb450-
chaptered-legislation.pdf
14

methodology22 to optimally locate vote centers and mail-ballot drop
boxes.
25. A failure to locate polling places and voting centers that are
convenient and accessible can discourage some citizens from voting.
The 2018 Current Population Survey’s Voting and Registration
Supplement asked a sample of U.S. citizens why they did not vote in
the 2018 midterm election. The most common response of
respondents (27%) was “too busy, conflicting schedule,” another 3.3%
cited an “inconvenient polling place,” and 2.9% said they faced
“transportation problems.” There are substantial differences in how
these barriers impact subgroups of the voting population. As shown in
Table 1, only 6% of the oldest voters (65 and older) said that
“conflicting schedules” were a reason that they did not vote, compared
to 35.4% of voters aged 25 to 44. Younger voters (18 to 24) were most
impacted by an “inconvenient polling place,” over three times as much
as the oldest voters.23 Other obstacles to voting that can reduce turnout
are waiting in long lines to vote and less accessible voting locations
that require longer travel distances and have limited parking. 24
22
https://ccepsitingtool.github.io/methodology.html
23
All data from the 2018 Current Population Survey, Voting and Registration Supplement, Table 10,
https://www.census.gov/data/tables/time-series/demo/voting-and-registration/p20-583.html, accessed February 26,
2020.
24
Stein, Robert M, and Greg Vonnahme. 2008. “Engaging the Unengaged Voter: Vote Centers and Voter Turnout.”
The Journal of Politics 70(02): 487–97.
15

Table 1: Reasons for Not Voting, 2018 CPS
Too Busy,
Conflicting Transportation Inconvenient
Schedule Problems Polling Place
Overall 26.9 2.9 3.3
18 to 24 years 31.0 1.1 4.3
25 to 44 years 35.4 2.0 3.5
45 to 64 years 25.3 3.1 3.7
65 years and over 6.0 6.3 1.2
26. Research also shows that greater distance between voters and polling
places, which can result from precinct consolidation, can negatively
impact voter turnout. In a study of three Maryland counties, Gimpel
and Schuknecht (2003), looked at the impact of distance and of other
impediments (such as speed limits, traffic congestion, or
topographical barriers) that stand in the way of getting from point A
to point B on turnout in the 2000 presidential election. They found that
the geographic accessibility of polling places has a significant and
independent effect on the likelihood that individuals will vote: “even
after controlling for variables that account for the motivation,
information and resource levels of local precinct populations, we find
that accessibility does make a significant difference to turnout.” 25
Haspel and Knotts (2005) followed a similar approach to Gimpel and
Schuckecht, and studied whether the distance from an individual
voter’s residence to a polling location affected turnout in the 2001
Atlanta mayoral election. Haspel and Knotts report that voting is
sensitive to distance to the polling place, particularly for citizens who
25
Gimpel, J G, and J E Schuknecht. 2003. “Political Participation and the Accessibility of the Ballot Box.” Political
Geography 22(5): 471–88.
16

do not have access to a car. They find “small differences in distance
from the polls can have a significant impact on voter turnout.” 26 They
report that a change from the minimum distance of .01 mile to the
median distance of .69 of a mile results in a 25% drop in the
probability of voting among those without access to a vehicle. For
voters with access to cars, the effect is smaller but still significant – a
drop of 5% in the probability of voting. (2005, p. 568)
27. Brady and McNulty studied precinct consolidation in Los Angeles

County in 2003 and confirm these past findings about distance and the
negative impact on turnout: “[t]he change in polling place location has
two effects: a transportation effect resulting from the change in
distance to the polling place and a search effect resulting from the
information required to find a new polling place”. 27 Brady and
McNulty find that an increase of just .4 miles in the distance to polling
places reduce the probability of polling place voting by 4% (p. 124).
28. The uniform hours requirement for early in-person voting locations
that is currently in place in North Carolina will only make it more
difficult for election administrators to operate the additional in-person
voting locations needed to meet voter demand. The standard hours law
removes the ability of local boards to open any early voting location
for fewer than 12 hours on weekday and removes the ability of local
boards to open any early voting location on some, but not all,
weekdays during the early voting period. The impact of the law is to
increase the costs of operating each additional early voting location,
compared to what additional locations would cost to operate in prior
26
Haspel, Moshe, and H Gibbs Knotts. 2005. “Location, Location, Location: Precinct Placement and the Costs of
Voting.” Journal of Politics 67(2): 560–73.
27
Pg. 116 of Brady, Henry E., and John E. McNulty. 2011. “Turning Out to Vote: The Costs of Finding and Getting
to the Polling Place.” American Political Science Review 105(01): 115–34.
17

elections, when such restrictions were not in place. In prior years, a
local board may judge that shorter operating hours and days in some
locations were sufficient to serve the voters in their county. Under the
uniform hours law, county boards have little flexibility if they wish to
open additional locations. The consequence is that many counties
chose to reduce the number of in-person locations for early voting,
increased the distance that many voters had to travel, and in all
likelihood, increased lines and reduced turnout.
29. A comparison of the 2014 midterm election and 2018 midterm

election in North Carolina (the first general election under the standard
hours requirement) shows that counties decreased access to early
voting in several significant ways. First, 42 counties reduced the
number of satellite early voting locations in 2018 compared to 2014,
and only 9 counties increased the number of early voting locations.
Second, more counties chose not to offer any satellite early voting
sites at all and instead conducted all early voting at the county board
of elections office. In 2014, 77 of 100 North Carolina counties offered
more than the mandated single early voting location. In 2018, a higher
turnout election, only 65 of 100 counties offered more than the
mandated single early voting location. Third, counties reduced access
to early voting on the weekend; 47 counties reduced the number of
weekend days in comparison to 2014 and 65 counties reduced total
weekend voting hours. These reductions occurred even though there
were more weekend days available for counties to use for early voting
in 2018 than in 2014.28
30. Finally, election administrators will need to staff polling places with
28
Calculations made by the author, based on One-Stop Voting Sites for the 2018 and 2014 elections, downloaded
from the North Carolina Board of Elections FTP site, https://dl.ncsbe.gov/?prefix=One-Stop_Early_Voting/.
18

temporary poll workers. Poll workers require legal and procedural
training, and poorly trained poll workers can negatively impact the
trust and confidence that voters have in election outcomes.29
31. During the 2016 election, the Election Assistance Commission (EAC)
reported that 917,694 poll workers were needed nationwide. Nearly
65% of jurisdictions reported that it was either “very difficult” or
“somewhat difficult” to obtain sufficient poll workers. The poll
worker population skews toward older Americans – of the
jurisdictions that reported to the EAC, 54% of poll workers were older
than 60, and 58.3% of North Carolina’s poll workers were over 60,
24% of poll workers nationwide and 23.1% of North Carolina poll
workers were over 70. 30 Between one-quarter and half of the poll
worker workforce are squarely in a high-risk category for risk from
COVID-19 solely due to age, according to the Centers for Disease
Control and Prevention, 31 and many of these individuals have
expressed an unwillingness to serve as a poll worker under current
conditions.32
32. Karen Brinson Bell, The Executive Director of the North Carolina
Board of Elections, wrote on April 22, 2020 that the procurement
process for supplies and training materials needed to have begun
29
Bridgett A. King, 2019, “Descriptive Representation in Election Administration: Poll Workers and Voter
Confidence.” Election Law Journal 18(1): 16-30; Thad Hall, J. Quin Monson, and Kelly D. Patterson, 2007, “Poll
workers and the vitality of democracy: An early assessment.” PS: Political Science and Politics. 40(4): 647-654.
30
Election Assistance Commission, November 15, 2017, “EAVS Deep Dive: Poll Workers and Polling Places.”
https://www.eac.gov/documents/2017/11/15/eavs-deep-dive-poll-workers-and-polling-places. Accessed May 25,
2020.
31
Centers for Disease Control and Prevention, “People Who Are At Higher Risk for Severe Illness.”
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html. Accessed June 1,
2020.
32
Amy Gardner and Elise Viebeck. March 15, 2020. “Intensifying coronavirus fears rattle voters and elections
officials in advance of Tuesday primary.” Washington Post. https://www.washingtonpost.com/politics/intensifying-
coronavirus-fears-rattle-voters-and-elections-officials-in-advance-of-tuesday-primaries/2020/03/15/426c8762-
66d3-11ea-abef-020f086a3fab_story.html. Accessed May 26, 2020.
19

immediately, and that many of the orders for preparing November
general election materials need to be finalized by June 15. 33 This
accords with deadlines identified by the Brennan Center for Justice on
May 11, 2020, which stated that critical purchasing and planning
decisions for a safe November elections needed to be made “in a
matter of weeks.”34
33. In addition to precinct consolidation, in light of SB 683’s prohibitions

on assistance,35 many voters who would like to vote by mail in order
to protect themselves from infection from Covid-19 may be forced to
vote in-person, thus further increasing the need for adequate numbers
of in-person voting sites.
34. In summary, COVID-19 will require North Carolina election

administrators to prepare for safe in-person voting in November.
Existing polling places will require sanitizing measures and other
protections. Administrators will need to either identify additional
polling locations or select new locations to consolidate precincts.
Local administrators will need to search more broadly for poll workers
among younger segments of the population. These adjustments will
take time, planning, and resources.
B. Voting By Mail
35. The Executive Director of the North Carolina Board of Elections

projects a seven- to ten-fold increase in demand for vote by mail
ballots in the state as a result of the COVID-19 pandemic. 36 The
33
Letter from Executive Director Karen Brinson Bell, NC State Board of Elections, to Governor Roy Cooper and
the General Assembly, dated April 22, 2020, provided to this expert.
34
Edgardo Cortes et al., May 11, 2020, “Preparing for Election Day: Deadlines for Running a Safe Election.”
Brennan Center for Justice. https://www.brennancenter.org/our-work/research-reports/preparing-election-day-
deadlines-running-safe-election. Accessed June 2, 2020.
35
N.C.G.S. 163-230.2
36
Letter from Executive Director Karen Brinson Bell, NC State Board of Elections, to Governor Roy Cooper and
the General Assembly, dated April 22, 2020, provided to this expert.
20

current election system as configured is unable to handle a dramatic
increase in the demand for mail ballots. Steps that need to be taken
include securing vendor relationships to print sufficient numbers of
ballots, envelopes, and other materials; coordinating with local United
States Postal Service operations to assure secure delivery and return
of election materials; providing accessible options for voters who
require assistive technology; obtaining ballot processing, sorting, and
verification equipment; and developing and training appropriate staff
in signature verification and other ballot handling procedures. Secure
and accessible ballot drop off locations need to be identified.37
36. Optimally, according to the National Vote at Home Institute, steps

needed to implement and expand mail voting options should have
begun in April to prepare for the November 2020 election.38 Many
other legal and administrative decisions ideally would be made in June,
2020, according to the Election Assistance Commission’s Vote by
Mail Project Timeline.39
37. One point of law that will further overextend the North Carolina Board
of Election’s capacity to deal with an increased inflow of absentee
ballots is the lack of any curing process for rejected absentee ballots.40
Providing an option for voters to “cure” a ballot that arrives with a
missing or unverifiable signature is recommended as a best practice
by the Cybersecurity and Infrastructure Security Agency (CISA)
Elections Infrastructure Government Coordinating Council’s Joint
37
Election Assistance Commission. “Voting by Mail / Absentee Voting.” https://www.eac.gov/election-
officials/voting-by-mail-absentee-voting. Accessed May 25, 2020.
38
Vote At Home Institute, March 2020, “Vote at home scale plan.” https://www.voteathome.org/wp-
content/uploads/2020/03/VAHScale_StrategyPlan.pdf, accessed May 25, 2020.
39
Election Assistance Commission, “Vote by Mail / Absentee Voting Timeline.”
https://www.eac.gov/sites/default/files/electionofficials/vbm/VBMProjectTimeline.pdf. Accessed May 25, 2020.
40
See Figure 5 for information on the percentage of ballots North Carolina rejected from 2014-2018
21

COVID Working Group 41 and the Center for Civic Design. 42
Escambia County, Florida reported a 70% drop in rejected ballots in
the 2016 election, compared to the 2012 election, after a cure process
was put in place for missing signatures.43 If county boards have to
resend absentee ballots to voters who incorrectly executed their
absentee ballots, it will add more pressure on the county board’s
ability to efficiently and effectively execute a robust vote-by-mail
program.
38. Finally, it remains unclear how it is possible to honor the two-witness

requirement in North Carolina given the requirements for social
distancing. Only 12 states currently have a witness requirement, and
only three have a two-witness requirement. 44 Two of those twelve
states—Virginia and South Carolina—have changed their witness
requirements for casting an absentee ballot in the June Primary, in
light of Covid-19.45
C. Evidence From Administering Recent Elections
39. At the time of the submission of this report, sixteen states have chosen
to postpone scheduled primaries or caucuses or have chosen to
conduct an all-mail primary in response to the pandemic.46 The recent
41
CISA #PROTECT2020 Resource page is available at https://www.cisa.gov/protect2020, and the document
recommending signature curing is
https://www.eac.gov/sites/default/files/electionofficials/vbm/Signature_Verification_Cure_Process.pdf.
42
Center for Civic Design, “Voting from Home: Scaling Up in 2020.” https://civicdesign.org/wp-
content/uploads/2020/04/CCD-Guide-to-mail-voting-4-10.pdf. Accessed June 3, 2020.
43
Center for Civic Design, “Counting more absentee ballots in Escambia County, Florida.”
https://civicdesign.org/showcase/counting-more-absentee-ballots-in-escambia-county-florida/. Accessed June 3,
2020.
44
National Conference of State Legislatures, 1/21/2020, “Verification of Absentee Ballots,”
https://www.ncsl.org/research/elections-and-campaigns/verification-of-absentee-ballots.aspx. Accessed June 2,
2020.
45
Absentee Ballot Requirements, Virginia State Board of Elections, https://www.elections.virginia.gov/casting-a-
ballot/absentee-voting/. Accessed June 2, 2020; Thomas v. Andino, --- F.Supp.3d ---- (D.S.C. 2020).
46
Nick Corasaniti and Stephanie Saul, May 22, 2020, “16 states have postponed primaries during the pandemic.
Here’s the list.” New York Times. https://www.nytimes.com/article/2020-campaign-primary-calendar-
coronavirus.html Accessed May 22, 2020.
22

experience of one state, Wisconsin, provides predictive evidence of
how COVID-19 will impact North Carolina in November 2020, and
the appropriate actions that the state will need to make to administer a
safe, secure, and accessible election. Like North Carolina, Wisconsin
is a “mostly polling place” state, with less than five percent of its
ballots cast by mail in 2018, even though the state requires no excuse
for casting an absentee ballot.
40. Wisconsin chose to hold an in-person primary on April 7, 2020.

Wisconsin is the best available example of the kinds of adjustments
that election administrators will have to make to prepare for in-person
voting during the pandemic, and how a short timeline and limited
resources may create long lines and restrict access to the polls.
41. The Wisconsin Elections Commission (WEC) recognized the

challenges the pandemic posed to the primary. In a March 18, 2020,
update to the WEC47, the commission’s administrator reported:
“The lack of available hand sanitizer and other sanitation

products has emerged as one of the key concerns of clerks and
election inspectors, a large percentage of whom are in the age
range of higher vulnerability.”
“Commission staff has advised clerks to implement any

contingency plan they have regarding alternative polling
locations in case of an emergency. When considering
alternatives, clerks should attempt to find locations that are
accessible to individuals with disabilities and large enough to
serve their community while practicing as much social
distancing as possible.”
42. The impact of these challenges on in-person voting became evident
during early in-person and Election Day voting.
47
Meagan Wolfe, March 18, 2020, “Update Regarding COVID-19 Election Planning.” Memo written to the
Wisconsin Election Commission. Accessed at https://elections.wi.gov/sites/elections.wi.gov/files/2020-
03/Com_.%20memo%20re%20COVID-19%20Election%20Planning%203.18.20.pdf
23

43. The first impact of COVID-19 in the Wisconsin primary was the
reduction of sites for early in-person and Election Day voting. A
number of local jurisdictions in Wisconsin were forced to severely
limit or close all in-person early voting locations because of
inadequate staffing and insufficient supplies of personal protective
equipment for election workers and voters.48 The City of Milwaukee,
which normally provides 180 Election Day polling locations, provided
only 5 in the April 7, 2020, primary.
44. The reduction was highly uneven in the metropolitan area, as shown
on the map in Figure 5.49 In wealthier, whiter suburban areas, there
were limited reductions. But in the lower-income, heavily African-
American urban core, only five in-person locations were available on
Election Day. Similarly, the City of Green Bay offered only 2 polling
locations instead of the normal 31.
48
Laurel White, March 23, 2020, “Election Officials Across Wisconsin Eliminate, Scale Back In-Person Early
Voting.” Wisconsin Public Radio. https://www.wpr.org/election-officials-across-wisconsin-eliminate-scale-back-
person-early-voting Accessed May 20, 2020.
49
Source: John A. Curiel, Research Scientist, MIT Elections Data and Science Lab. Healthy Elections Project data
repository, https://github.com/MEDSL/healthy_elections/tree/master/WI, accessed May 25, 2020.
24

Figure 5: Election Day Polling Locations in Milwaukee, WI in
the 2016 and 2020 Presidential Primaries (City of Milwaukee
boundaries colored in green; polling locations in red [suburban]
and blue [city].)
45. On June 2, 2020, Pennsylvania had its primary and many counties and
cities had to consolidate their polling places. Philadelphia cut its
polling places by more than 60%, to 190 polling places, down from
831 polling places that they had in the November 2019 Municipal
50
Election. Many officials in the state describe encountered
difficulties in finding alternative polling locations because of
“restrictions on large public venues that have historically served as
50
Michael Tanenbaum, May 13, 2020, “Philly plans sharp reduction of polling places for June 2 primary election”
Philly Voice. https://www.phillyvoice.com/philly-polling-places-primary-election-june-2-2020-poll-workers-mail-
in-absentee-ballot/. Accessed June 3, 2020.
25

polling places, such as schools, libraries, and municipal buildings.”51
46. The second impact of COVID-19 was the increase in lines. As a

consequence of the reduction of locations, there were excessively long
lines at some of the remaining locations where reductions had
occurred. Voters waited two to three hours to cast a ballot in
Milwaukee, Green Bay, and in other locations.52
47. The third impact of COVID-19 was the increase in the number of
absentee ballots requests by over 500 percent. There were 1,303,985
absentee ballots requested for the April 7, 2020 primary and 1,159,800
absentee ballots were returned and counted. 53 It was a 5:1 ratio of
mail-in to in-person absentee ballots. In the April 2016 primary,
247,052 absentee ballots were requested and 212,832 were returned
and counted.54 The number of requests represented a 527% increase
when compared to the April 2016 primary. The percentage of absentee
ballots cast by mail in the 2016 primary was 8.1% of the total ballots
cast, and the percentage of absentee ballots cast by mail in the 2020
primary was an unprecedented 61.8% of all ballots cast.55
48. It is important to note that even under the April 7, 2020, conditions of
the pandemic, with an essentially uncontested presidential primary
51
Ivey De-Jesus. April 28, 2020. “As counties look to consolidate polling places, advocates worry about voter
disenfranchisement.” Harrisburg Patriot-News / Penn-Live. https://www.pennlive.com/coronavirus/2020/04/as-
counties-look-to-consolidate-polling-places-advocates-worry-about-voter-disenfranchisement.html
Accessed May 20, 2020.
52
New York Times, April 7, 2020, “Wisconsin Primary Recap: Voters Forced To Choose Between Their Health and
Their Civic Duty.” https://www.nytimes.com/2020/04/07/us/politics/wisconsin-primary-election.html
53
Wisconsin Elections Commission, Absentee Ballot Report. May 15, 2020. “April 7, 2020 Absentee Voting
Report.”. https://elections.wi.gov/sites/elections.wi.gov/files/2020-
05/April%202020%20Absentee%20Voting%20Report.pdf
54
2016 totals calculated by the author from the Wisconsin Board of Elections “2016 Presidential Preference and
Spring Election GAB-190F: Election Voting and Registration Statistics Report”, downloaded from
https://elections.wi.gov/publications/statistics/gab-190/2016-spring-election-presidential-primary
55
Wisconsin Elections Commission, Pg. 6, https://elections.wi.gov/sites/elections.wi.gov/files/2020-
05/April%202020%20Absentee%20Voting%20Report.pdf
26

and a competitive State Supreme Court race, over 25% of Wisconsin
voters chose to vote in person on Election Day and 12.6% chose to
cast an in-person absentee ballot, as shown in Figure 6. 56 Even with a
pandemic in full force, over 37% of Wisconsin’s voters still opted to
cast an in-person ballot. This provides predictive evidence that a
substantial portion of North Carolina’s voters will want to cast an in-
person ballot in the November 3, 2020 general election given the
similarities between the two states and the number of people who vote
in-person.
Figure 6: Comparison of Voting Methods in Wisconsin, April 2016-

April 2020
56
Wisconsin Elections Commission, May 15, 2020. “April 7, 2020 Absentee Voting Report #3.”, pg. 6,
https://elections.wi.gov/sites/elections.wi.gov/files/2020-05/April%202020%20Absentee%20Voting%20Report.pdf
27

49. Elections officials in Florida,57 Ohio,58 South Carolina,59 and multiple
other states have reported difficulties finding sufficient poll workers,
having poll workers drop out, and facing other challenges in preparing
to conduct elections during the pandemic.60 Several thousand absentee
ballots never made it to Wisconsin voters.61 Other states have had the
same experience. During the April 28th primary in Ohio, one estimate
is that “thousands” of Ohioans never got their ballots by the April 28th
deadline.62 The June 2nd primary in the District of Columbia resulted
in long lines due to a reduction in polling places. One-third of those
voters who were interviewed said they had to vote in-person because
their absentee ballots did not arrive in time.63
50. The experiences of Wisconsin, Pennsylvania, and other states provide

evidence that North Carolina will want to prepare as soon as possible
and provide flexibility in selecting alternative voting locations and in
recruiting poll workers for the November. 3, 2020, election. The state
should also expand the options for requesting absentee ballots beyond
57
Andrew O’Reilly. March 12, 2020. “Coronavirus fears cause poll worker dropouts, safety concerns ahead of
Florida primary”. Fox News. https://www.foxnews.com/politics/coronavirus-poll-worker-florida Accessed May 25,
2020.
58
Julia Harte, March 13, 2020, “Exclusive: Fewer poll workers, coronavirus, spark fears of election day woes in
Ohio Democratic primary”, Reuters, https://www.reuters.com/article/us-usa-election-ohio-exclusive/exclusive-
fewer-poll-workers-coronavirus-spark-fears-of-election-day-woes-in-ohio-democratic-primary-idUSKBN210328.
59
Bristow Marchant, April 29, 2020, “Richland County is losing hundreds of June primary poll workers to
coronavirus fears,” The State https://www.thestate.com/news/politics-government/election/article242381961.html
60
Pam Fessler, March 2, 2020, “Coronavirus and Super Tuesday Voting: It’s Touchy.” National Public Radio,
https://www.npr.org/2020/03/02/811323562/coronavirus-and-super-tuesday-voting-its-touchy, Accessed May 26,
2020.
61
Nick Corasaniti and Stephanie Saul, April 9, 2020, “Inside Wisconsin’s Election Mess: Thousands of Missing or
Nullified Ballots.” New York Times https://www.nytimes.com/2020/04/09/us/politics/wisconsin-election-absentee-
coronavirus.html. Accessed June 2, 2020.
62
Darrel Rowland and Rick Rouan. April 28, 2020. “After a problem-plagued primary, Ohio leaders disagree about
a November election plan.” Columbus Dispatch. https://www.dispatch.com/news/20200428/after-problem-plagued-
primary-ohio-leaders-disagree-about-november-election-plan. Accessed June 3, 2020.
63
Julie Sauzmer and Genir Nirappit. June 3, 2020. “Bowser ally Brandon Todd loses D.C. Council primary to left-
leaning challenger; Evans far behind in Ward 2 race.” Washington Post. https://www.washingtonpost.com/local/dc-
politics/tuesday-is-election-day-in-dc-though-much-of-the-voting-has-already-happened/2020/06/01/f9738568-
a437-11ea-b619-3f9133bbb482_story.html. Accessed June 3, 2020.
28

a mail-only option in order to reduce pressure on early in-person and
Election Day polling places. Additionally, the uniform hours
requirement for early in-person satellite locations should also be lifted
so as to provide more flexibility for county boards in securing
locations and offering early voting options to their residents.
Additionally, the state should relax the requirement that a majority of
poll workers live in a precinct so as to expand the recruitment pool.
III. The Impact of the COVID-19 Pandemic On North Carolina’s 2020

General Election
A. The Pandemic’s Effect on Voter Preferences
51. The pandemic will likely cause a substantial increase in voting by mail
in North Carolina. At the same time, due to historical voting patterns
within the State, a significant number of North Carolina voters will
continue to vote in person.
52. An April 2020 poll conducted by the Pew Research Center reported
that two-thirds of Americans expect some disruption of the November
2020 election due to the pandemic. Seventy percent of the respondents
favor allowing any voter to vote by mail if the voters wants to.64
53. A May 2020 national poll conducted by a university consortium found

that 60% of respondents supported making voting by mail easier, and
36% said that they would be more likely to vote if they had the option
to vote by mail. However, 44% of respondents under 25 said they were
not confident that they understood the process of voting by mail, and
40% of respondents aged 25 to 44 also said they were not confident
64
Carroll Doherty, Jocelyn Kiley, and Nida Ascher. April, 2020. “Two-Thirds of Americans Expect Presidential
Election Will Be Disrupted by COVID-19.” Report of the Pew Research Center, Washington DC.
https://www.people-press.org/2020/04/28/two-thirds-of-americans-expect-presidential-election-will-be-disrupted-
by-covid-19/.
29

about the mail voting process. 65 This survey also indicates that a
significant number of respondents will vote as they always have, using
the in-person method.
54. Evidence from the Wisconsin primary and other recent primaries
shows that while there is likely to be a dramatic surge in requests for
absentee ballots in November, particularly in a state like North
Carolina that does not require an excuse. But, there will also be
substantial numbers of voters who will continue to want to cast a ballot
in-person, either early or on Election Day.
55. As noted above, because of the increase in the number of absentee

ballot requests in Wisconsin, many voters never received their
absentee ballots by election day despite timely requesting them.66
Absentee ballots arriving late, or not arriving at all, had been an issue
for UOCAVA voters for many years, as the Pew Center on the States
documented in the “No Time To Vote” report, and the Federal Write-
In Ballot67 serves as a fail-safe option for these voters.68 The Federal
Write-In Ballot is already familiar to election officials. Therefore, it
will be important for North Carolina to offer a fail-safe option for
voting such as the Federal Write-In Ballot if the State’s capacity to
execute a more robust mail-in voting program falters.
56. Research shows that voters habituate to a particular way of voting due
69
to “behavioral repetition.” Even though convenience voting
65
Covidstates.org. May 22, 2020, “The State of the Nation: A 50-State COVID-19 Survey: Report 3 .”
66
Carrie Levine, Ohio’s Mail-in Ballot Brouhaha: A Sign of Coming Trouble? The Ctr. For Public Integrity (Apr.
28, 2020), https://publicintegrity.org/politics/elections/ohios-mail-in-ballot-brouhaha-a-sign-of-coming-trouble/
(mentioning Wisconsin’s absentee voting issues)
67
52 U.S.C. § 20303
68
Pew Center on the State, January 2009, “No Time To Vote: Challenges Facing America’s Overseas Military
Voters.” Washington, DC: Pew Center on the States.
69
John Aldrich et al, 2011, “Turnout as a habit,” Political Behavior 33: 535-563.
30

methods (early in-person, no-excuse absentee) have expanded across
the country, millions of citizens continue to vote on Election Day due
to this habituation.70 As shown in Figure 4 above, approximately half
of North Carolina voters continued to vote on Election Day in 2018.
B. Challenges in Ensuring a Safe Election in North Carolina
57. Seven county boards in North Carolina have already obtained

approval for precinct consolidations for the June 23, 2020, primary
and one additional county request is pending. Consolidations were
requested because locations that were previously used are now
inaccessible; in order to assure sufficient space for social distancing;
in order to assure poll worker safety; and to adjust to the lower demand
for Election Day voting. Forty-six polling places have been eliminated
through consolidation, and another 18 are pending elimination. 71
Counties will need to begin this process as soon as possible so that
voters understand their newly assigned polling places. If this process
is not started early enough, as shown in prior research, consolidation
can adversely impact some voters and lower voter turnout.
58. County boards will also need sufficient time to be able to recruit poll
workers. Statewide, as shown in Figure 7, 58.3% of poll workers in
North Carolina in the 2016 election were over 61, with substantial
variation across counties. 23.1% of poll workers were 71 or older in
the state, as shown in Figure 8. The experience of other states
conducting primaries indicates that a substantial number of these
70
Brian Amos, Daniel Smith, and Casey Ste. Claire.2016. “Reprecincting and Voting Behavior.” Political Behavior
39: 133-156.
71
The counties are Buncombe, Jackson, Macon, Madison, Mitchell, Transylvania, and Yancey. Haywood County
request is pending as the time of this writing. Source: NC Board of Elections,
https://dl.ncsbe.gov/index.html?prefix=Public_Records_Requests/June%2023%20Second%20Primary_temporary_p
recinct_transfers
31

workers may decline to work on Election Day.
Figure 7: Poll workers Over 61 in North Carolina in 2016.
Figure 8: Poll workers over 71 in North Carolina in 2016
59. Recruitment of replacement workers will be difficult across the state,

but particularly in counties that fall on the left hand side of Figure 7
and Figure 8 because of the requirement that a majority of the poll
32

workers resides in the precinct where they wish to serve. 72 North
Carolina is one of only eleven states that place precinct residency
restrictions on poll workers, and six of the eleven states that retain
these restrictions conduct elections at the township or municipality
level.73 Only five states that conduct elections at the county level, like
North Carolina, place precinct residency restrictions on poll
workers.74
60. Recommendations
County boards should immediately identify sufficient in-person
voting locations for early voting and precinct place voting, and require
this information publicly at the earliest possible instance. The uniform
hours requirement for satellite early in-person voting locations should
also be suspended, so that County Boards can provide more in-person
voting locations. The requirement that a majority of Election Day poll
workers reside within an election precinct is also unnecessarily
burdensome and is a requirement in very few states. If were relaxed,
it will allow County boards more latitude to recruit sufficient Election
Day poll workers to staff precinct place voting locations. Additionally,
the state should allow for electronic requests of absentee ballots,
suspend the requirement for two witness signatures on the returned
ballot materials, and develop a fail-safe absentee voting method or
allow all eligible voters to use the Federal Write-In Absentee Ballot,
as a way to meet the demand for by-mail balloting and accommodate
those citizens who feel unsafe at in-person voting. Finally, each
county board should have sufficient time and resources to implement
72
Source: North Carolina Board of Elections https://www.ncsbe.gov/get-involved and NC Revised Statutes 163-41.
73
John Aldrich et al, 2011, “Turnout as a habit,” Political Behavior 33: 535-563.
74
Totals were calculated by the author from the Federal Election Assistance Commission, May 2016, “State by State
Compendium: Election Worker Laws and Statutes.”
https://www.eac.gov/sites/default/files/eac_assets/1/28/Compendium.2016.pdf, accessed June 2, 2020.
33

these changes.
VI. Conclusion
61. The COVID-19 pandemic has impacted nearly every aspect of

American life, and elections are no exception. Elections and election
administration are, in fact, traditionally a high-touch, face-to-face
process. Even with the increased adoption of convenience voting
methods by the states, millions of Americans continue to opt to vote
in person on Election Day. Numerous expert commissions
recommend that states prepare for a dramatic increase in mail voting
in November 2020, but also maintain sufficient access to in-person
voting.
62. My expert evaluation of the evidence is that North Carolina is likely

to experience a substantial increase in the use of mail balloting in the
November 3, 2020, election, but the state’s election administration
system is currently designed around in-person voting and citizens are
habituated to that method. Many will continue to vote in person in
November.
63. County boards must begin to prepare immediately to assure a safe,

secure, and accessible election. Early in-person voting should be
maintained and where possible increased, by suspending the uniform
hours requirement. Precinct consolidations, if necessary, must be done
with care, using the best tools available to assure that consolidation is
done fairly and equitably, without respect to age, race, income,
disability, or other status. Consolidations must be completed and
announced in enough time so that election officials, candidates,
political parties, and other organizations can communicate this
information to voters.
64. County boards should not be constrained to precinct residents when
34

recruiting poll workers during this election. The typical poll worker is
over 60 years old, with nearly a quarter over 70. In a number of
counties, more an three-quarters of their poll workers were over 61 in
2016. Artificial barriers to poll worker recruitment should be removed
for this election.
I declare under penalty of perjury that the foregoing is true and correct.
Dr. Paul Gronke
35


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF GARY BARTLETT IN SUPPORT OF PLAINTIFFS’


I, Gary Bartlett, hereby declare as follows:
1. I am a U.S. citizen and a resident of Wayne County, North Carolina. I am
currently an independent consultant based out of Goldsboro, North Carolina and
President and CEO of the Elections Administration Resource Center 501(c)(3)
d/b/a Ranked Choice Voting Resource Center. I am a 1976 graduate of
University of North Carolina at Chapel Hill, having earned a B.A. in history.
Relevant Background
2. From 1993 to May 15, 2013, I served as the Executive Director of the North
Carolina State Board of Elections.
3. My responsibilities as Executive Director of the State Board of Elections were
designated in Chapter 163 of the North Carolina General Statutes. In this role, I
was responsible for staffing, administering, and executing the State Board of
Election’s decisions and orders, as well as other responsibilities assigned to me
by the State Board, and was the chief State elections official in North Carolina.
My responsibilities also included overseeing North Carolina’s 100 county
election boards to ensure that they correctly managed all primary and general
elections on a state, county, and local levels. All officials involved in election
procedure inside North Carolina either directly or indirectly reported to me.
4. During my tenure as Executive Director, I oversaw dramatic changes in North
Carolina’s voting practices. These included (i) bringing North Carolina into
compliance with the National Voter Registration Act of 1993, including
implementing agency voter registration and management systems; (ii) the

initiation in 2000 of early voting options; (iii) the expansion in 2001 of absentee
ballots to all voters without requiring a qualifying excuse; (iv) offering a system
that allowed voters to check their registration status online prior to an election;
and (v) allowing for same-day registration during early voting starting in 2007.
I was also personally involved with ensuring disabled voters had the means to
cast their ballots, both with absentee voting procedures and ensuring that polling
places would be handicap-accessible if at all possible. Also, with the assistance
of staff, I developed and implemented an election certification program to train
and educate election officials. Innovations I implemented during my tenure
include a procedure and policy manual that covered every part of election duties
and responsibilities, an on-line elections library, and a self-audit program for
counties to ensure compliance and that they were staying up-to-date.
5. North Carolina’s voter turnout increased dramatically under my leadership.
Shortly after the beginning of my tenure, in 1996, North Carolina ranked almost
last (fortieth) of all states. 1 By the end, in 2012, North Carolina ranked twelfth
nationally in voter turnout. 2
1
See Voter Registration and Turnout – 1996, United States Election Assistance
Commission,
https://www.eac.gov/sites/default/files/eac_assets/1/6/1996%20Voter%20Registration%2
0and%20Turnout%20by%20State.pdf.
2
See The 2012 Election Administration and Voting Survey at p. 9, United States Election
Assistance Commission, https://www.eac.gov/sites/default/files/eac_assets/1/28/990-
050_EAC_VoterSurvey_508Compliant_1.pdf

6. During my tenure as Executive Director of the State Board of Elections, I was
an active member in the National Association of State Election Directors (better
known as NASED). I am a former board member of the Election Center, which
is an association of election officials from across the United States and some
areas of Canada that get together to help resolve election issues, provide
educational opportunities and explore new or better ways of how to administer
elections. I have also been involved with the National Task Force on Election
Reform, and was the national co-chair for four years of the National Task Force
on Elections Accessibility. I also served on the Federal Elections Commission
Advisory Panel and the Standards Board of the United States Election Assistance
Commission.
7. Before serving as Executive Director, I served as a legislative assistant to N.C.
Congressman H. Martin Lancaster. I have appended my full CV as Exhibit 1 to
this Declaration.
8. I have served as an expert witness in Gilbert v. Guilford County, Case No. 13
CVS 3227 (Guilford Cty. Super. Ct), Third Sector Development, Inc. v. Kemp,
Civil Action No. 2014CV252546 (GA Super. Ct), and Ga. State Conf. of the
NAACP v. Georgia, No. 1:17-cv-1427 (N.D. Ga.). I will be paid a fee of $2,500
for preparing this report, with additional compensation should my testimony be
required in this case.
9. During my tenure as Executive Director, I also oversaw the administration of
elections notwithstanding challenges presented by natural disasters in North

Carolina, including Hurricane Floyd in 1999, Tropical Storm Gustav in 2002, a
tornado knocking out power at a polling place in Brunswick County, a freak ice
storming causing a special election in Harnett County Township to stop and be
rescheduled. In addition to rescheduling elections due to flooding caused by
Hurricane Floyd in Lenoir and Edgecombe Counties, my office facilitated voter
participation by many displaced voters in Edgecombe County, whose homes
were destroyed. The State Board of Elections joined in a Consent Decree with
the U.S. Department Justice to allow those voters to vote in polling place
corresponding to their residence before the flood in the next general election so
they would not be disenfranchised by residency laws.
10. Other non-natural disasters occurred during my tenure that impacted elections.
Examples of these incidences include bomb threats, a voter tragically killed by
a car in front of polling after voting, a chemical truck wreck causing the poll to
close and voters be redirected, and state authorities closing the only road to a
polling place to repave on election day.
11. In my view, these natural and non-natural disasters pale in comparison to the
challenges to elections presented by the Covid-19 virus pandemic.
12. I have read Executive Director Karen Brinson Bell’s letters dated March 26,
2020, and April 22, 2020, to Governor Roy Cooper and the General Assembly
Leadership recommending how to “address election-related issues affected by

COVID-19.”3 I generally concur with her requests and find them well thought
out and practicable. I believe that the State Board of Elections and the county
boards of elections will perform their duties to the best of their abilities with the
aim of achieving a fair and successful general election in November, but that
they will only be able to achieve this result if they are able to implement changes
to the current North Carolina election code and the election administration that
are needed in the interest of safety, efficiencies, fairness. Many changes are
needed.
North Carolina’s Voter Registration During COVID-19

13. As we experience the unknowns, trials, and tribulations of the novel coronavirus
pandemic, it is important that we reevaluate how citizens can register and safely,
easily, and securely cast their votes in the upcoming elections. Our worst of
times can bring out our best: Working together, building trust, exploring
innovations and establishing federal, state and local partnerships to ensure that
all eligible voters can exercise their right to vote.
14. Federal and state laws provide many opportunities in registering to vote. During
my tenure, the most popular and traditional ways were North Carolina Driver
License Offices (DMV), Public Service Agencies, Employment Security
Commission, at the County Board of Elections office, and the do-it-yourself
mail-in form. Before a general election, especially a presidential election year,
3
I understand these letters have been filed as Exhibits 1 and 2 to the Complaint in this
matter.

voter registration drives are rich in tradition, effective, and generate enthusiasm
leading into the election. They are carried out by, but not limited to, civic
activists and organizations, political parties, partisans, candidate committees,
and churches.
15. Certainly, COVID-19 has had a chilling effect on registering new voters and
encouraging them to vote in the upcoming general election. I understand that
while there was an increase of 162% in voter registrations in January 2020
compared to January 2016, by April there was a 50 percent decrease in voter
registrations compared to April 2016. In my experience, this decline is very
unusual for a presidential election year and reflects a lack of accessible options
for eligible individuals to register to vote.
16. In my experience, given the challenges that the coronavirus pandemic is
presenting to voter registration, the 25 day deadline before an election for voter
registration should be extended through to the close of One-Stop Absentee
Voting (Early Voting) to allow eligible individuals the opportunity to register to
vote. Furthermore, the canvass period needs to be extended a month to ensure
enough time for verification mailings, processing, inspection of the public, and
challenges if necessary.
17. It is also crucial that North Carolina voters be given greater access to online
voter registration during this time, when the classic in-person voter registration
activities are no longer feasible due to the coronavirus pandemic. In my view,
there is no justification for North Carolina’s failure to expand online voter

registration to date. As early as 2007, the IT division at the State Board of
Elections had an on-line voter registration system ready to test and roll out.
However, this platform was never approved by the legislature. During the same
time frame or shortly thereafter, we tried to get agency-based voter registration
placed in the N.C. Department of Health and Human Services’ Families
Accessing Services through Technology (“FAST”) program so voter
registrations could be automated, but this was unsuccessful and voter registration
and stayed paper-based. Ironically, the Employment Security Commission was
totally automated, allowing individuals to enroll in certain services online, but
voter registration remained paper-based.
18. It is my view that, given the current barriers to voter registration (and the
resulting barrier to voting this will present), all agencies dealing with voter
registration should offer on-line voter registration and digitized signatures
should be allowed. More crucially, the State Board of Elections should offer this
important, necessary service directly.
COVID-19 Challenges to In-Person Voting
19. Changes are also needed to ensure that voters in North Carolina can safely vote
in person. North Carolina has a culture of voting in-person, both during one-stop
“early” voting and on Election Day. During my tenure as Executive Director, I
tried to persuade the General Assembly and the Municipality of Bald Head
Island to hold a pilot program for an all mail election. There were 101 registered
voters on the island, and they all had to travel by ferry to their polling place in

order to vote in person. Both the Village Council and the General Assembly
strongly rejected the elimination of in-person voting, and I saw through this
experience that traditions, such as in-person voting, are hard to change regardless
of merit.
20. Even before COVID-19, early voting has been vital to facilitating in-person
voting, and has allowed county boards of elections to reduce crowding and long
lines. Until early voting was implemented in 2000, long lines were the norm in
presidential elections, and wait time at the close of the polls with voters in line
could run from one to four hours in our urban counties. However, North Carolina
voters now love early voting, and it continues to be the most popular way to cast
a ballot.
21. As Executive Director Bell mentions in her March 26, 2020 letter, there are two
provisions of North Carolina’s election code that need to change in order to
ensure North Carolina voters can vote safely in-person. First, the uniform hours
requirement, requiring early voting sites to all have uniform hours within each
county, will hurt more than it helps during the ongoing pandemic because this
requirement generally causes closure of early voting sites. In short, uniform
hours are not the best and most efficient way to process early voters because
every county has varying hours of the day and night that voters choose to come
to vote. For example, early voters in rural areas tend to vote in earlier hours,
whereas counties with shift work and factories tend to vote later. Furthermore,
night and weekend voting is essential, and is likely to only be possible if counties

have the flexibility to choose varying hours for their precincts. In sum, the more
early voting opportunities are available, the better and safer the general election
will be.
22. The second important change that is required is to eliminate the requirement that
a majority of poll workers come from the precinct they serve in. There are many
reasons for this. For example, curbside voting will be very important this
election, and it requires poll workers to facilitate this method of voting. The
majority precinct poll worker requirement will strain the responsibilities poll
workers have for processing voters in the polling place, including curbside
voting. In some locations, workers might be needed for traffic control
management as well. Labor is the most expensive and important part of the
election process. The requirement that a majority of poll workers be from the
precinct in which they are serving will put a strain on the crucial resource of
labor, and will do so when curbside voting is likely to be more important and
sought after than ever.
23. These changes are not merely needed to reduce inconveniences, they are critical
to reducing crowding and long lines, and therefore to ensuring safe elections
during the ongoing pandemic. It is important to remember that voters will not be
the only individuals at voting sites: during early voting and Election Day, there
will likely also be electioneers / campaigners and others who congregate at the
50 foot line from the polling place. If there are also long lines for voters, this
10

could cause large crowds outside of polling sites even if social distancing is
made possible within.
The Need to Expand Access to Ballots By Mail In Light of COVID-19
24. In my experience, the ongoing pandemic requires that changes be made to
absentee voting by mail in light of the need for many voters to social distance.
As an initial matter, absentee applications and ballot requests by the voter or
near relative should be accepted via phone, fax, email, text, and on-line as long
as it can be traceable back to the voter. In my view, this change is a long time
coming, and Executive Director Bell’s request for funding and developing of a
public access portal for absentee management and transparency is necessary
regardless of COVID-19. It is imperative, however, now. It is also important that
these changes are implemented immediately because of the almost certain
increased volume of voters wishing to vote by mail as well as other
considerations, such as providing for secure storage and processing of absentee
mail-in ballots, which are likely to impact every county.
25. Secure drop boxes for absentee ballot envelopes should be strategically placed
for voter use. Oregon and other states have successfully implemented this
service, and North Carolina could easily replicate the systems that work in these
states. In short, in my view there is no reason for North Carolina to fail to provide
secure drop boxes, especially given that they would not have to reinvent the
wheel to do so.
11

26. There is also a need to allow voters to remedy any issues with their absentee
ballot request forms or absentee ballots. I am not aware of any uniform procedure
in effect right for county boards of election to do so. During my time, and as a
requirement for HAVA funding, the State Board had to define and publish,
“Standards for Determining What Constitutes A Vote.” By unanimous vote of a
bipartisan State Board of Elections, this was ordered and executed before the
2006 election. Under the guidance in this document, if there were essential
missing pieces of information on the absentee ballot form (container envelope),
the county board of elections had to make a good faith effort to contact the voter
and resolve the issue(s). I am concerned that after my tenure as Executive
Director, new county directors and board members have not been made aware
of this guidance and, as a result, I am not aware of any uniform procedures for
voters to cure their absentee ballots or request forms.
27. Without a robust and successful voter participation in mail absentee and early
voting, it is likely that voters will either be prevented from voting entirely, or
they will try to vote on Election day and that counties, especially those that
exceed 5,000 voters in a precinct, will experience long lines as a result.
Furthermore, long lines and crowding are not just unsafe during the ongoing
pandemic, but in my experience I have found that long lines will cause some
voters to come seeking to vote only to leave without casting a ballot. Although
splitting these precincts is theoretically an option, such a move would require
even more poll workers and would incur an increased level of expense. It would
12

also cause possible confusion. In other words, this would be a last resort for
preventing long lines. It would be much better to make absentee voting by mail
easier and to allow for expanded opportunities for one-stop “early” voting.
28. In my view, the two-witness signature requirement, which I understand was
enacted to prevent absentee ballot fraud, needs to be temporarily suspended or
dropped in light of the importance of voting by mail to the upcoming general
election. The challenges presented by the ongoing pandemic have rendered this
requirement too high a burden on voters, and its enforcement will disenfranchise
eligible voters who, for health and safety reasons, cannot obtain two witnesses
to their absentee ballot. I am familiar with past illegal activities involving
incidences of voter fraud, and in my experience I believe the voter’s signature
or mark should be accepted and will be adequate for the upcoming general
election to ensure a safe and secure election. Other measures, such as fining or
incarcerating violators, would be much more effective in deterring voter fraud
than imposing a blanket two-witness requirement, and these alternative
measures moreover do not present the same barrier to voting that the two-witness
requirement will.
The Need To Prepare Now for The November 3, 2020 Election
29. I agree with Executive Director Bell’s assessment in her April 22, 2020 letter
that immediate action is needed to meet deadlines associated with the upcoming
general election. She is correct that any expansion of absentee ballot requests
need to be made immediately because voters may also be trying to request
13

absentee ballots for the November 3 election, and any change to the witness
requirement needs to be reflected on the absentee ballot instructions and
envelope. She is also correct that changes to the poll worker precinct requirement
and uniform hours requirements need to happen soon so that county boards of
elections can start recruiting poll workers and making decisions about voting
sites.
Executed this _2 day of June, 2020.
GaryB
14

EXHIBIT 1
Gary O. Bartlett
209 Cashwell Drive, Goldsboro, NC 27534
H: (919) 735-3006 * C: (919) 705-3366
gobartlett@nc.rr.com
HIGHLIGHTS OF EXPERIENCE
• Managed state agency representing 100 counties, 500+ municipalities.

• Supervised 152 staff and provided oversight to 750 county board members and staff and 25,000
election officials.
• Managed a budget for planning and implementation that ranged from $5.7 to $6.4 million.
• Managed federal grants equaling $84 million.
• Extensively worked under Board leadership; effective implementing orders and assignments.
• Provided oversight to education and training of election officials and certification programs.
• Resolved time sensitive issues in a public forum.
• Provided oversight to Investigations and Investigative Hearings.
• Implemented laws, rules, policies and guidelines.
• Served as agency legislative liaison.
WORK EXPERIENCE
Current General Consultant

Hospice Volunteer for 3HC at Kitty Askins Hospice and Crystal Coast Hospice
6/2013 Panelist for the Lawyers Committee For Civil Rights on “Crafting the Ideal
Elections Administration System”, 50th Anniversary Legal Symposium,
Georgetown University Law Center
8/3/1993 – 5/15/13 North Carolina State Board of Elections

Executive Director
Responsible for staffing, administration, execution of decisions and orders and

other responsibilities as assigned by the Board. Managed Agency’s divisions -
Administration, Campaign Finance and IT and Agency Legislative Liaison.
See detailed summary.
Member of National Association of State Election Directors

N.C. Representative - Standards Board of the Elections Assistance Commission
Panelist on NVRA Section 7 Compliance, U.S. Commission on Civil Rights
Member of the FEC Election Administration Advisory Panel
Election Center Board of Directors (professional and elections national non-profit)
Co-Chair National Task Force on Election Accessibility
Member of Four Governors Better Campaigns Committee
Prior employment: Legislative Assistant, Congressman H. Martin Lancaster

Management, Weil Enterprises
Consultant, Business Matters, Inc.

Mason, Oz Bartlett, Inc.
North Carolina State Board of Elections, Executive Director

Detailed Summary of Duties and Responsibilities
As Executive Director of the State Board of Elections, I have duties that involve large-scale
oversight, others that are directly managerial and supervisory, and still others that are judicial or
discretionary in nature.
Large-scale oversight
• Chief elections officer of the state; oversight for the State Board of the conduct of all primaries
and elections throughout North Carolina.
• Ultimate supervisory responsibility for 100 directors of county boards of elections.
• Oversight of 300 county board members, 350 county board staff employees, and 8,400 precinct
judges.
• Responsibility for implementation of elections laws, including the National Voter Registration
Act, the Help America Vote Act, Chapter 163 of the North Carolina General Statutes, and the
regulations of the State Board
• Implementation of North Carolina’s first statewide computerized elections information system the
(State Elections Information Management System) and four major revisions and oversight of its
operation.
• Management of registration of almost 7,000,000 voters.
• Oversight of 800 non-elections agencies where voter registration is conducted
• Implement state and federal laws by interpreting and formulating policies, procedures, rules,
guidelines and management.
Managerial and supervisory
• Day-to-day direct supervision of the office of the State Board of Elections, with 52 employees;
• Management of the drafting and editing of job descriptions and postings, performance or
oversight of employee reviews, and conduct of grievance, disciplinary and dismissal proceedings
and mediations.
• Development and administration of the budget of the agency.
• Frequent newspaper, television and radio interviews.
Judicial or discretionary
• Execution of emergency powers as defined by statute if election schedule is disrupted.

• Oversight of State Board hearings.
• Presentations to General Assembly committees.
• Issuance of campaign finance written opinions and mediation of penalties.
• Oversight of investigations and investigative hearings.

WORK EXPERIENCE PRIOR TO STATE ELECTIONS EXECUTIVE DIRECTOR
• January 1991 – July 1993, Congressman H. Martin Lancaster

o Campaign Manager, Lancaster for Congress 1986, 1990, 1992;
• September 1983 – December 1990, Managing Agent,Weil Enterprises;
• May 1976 – August 1983, Oz Bartlett, Inc.
o Part-time June 1969 – September 1970; June 1971 – May 1976;
• September 1970 – May 1971, Gideon’s Jewelry Store.
HIGHLIGHTS OF EXPERIENCE AND QUALIFICATIONS
• Legislative Assistant, Congressman Lancaster: Monitored U.S. House Committees and

constituent services related to: Small Business (Congressman was a member), Commerce,
Utilities, Trade, House Administration and Post Office. In addition, assisted governments
within the District, monitored redistricting and attended to political matters;
• Managing Agent, Weil Enterprises: oversight and management of rental properties and
Section 8 Housing, Carolina Terminals (30% nitrogen storage and loading facility) and civic
projects for the Chamber, Goldsboro and Wayne County;
o Civic Projects: Guidance to ad hoc Goldsboro City School Citizen Group; The four
bond referenda for Wayne Community College, Wayne County Schools, Courthouse
and Economic Development in late 1980’s; City of Goldsboro Mixed Beverage
Referendum;
• Mason and Laborer, Oz Bartlett, Inc.: Began as part-time through high school and college;
full-time upon graduation;
• Engraver, Gideon’s Jewelry Store – Part-time.
Efficiency and Innovation

During My Time at the North Carolina State Board of Elections
I was determined to improve the efficiency of elections administration in our state and to be
innovative. With the help of a great number of terrific people, I was successful.
Efficiency
• We instituted one of the most thorough ballot proofing processes in the nation.
• We put in place one of the most comprehensive and cost-effective voter registration
systems in the nation.
• We were a leader among states in developing uniform standards (forms, letters, notices,
etc.) for election jurisdictions.
• Our office was the first state elections agency in the nation to implement technology
(through bar code scanners) to ensure that voters receive the proper ballots.
• North Carolina was the first southern state (and one of first states nationally) to
implement the requirements of the National Voter Registration Act of 1992.
• North Carolina is recognized nationally as a model for states to follow in managing voter
registration at non-elections offices such as the DMV or social services offices.

Innovation
• We implemented one of the nation’s first certification programs for elections officials.
• We put in place a unique system of regional technicians to ensure proper maintenance
and use of elections equipment, even in counties with modest resources.
• We are recognized as having an outstanding elections night return system.
• We conducted the first statewide election in the era of modern voting machines using the
instant runoff voting method, an achievement requiring significant creativity.
• Our voter accessibility program is a national model.
• We were among the very first states to offer voters the ability to check their registration,
voting record, and provisional voting status on-line.
• Ours was the first and is still the only state election office to conduct wellness checks of
its county election offices to ensure compliance and uniformity.
PUBLICATIONS
Gary O. Bartlett and Robert P. Joyce, “Would North Carolina Have Looked as Bad as Florida on
Election Night 2000?” Popular Government, Institute of Government, University of North Carolina at
Chapel Hill, Chapel Hill, N.C. (Fall 2002).
Gary Bartlett, Health & Human Services Accessibility - HAVA Grants in North Carolina, January
2010, available at https://www.ncsbe.gov/Portals/0/FilesP/HAVAAccessibilityNASED.pdf.
Testimony before U.S. Commission on Civil Rights, Increasing Compliance with Section 7 of the
National Voter Registration Act (Apr. 19, 2013) (testimony of Gary Bartlett), available at
https://www.usccr.gov/pubs/docs/NVRA-09-07-16.pdf.
Gary Bartlett, “First Person Singular”, ELECTIONLINEWEEKLY, May 17, 2013, archived at
https://editions.lib.umn.edu/electionacademy/2013/05/17/outgoing-nc-director-gary-bart/.
Living History: Meaning of a Vote, Interview with Gary Bartlett, April 6, 2016,
https://sites.duke.edu/pjms364s_01_s2016_bartlettvotingpolitics/full-interview-with-gary-bartlett-video-
and-transcript/.
Gary Bartlett, North Carolina State Board of Elections, Standards for Determining What Constitutes a
Vote And What Will Be Counted As a Vote Pursuant to 42 U.S.C. § 15481(a)(6) & N.C.G.S. §
163.182.1(b), https://www.ncsbe.gov/Portals/0/FilesP/WhatIsVote.pdf.
Gary Bartlett, Former NC elections chief: A wake-up call on elections, THE TIMES NEWS, May 30,
2020, https://www.thetimesnews.com/opinion/20200530/former-nc-elections-chief-wake-up-call-on-
elections.
Gary Bartlett, Options for Administering Ranked Choice Voting in Utah Primary Elections, RANKED
CHOICE VOTING RESOURCE CENTER, 2017, https://le.utah.gov/interim/2017/pdf/00002422.pdf.

Gary Bartlett & Robert Montjoy, Alternative Voting Systems in the U.S., August 2017,
https://drive.google.com/file/d/0B3K2g6lIQMWsT3Ftem1DUldVSkE/view?usp=sharing.
Gary Bartlett, Implementing Ranked Choice Voting Statewide and Across Jurisdictions When Multiple
Voting Systems Are Used, RANKED CHOICE VOTING RESOURCES CENTER, September 2017,
https://drive.google.com/file/d/0B3K2g6lIQMWsZ294RklzNEMyeHc/view.


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF MARSHALL TUTOR IN SUPPORT OF PLAINTIFFS’


I, Marshall Tutor, hereby declare as follows:
1. I have nearly 25 years of experience as an investigator in North Carolina. I
worked as a Criminal Investigator in the North Carolina Department of Insurance for over
four and a half years, a Securities Investigator for the North Carolina Secretary of State
Office for over four and a half years, an Elections Investigator for the NC State Board of
Elections for 9 years, and then Lead Investigator for the North Carolina State Board of
Elections for 6 years. I left the State Board of Elections in 2018.
2. Over the years, I have investigated numerous complaints related to elections
in Bladen County.
3. McCrae Dowless has been indicted for election fraud crimes in North
Carolina. My investigation of McCrae Dowless and mail-in absentee ballot fraud in Bladen
County was a continuous case from 2016 until I left the State Board of Elections in 2018,
prior to the 2018 fall general election.
4. In both 2016 and 2018, Mr. Dowless hired people who, often in two-person
teams, would visit households that had been mailed absentee ballots by the Bladen County
Board of Elections. His teams would show up with marked sample ballots in hand and
would encourage these voters to mark their ballots the same way. Dowless’s teams would
offer to take the ballots and turn them in. Instead, the ballots collected went directly to Mr.
Dowless; some made it to the Bladen County Board of Elections and some did not.

5. The ballots were collected with or without witness signatures. When there
was no witness signature, Dowless’ teams would forge the signatures, and they would sign
those ballots out of the presence of the voter. I never detected a forgery just by reviewing
the face of the absentee ballot envelope.
6. Mr. Dowless’ illegal mail-in absentee ballot fraud enterprise was almost
totally dependent on his daily access to the names and addresses of those who requested
absentee ballots from the Bladen County Board of Elections. Mr. Dowless was known to
have had a very long and cordial relationship with the staff at the Bladen County Board of
Elections. He would either call the county board staff or come by on a daily basis to get
the list of absentee ballot requests. At that time, the names and addresses of those
requesting a mail-in absentee ballot were public record.
7. Now that the law has been changed so that the identities of voters requesting
mail-in absentee ballots is not a public record until Election Day, I do not believe anyone
can fraudulently manipulate the system as Mr. Dowless did. A person would need an
accomplice working in a county board of elections office to break the law in order to get
this confidential information.
8. I do not believe a two-witness signature requirement in any way prevents
potential fraud such as that conducted by Mr. Dowless’ illegal ballot fraud activities. In my
15 years’ experience as an investigator with the State Board of Elections, I cannot think of
a time or situation in which two absentee ballot witness signatures would have prevented
absentee ballot fraud.

I declare under penalty of perjury under the laws or the Unikd States of Amcrirn
that the foregoing is trnc nnd correct lo the best or my knowkdgc.

rd
Executed this ·~-- of .h1m\ 20:20.
Marshall Tutor


SCHAFFER.
Plaintiffs,
vs.
SERVICES,
Defendants.
DECLARATION OF CHRISTOPHER KETCHIE IN SUPPORT OF

PLAINTIFFS’ MOTION FOR PRELIMINARY INJUNCTION

I, Christopher Ketchie, hereby declare:
1. All facts set forth herein are based on my personal knowledge, and if called
upon to testify as to the contents of this Declaration, I could and would do so.
2. I am a demographer and data analyst for Southern Coalition for Social
Justice, where I specialize in research, analysis, and spatial visualization of demographic
and electoral data.
3. In this matter, I have used public data sets to isolate certain statistics for
reference in the Complaint and the Brief in Support of Plaintiffs’ Motion for Preliminary
Injunction.
4. To determine changes in voter registration rates between 2016 and 2020, I
used the NVRA Data (2008 to present) (last updated June 2, 2020), published by the North
Carolina State Board of Elections and available at
https://s3.amazonaws.com/dl.ncsbe.gov/NVRA/nvra_stats_all.txt. The data file is
accessible by going to https://www.ncsbe.gov/Public-Records-Data-Info/Election-Results-
Data, and navigating to “FTP Site”  “NVRA”  “nvra_stats_all.txt.” By summing the
“Count” field for total registrations (new, changed, and duplicate) and aggregating by year
and month (using the “NVRA Date” field) for each month in 2016 and 2020, I determined
that January 2020 had a 162% increase in registrations compared to 2016, while February,
March, and April 2020 had changes of -10%, -14%, and -50% compared to the same
months of 2016 respectively.
5. To determine the rate of absentee mail-in ballots rejected for the March 2020
North Carolina primary, I used data from the March 3, 2020 Absentee File, published by

the North Carolina State Board of Elections and available at
https://s3.amazonaws.com/dl.ncsbe.gov/ENRS/2020_03_03/absentee_20200303.zip. This data
file is accessible by going to https://www.ncsbe.gov/Public-Records-Data-Info/Election-
Results-Data and navigating to “FTP Site”  “ENRS”  “2020_03_03” 
“absentee_20200303.zip”. By aggregating absentee mail-in ballots by ballot return status
in the “ballot_rtn_status” field (either accepted or reason for rejection), and dividing those
rejected by the total, I determined that almost 15% (14.6%) of submitted absentee mail-in
ballots were rejected. The statistics generated from the absentee file do not include absentee
by mail ballots that were either requested and not sent to the voter or sent to the voter but
not returned to the State Board of Elections (i.e. those with a null value in the
“ballot_rtn_status” field).
6. To determine the percent of voters who cast mail-in absentee ballots in the
2016 general election, I used data from November 8, 2016 History Statistics, published by
the North Carolina State Board of Elections and available at
https://s3.amazonaws.com/dl.ncsbe.gov/ENRS/2016_11_08/history_stats_20161108.zip.
This data file is accessible by going to https://www.ncsbe.gov/Public-Records-Data-
Info/Election-Results-Data and navigating to “FTP Site”  “ENRS”  “2016_11_08” 
“history_stats_20161108.zip”. By aggregating all votes cast by voting method in the
“voting_method_desc” field, and dividing those with the “ABSENTEE BY MAIL”
category by that aggregate, I determined that 4% of voters cast mail-in absentee ballots in
the 2016 general election.
7. To determine the percent of precincts in North Carolina that have over 5,000

voters, I used data from Voter Registration File (Last updated May 30, 2020), published
by the North Carolina State Board of Elections and available at
https://s3.amazonaws.com/dl.ncsbe.gov/data/ncvoter_Statewide.zip. This data file is
accessible by going to https://www.ncsbe.gov/Public-Records-Data-Info/Election-Results-
Data and navigating to “FTP Site”  “data”  “ncvoter_Statewide.zip”. By aggregating
voters by county and precinct using the “county_desc” and “precinct_abbrv” fields, and
sorting by total voters, I determined that 216 precincts in North Carolina have 5,000 or
more voters.
Executed this 4th day of June, 2020
/s/
Christopher Ketchie

UNITED STATES DISTRICT COURT

SCHAFFER.
Plaintiffs,
vs. Civil Action No. 20-cv-457
SERVICES,
Defendants.
DECLARATION OF ALLISON J. RIGGS IN SUPPORT OF PLAINTIFFS’


I, Allison J. Riggs, hereby declare:
1. All facts set forth herein are based on my personal knowledge, and if called
upon to testify as to the contents of this Declaration, I could and would do so.
2. I am the Interim Executive Director and Chief Counsel for Voting Rights at
Southern Coalition for Social Justice.
3. Attached hereto as Exhibit 1 is a true and correct copy of a letter dated
March 26, 2020, from Defendant Karen Brinson Bell, Executive Director of the North
Carolina State Board. of Elections, to Governor Roy Cooper and General Assembly
leadership regarding “Recommendations to Address Election-Related Issues Affected by
COVID-19,” in which she requests, inter alia: (i) expanding options for voters to submit
mail-in absentee ballot requests beyond the current mail-only option to enable requests by
fax, email, and an online portal; (ii) establishing a fund to pay for postage for returned
absentee ballots; (iii) reducing or eliminating the requirements that two witnesses sign an
absentee mail container envelope in order for the ballot to be counted; (iv) lifting the
requirement that a majority of Election Day poll workers reside in the precinct in which
they work; and (v) lifting the uniformity requirement for early voting sites, days and
hours.
April 22, 2020, from Defendant Bell to Governor Roy Cooper and General Assembly
leadership regarding “CARES Act Request and Clarification to Recommendations to
Address Election-Related Issues Affected by COVID-19.”

April 29, 2020, from Board of Elections Members in Congressional District 11 to
General Assembly Leaders, Election Committee Members, and Western North Carolina
Legislators.
6. Attached hereto as Exhibit 4 is a true and correct copy of Statement on the
second meeting of the International Health Regulations (2005) Emergency Committee
Regarding the Outbreak of Novel Coronavirus (2019-nCoV) published by the World
Health Organization and available at https://www.who.int/news-room/detail/30-01-2020-
statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-
emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov).
7. Attached hereto as Exhibit 5 is a true and correct copy of People who are
at higher risk for severe illness, published by the Center for Disease Control and
Prevention (“CDC”) and available at https://www.cdc.gov/coronavirus/2019-
ncov/specific-groups/people-at-higher-risk.html.
8. Attached hereto as Exhibit 6 is a true and correct copy of Remarks by
President Trump, Vice President Pence, and Members of the Coronavirus Task Force
(Mar. 25, 2020) from a White House Press Briefing and available at
https://www.whitehouse.gov/briefings-statements/remarks-president-trump-vice-
president-pence-members-coronavirus-task-force-press-briefing-11/.
9. Attached hereto as Exhibit 7 is a true and correct copy of CDC Director
Warns Second Wave of Coronavirus Might be ‘More Difficult” (Apr. 21, 2020),
published by the Hill and available at https://thehill.com/policy/healthcare/493973-cdc-
director-warns-second-wave-of-coronavirus-might-be-more-difficult.

10. Attached hereto as Exhibit 8 is a true and correct copy of Governor Roy
Cooper’s Exec. Order No. 141 (May 20, 2020), available at https://htv-prod-
11. Attached hereto as Exhibit 9 is a true and correct copy of NCDMW
Announces Driver License Office Changes during COVID-19 Outbreak (last updated
June 2, 2020), published by the North Carolina Department of Transportation, and
available at https://www.ncdot.gov/news/press-releases/Pages/2020/2020-03-17-ncdmv-
driver-license-impact-coronavirus.aspx. The page states that as of June 2, 2020, there are
60 Department of Motor Vehicles (“DMV”) offices that are closed.
12. Attached hereto as Exhibit 10 is a true and correct copy of a February 28,
2020 Letter from Disability Rights North Carolina to members of the Davidson County
Board of Elections and the General Counsel for the North Carolina State Board of
Elections regarding Davidson County’s failure to assemble a Multipartisan Assistance
Team to help a voter residing in a skilled nursing facility in Davidson County.
13. Attached hereto as Exhibit 11 is a true and correct copy of An Act to
Provide Aid to North Carolinians in Response to the Coronavirus Disease (COVID-19)
Crisis, Sl. 2020-3 §4.1(c) (May 4, 2020), available at
https://www.ncleg.gov/EnactedLegislation/SessionLaws/PDF/2019-2020/SL2020-3.pdf.
The Senate bill states, “Nothing in this section shall apply to any notarization under
Article 20 of Chapter 163 of the General Statutes [regarding absentee ballots].”). Id. at
31.
14. Attached hereto as Exhibit 12 is a true and correct copy of a North

Carolina Absentee Application and Certificate, made available by Pitt County, North
Carolina at https://www.pittcountync.gov/DocumentCenter/View/8432/Absentee-
Envelope_EL_v3.
15. Attached hereto as Exhibit 13 is a true and correct copy of a Federal Write-
in Absentee Ballot, made available by the Federal Voting Assistance Program at https://
www.fvap.gov/uploads/FVAP/Forms/fwab2013.pdf, p. 3.
16. Attached hereto as Exhibit 14 is a true and correct copy of
Recommendations for Election Polling Locations, published by the CDC and available at
https://www.cdc.gov/coronavirus/2019-ncov/community/election-polling-locations.html.
17. Attached hereto as Exhibit 15 is a true and correct excerpt of The 2014
EAC Election Administration and Voting Survey Comprehensive Report (Table 39),
published by the U.S. Election Assistance Comm’n and available at
https://www.eac.gov/sites/default/files/eac_assets/1/1/2014_EAC_EAVS_Comprehensiv
e_Report_508_Compliant.pdf.
18. Attached hereto as Exhibit 16 is a true and correct copy of Voting Rights
and Election Administration in North Carolina: Field Hearing Before the Subcomm. on
Elections of the H. Comm. on House Administration (Apr. 18, 2019), available through
the testimony of Tomas Lopez, Exec. Dir., Democracy North Carolina at
https://docs.house.gov/meetings/HA/HA08/20190418/109315/HHRG-116-HA08-Wstate-
LopezT-20190418.pdf.
19. Attached hereto as Exhibit 17 is a true and correct copy of Bipartisan Furor as
North Carolina Election Law Shrinks Early Voting Locations by Almost 20 Percent

(Sept. 24, 2018), written by Blake Peterson and published by ProPublica, and available at
https://www.propublica.org/article/bipartisan-furor-as-north-carolina-election-law-
shrinks-early-voting-locations-by-almost-20-
percenthttps://www.propublica.org/article/bipartisan-furor-as-north-carolina-election-
law-shrinks-early-voting-locations-by-almost-20-percent.
20. A compilation of files related to precinct closures for the upcoming
Congressional District 11 Second Republican Primary was published by the North
Carolina State Board of Elections in response to a public records request dated May 14,
2020, and these files are available at
https://dl.ncsbe.gov/index.html?prefix=Public_Records_Requests/June%2023%20Second
%20Primary_temporary_precinct_transfers/. Among these documents are letters from
the count boards of elections of Yancy, Madison, and Jackson counties indicating that
lack of poll workers contributed to the need to consolidate, and a letter from Macon
County Board of Elections requesting to consolidate 12 precincts into one site. See
Exhibits 18, 19, 20, and 21.
21. Attached hereto as Exhibit 22 is a true and correct copy of State Board,
DMV Partner to Expand Online Voter Registration Service (Mar. 30, 2020), published by
N.C. State Board of Elections, and available at https://www.ncsbe.gov/Press-Releases?
udt_2226_param_detail=2195.
22. Attached hereto as Exhibit 23 is a true and correct copy of North Carolina's
COVID-19 Response for Individuals and Families (last accessed Jun. 4, 2020), published
by N.C. Department of Health and Human Services, and available at

https://www.ncdhhs.gov/divisions/public-health/covid19/individuals-and-
families.
23. I am aware that, in a May 15, 2020 meeting of the North Carolina State
Board of Elections, Executive Director Karen Brinson Bell announced that the State
Board had ordered Personal Protective Equipment for those counties participating in
the June 23 second Republican primary in Congressional District 11, including masks,
unique pens for voters, cleaners and wipes, and gloves and face shields for poll
workers.

/s/
Allison Riggs

EXHIBIT 1
Letter from Karen Brinson Bell, Executive Director,

N.C. State Board of Elections, to Governor Roy
Cooper et al. (Mar. 26, 2020)
Exhibit to Declaration of Allison J. Riggs in support of Plaintiffs Motion for a Preliminary

Injunction
Mailing Address:
P.O. Box 27255, Ra-
leigh, NC 27611
(919) 814-0700 or
(866) 522-4723
Fax: (919) 715-0135
TO: Governor Roy Cooper; Speaker Tim Moore; President Pro Tempore Phil Berger;
Joint Legislative Elections Oversight Committee; Joint Legislative Oversight Com-
mittee on General Government; and House Select Committee on COVID-19, Con-
tinuity of State Operations Working Group
FROM: Karen Brinson Bell, Executive Director
RE: Recommendations to Address Election-Related Issues Affected by COVID-19
DATE: March 26, 2020
The spread of the novel coronavirus (COVID-19) impacts the conduct of elections and daily op-
erations for the State Board of Elections (State Board) and county boards of elections. In response,
our agency has taken a number of actions in recent days and weeks to address election-related
impacts of the pandemic and inform the public about our efforts. These include:
• An emergency Executive Order issued on March 20, 2020, that, among other things,
rescheduled the Republican second primary in Congressional District 11 from May
12, 2020, to June 23, 2020.
• An amended Administrative Rule 08 NCAC 01 .0106, by both emergency and pro-

posed temporary rulemaking, to clarify the Executive Director’s statutory authority
to exercise emergency powers to conduct an election in a district where the normal
schedule for the election is disrupted by a natural disaster, extremely inclement
weather, or armed conflict. The amendment clarifies that a catastrophe arising from
natural causes includes a disease epidemic or other public health incident that makes
it impossible or extremely hazardous for elections officials or voters to reach or oth-
erwise access the voting place or that creates a significant risk of physical harm to
persons in the voting place, or that would otherwise convince a reasonable person to
avoid traveling to or being in a voting place.
• Numbered Memo 2020-11, released on March 15, 2020, provides guidance on im-
mediate actions that may be taken by authority of the Executive Director and other
steps that may be taken by county boards of elections.
• Establishment of a working group of State and county election officials to consider

immediate steps that should be taken for the conduct of the federal second primary
and also more long-term steps including legislative requests to administer elections
in times of disease epidemics, necessary measures if mail balloting were expanded,
and efforts that must be taken to ensure the health and well-being of voters and work-
ers during in-person voting.
• A statement released by the NCSBE on March 12, 2020.

While the State Board will continue to administer elections in the wake of COVID-19 within our
current legal authority, the State Board respectfully recommends the General Assembly consider
making the following statutory changes to address the impacts of the coronavirus pandemic on our
elections. We believe that, in order to ensure continuity and avoid voter confusion, the changes
should be made permanent, except where indicated otherwise.
• Expand options for absentee requests. We recommend allowing a voter to sub-

mit an absentee ballot request form by fax and email. Current law restricts the
return of the absentee request form to the voter and the voter’s near relative or
legal guardian, and restricts the methods by which the requests can be returned to
in-person or by mail or designated delivery service. We also recommend a lim-
ited exception to G.S. § 163-230.2(e)(2) to allow county boards of elections to
pre-fill a voter’s information on an absentee request form. The voter or near rel-
ative would still be required to sign the form, but this change would allow voters
who are home due to COVID-19 to request an absentee request form by phone
and have a pre-filled form sent to them rather than having to travel to the county
board office to receive assistance.
• Establish online portal for absentee requests. The State Board expects a large
increase in the number of voters who choose to vote absentee by mail this year,
and creating an online portal for absentee voting would make it easier for voters
to request an absentee ballot from home. The voter or near relative would provide
identifying information (including the voter’s date of birth and the last four digits
of the voter’s Social Security or drivers license number), and an electronic signa-
ture as defined in G.S. § 66-312 of the Uniform Electronic Transaction Act would
be permitted. An allocation of funds to purchase a program or application to
support this functionality may be needed.
• Allow a voter to include a copy of a HAVA document with their absentee

request form if the voter is unable to provide their drivers license number or
last four digits of their Social Security number. We recommend allowing a
voter who did not include their drivers license number or the last four digits of
their Social Security number the option to include a copy of a current utility bill,
bank statement, government check, paycheck, or other government document
showing the name and address of the voter. Making this change to G.S. § 163-
230.2 would make it easier for those who wish to vote absentee by-mail to do so.
The State Board has received multiple reports from county boards of elections
and from voters that, without this option, some voters are no longer able to request
an absentee ballot. This particularly affects senior citizens who may not have a
drivers license number and cannot recall or do not have access to their Social
Security number. Allowing this option will make it easier for those most at risk
of contracting COVID-19 to vote absentee by mail.
• Establish a fund to pay for postage for returned absentee ballots. Elections
officials across the nation are anticipating a surge in absentee voting in light of

restrictions on movement imposed due to the spread of COVID-19. Prepaid post-
age would increase the likelihood that a voter would return their ballot, would
eliminate the need for a voter to leave their home to purchase postage, and would
also decrease any incentive for a voter to turn their ballot over to someone else.
Prepaid postage for the return of absentee ballots would also further enable resi-
dents and patients of facilities such as nursing homes and group homes to return
their ballots safely, easily, and with minimal human contact.
• Reduce or eliminate the witness requirement. In light of social distancing re-

quirements to prevent the spread of COVID-19, we recommend reducing the wit-
ness requirement for the certification on absentee container-return envelopes.
Currently, a voter must have their absentee envelope signed by two witnesses or
one notary. North Carolina residents are currently being asked to stay at home,
and without a timeline for when the disease will be under control, requiring only
one witness would reduce the likelihood that a voter would have to go out into
the community or invite someone to their home to have their ballot witnessed.
Eliminating the witness requirement altogether is another option and would fur-
ther reduce the risk.
• Modify procedure for counting of ballots on Election Day. To allow county

boards of elections more time to process the anticipated surge in absentee ballots,
we recommend amending the law to provide that ballots received by the Saturday
prior to the election must be counted on Election Day, and all other absentee bal-
lots that are timely received will be counted on the day of the canvass. Currently,
G.S. § 163-234(2) requires county boards to meet on Election Day to count all
absentee ballots received by 5:00 p.m. on the day before the election. Changing
the timeframe for when absentee ballots are counted would help ease the burden
of an increased volume of absentee ballots, especially in larger counties. This
change would not affect the deadline for the county boards to receive absentee
ballots, nor would it affect which ballots are counted; rather, it would ameliorate
the anticipated increase in absentee ballots received by county boards between
the Saturday before the election and 5:00 p.m. on the day before the election. As
part of this change, we also recommend extending county canvass to 14 days after
the election, rather than 10 days after the election as provided in G.S. § 163-
182.5(b), to allow county boards of elections sufficient time to count the large
number of ballots that are anticipated being received; State Board canvass would
also need to extended accordingly.
• Temporarily modify restrictions on assistance in care facilities. Currently,

G.S. § 163-226.3(a)(4) makes it a Class I felony for an owner, director, manager,
or employee of a hospital, clinic, nursing home, or adult care home to assist a
voter in that facility in requesting, voting, or returning the voter’s absentee ballot.
There are important reasons to discourage facility employees from assisting pa-
tients and residents with their absentee requests and with voting their ballots.
However, many localities are currently restricting or banning visitors to facilities,
and an Executive Order issued by the Governor prevents visitors altogether to
reduce the spread of COVID-19. With this in mind, it may not be possible for

multipartisan assistance teams (MATs), or others who would traditionally assist
facility residents, to provide assistance. Individuals may also be unwilling to
serve on MATs due to the increased risk of transmission of COVID-19 at a facil-
ity. Many voters in these facilities do require help with requesting, voting, and/or
returning their ballots, and with no option available for assistance they may ef-
fectively be disenfranchised. We suggest considering options, such as temporar-
ily allowing a facility employee to assist, to ensure these voters are able to con-
tinue to exercise their right to vote.
• Clarify authorization for telephonic meetings. It would be helpful to clarify

that telephonic meetings and meetings held by other remote means are specifi-
cally authorized by the open meetings law. State Board counsel construe Article
33C of Chapter 143 to permit telephonic and other remotely held meetings. How-
ever, the UNC School of Government has a different interpretation of the law
based on its stated familiarity with the law’s history.
• Expand student pollworker program. We are recommending expanding the

student pollworker program to allow students to fill the role of judge or chief
judge, to allow juniors or seniors to serve as long as they are at least 16 years old,
and to allow service as a pollworker to count as an approved school trip. Chief
judges and judges would still be appointed from recommendations provided by
the political parties. Currently, G.S. § 163-42.1 requires students be at least 17
years old and only allows them to serve in the role of precinct assistant. It also
requires the principal of the student’s school to recommend the student; we sug-
gest this section include an exception to that requirement if the school is closed.
These changes would increase the county boards of elections’ recruitment of stu-
dents, who tend to be less at risk of COVID-19. The changes will be especially
necessary if large numbers of pollworkers are unable to serve. The average age
of pollworkers in North Carolina is around 70 and the role requires significant
interaction with the public, so we anticipate that pollworkers in at-risk categories
may be advised not to serve or may be unable to serve this year.
• Make Election Day a holiday. Designating Election Day as a State holiday

would expand the potential pool of pollworkers to students, teachers, and younger
individuals. It would also encourage state and county employees to work the
polls. These groups tend to be in a lower-risk category for COVID-19 and there-
fore would be an asset given current concerns. An alternative option would be to
provide paid leave for state and county employees who serve as pollworkers and
providing course credit for student pollworkers.
• Increase pay for pollworkers. Precinct officials safeguard the democratic pro-
cess and help ensure confidence in the system. Increasing pay for pollworkers
will help county boards of elections recruit and retain a strong elections workforce
this year and for years to come. Current pay for precinct officials is the state
minimum wage, $7.25 per hour. G.S. § 163-46. On Election Day, pollworkers
must serve for the entire day without leaving the site—a shift of more than 14
hours. The minimum wage requirement was put in place in 1981 (see Session

Law 1981-796). Ensuring that pollworkers’ unemployment benefits are not af-
fected by their service is another way to increase recruitment efforts.
• Eliminate requirement that a majority of pollworkers reside in precinct.

Eliminating the requirement in G.S. § 163-41(c) that a majority of pollworkers at
a polling place must reside in the precinct would provide county boards of elec-
tions with greater flexibility to staff their precincts. It would increase the likeli-
hood a county board of elections would be able to keep a polling place open rather
than having to combine it with another polling place to meet the residency re-
quirement.
• Temporarily suspend purchase and contract requirements for elections-re-

lated supplies and other items. To allow the State Board and county boards to
continue operating in a time when many business and government entities have
reduced capacity or have closed, temporarily lifting the purchase and contract
requirements of Article 3 of Chapter 143 in 2020 would significantly speed up
the ability to procure necessary supplies.
• Match HAVA funds. In order to receive federal elections security funds that
were authorized in late 2019, the State must make a 20% match. This funding
will be indispensable in our agency’s continued effort to secure North Carolina’s
elections. This is true even more so as we react and respond to the pandemic,
since times of crisis and uncertainty increase the threats of cyber attacks, phishing
attempts, and scams. Federal authorities have also indicated these funds may be
used for COVID-19 response efforts such as cleaning supplies and protective
masks for staff and pollworkers, resources to meet an unanticipated increased de-
mand for mail ballots due to self-isolation and quarantine in response to COVID-
19, and temporary staff to process the increased absentee ballot demand. Funds
may also be used for costs incurred to communicate law changes, such as changes
in absentee-by-mail ballot rules, that could result from the pandemic. Exempting
HAVA-funded positions at the State Board from a possible hiring freeze would
also be important to ensuring the agency is able to continue to secure the statewide
voter registration database and many other duties to protect North Carolina’s elec-
tions from cyber threats.
• One-Stop. Consider whether changes to one-stop requirements, such as site and

hour requirements, may be needed in light of the uncertainty regarding contain-
ment of the COVID-19 pandemic by the early voting period in October 2020.
Currently, if any one-stop site is open all one stop-sites must be open and all sites
other than the county board office must be open 8:00 a.m. to 7:30 p.m. County
boards of elections need flexibility to determine hours because they are affected
differently by, and respond differently to, the COVID-19 pandemic.
While the situation with COVID-19 is changing on a daily and sometimes hourly basis, we believe
the above recommendations will help the elections that form the basis of North Carolina’s democ-
racy remain strong and resilient in these uncertain times.

We are appreciative of the appointment of the House Select Committee on COVID-19, Continuity
of State Operations Working Group, and I stand ready to answer your questions or provide any
other information that may be useful in consideration of these recommendations.
Sincerely,
Karen Brinson Bell

Executive Director
State Board of Elections

EXHIBIT 2
Letter from Karen Brinson Bell, Executive Director,

N.C. State Board of Elections, to Governor Roy
Cooper et al. (Apr. 22, 2020)

Injunction
KAREN BRINSON BELL Mailing Address: Phone: Fax:
Executive Director P.O. Box 27255, (919) 814-0700 or (919) 715-0135
Raleigh, NC 27611 (866) 522-4723
TO: Governor Roy Cooper; Speaker Tim Moore; President Pro Tempore Phil Berger;
Joint Legislative Elections Oversight Committee; Joint Legislative Oversight
Committee on General Government; House Select Committee on COVID-19,
Continuity of State Operations Working Group; House Democratic Leader Darren
Jackson; Senate Democratic Leader Dan Blue
FROM: Karen Brinson Bell, Executive Director
RE: CARES Act Request and Clarification to Recommendations to Address Election-
Related Issues Affected by COVID-19
DATE: April 22, 2020
We write to provide you with updated information regarding our legislative requests made on
March 26, 2020, including estimated costs and the timeframes for when changes would need to be
made. We are also writing to provide additional detail about the Coronavirus Aid, Relief, and
Economic Security (CARES) Act requirements that we received last week. On April 6, 2020, we
were informed of North Carolina’s award of $10,897,295 under the CARES Act, which was
appropriated “to prevent, prepare for, and respond to coronavirus, domestically or internationally,
for the 2020 Federal election cycle.” The State match requirement is 20%, or $2,179,459.
We have completed two trainings to better understand how the match may be met and how the
funds may be applied. Some key points are:
• The funds are for additional costs, either new or increased, associated with the national
emergency related to coronavirus.
• All funds must be spent or incurred by December 31, 2020 or returned to the federal
government.
• Pre-award costs may be included if they were incurred on or after January 20, 2020.
• The State match may be funded over two years and may also be met:
o By direct funding of the State;
o By indirect or direct costs incurred by the State Board of Elections, county boards
of elections, and/or partners supporting state or county election boards to conduct
elections through this pandemic; and/or,
o Through in-kind contributions. We are working with the National Association of
State Election Directors to identify hand sanitizer and other supplies that may be
provided free of charge if available.

To date, we have identified $58,962 already incurred by the State Board of Elections, county
boards of elections, and supporting entities that can be credited towards the State’s match. This
includes $38,031 in indirect costs incurred by the State Board of Elections; $14,931 in direct costs
incurred by the county boards of elections; and $6,000 in in-kind donations.
We therefore are requesting state funding of $2,120,497 to receive the $10+ million awarded
to North Carolina.
Through these funds we can offset significant new and increased costs to the counties because of
a projected 30% to 40% voter absentee-by-mail participation rate (compared to a 4% to 5% rate
traditionally), the need to more thoroughly sanitize and improve hygiene methods during one-stop
early voting and on Election Day, and to address possible poll worker shortage due to illness or
reluctance or inability to serve. The CARES Act funds would directly assist counties through bulk
purchases, state purchase and distribution to the counties, or through reimbursement, and could
include but are not limited to the cost of:
• One-time-use pens and styluses for each voter, or sanitization of reusable supplies
• Hand sanitizer and masks for voters, poll workers, and election staff
• Social distancing tools and protective devices such as face shields, stanchions and
plexiglass shields at check-in stations
• Facility rental fees to assist counties in moving to sites large enough to accommodate social
distancing, including former department stores or grocery stores, if available
• Facility cleaning fees before, during, and after the election
• Increased postage costs due to a higher volume of absentee-by-mail requests
• Mail tracking software to help the voter understand where their ballot is in the process and
to help the counties prepare for the volume of incoming returned ballots
• Cost of additional absentee-by-mail envelopes and other supplies
Just to conduct the General Election statewide on Election Day, we will operate nearly 2,700
voting sites with approximately 18,000 workers employed for 14 to 16 hours. We are preparing
for more than 4.5 million voters to vote in-person or by-mail in this election. To ensure the health
and safety of the voters and workers, the costs add up quickly. And while we would like to think
that coronavirus will be a distant memory by November, we must prepare to address lingering
fears, new social norms, and the possibility that the virus could reoccur seasonally as do influenza
and other viruses. As elections officials, we must prepare for the worst-case scenario to ensure that
voters are able to cast their ballots. All of this means we need legislative approval for the associated
State match to move forward with the CARES Act funding.
Procuring and purchasing these supplies must happen now to ensure delivery by July when
counties will begin to assemble their supply kits, train poll workers, and receive orders from print
houses. We must also be mindful that all 50 states and territories will be implementing similar
procedures for the same Election Day and the supply chain is very stressed to meet the demands.

For these reasons, we also request that the General Assembly move forward with the
following recommendations during the special session beginning April 28, 2020. These are
immediate needs that apply to the 11th Congressional District Republican Second Primary,
the new Columbus County Commissioner District 2 Republican Primary, and the 2020
General Election. Particular to the General Election, because of the high expected turnout for a
presidential general election, supplies must be ordered, printing changes must be submitted and
scheduled with print houses, and other changes or orders should be completed by June 15, 2020 to
meet deadlines associated with that election, which starts with absentee-by-mail voting on
September 4, 2020. The recommendations needing immediate consideration for all three elections
are:
• Match CARES Act funds as outlined above.
• Match HAVA funds as outlined in my March 26, 2020 letter.
• Temporarily suspend purchase and contract requirements for elections-related

supplies and other items. Because of the time limitations and amount of supplies
needed to protect voters and pollworkers from COVID-19, the State Board and county
boards may have difficulty complying with procurement processes without the
temporary suspension. This change would need to happen right away as we are currently
attempting to procure many supplies due to the upcoming second primary and the
shortages that have occurred with so many states competing for resources.
 No additional expected cost
• Expand options for absentee requests (allow requests by fax and email). We
recommend allowing a voter to submit an absentee ballot request form by fax and email
to allow voters to submit their absentee requests without leaving their home or needing to
purchase stamps or envelopes. This change needs to be made as soon as possible as voters
may already request absentee ballots for the June 23 and November 3 elections.
• Allow a voter to include a copy of a HAVA document with their absentee request
form if the voter is unable to provide their driver’s license number or last four digits
of their Social Security number. Restoring this option will make it easier for those most
at risk of contracting COVID-19 to vote absentee by-mail. This change is needs to be
made as soon as possible as voters may already request absentee ballots for the June 23
and November 3 elections.
• Reduce or eliminate the witness requirement for absentee ballots. Most voters, under
current law, would have to invite another adult into the voter’s home to complete the
voting process since most voters do not live with two other individuals age 18 or older.
This increases the risk of transmission or exposure to disease. By reducing the witness
requirement to one witness during a disease epidemic, we can effectively conduct

absentee-by-mail voting while reducing a voter’s risk of disease. Additionally, it should
be noted that we continue to support restricting the return of absentee-by-mail ballots to
the voter or near relative as enacted by Session Law 2019-239. It is necessary to make the
change now in order to update the absentee instructions and return envelope, since these
will need to be redesigned by June and printed in early July to ensure the counties can
meet the start of absentee-by-mail voting on September 4, 2020.
An alternative option, and one that could be carried out beyond the 2020 General Election,
is to consider signature matching software. Software is available to compare the voter’s
signature on file to the signature provided on the absentee-ballot return envelope. Moving
to this verification process would eliminate the need for witnesses.
 No additional expected cost to reducing witness requirement. Software would

have added cost, but we do not yet have information about the expected cost.
• Temporarily modify restrictions on assistance in care facilities. Many localities are

currently restricting or banning visitors and family members to facilities, and an Executive
Order issued by the Governor prevents visitors altogether to reduce the spread of COVID-
19. Additionally, across the state, care facilities have tragically experienced large numbers
of coronavirus cases and deaths. We do not know what the conditions will be like when
absentee voting occurs from September to November this year. With this in mind, it may
not be possible for multipartisan assistance teams (MATs), or others who would
traditionally assist facility residents, to provide assistance. Many voters in these facilities
do require help with requesting, voting, and/or returning their ballots, and with no option
available for assistance, they may effectively be disenfranchised. We suggest considering
options, such as temporarily allowing a facility employee to assist, to ensure these voters
are able to continue to exercise their right to vote. Similar to states like Indiana, two trained
facility employees not of the same political party could be designated to administer voting
and could be trained accordingly by the county board prior to serving in this capacity.
Election officials could then transport materials to and from the facility with chain of
custody procedures documenting the acceptance of materials by the designated facility
administrators. It is necessary to make this change as soon as possible to designate and
train appropriate individuals to serve in facilities.
• Expand student pollworker program and eliminate requirement that a majority of

pollworkers reside in the precinct. We recommend this change be made immediately
because there are shortages in some polling places in the 11th Congressional District
Republican Second Primary and the new Columbus County Commissioner District 2
Republican Primary that may require transferring voters to another precinct.
 No additional cost expected

We also request the General Assembly move forward with the following
recommendations during the special session beginning April 28, 2020. These are
immediate needs, but it is not possible to implement them for the 11th Congressional
District Republican Second Primary and the new Columbus County Commissioner
District 2 Republican Primary. Because of deadlines associated with the 2020 General
Election, however, there is an immediate need to prepare for a coronavirus response:
• Establish online portal for absentee requests. This change would need to be made
immediately due to the time required to acquire software, modify the State Board of
Elections’ Statewide Elections Information Management System (SEIMS), and inform the
public of the change prior to the start of absentee voting on September 4, 2020.
 We have received a quote from a vendor who supports numerous states and
jurisdictions throughout the country. Based upon the volume projected for North
Carolina, the annual license fee is $398,000 with a pre-election configuration fee
of $25,950.
• Establish a fund to pay for postage for outbound and returned absentee ballots. We
would request any funds be allocated as soon as possible to allow county boards of
elections to budget for the election and in light of the budgetary reductions they are already
being requested to make at the county level.
 The estimate for prepaid postage for the November general election, based upon
65% of registered voters participating in the election and 40% of those
participating by mail, would be $3,640,000, at a cost of approximately $2 total
per ballot (7 million voters x 65% overall participation=4,550,000 participating
voters with 40% participating by mail=1,820,000 by mail ballots). This prepaid
cost would include both the outgoing and incoming postage cost. Envelope size
and weight may affect this estimate.
• Modify one-stop site and hour requirements. We recommend any changes be made
as soon as possible to allow time for county boards of elections to locate and procure
appropriate sites, a process that has already begun for the November 3 election.
 We expect a change would reduce costs for the county boards of elections. Due
to the uncertainty of any possible change, it is not currently possible to estimate
the savings.
We appreciate the dialogue we have had with many of you through this process and uncharted
waters. Our goal is to “prepare for the worst” in hopes that we are overly prepared. Elections
administration, as we have discussed, is a planning and logistics operation. The bulk of an election
is executed before voting ever begins, which is why we come before you now. If we can secure
the funds needed and know any legislative changes that may occur, then we can better prepare and
deliver successful elections under normal conditions or in times of crisis.

I stand ready to answer your questions or provide any other information that may be useful in
consideration of these funding requests and recommendations.
Sincerely,
Karen Brinson Bell

Executive Director

EXHIBIT 3
Letter from Board of Elections Members in

Congressional District 11 to General Assembly
Leaders et al. (Apr. 29, 2020)

Injunction
CONGRESSIONAL DISTRICT 11 BOARDS OF ELECTIONS
c/o Kathy Ray, Madison County Board of Elections
Marshall, NC 28753
Phone: 828-649-3731
Email: madison.boe@madisoncountync.gov
April 27, 2020
Dear General Assembly Leaders, Election Committee Members, and Western NC Legislators,
We write as Republican and Democratic members of the county boards of elections in

Congressional District 11 with an urgent request.
As we prepare to administer the runoff election (Second Primary) on June 23, we are learning that
many of our regular poll workers are reluctant to serve. A large percent of them are elderly and
are genuinely concerned about their health. In addition, some of our polling places are now being
used by other agencies for emergency purposes. If we must change or combine polling places
because of a poll worker shortage or a need for alternative locations, we must place a public notice
in the media by May 9th and must mail notices to all affected voters by May 23rd.
Under current law, a majority of poll workers must reside in the precinct where they serve on
Election Day. State Board of Elections Director Karen Brinson Bell has requested a change in
state law to allow county boards to recruit and train poll workers from across the county. This
change would significantly help us staff polling places in these challenging times. Because we
must make decisions very soon, we encourage you to include this change in the actions you take
when you reconvene next week.
We are committed to administering secure and fair elections, and we would be happy to provide
our insights about other changes that may be needed in the future. Our county directors are also
valuable resources for conducting safe and secure elections at the county level. The State Board
of Elections has provided a number of suggestions that address important issues at the state level,
and many of them are also time sensitive, including matching state funds to release federal dollars
for enhanced security and COVID-19 related election expenses.
We appreciate your leadership and look forward to working with you.
Sincerely,
Board of Elections Members in Congressional District 11 (alphabetical order of signers)
Pat Ackerman, Cherokee County

Eddie Adams, Cherokee County
Craig Allen, Cherokee County
Jerry Anderson, Clay County
Brian Ball, Madison County
Gary Boone, Yancey County

Sara Champion, Transylvania County
Juanita Colvard, Graham County
Lowell Crisp, Graham County
Gail Criss, Clay County
William Cutler, Henderson County
Pamela Dashiell, Transylvania County
Danny Davis, Haywood County
Gary Dills, Macon County
Billy Ditmore, Graham County
Teresa Eller, Graham County
Lynne Garrison, Macon County
Jeff Gillette, Macon County
Gary Kilpatrick, Cherokee County
Ray Lewis, Madison County
Frances Lockwood, Rutherford County
Pat Margo, Clay County
Charles McCurry, Yancey County
Rusty McLean, Haywood County
Lee McMinn, Transylvania County
Charles Medd, Henderson County
Joey Miller, Yancey County
David Morrow, Transylvania County
Elizabeth Norris, Haywood County
June Ray, Haywood County
Keith Rogers, Graham County
Paul Rohs, Clay County
Dyatt Smathers, Madison County
Linda Smith, Rutherford County
Sandy Solsbee, Cherokee County
Howard Sorrells, Haywood County
Christian Stolz, Henderson County
Kathy Tinsley, Macon County
Julia Tipton, Yancey County
Sandra Tolley, Madison County
John Vanhook, Macon County
Michael Wainwright, Transylvania County
Jerry Wallin, Madison County
Brenda Wilson, Yancey County
Keyla Youngblood-Stillwell, Clay County

EXHIBIT 4
Statement on the second meeting of the International

Health Regulations (2005) Emergency Committee
Regarding the Outbreak of Novel Coronavirus
(2019-nCoV) published by the World Health
Organization

Injunction

©
Newsroom Detail
Statement on the second

meeting of the International
Health Regulations (2005)
Emergency Committee
regarding the outbreak of
novel coronavirus (2019-nCoV)
30 January 2020 |Statement |Geneva, Switzerland
The second meeting of the Emergency Committee convened by the WHO Director-General under
the International Health Regulations (IHR) (2005) regarding the outbreak of novel coronavirus
2019 in the People’s Republic of China, with exportations to other countries, took place on Thursday,
30 January 2020, from 13:30 to 18:35 Geneva time (CEST). The Committee’s role is to give advice
to the Director-General, who makes the final decision on the determination of a Public Health
Emergency of International Concern (PHEIC). The Committee also provides public health advice or
suggests formal Temporary Recommendations as appropriate.
Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference
The Director-General welcomed the Committee and thanked them for their support. He turned the
meeting over to the Chair, Professor Didier Houssin.
Professor Houssin also welcomed the Committee and gave the floor to the Secretariat.
A representative of the department of compliance, risk management, and ethics briefed the
Committee members on their roles and responsibilities.
Committee members were reminded of their duty of confidentiality and their responsibility to disclose
personal, financial, or professional connections that might be seen to constitute a conflict of interest.
Each member who was present was surveyed and no conflicts of interest were judged to be relevant
to the meeting. There were no changes since the previous meeting.
The Chair then reviewed the agenda for the meeting and introduced the presenters.
Representatives of the Ministry of Health of the People’s Republic of China reported on

the current situation and the public health measures being taken. There are now 7711 confirmed
and 12167 suspected cases throughout the country. Of the confirmed cases, 1370 are severe and
170 people have died. 124 people have recovered and been discharged from hospital.
The WHO Secretariat provided an overview of the situation in other countries. There are
now 83 cases in 18 countries. Of these, only 7 had no history of travel in China. There has been
human-to-human transmission in 3 countries outside China. One of these cases is severe and there
have been no deaths.
At its first meeting, the Committee expressed divergent views on whether this event constitutes a
PHEIC or not. At that time, the advice was that the event did not constitute a PHEIC, but
theCommittee members agreed on the urgency of the situation and suggested that the Committee
should continue its meeting on the next day, when it reached the same conclusion.
This second meeting takes place in view of significant increases in numbers of cases and additional
countries reporting confirmed cases.
Conclusions and advice

The Committee welcomed the leadership and political commitment of the very highest levels
of Chinese government, their commitment to transparency, and the efforts made to investigate and
contain the current outbreak. China quickly identified the virus and shared its sequence, so that

other countries could diagnose it quickly and protect themselves, which has resulted in the rapid
development of diagnostic tools.
The very strong measures the country has taken include daily contact with WHO
and comprehensive multi-sectoral approaches to prevent further spread. It has also taken public
health measures in other cities and provinces; is conducting studies on the severity and
transmissibility of the virus, and sharing data and biological material. The country has also agreed to
work with other countries who need their support. The measures China has taken are good not only
for that country but also for the rest of the world.
The Committee acknowledged the leading role of WHO and its partners.
The Committee also acknowledged that there are still many unknowns, cases have now been
reported in five WHO regions in one month, and human-to-human transmission has
occurred outside Wuhan and outside China.
The Committee believes that it is still possible to interrupt virus spread, provided that countries put in
place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote
social distancing measures commensurate with the risk. It is important to note that as the situation
continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the
infection. The Committee agreed that the outbreak now meets the criteria for a Public Health
Emergency of International Concern and proposed the following advice to be issued as Temporary
Recommendations.
The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support
and appreciation for China, its people, and the actions China has taken on the frontlines of this
outbreak, with transparency, and, it is to be hoped, with success. In line with the need for global
solidarity, the Committee felt that a global coordinated effort is needed to enhance preparedness in
other regions of the world that may need additional support for that.
Advice to WHO
The Committee welcomed a forthcoming WHO multidisciplinary technical mission to China, including
national and local experts. The mission should review and support efforts to investigate the animal
source of the outbreak, the clinical spectrum of the disease and its severity, the extent of human-to-
human transmission in the community and in healthcare facilities, and efforts to control the
outbreak. This mission will provide information to the international community to aid in
understanding the situation and its impact and enable sharing of experience and successful
measures.

The Committee wished to re-emphasize the importance of studying the possible source, to rule
out hidden transmission and to inform risk management measures
The Committee also emphasized the need for enhanced surveillance in regions outside Hubei,
including pathogen genomic sequencing, to understand whether local cycles of transmission
are occurring.
WHO should continue to use its networks of technical experts to assess how best this outbreak can
be contained globally.
WHO should provide intensified support for preparation and response, especially in vulnerable
countries and regions.
Measures to ensure rapid development and access to potential vaccines, diagnostics, antiviral
medicines and other therapeutics for low- and middle-income countries should be developed.
WHO should continue to provide all necessary technical and operational support to respond to this
outbreak, including with its extensive networks of partners and collaborating
institutions, to implement a comprehensive risk communication strategy, and to allow for the
advancement of research and scientific developments in relation to this novel coronavirus.
WHO should continue to explore the advisability of creating an intermediate level of alert between
the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations
on the text of the IHR (2005).
WHO should timely review the situation with transparency and update its evidence-based
recommendations.
The Committee does not recommend any travel or trade restriction based on the current information
available.
The Director-General declared that the outbreak of 2019-nCoV constitutes a PHEIC and
accepted the Committee’s advice and issued this advice as Temporary Recommendations
under the IHR.
To the People’s Republic of China

Continue to:

• Implement a comprehensive risk communication strategy to regularly inform the population on the
evolution of the outbreak, the prevention and protection measures for the population, and the
response measures taken for its containment.
• Enhance public health measures for containment of the current outbreak.
• Ensure the resilience of the health system and protect the health workforce.
• Enhance surveillance and active case finding across China.
• Collaborate with WHO and partners to conduct investigations to understand the epidemiology and
the evolution of this outbreak and measures to contain it.
• Share relevant data on human cases.
• Continue to identify the zoonotic source of the outbreak, and particularly the potential for
circulation with WHO as soon as it becomes available.
• Conduct exit screening at international airports and ports, with the aim of early detection
of symptomatic travelers for further evaluation and treatment, while minimizing interference with
international traffic.
To all countries
It is expected that further international exportation of cases may appear in any country. Thus, all
countries should be prepared for containment, including active surveillance, early detection,
isolation and case management, contact tracing and prevention of onward spread of 2019-
nCoVinfection, and to share full data with WHO. Technical advice is available on the WHO website.
Countries are reminded that they are legally required to share information with WHO under the IHR.
Any detection of 2019-nCoV in an animal (including information about the species, diagnostic tests,
and relevant epidemiological information) should be reported to the World Organization for Animal
Health (OIE) as an emerging disease.
Countries should place particular emphasis on reducing human infection, prevention of secondary
transmission and international spread, and contributing to the international response though multi-
sectoral communication and collaboration and active participation in increasing knowledge on
the virus and the disease, as well as advancing research.

The Committee does not recommend any travel or trade restriction based on the current information
available.
Countries must inform WHO about travel measures taken, as required by the IHR. Countries are
cautioned against actions that promote stigma or discrimination, in line with the principles of Article 3
of the IHR.
The Committee asked the Director-General to provide further advice on these matters and, if
necessary, to make new case-by-case recommendations, in view of this rapidly evolving situation.
To the global community

As this is a new coronavirus, and it has been previously shown that similar coronaviruses required
substantial efforts to enable regular information sharing and research, the global community should
continue to demonstrate solidarity and cooperation, in compliance with Article 44 of the IHR
(2005), in supporting each other on the identification of the source of this new virus, its full potential
for human-to-human transmission, preparedness for potential importation of cases, and research for
developing necessary treatment.
Provide support to low- and middle-income countries to enable their response to this event, as well
as to facilitate access to diagnostics, potential vaccines and therapeutics.
Under Article 43 of the IHR, States Parties implementing additional health measures that
significantly interfere with international traffic (refusal of entry or departure of international travellers,
baggage, cargo, containers, conveyances, goods, and the like, or their delay, for more than 24
hours) are obliged to send to WHO the public health rationale and justification within 48 hours of
their implementation. WHO will review the justification and may request countries to reconsider their
measures. WHO is required to share with other States Parties the information about measures and
the justification received.
The Emergency Committee will be reconvened within three months or earlier, at the discretion of the
Director-General.
The Director-General thanked the Committee for its work.
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EXHIBIT 5
People who are at higher risk for severe illness,

published by Ctrs. for Disease Control and
Prevention (“CDC”)

Injunction

COVID-19 is a new disease and there is limited information regarding risk factors for severe disease. Based on currently
available information and clinical expertise, older adults and people of any age who have serious underlying medical
conditions might be at higher risk for severe illness from COVID-19.
Based on what we know now, those at high-risk for severe illness from COVID-19 are:
People 65 years and older

People who live in a nursing home or long-term care facility
People of all ages with underlying medical conditions, particularly if not well controlled, including:
People with chronic lung disease or moderate to severe asthma

People who have serious heart conditions
People who are immunocompromised
Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone
marrow or organ transplantation, immune de ciencies, poorly controlled HIV or AIDS, and prolonged use of
corticosteroids and other immune weakening medications
People with severe obesity (body mass index [BMI] of 40 or higher)
People with diabetes
People with chronic kidney disease undergoing dialysis
People with liver disease
 Older Adults  People with Asthma
 At Risk For Severe Illness  People with HIV
People Who Are

 People with Liver Disease  Immunocompromised
COVID-19: Are You at Higher Risk for Severe Illness?
Resources
ASL Video Series: COVID-19: Are You at Higher Risk for Severe Illness?
Learn how you can help protect yourself if you are at higher risk of severe illness from COVID-19 
Page last reviewed: May 14 2020

EXHIBIT 6
Remarks by President Trump, Vice President Pence,

and Members of the Coronavirus Task Force
(Mar. 25, 2020)

Injunction

REMARKS
Remarks by President Trump, Vice President Pence,

and Members of the Coronavirus Task Force in Press
Brie ng
HEALTHCARE
Issued on: March 25, 2020
★ ★ ★
James S. Brady Press Briefing Room
5:54 P.M. EDT
THE PRESIDENT: Thank you very much. So, nice to be with you. America continues to gain ground
in the war against the virus.
I want to thank the American people for answering the call, following our guidelines, and making
the sacrifices required to overcome this terrible threat. More aggressively we commit to social
distancing — so important. Social distancing — such an important phrase. And we do it right now.
The more lives we can save and the sooner we can eventually get people back to work, back to
school, and back to normal.
And there are large sections of our country — probably can go back much sooner than other
sections. And we’re obviously looking at that also. People are asking, “Is that an alternative?” And
I say, “Absolutely, it is an alternative.”
I have now approved major disaster declarations for New York, California, Washington, Iowa,
Louisiana, Texas, and Florida. That has great significance, as you know, and legal significance.

So, each person in every place — no matter what county, what community, what state — can work
with us to ensure that we prevent the spread of this virus to others. So thank you.
THE VICE PRESIDENT: Well done.
Doctor?
DR. FAUCI: Thank you, Mr. Vice President. I just want to spend a couple of minutes telling you a
little bit about some information that I got on our weekly call that we have at least once a week
with the W- — with WHO, which is led by Dr. Tedros and Mike Ryan, who’s the point man there, to
give us some information. And, in that regard, I want to apologize for my curt response to you
when you asked me about the China deal because I shouldn’t have done that. That’s not my style.
But what I really wanted to say is that my job is that I’m a scientist, I’m a physician, and I’m a
public-health person and I don’t like to get involved in that stu .
So, anyway, getting back to the WHO. So we learned some really interesting information because,
obviously, the other countries, like China and others, have — had been hit prior that we did.
One of the things that was striking to me — and I just throw it out because it’s something that we
will face. We’re not facing it now, but we will face — our Chinese colleagues are very concerned
because they went through the entire cycle of the curve to come down. And they have very, very
few cases. But what they’re starting to see as they’re relaxing the constraints on travel, that they’re
getting imported cases. And they wanted to warn us that when we get successful, make sure you
very carefully examine how you’re going to release the constraints on inputs.
So I know we’re going to be successful in putting this under control, but I think we’re going to have
to remember, we don’t want to import cases in. That’s the first thing for today.
The second thing that was important is that — it was something that Dr. Birx mentioned. And that
is, when you look at the inflection of the curves, we now have multiple di erent countries that have
gone through various phases of their individual outbreaks and you could learn something from
them about where you are in your own outbreak.

For example, when China went up, what happened is they just didn’t turn around. They went from
going to — I’ll just take an arbitrary number — 500 new cases a day. The next day, it was 1,000
cases, then 1,500, and then 2,000. But once the number of new cases each day starts to flatten out,
that’s when you get to that point where the inflection goes down.
So if you — what — things we want to look for are the things that Dr. Birx had mentioned. That
doesn’t mean you declare victory when it does that, but you know you’re at least on the way to
where you want to go. And I think that’s really very important.
The third and final thing that I think gets back to the question that many of you in the audience
have asked of us, is about: Would this possibly become a seasonal cyclic thing? And I’ve always
indicated to you that I think it very well might.
And the reason I say that is that what we’re starting to see now in the Southern Hemisphere — in
southern Africa and in the Southern-Hemisphere countries — is that we’re having cases that are
appearing as they go into their winter season. And if, in fact, they have a substantial outbreak, it
will be inevitable that we need to be prepared that we’ll get a cycle around the second time.
What does that mean for us and what we’re doing? It totally emphasizes the need to do what we’re
doing in developing a vaccine, testing it quickly, and trying to get it ready so that we’ll have a
vaccine available for that next cycle. In addition, to do the randomized controlled trials of drugs, so
that we will have a menu of drugs that we have shown to be e ective and shown to be safe.
Because I know we’ll be successful in putting this down now, but we really need to be prepared for
another cycle. And what we’re doing, I believe, will prepare us well.
Thank you.
THE VICE PRESIDENT: Thanks, Doctor. We’ll take a few questions. Please.
Q Mr. Vice President, on ventilators, some really important reporting from the Center of Public
Integrity today. They suggested that there’s only 16,000 in the National Stockpile. Can you just give
us some clarity: How many ventilators do you have the National Stockpile? Who else is making
them? And how long will it take for them to make the critical mass? Because based on the Center
for Public Integrity, it appears there aren’t enough and people are doing to die as a result.

EXHIBIT 7
CDC Director Warns Second Wave of Coronavirus

Might be ‘More Difficult” (Apr. 21, 2020)
published by the Hill

Injunction

CDC director warns second wa
coronavirus might be 'more di
BY ZACK BUDRYK - 04/21/20 04:51 PM EDT
16,793 SHARES SHARE TW
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pandemic response
IN THE NEWS — 9M 49S AGO
A potential second wave of the novel coronavirus late in the year would
likely be more deadly, as it would overlap with lu season, Centers for
Dershowitz: Does Disease Control and Prevention (CDC) head Robert Red ield told The
President Trump have Washington Post on Tuesday.
power to declare
martial law?
“There’s a possibility that the assault of the virus on our nation next winter
OPINION — 11M 39S AGO
will actually be even more di icult than the one we just went through,”
Red ield told the Post. “And when I’ve said this to others, they kind of put
ADP report shows 2.8 their head back, they don’t understand what I mean.”
million jobs lost in May
FINANCE — 14M 40S AGO Red ield said two coinciding respiratory outbreaks would strain the
nation’s health care system even further than the current pandemic, which
Pope condemns racism, has been marked by shortages of ventilators, test kits and personal
says street violence is protective equipment.
'self-defeating'
INTERNATIONAL — 22M 4S AGO Americans can make such a scenario less likely, he said, by keeping up to
date on lu vaccinations, which he said “may allow there to be a hospital
Poll: Majority bed available for your mother or grandmother that may get coronavirus.”
'sympathetic' to
protesters, disapprove
of Trump's response Governors detail frustrations with Trump over COVID-19 supplies
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winning streak amid Red ield said the U.S. was spared a much worse COVID-19
protests
outbreak because the coronavirus hit the nation when the seasonal lu
FINANCE — 31M 1S AGO
was already on the decline. Had they hit at the same time, “it could have

VIEW ALL
been really, really, really, really di icult in terms of health capacity,” he
said.
The 2009 swine lu pandemic followed a similar trajectory, with an initial

wave in spring and then a second in fall and winter, when lu season in the
U.S. typically takes place.
The CDC head told the Post that federal and state o icials should use the
months ahead to scale up their testing capacity for after more widespread
restrictions are lifted as well as their ability to ind anyone with whom a

con irmed case has interacted. O icials must also continue to stress the
importance of social distancing even after the restrictions end, Red ield
said.
TAGS THE WASHINGTON POST ROBERT REDFIELD CORONAVIRUS FLU SEASON PANDEMIC
SOCIAL DISTANCING PERSONAL PROTECTIVE EQUIPMENT
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EXHIBIT 8
Governor Roy Cooper’s Exec. Order No. 141

(May 20, 2020)

Injunction

~fair of ~nr±lf filarnlina
ROY COOPER
GOVERNOR
May 20, 2020
EXECUTIVE ORDER NO. 141
EASING RESTRICTIONS ON TRAVEL, BUSINESS OPERATIONS,

AND MASS GATHERINGS: PHASE 2
WHEREAS, on March 10, 2020, the undersigned issued Executive Order No. 11 6 which
declared a State of Emergency to coordinate the State' s response and protective actions to address
the Coronavirus Disease 20 19 ("COVID-1 9") public health emergency and provide for the health,
safety, and welfare ofresidents and visitors located in North Carolina; and
WHEREAS, on March 11, 2020, the World Heal th Organization declared COVID-1 9 a
global pandemic; and
WHEREAS, on March 13, 2020, the President of the United States issued an emergency
declaration for all states, tribes, territories, and the District of Columbia, retroactive to March I ,
2020, and the President declared that the COVID- 19 pandemic in the United States constitutes a
national emergency; and
WHEREAS, on March 25, 2020, the President approved a Major D isaster Declaration,
FEMA-4487-DR, for the State of North Carolina; and
WHEREAS, in responding to the COVID-1 9 pandemic, and for the purpose of protecting
the health, safety, and welfare of the people of North Carolina, the undersigned has issued
Executive Order Nos. 11 6-1 22, 124- 125, 129- 13 1, 133-136, and 138-140; and
WHEREAS, more than twenty thousand people in North Carolina have had laboratory-
confirmed cases of COVID-1 9, and hundreds of people in North Carol ina have died from the
disease; and
WHEREAS, hospital administrators and health care providers have expressed concerns
that unless the spread of COVID- 19 is limited, existing health care faci lities may be insufficient
to care for those who become sick; and
WHEREAS, the undersigned and the Secretary of Health and Human Services have
directed hospitals, physicians' practices, and other health care entities to undertake significant
actions as part of North Carolina' s emergency response to address the COVID-19 pandemic; and
WHEREAS, slowing and controlling community spread of COVID-1 9 is critical to

ensuring that the state' s healthcare fac ilities remain ab le to accommodate those who require
medical assi stance; and

WHEREAS, the continued community spread of COVID-19 within North Carolina
requires the state to continue some measures to slow the spread of this virus during the pandemic;
and
WHEREAS, since the issuance of executive orders to slow the spread of COVID-19,
North Carolina has "flattened the curve" and prevented a surge or spike in cases across the state,
and North Carolina has also increased its capacity for testing, tracing and the availability of
personal protective equipment ("PPE"); and
WHEREAS, despite the overall stability in key metrics, North Carolina's daily case counts
of COVID-19 continue to increase slightly in the context of increased testing, demonstrating the
state must remain vigilant in its work to slow the spread of the virus; and
WHEREAS, should there be an increase in the percentage of emergency department visits

that are due to COVID-19 like illness, an increase in the number of laboratory-confirmed cases,
an increase in the positive tests as a percent of total tests, an increase in COVID-19-related
hospitalizations that threaten the ability of the health care system to properly respond, or should
the State's ability to conduct testing and tracing be compromised, it may be necessary to reinstate
certain restrictions eased by this Executive Order so as to protect the health, safety, and welfare of
North Carolinians; and
WHEREAS, the risk of contracting and transmitting COVID-19 is higher in settings that
are indoors, where air does not circulate freely and where people are less likely to maintain social
distancing by staying six (6) feet apart; and
WHEREAS, the risk of contracting and transmitting COVID-19 is higher in settings where
people are stationary and in close contact for long periods of time; and
WHEREAS, the risk of contracting and transmitting COVID-19 is higher in gatherings of

larger groups of people because these gatherings offer more opportunity for person-to-person
contact with someone infected with COVID-19; and
WHEREAS, to lower the risk of contracting and transmitting COVID-19, this Executive
Order imposes restrictions on businesses that limit the number of contacts between people,
particularly in settings that are indoors, involve people being stationary and in close contact for
long periods of time, or are part of mass gatherings; and
WHEREAS, certain types of businesses by their very nature present greater risks of the
spread of COVID-19 because of the nature of the activity, the way that people have traditionally
acted and interacted with each other in that space, and the duration that patrons stay in the
establishment; and
WHEREAS, people in North Carolina are encouraged to use a cloth face covering to
reduce the spread of COVID-19, but some populations may experience increased anxiety and fear
of bias and being profiled if wearing face coverings in public spaces; and
WHEREAS, if someone is the target of ethnic or racial intimidation as the result of

adhering to the mask provision or as a result of the pandemic, they are encouraged to report the
matter to law enforcement or another government entity; and
WHEREAS, people in North Carolina must remain flexible to account for the evolving
nature and scope of the public health emergency posed by COVID-19, and also return to-in a
safe, strategic, and incremental manner-their normal personal and professional activities, to the
extent public health circumstances permit; and
WHEREAS, people in North Carolina are encouraged to take on the challenges of living
in a community beset by a global pandemic, while also returning to school, work, and social
activities in a safe, strategic and incremental manner to help reduce the risk of COVID-19
transmission; and

WHEREAS, businesses that are open during the duration of this Executive Order are
encouraged to follow the Guidelines for Businesses published by the North Carolina Department
of Health and Human Services ("NCDHHS"), available electronically on its website; and
WHEREAS, food service and food availability remain an important component of North
Carolina's response to the COVID-19 pandemic, such that food service providers, including
restaurants and other dine-in facilities are encouraged to open to the extent practicable to safely
provide food and nutrition to people in North Carolina; and
WHEREAS, it is in the interest of the State of North Carolina to provide as many viable
avenues as practicable for North Carolina agricultural products to be consumed in-state in order to
avoid unnecessary waste in the production of food; and
WHEREAS, the closure of on-premises dining in restaurants has significantly curtailed

demand for food sold by restaurants and, therefore, disproportionately harmed workers, farms, and
businesses involved in the sale of food through the restaurant supply chain and led to the waste of
food produced by such workers, farms, and businesses; and
WHEREAS, because restaurants and grocery stores are served by different supply chains
that cannot always be rapidly adjusted, the closure of on-premises dining in restaurants has shifted
food demand to grocery stores, taxing the supply chain for grocery stores and leading to higher
grocery prices for consumers; and
WHEREAS, reopening restaurants for on-premises dining in a safe, strategic manner

should ameliorate the adverse economic effects on workers, farms, and businesses involved in the
sale of food through the restaurant supply chain, prevent the waste of food, and reduce stress on
the supply chain for grocery stores, thereby lowering grocery prices for consumers; and
WHEREAS, despite the unprecedented nature of the COVID-19 pandemic, people in

North Carolina should have the opportunity to enjoy performing arts and competitive sporting
events broadcast into their homes; and
WHEREAS, as long as progress continues to be met on the COVID-19 metrics, and as

long as health care systems continue to be projected to have sufficient capacity for patient care,
commerce that does not raise unreasonable risks of COVID-19 spread may be reopened; and
WHEREAS, with public health requirements in place and face coverings more readily
available, personal care, grooming, and tattoo businesses may be reopened in a safe, strategic
manner without raising unreasonable risk of COVID-19 spread; and
WHEREAS, Executive Order No. 116 invoked the Emergency Management Act, and
authorizes the undersigned to exercise the powers and duties set forth therein to direct and aid in
the response to, recovery from, and mitigation against emergencies; and
WHEREAS, pursuant to N. C. Gen. Stat. § l 66A- l 9 .1 O(b)(2), the undersigned may make,
amend, or rescind necessary orders, rules, and regulations within the limits of the authority
conferred upon the Governor in the Emergency Management Act; and
WHEREAS, N.C. Gen. Stat. § 166A-l 9.10(b)(3) authorizes and empowers the
undersigned to delegate Gubernatorial vested authority under the Emergency Management Act
and to provide for the sub-delegation of that authority; and
WHEREAS, N.C. Gen. Stat.§ l66A-l9.I0(b)(4) gives the undersigned the authority to
"cooperate and coordinate" with the President of the United States; and
WHEREAS, pursuant to N.C. Gen. Stat.§ 166A-l 9.12(3)(e), the Division of Emergency
Management must coordinate with the State Health Director to revise the North Carolina
Emergency Operations Plan as conditions change, including making revisions to set "the
appropriate conditions for quarantine and isolation in order to prevent the further transmission of
disease," and following this coordination, the Emergency Management Director and the State

Health Director have recommended that the Governor develop and order the plan and actions
identified in this Executive Order; and
WHEREAS, pursuant to N.C. Gen. Stat.§ 166A-19.23 in conjunction with N.C. Gen. Stat.
§§ 75-37 and 75-38, the undersigned may issue a declaration that shall trigger the prohibitions
against excessive pricing during states of disaster, states of emergency or abnormal market
disruptions; and
WHEREAS, pursuant to N.C. Gen. Stat.§ 166A-19.30(a)(l), the undersigned may utilize
all available state resources as reasonably necessary to cope with an emergency, including the
transfer and direction of personnel or functions of state agencies or units thereof for the purpose
of performing or facilitating emergency services; and
WHEREAS, pursuant to N.C. Gen. Stat. § 166A-19.30(a)(2), the undersigned may take
such action and give such directions to state and local law enforcement officers and agencies as
may be reasonable and necessary for the purpose of securing compliance with the provisions of
the Emergency Management Act and with the orders, rules, and regulations made thereunder; and
WHEREAS, pursuant to N.C. Gen. Stat. § 166A-19.30(c)(i), the undersigned has

determined that local control of the emergency is insufficient to assure adequate protection for
lives and property of North Carolinians because not all local authorities have enacted such
appropriate ordinances or issued such appropriate declarations restricting the operation of
businesses and limiting person-to-person contact, thus needed control cannot be imposed locally;
and
WHEREAS, pursuant to N.C. Gen. Stat. § l66A-I9.30(c)(ii), the undersigned has

lives and property of North Carolinians because some but not all local authorities have taken
implementing steps under such ordinances or declarations, if enacted or declared, in order to
effectuate control over the emergency that has arisen; and
WHEREAS, pursuant to N.C. Gen. Stat. § I66A-l9.30(c)(iii), the undersigned has

lives and property of North Carolinians because the area in which the emergency exists spreads
across local jurisdictional boundaries and the legal control measures of the jurisdictions are
conflicting or uncoordinated to the extent that efforts to protect life and property are, or
unquestionably will be, severely hampered; and
WHEREAS, pursuant to N.C. Gen. Stat. § 166A-19.30(c)(iv), the undersigned has

determined that local control of the emergency is insufficient to assure adequate protection oflives
and property of North Carolinians because the scale of the emergency is so great that it exceeds
the capability of local authorities to cope with it; and
WHEREAS, N.C. Gen. Stat.§ 166A-19.30(c) in conjunction with N.C. Gen. Stat.§ 166A-
19 .31 (b )(1) authorizes the undersigned to prohibit and restrict the movement of people in public
places; and
WHEREAS, N.C. Gen. Stat.§ 166A-19.30(c) in conjunction with N.C. Gen. Stat.§ 166A-
19.3 l(b)(2) authorizes the undersigned to prohibit and restrict the operation of offices, business
establishments, and other places to and from which people may travel or at which they may
congregate; and
WHEREAS, N.C. Gen. Stat.§ 166A-l 9.30(c) in conjunction with N.C. Gen. Stat.§ 166A-
l 9 .31 (b )( 5) authorizes the undersigned to prohibit and restrict other activities or conditions, the
control of which may be reasonably necessary to maintain order and protect lives or property
during a state of emergency; and
WHEREAS, pursuant to N.C. Gen. Stat. § 166A-19.30(c)(l), when the undersigned

imposes the prohibitions and restrictions enumerated in N.C. Gen. Stat. § 166A-19.3l(b), the

undersigned may amend or rescind the prohibitions and restrictions imposed by local authorities;
and
WH EREAS, pursuant to N.C. Gen. Stat. § 166A-l 9.30(a)(2), during a Gubematorially

declared State of Emergency, the undersigned has the power to "give such directions to State and
local law enforcement officers and agencies as may be reasonable and necessary for the purpose
of seeming compliance with the provisions of this Arti cle."
NOW, THEREFORE, by the authority vested in me as Governor by the Constitution and

the laws of the State of North Carolina, IT IS ORDERED:
Section 1. Definitions. In this Executive Order:
1. " Bars" means establishments that are not eating establishments or restaurants as
defined in N.C. Gen. Stat. §§ 18B-1000(2) and 18B-1000(6), that have a permit to sell
alcoho lic beverages for onsite consumption under N .C. Gen. Stat. § l 8B-1 00 1, and that
are principally engaged in the business of selling alcoholic beverages for onsite
consumption.
2. "Core Signage. Screenin g. and Sanitation Req uirements" are the fol lowing actions
which establishments open to the public under the terms of this Executive Order must
foll ow, namely:
a. Post the Emergency Maximum Occupancy in a noticeable place.
b. Post signage reminding attendees, customers, and workers about social

distancing (staying at least six (6) feet away from others) and requesting that
people who have been symptomatic with fever and/or cough not enter.
c. Conduct daily symptom screening of workers, using a standard interview

questionnaire of symptoms, before workers enter the workplace.
d. Immediately isolate and remove sick workers.
e. Perform frequent and routine environmental cleaning and disinfection of

high-touch areas with an EPA-approved disinfectant for SARS-CoV-2 (the
virus that causes COVID-1 9).
NCDHHS has prepared sample signs and a san1ple screening checkl ist questionnaire,
available at https://covid 19.ncdhhs.i:.rnv/guidance, that may be used to meet some of the
requirements above. Businesses or operations do not need to use the NCDHHS samp le
signs and questionnaires to meet the requirements of this Executive Order.
3. "Emergency Maximum Occupancy" is defined in Section 6.
4. "Face Covering" means a covering of the nose and mouth by wearing a covering or
mask for the purpose of ensuring the physical health or safety of the wearer or others
as defined in Session Law 2020-3 s. 4.3(a). In the context of the COVID-1 9
emergency, the Face Covering works to protect other people more than the wearer.
5. "Personal Care. Grooming. and Tattoo Businesses" means businesses that (a) do not
provide health care services; and (b) either (i) have workers directly touch customers
or (ii) have a piece of equipment (other than a touchscreen) repeatedly come into
contact directly with customers' skin. This includes, but is not lim ited to, barber shops,
beauty salons (including but not limited to waxing and hair removal centers), hair
salons, nail salons, man icure or pedicure providers, tattoo parlors, tanning salons, and
massage therapists.
6. "Recommendations to Promote Social Distancing and Reduce Transmission" are

defi ned in Section 3(8) below.

7. "Restaurants" means permitted food establishments, under N.C. Gen. Stat. § 130A-
248, and other establishments that both prepare and serve food. This includes, but is
not limited to, restaurants, cafeterias, food halls, dining halls, food courts, and food
kiosks. This includes not only free-standing locations but also locations within other
businesses or facilities, including, but not limited to airports, shopping centers,
educational institutions, or private or members-only clubs where food and beverages
are permitted to be consumed on premises.
8. "Retail Business" means any business in which customers enter a space to purchase
goods or services, including but not limited to grocery stores, convenience stores,
large-format retail stores, pharmacies, banks, and ABC stores. This also includes, but
is not limited to, (i) retail establishments operated by the state, its political subdivisions,
or agencies thereof, and (ii) state agencies under the jurisdiction of the undersigned
which have a public-facing component offering a service, such as the Division of Motor
Vehicles, the Department of Revenue, and shops in Department ofNatural and Cultural
Resources facilities.
Section 2. High-Risk Individuals Encouraged to Stay at Home.
People who are at high risk of severe illness from COVID-19 are very strongly encouraged
to stay home and travel only for absolutely essential purposes. The Centers for Disease Control
and Prevention ("CDC") defines high-risk individuals as people 65 years or older and people of
any age who have serious underlying medical conditions, including people who are
immunocompromised or who have chronic lung disease, moderate-to-severe asthma, serious heart
conditions, severe obesity, diabetes, chronic kidney disease undergoing dialysis, or liver disease.
Section 3. Activities Outside the Home.
For the reasons and pursuant to the authority set forth above, the undersigned orders as follows:
A. Stay at Home Order Lifted. The Stay at Home Order in Executive Order No. 138 is lifted.
Individuals are strongly encouraged to telework to the greatest extent permissible by their
employer.
B. Follow the Recommendations to Promote Social Distancing and Reduce Transmission.

When people are outside their homes, they are strongly encouraged to take the following
Recommendations to Promote Social Distancing and Reduce Transmission:
1. Maintain at least six (6) feet social distancing from other individuals, with the exception
of family or household members.
2. Wear a cloth Face Covering when leaving home and wear it inside all public settings
such as grocery stores, pharmacies, or other retail or public-serving businesses. A Face
Covering should also be worn outdoors when you cannot maintain at least six (6) feet
distancing from other people with the exception of family or household members.
These coverings function to protect other people more than the wearer.
3. Carry hand sanitizer with you when leaving home, and use it frequently.
4. Wash hands using soap and water for at least twenty (20) seconds as frequently as
possible.
5. Regularly clean high-touch surfaces such as steering wheels, wallets, and phones.
6. Stay at home if sick.
Section 4. Exemptions from This Executive Order.
Worship, religious, and spiritual gatherings, funeral ceremonies, wedding ceremonies, and
other activities constituting the exercise of First Amendment rights are exempt from all the

requirements of this Executive Order and Executive Order Nos. 121 and 138, notwithstanding any
other provision of this Executive Order or of Executive Order Nos. 121 and 13 8.
The undersigned strongly urges that entities and individuals engaging in these exempted
activities follow the Recommendations to Promote Social Distancing and Reduce Transmission,
avoid exceeding Emergency Maximum Occupancy in the places where they meet, and avoid
holding Mass Gatherings.
Section 5. Structure of This Executive Order.
The restrictions in this Executive Order are tailored for particular situations where
COVID-19 can spread. As a result, the restrictions in this Executive Order fall into three
categories:
• Section 6 establishes restrictions for certain listed kinds of businesses and operations. The
restrictions in this Section ensure that there is not overcrowding and spread people out in each
space to reduce the risk from COVID-19.
• Section 7 establishes a Mass Gathering limit. This limit controls the risk of COVID-19 spread
in events or convenings that are not covered by the specific restrictions in Section 6.
• Section 8 keeps closed certain kinds of businesses and operations because those types of
businesses, by their very nature, present greater risks of the spread of COVID-19. These
greater risks are due to factors such as people traditionally interacting in that space in a way
that would spread COVID-19, shared equipment that is repeatedly touched by customers or
attendees, or a business model that involves customers or attendees remaining in a confined
indoor space over a sustained period.
Section 6. Restrictions on Certain Businesses and Operations.
A. Prohibition. To control the spread of COVID-19 and protect lives during the State of
Emergency, this Section lists restrictions on the operations of business establishments and
other places to or from which people may travel or at which they may congregate. Businesses
or operations within the scope of this Section are prohibited from operating unless they follow
the restrictions stated in this Section.
B. Retail Businesses.
1. Requirements for Retail Businesses. While this Executive Order is in effect, all open
Retail Businesses must do all of the following.
a. Limit customers inside the store to Emergency Maximum Occupancy.

Under this Executive Order, the Emergency Maximum Occupancy for a Retail
Business is the lowest number produced by applying the following two tests:
1. Limit the number of customers in the store to fifty percent (50%) of

stated fire capacity (or, for spaces without a stated fire capacity, no more
than twelve (12) customers for every one thousand (1000) square feet
of the location's total square footage, including the parts of the location
that are not accessible to customers or guests).
11. Limit the number of people in the store so that everyone can stay six (6)
feet apart.
b. Mark six (6) feet of spacing in lines at point of sale and in other high-traffic
areas for customers, such as at deli counters and near high-demand products.
c. Follow the Core Signage, Screening, and Sanitation Requirements as defined

in this Executive Order.

C. Restaurants.
1. Restaurants May Open for On-Premises Service. During the effective period of this
Executive Order, restaurants may allow on-premises consumption of food and
beverages. Restaurants must meet the sanitation requirements of this Section even if
they are open only for take-out or delivery service.
2. Requirements. While this Executive Order is in effect, all open restaurants must do
all of the following:
a. Limit customers in indoor and outdoor seating areas to Emergency Maximum

Occupancy. Under this Executive Order, the Emergency Maximum Occupancy
for a restaurant is the lowest number produced by applying the following three
tests:
1. Limit the number of customers in the restaurant to fifty percent (50%)

of stated fire capacity (or, for spaces without a stated fire capacity, no
more than twelve (12) customers for every one thousand (1000) square
feet of the location's total square footage, including the parts of the
location that are not accessible to customers or guests).
11. Limit the number of people in the space so that groups can stay six (6)
feet apart.
iii. Arrange the restaurant so that customers sitting at a table are not within
six (6) feet of any customers sitting at another table. Moreover, each
group of customers sitting at a counter should be separated from other
groups by six (6) feet.
b. Limit customers at tables so that no more than ten ( 10) people shall be seated
together at the same table. However, more than ten (10) people may sit together
at the same table if they are members of the same household.
c. Workers in Restaurants are strongly encouraged to wear Face Coverings when

they are within six (6) feet of another person. Notwithstanding this general rule,
people whose religious beliefs prevent them from wearing a Face Covering,
people who cannot wear a Face Covering due to a medical or behavioral health
condition, and people who are under twelve (12) years of age are excepted from
the requirement to wear a Face Covering. Children under two (2) years of age
shall not wear a Face Covering so that their breathing may not be inhibited.
d. Follow the Core Signage, Screening, and Sanitation Requirements as defined

in this Executive Order, along with the following additional requirements:
1. Increase disinfection during peak times or high customer density times,

and disinfect all shared objects (e.g., dining tables, booths, counters,
payment terminals, tables, countertops/bars, receipt trays, condiment
holders, and reusable menus) between each use.
11. Promote frequent use of hand-washing and hand sanitizer for wait staff
and food service staff throughout the shift and upon reporting to work.
Hand washing must at least meet the requirements specified in the North
Carolina Food Code Manual.
e. Mark six (6) feet of spacing in lines at high-traffic areas for customers, such as
a cash register or place where customers wait to be seated at their table.
3. Clarifications. People sitting at a table need not be members of the same household
and do not need to stay six (6) feet apart. Moreover, this Executive Order does not
require servers and wait staff to stay six (6) feet away from customers.

4. Miscellaneous. A restaurant that operates consistent with the terms of this Subsection
of this Executive Order shall continue to be considered an "Essential Business" for the
purpose of N.C. Sess. L. 2020-03, Sec. 4.14(a) to the extent that COVID-19-related
claims are made against the restaurant.
D. Personal Care, Grooming, and Tattoo Businesses.
1. Personal Care, Grooming, and Tattoo Businesses May Open. During the effective
period of this Executive Order, Personal Care, Grooming, and Tattoo Businesses may
operate, but must be in compliance with this Section.
2. Requirements. While this Executive Order is in effect, all open Personal Care,
Grooming, and Tattoo Businesses must do all of the following:
a. Limit customers inside the store to Emergency Maximum Occupancy. Under

this Executive Order, the Emergency Maximum Occupancy for a Personal
Care, Grooming, and Tattoo Business is the lowest number produced by
applying the following two tests:
1. Limit the number of customers in the store to fifty percent (50%) of

stated fire capacity (or, for spaces without a stated fire capacity, no more
than twelve (12) customers for every one thousand (1000) square feet
of the location's total square footage, including the parts of the location
that are not accessible to customers or guests).
11. Limit the number of people in the store so that patrons can stay six (6)
feet apart.
b. Arrange seating so that groups of customers are separated from one another by
six (6) feet.
c. Workers in Personal Care, Grooming, and Tattoo Businesses shall wear Face
Coverings when they are within six (6) feet of another person. Notwithstanding
this general requirement, people whose religious beliefs prevent them from
wearing a Face Covering, people who cannot wear a Face Covering due to a
medical or behavioral condition, and people who are under twelve (12) years of
age are excepted from the requirement to wear a Face Covering. Children under
two (2) years of age shall not wear a Face Covering so that their breathing may
not be inhibited.
d. Follow the Core Signage, Screening, and Sanitation Requirements as defined

in this Executive Order, except for the requirement to have signage remind
people about staying six (6) feet apart.
e. Ensure that all equipment that comes into direct personal contact with
customers and all furniture in service areas (such as chairs, capes, and the
shampooing area in a barber shop or salon) is completely cleaned and
disinfected between each customer.
f. Mark six (6) feet of spacing in lines at point of sale and in other high-traffic
areas for customers, such as at cash registers and waiting areas.
3. Recommendation. Patrons in Personal Care, Grooming, and Tattoo Businesses are

strongly encouraged to wear Face Coverings when they are within six (6) feet of
another person, unless they cannot wear Face Coverings due to religious beliefs, age,
or a medical or behavioral health condition.

E. Pools.
1. Indoor and Outdoor Pools May Open. During the effective period of this Executive
Order, indoor or outdoor pool facilities (whether stand-alone or part of other facilities)
may operate, but must be in compliance with this Subsection.
2. Requirements. While this Executive Order is in effect, all open pool facilities must
do all of the following:
a. Limit the user capacity in the pool to no more than 50% of maximum occupancy
as determined by fire code (or, when fire code number is not known, thirty-three
(33) people per one thousand (1000) square feet in deck areas, wading pools
and splash pads), and a maximum occupancy in the water often (10) people per
one thousand (1000) square feet. This user capacity is the Emergency
Maximum Occupancy for the pool facility.
b. Follow the Core Signage, Screening, and Sanitation Requirements as defined

3. This Subsection applies only to shared pools in commercial settings or at residential

complexes. It does not apply to family pools at people's homes.
F. Child Care Facilities.
1. Child Care Facilities May Open and May Serve All Children. Child care facilities
may open or reopen, and they may serve all children in North Carolina. All references
to "covered children" in Executive Order Nos. 130 and 138 shall refer to all children.
2. Requirements. Child care facilities that are open or reopened consistent with the
Executive Order must abide by the following requirements:
a. Follow all applicable NCDHHS guidelines.

c. Conduct a daily health screening on all individuals who are entering the
building.
d. Immediately isolate sick workers and children from the rest of the facility and
send them home.
e. Have a plan to work with local health departments to identify close contacts of
confirmed cases in the child care setting.
f. Before reopening, child care facilities shall submit to NCDHHS the Emergency
Child Care Provider Application. NCDHHS must approve the Emergency
Child Care Provider Application before the child care facility can reopen.
3. Relationship to Previous Executive Orders. Subdivisions 1 and 2(a) of this

Subsection completely replace Subsections (C) and (D) of Section 2 of Executive Order
No. 130. Otherwise, Section 2 of Executive Order No. 130 and Section 3 of Executive
Order No. 139 shall remain in effect through 5:00 pm on June 26, 2020. The effective
date provisions of those Executive Orders are amended accordingly.
G. Day Camps and Overnight Camps.
1. Requirements for Day Camps.

c. Conduct a daily health screening on all individuals who are entering the
building.
d. Immediately isolate sick workers and children from the rest of the facility and
send them home.
e. Public schools operating day camps and programs may open for the purpose of
the day camp or program, but must otherwise remain closed to the general
public.
f. Have a plan to work with local health departments to identify close contacts of
confirmed cases in the camp setting.
2. Requirements for Overnight Camps.
b. Conduct daily symptom screening of workers.
c. Immediately isolate sick campers and staff away from others.
d. If a camper or staff member has been diagnosed with COVID-19 or is presumed

positive by a medical professional due to symptoms, the camper or staff
member should be isolated away from other campers and staff until they meet
the CDC criteria for release from isolation:
1. No fever for at least 72 hours since recovery (without the use of fever-
reducing medicine); and
ii. Other symptoms have improved (e.g., coughing, shortness of breath);
and
iii. At least ten ( I 0) days have passed since first symptoms.
e. Have a plan to work with local health departments to identify close contacts of
confirmed cases in a camp setting
f. Perform ongoing and routine environmental cleaning and disinfection of high-

touch areas (e.g., doors, doorknobs, rails) with an EPA approved disinfectant
for SARS-Co V-2 (the virus that causes COVID-19), increasing disinfection
during peak times or high camper density times.
3. Programs and camps for adults are not covered by this Section.
Section 7. Mass Gatherings.
A. Prohibition on Mass Gatherings.
I. Prohibition. Mass Gatherings are prohibited. "Mass Gathering" means an event or

convening that brings together more than ten ( I 0) people indoors or more than
twenty-five (25) people outdoors at the same time in a single confined indoor or
outdoor space, such as an auditorium, stadium, arena, or meeting hall. This includes
parades, fairs, and festivals. In publicly accessible indoor facilities, the Mass Gathering
limit applies per room of the facility. A household where more than ten ( I 0) people
reside is not a Mass Gathering.
The outdoor Mass Gathering limit of twenty-five (25) people applies to groups of
people that may gather together in a park, and on a beach or trail.

2. Exceptions from Prohibition on Mass Gatherings. Notwithstanding Subsection
(A)( I) above:
a. The prohibition on Mass Gatherings does not apply to any of the restricted
businesses and operations identified in Section 6 of this Executive Order,
because in those situations, transmission of COVID-19 will be controlled
through the measures specifically tailored for each situation that are listed in
those Sections. The prohibition on Mass Gatherings also does not apply to
educational institutions or government operations.
b. The prohibition on Mass Gatherings does not include gatherings for health and
safety, to look for and obtain goods and services, for work, or for receiving
governmental services. A Mass Gathering does not include normal operations
at airports, bus and train stations or stops, medical facilities, libraries, shopping
malls, and shopping centers. However, in those settings, people must follow
the Recommendations to Promote Social Distancing and Reduce Transmission
as much as possible, and they should circulate within the space so that there is
no sustained contact between people.
B. Parks, Trails, and Beaches.
1. Each group of people within a park, trail, or beach must be limited so that the group,
counted on its own, does not exceed the Mass Gathering limit.
2. All operators of open public or private parks must meet the following requirements:
a. Post signage reminding attendees, customers, and workers about social

distancing (staying at least six (6) feet away from others) and requesting that
people who have been symptomatic with fever and/or cough not enter.
b. Conduct daily symptom screening of workers, using a standard interview

questionnaire of symptoms, before workers enter the workplace.
c. Immediately isolate and remove sick workers.
d. Perform frequent and routine environmental cleaning and disinfection of

high-touch areas with an EPA-approved disinfectant for SARS-CoV-2 (the
virus that causes COVID-19).
3. Public Playgrounds Remain Closed. Because public playground equipment may

increase spread of COVID-19, public playgrounds will remain closed during the
effective phase of this Executive Order, including public playground equipment located
in parks.
C. Drive-ins. Events are not prohibited Mass Gatherings if the participants all stay within their
cars, such as at a drive-in movie theater.
D. Households. A household where more than ten ( 10) people reside is not a Mass Gathering.
Section 8. Orders of Closure.
A. Entertainment and Fitness Facilities.
1. In addition to the restrictions on Mass Gatherings identified in Section 7 of this

Executive Order, the following entertainment and fitness facilities that operate within
a confined indoor or outdoor space and do not offer a retail or dining component are
ordered to close. Any retail or dining component within the following entertainment
and fitness facilities may operate solely for retail or dining, but those components must
comply with the restrictions set out in Section 6 of this Executive Order.

2. Entertainment and fitness facilities restricted by this Subsection include, but are not
limited to, the following types of business:
• Bingo Parlors, including bingo sites operated by charitable organizations

• Bowling Alleys
• Indoor Exercise Facilities (e.g., yoga studios, dance studios, martial arts facilities,
indoor trampoline and rock climbing facilities)
• Gyms
• Indoor Fitness Facilities, including but not limited to indoor basketball courts,
volleyball courts, racquetball courts, squash courts, and tennis courts
• Health Clubs and Fitness Centers
• Movie Theaters
• Skating Rinks
• Gaming and business establishments which allow gaming activities (e.g., video
poker, gaming, sweepstakes, video games, arcade games, pinball machines or other
computer, electronic or mechanical devices played for amusement)
• Venues for Receptions or Parties
• Museums
• Amusement Parks
• Bars
• Night Clubs, Dance Halls, or Music Halls where patrons are not seated.
B. Limitations of this Executive Order. This Executive Order solely directs that bars are not to
serve alcoholic beverages for onsite consumption, and this Executive Order does not direct the
closure of retail beverage venues that provide for the sale of beer, wine, and liquor for off-site
consumption only. It also does not require the closure of production operations at breweries,
wineries, or distilleries.
C. Training of Professional and Collegiate Athletes. Professional athletes and athletes

performing on an agreement with an educational institution to receive a scholarship or other
benefit may train within indoor fitness facilities that otherwise would be closed under
Subsection A above, provided they do not exceed the Mass Gathering limit.
D. ABC Commission. If the Alcoholic Beverage Control Commission (the "ABC Commission")
identifies other state laws, regulations, and policies that may affect bars, restaurants, and other
dining establishments identified in this Executive Order, it is directed to inform the Office of
the Governor in writing. Upon written authorization from the Office of the Governor, the ABC
Commission may interpret flexibly, modify, or waive those state laws, regulations and policies,
as appropriate, and to the maximum extent permitted under applicable state and federal law, to
effectuate the purposes of this Executive Order.
Section 9. Entertainment and Sporting Events in Large Venues.
A. Intent. The intent of this Section is to permit venues to hold sporting or entertainment events,
for the recording of and broadcast to the public, if the venue is of sufficient size to allow people
to flow in and out of the venue in a way that would avoid creating a risk of spreading COVID-
19.
B. Exception. Therefore, as an exception to the closure of entertainment and fitness facilities in

Section 8 above, an entertainment or sporting venue with at least two entrances and exits and
a stated fire capacity of at least five hundred (500) may hold a performance by entertainers,
performers, or athletes. The venue must control the flow of people through lobbies and other
common spaces to allow social distancing and avoid the spread of COVID-19.
C. Treatment under Mass Gathering Limit. In this situation, and only in this situation:
(I) entertainers, performers, and athletes, along with coaches, training, support, and broadcast
staff, shall not count toward the Mass Gathering limit and (2) employees and other workers at
facilities where entertainment and sporting events occur also shall not count toward the Mass
Gathering limit.

D. Restrictions on Spectators. Spectators or other attendees at any sporting or entertainment
events allowed under this Section must be no more than the Mass Gathering limit of ten ( 10)
people indoors or more than twenty-five (25) people outdoors. Moreover, any entertainers or
athletes must stay six (6) feet away from spectators.
E. Requirements for Large Venue Operators. Any venue operator subject to this Section
allowing an event permitted by this Section shall:
1. Follow the Core Signage, Screening, and Sanitation Requirements as defined in this
Executive Order.
2. Increase disinfection during peak times or high customer density times, and disinfect
all shared objects (e.g., payment terminals, tables, countertops/bars, receipt trays,
condiment holders) between use.
3. Immediately isolate and remove sick workers.
4. Any food service at sporting or entertainment events must comply with the restrictions
set out in Section 6 of this Executive Order. Bars at sporting or entertainment events
must remain closed.
Section 10. Provisions from Previous Executive Orders.
A. The provisions on schools contained in Section 4(E) of Executive Order No. 138 and signed
on May 05, 2020 by the undersigned are incorporated by reference into this Executive Order
and adopted as if reprinted here in full.
B. The Long Term Care provisions contained in Section 7 of Executive Order No. 138 and signed
on May 05, 2020 by the undersigned are incorporated by reference into this Executive Order
and adopted as if reprinted here in full.
C. The Local Order provisions contained in Section 8 of Executive Order No. 138 and signed on
May 05, 2020 by the undersigned are incorporated by reference into this Executive Order and
adopted as if reprinted here in full. The references to maximum occupancy standards for Retail
Businesses in Section 8 of Executive Order No. 138 shall instead refer to the equivalent
provisions in this Executive Order.
D. Otherwise, all previous travel restrictions, orders to stay at home, and prohibitions of mass
gatherings in Executive Orders Nos. 121 and 138 are no longer in effect and are replaced by
this Executive Order.
Section 11. Extension of Price Gouging Period.
Pursuant to N.C. Gen. Stat. § 166A-l 9.23, the undersigned extends the prohibition against
excessive pricing, as provided in N.C. Gen. Stat. §§ 75-37 and 75-38, from the issuance of
Executive Order No. 116 through 5:00 pm on June 26, 2020.
The undersigned further hereby encourages the North Carolina Attorney General to use all
resources available to monitor reports of abusive trade practices towards consumers and make
readily available opportunities to report to the public any price gouging and unfair or deceptive
trade practices under Chapter 75 of the North Carolina General Statutes.
Section 12. No Private Right of Action.
This Executive Order is not intended to create, and does not create, any individual right,
privilege, or benefit, whether substantive or procedural, enforceable at law or in equity by any
party against the State of North Carolina, its agencies, departments, political subdivisions, or other
entities, or any officers, employees, or agents thereof, or any emergency management worker (as
defined in N.C. Gen. Stat.§ 166A-l 9.60) or any other person.

Section 13. Savings Clause.
If any provision of this Executive Order or its application to any person or circumstances
is held invalid by any court of competent jurisdiction, this invalidity does not affect any other
provision or application of this Executive Order, which can be given effect without the invalid
provision or application. To achieve this purpose, the provisions of this Executive Order are
declared to be severable.
Section 14. Distribution.
I hereby order that this Executive Order be: ( 1) distributed to the news media and other
organizations calculated to bring its contents to the attention of the general public; (2) promptly
filed with the Secretary of the North Carolina Department of Public Safety, the Secretary of State,
and the superior court clerks in the counties to which it applies, unless t he circumstances of the
State of Emergency would prevent or impede such filing; and (3) distributed to others as necessary
to ensure proper implementation of this Executive Order.
Section 15. Enforcement.
A. Pursuant to N .C. Gen. Stat.§ 166A-19.30(a)(2), the provisions of this Executive Order shall
be enforced by state and local law enforcement officers.
B. A violation of this Executive Order may be subject to prosecution pursuant to N.C. Gen. Stat.
§ 166A-1 9.30(d), and is punishable as a Class 2 misdemeanor in accordance with N.C. Gen.
Stat. § 14-288.20A.
C. Nothing in this Executive Order shall be construed to preempt or ovetTule a court order
regarding an individual's conduct (e.g. , a Domestic Violence Protection Order or similar
orders limiting an individual's access to a particular place).
Section 16. Effective Date.
This Executive Order is effective at 5:00 pm on May 22, 2020. This Executive Order shall
remain in effect through 5 :00 pm on June 26, 2020 unless repealed, replaced, or rescinded by
another applicable Executive Order. An Executive Order rescinding the Declaration of the State
of Emergency will automatically rescind this Executive Order.
IN WITNESS WHEREOF, I have hereunto signed my name and affixed the Great Seal
of the State of North Carolina at the Capitol in the City of Raleigh, this 20111 day of May in the year
of our Lord two thousand and twenty.
ATTEST:
Secretary of State

EXHIBIT 9
NCDMW Announces Driver License Office Changes

during COVID-19 Outbreak (last updated
June 2, 2020), published by the
Department of Transportation

Injunction

6/4/2020 NCDMV Announces Driver License Office Changes during COVID-19 Outbreak
D NCDMV Announces Driver License Office Changes during COVID-19 Outbreak +
NCDMV Announces Driver License

Office Changes during COVID-19
Outbreak
RALEIGH - Due to concern for the health and safety of its customers and staff during
the coronavirus outbreak, the N.C. Division of Motor Vehicles will consolidate in-person
services to offices Large enough to maintain social distancing as defined by the Centers
for Disease Control and Prevention (CDC), effective Wednesday, until further notice.
The DMV will close about 60 offices that have the fewest examiner stations or have
office setups that make it difficult to provide customers with the recommended space
recommended by the CDC. Customers who have appointments at those offices are being
contacted and will be given new appointments once those offices re-open. Affected
employees will be re-assigned to help staff at about 50 offices that are scheduled
to remain open, or to assist at our customer service call centers.
JUNE 2 UPDATE: This PDF Lists which offices remain open and which have now closed.
The open offices will be transitioned to handle appointment-only visits and will Limit the
number of customers allowed inside at the same time, depending on the office size.
They will also no Longer conduct road tests except for commercial driver's License and
medical reassessments. All customers for the driver License offices will be asked to
complete a wellness questionnaire provided by the state health officials to mitigate the
potential spread of the virus in our driver License offices.
You can check on the status of your Local office on the DMV website.
https://www.ncdot.gov/news/press-releases/Pages/2020/2020-03-17-ncdmv-driver-license-impact-coronavirus.aspx 1/3
Customers who have appointments at the open offices can keep those appointments,
except for driving tests, and will be given priority if they reschedule their appointments
after offices re-open.
Appointments can be made by calling the DMV customer center at (919) 715-7000.
People who can use the offices in Cary. West Raleigh, Clayton and Goldsboro can make
online appointments. Other offices are being added to the online aP-P-Ointment system as
quickly as possible.
"The safety of our customers and staff is our top priority," said DMV Commissioner
Torre Jessup. "So we are putting in place a number of measures to better protect
everyone from the spread of the virus. As always, we encourage everyone to conduct
their business online if possible. We are all in this together and everyone has an
important role to play in the safety and well-being of the public."
The DMV services that can be handled online include License and registration renewals,
and ordering a duplicate License and registration card. Customers are encouraged to visit
www.ncdot.gov/dmv to review a complete List of what services are available. There are
fake DMV websites on the internet so please make sure that you are using a website
that includes ".gov."
Other steps being taken include:
• Suspending the use of mobile offices:

• Suspending road tests except for commercial driver's License and in-office medical re-
evaluations:
• Postponing DMV Hearings for 30 days, with exceptions for insurance Liability and
safety responsibility hearings, which are conducted by phone: and
• Salvage and special vehicle inspections conducted by appointment only.
ALL these steps being taken do not apply to DMV License Plate Agencies, as all but one
of those is operated either by a contractor or Local government. The status of those
offices is available on the DMV website.
For information on how to conduct your critical DMV business or if you have additional
questions. please visit www.ncdot.gov/dmv. First or official information regarding COVID-
19, please visit ncdhhs.gov and governor.nc.gov.
***NCDOT***
Last updated 8:31 a.m. on Jun. 2, 2020
Published Date:
3/17/2020
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EXHIBIT 10
Letter from Disability Rights North Carolina to

members of the Davidson County Board of Elections
and the General Counsel for the North Carolina State
Board of Elections (Feb. 28, 2020)

Injunction

Disability Rights
North Carolina
Sent Via E-Mail Only

February 28, 2020
Ruth Huneycutt, Director

Randall K. Lanier, Chairman
Dawn L. Mitchell, Secretary
Jon W. Myers, Member
Rita C. Haire, Member
Lewie Phillips, Member
Davidson County Board of Elections
Katelyn Love, General Counsel

North Carolina State Board of Elections
Dear Director Huneycutt, General Counsel Love, and others:
Disability Rights NC previously corresponded with you on February 25, 2020 about
a voter residing in a skilled nursing facility in Davidson County who sought help
from a Multipartisan Assistance Team ("MAT'') exercising her right to vote.
Davidson County has not assembled a MAT and has given no indication one will be
formed in time to assist the voter in requesting and casting her absentee ballot in
the primary election taking place on March 3rd. See N.C. Gen. Stat. § 163-226.3(4);
8 N.C.A.C. 16.0101 (each county board of elections required to establish a MAT to
assist individuals with disabilities residing in residential facilities to vote via
absentee ballot). While we appreciate the reminder that a voter may request and
cast an absentee ballot without the assistance of a MAT, it misses the point. The
MATs exist to provide voters with disabilities critical access to the ballot when they
do not have readily available guardians or near relatives.
Davidson County can still act to ensure voters with disabilities who do not have a
readily available near relative, guardian, or MAT to vote in the primary. The time
period for a voter who is sick or has a physical disability to request an absentee
ballot in-person remains open and does not expire until 5:00 p.m. on Monday,
March 2nd. See N.C. Gen. Stat.§ 163-230.l(b). Cf. N.C. Gen. Stat.§ 163-230.l(a)
(the time period for voters not covered by subsection (b) to request an absentee
North Carolina's Protection 3724 National Drive 919-856-2195 www .disabilityrightsnc.or9

Suite 100 877-235-4210
and Advocacy System
Raleigh, NC 27612 919-856-2244 fax
'ITY users, dial 711

ballot expires at 5:00 p.m. on the Tuesday before the election (February 25, 2020)).
In instances where a near relative, guardian, or MAT is not available to assist
individuals with disabilities request and vote their absentee ballot, the county
board of elections must allow any person other than
(i) an owner, manager, director, employee of the hospital, clinic,
nursing home, or rest home in which the voter is a patient or
resident;
(ii) an individual who holds any elective office under the United
States, this State, or any political subdivision of this State;
(iii) an individual who is a candidate for nomination or election to
such office; or
(iv) an individual who holds any office in a State, congressional
district, county, or precinct political party or organization, or who
is a campaign manager or treasurer for any candidate or political
party ...
to assist voters in requesting, casting, and witnessing their ballot. See
N.C. Gen. Stat. § 163-226.3(4).
It appears employees and volunteers of non-partisan non-profit organizations who

are otherwise not a prohibited person (as outlined above), are among those allowed
to request and witness an absentee ballot on behalf of voters with disabilities
without readily available near relatives, guardians, or MATs. Please advise
immediately if you will permit representatives of Disability Rights NC or
other non-partisan organizations to assist voters with disabilities residing
in facilities in Davidson County with voting via absentee ballot.
sidf--
Holly Stiles
Litigation Counsel Voting Rights Advocate

EXHIBIT 11
An Act to Provide Aid to North Carolinians in

Response to the Coronavirus Disease (COVID-19)
Crisis, Sl. 2020-3 §4.1(c) (May 4, 2020)

Injunction

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2019
SESSION LAW 2020-3

SENATE BILL 704
AN ACT TO PROVIDE AID TO NORTH CAROLINIANS IN RESPONSE TO THE

CORONAVIRUS DISEASE 2019 (COVID-19) CRISIS.
The General Assembly of North Carolina enacts:
PART I. ECONOMIC SUPPORT
WAIVE ACCRUAL OF INTEREST ON DEFERRED PAYMENT OF CORPORATE

INCOME AND FRANCHISE TAX AND INDIVIDUAL INCOME TAX AND EXTEND
CERTAIN TAX-RELATED DEADLINES
SECTION 1.1.(a) Interest Waiver. – As a result of the COVID-19 outbreak, the
Secretary of Revenue has extended the franchise, corporate income, and individual income tax
payment deadline from April 15, 2020, to July 15, 2020, and pursuant to G.S. 105-249.2, the
Secretary will not assess a penalty for failure to file a return or pay a tax due as long as the return
is filed and the tax due is paid by July 15, 2020. Notwithstanding G.S. 105-241.21(b), the
Secretary of Revenue shall also waive the accrual of interest from April 15, 2020, through July
15, 2020, on an underpayment of tax imposed on a franchise, corporate income, or individual
income tax return, including a partnership and estate and trust tax return, due from April 15,
2020, through July 15, 2020. The relief from accrual of interest from April 15, 2020, through
July 15, 2020, also includes interest imposed pursuant to G.S. 105-163.15 and G.S. 105-163.41
for payments due on or before July 15, 2020.
SECTION 1.1.(b) Refund Request. – For franchise, corporate income, and
individual income tax, the statute of limitations for obtaining a refund is extended to July 15,
2020, for refund claims for which the statute of limitations to seek a refund expires on or after
April 15, 2020, and before July 15, 2020.
SECTION 1.1.(c) Time-Sensitive Actions. – Certain actions required to be taken by
a taxpayer on or after April 1, 2020, and before July 15, 2020, will be considered timely if the
request or petition is filed on or before July 15, 2020. This subsection applies to requests for
Departmental review under G.S. 105-241.11, petitions for a contested case hearing at the Office
of Administrative Hearings under Article 3 of Chapter 150B of the General Statutes and
G.S. 105-241.15, and petitions for judicial review under Article 4 of Chapter 150B of the General
Statutes and G.S. 105-241.16.
SECTION 1.1.(d) This section is effective when it becomes law.
FLEXIBILITY TO ADMINISTER UNEMPLOYMENT COMPENSATION AND SUTA

TAX CREDIT
SECTION 1.2.(a) Chapter 96 of the General Statutes is amended by adding a new
section to read:
"§ 96-14.15. Emergency unemployment benefits and tax credit to respond to the
coronavirus emergency of 2020.
(a) Benefits Payable. – Unemployment benefits are payable in response to the
coronavirus emergency in any of the following circumstances:
*S704-v-6*
SECTION 3F.1.(d) This section is effective when it becomes law and expires 30
days after Executive Order No. 116 is rescinded.
INCREASED ACCESS TO TELEHEALTH UNDER THE MEDICARE PROGRAM

SECTION 3F.2. The General Assembly urges the federal Centers for Medicaid and
Medicare Services to provide reimbursement for health care delivered through audio-only
communication, such as over the telephone, under the Medicare program in order to reduce
barriers and increase access to health care for older adults.
PART IV. CONTINUITY OF STATE GOVERNMENT/REGULATORY RELIEF
EMERGENCY VIDEO NOTARIZATION

SECTION 4.1.(a) G.S. 10B-3 is amended by adding a new subdivision to read:
"(7a) Emergency video notarization. – An acknowledgement, affirmation, or oath
notarization completed by a notary in compliance with the requirements of
G.S. 10B-25. Emergency video notarization shall not include a verification
proof as defined in G.S. 10B-3(28)."
SECTION 4.1.(b) G.S. 10B-10 reads as rewritten:
"§ 10B-10. Commission; oath of office.office; emergency extension.
…
(b) The Except as provided in subsection (b1) of this section, the appointee shall appear
before the register of deeds no later than 45 days after commissioning and shall be duly qualified
by taking the general oath of office prescribed in G.S. 11-11 and the oath prescribed for officers
in G.S. 11-7.
(b1) Notwithstanding subsection (b) of this section, if the Secretary grants a commission
after March 9, 2020, and before August 1, 2020, the appointee shall have 90 days to appear before
the register of deeds to take the general oath of office. A register of deeds may administer the
required oath to such appointee using video conference technology provided the appointee is
personally known to the register of deeds or the appointee provides satisfactory evidence of the
appointee's identity to the register of deeds. As used in this subsection, video conference
technology and satisfactory evidence are as defined in G.S. 10B-25.
…
(e) If the appointee does not appear before the register of deeds within 45 days of
commissioning, the time prescribed in this section, the register of deeds must return the
commission to the Secretary, and the appointee must reapply for commissioning. If the appointee
reapplies within one year of the granting of the commission, the Secretary may waive the
educational requirements of this Chapter."
SECTION 4.1.(c) Part 3 of Article 1 of Chapter 10B of the General Statutes is
amended by adding a new section to read:
"§ 10B-25. Emergency video notarization.
(a) Notwithstanding any other provision of law, a notary may perform an emergency
video notarization using video conference technology provided all of the requirements of this
section are satisfied. A notary who is not satisfied that the principal's identity has been proven by
satisfactory evidence shall not be required to complete an emergency video notarization. An
emergency video notarization shall not change any originality verification requirements for
recording with a register of deeds, clerk of superior court, or other government or private office
in this State. Nothing in this section shall apply to any notarization under Article 20 of Chapter
163 of the General Statutes.
(b) As used in this section, video conference technology is electronic communication
that:
(1) Occurs in real time.
Senate Bill 704 Session Law 2020-3 Page 31

(1a) Allows direct interaction between the principal seeking the notary's services
and the notary so that each can communicate simultaneously by sight and
sound through an electronic device or process.
(2) Includes audio with sound clear enough that each participant in the notarial
act can hear and understand all other participants.
(3) Has sufficient quality to allow a clear and unobstructed visual observation of
the face of each participant, and any identification provided by the principal
for a sufficient time to allow the notary to determine if it is satisfactory
evidence. The notary shall determine if the time is sufficient.
(4) Is not prerecorded video or audio or both.
(5) May be capable of recording by means of one of the following:
a. The video conference technology's recording and storage services.
b. An independent video recording device.
c. Electronically saved screenshots clearly showing each participant's
face, identification presented by the principal, and the notarized
document.
(c) The requirement of personal appearance, appear in person before a notary, physical
presence, and presence, as those terms are used in this Chapter, are satisfied for the purpose of
an emergency video notarization if the notary is physically present in North Carolina, the
principal verifies to the notary that he or she is physically present in North Carolina at the time
of the notarization, the principal identifies the county where he or she is located at the time of the
notarial act, and the principal and notary use video conference technology that complies with the
requirements of this section.
(d) A notary who has personal knowledge of a principal may rely on the video conference
technology to verify the principal's identity unless the notary, in the notary's sole discretion,
requires satisfactory evidence. A notary who does not have personal knowledge of a principal
shall require satisfactory evidence of the principal's identity. The requirement of satisfactory
evidence, as that term is used in this Chapter, is satisfied for the purpose of an emergency video
notarization if identification of the principal is based on at least one document that meets all of
the following:
(1) Is current or, if expired, did not expire prior to March 10, 2020.
(2) Is issued by a federal, state, or federal or state-recognized tribal government
agency.
(3) Bears a photographic image of the principal's face.
(4) Has both the principal's signature and a physical description of the principal.
(e) The notary shall use video conference technology to observe each principal sign each
document that is to be notarized. The principal shall verbally state what documents are being
signed for the notarial record. After the document is signed by the principal, the principal or the
principal's designee shall do the following:
(1) If an original wet-signed notarization on an original wet-signed document is
not required, transmit a legible copy of the signed document to the notary by
fax or other electronic means on the same day it was signed. The notary shall
notarize the document on the same day the notary receives the document, and
the notary shall transmit the notarized document back to the principal or the
principal's designee by physical delivery, fax, or other electronic means on the
same day the notary signed the document.
(2) If an original wet-signed notarization on an original wet-signed document is
required, transmit a legible copy of the signed document by fax or other
electronic means to the notary on the same day on which the document was
signed and also deliver the original signed document to the notary by mail or
other physical method. The notary shall compare the original document with
Page 32 Session Law 2020-3 Senate Bill 704

the document transmitted by fax or other electronic means. If the faxed or
electronic document is the same as the document received by mail or physical
delivery, the notary shall notarize the wet signature on the original document
and date the notarial act as of the date of the act observed using video
conference technology and promptly transmit the original wet-notarized
original document to the principal or the principal's designee by mail or other
physical delivery as directed by the principal.
(f) If the notarial act is an oath or affirmation, the notary shall administer the oath or
affirmation to the affiant using video conference technology.
(g) An acknowledgement or jurat certificate for an emergency video notarization shall
include all of the following:
(1) The North Carolina county in which the notary public was located during the
emergency video notarization.
(2) The North Carolina county in which the principal stated he or she was
physically located during the emergency video notarization.
(3) The following statement:
I signed this notarial certificate on _________ (Date) according to the emergency video
notarization requirements contained in G.S. 10B-25.
(h) If an acknowledgement or jurat certificate provided to a notary does not include the
statement required by subsection (g) of this section, the notary shall insert the statement. By
making or giving a notarial certificate using emergency video notarization, whether or not stated
in the certificate, a notary certifies compliance with all the requirements of this section.
(i) A notary who performs an emergency video notarization shall record information
about the notarization in a notary journal that is the exclusive property of the notary. The journal
shall be retained by the notary for at least 10 years and may be maintained in electronic form.
The notary shall keep the journal in a secure location and shall not allow another person to make
entries in the journal. A notary may surrender the journal to the notary's employer upon
termination of employment, but the notary shall also keep and maintain an accurate copy of the
journal.
(j) At a minimum, for each emergency video notarization, the notary shall include the
following information in the journal:
(1) The time of day when the notary observed the signing of the document by
each principal and was presented with the principal's acceptable form of
identification.
(2) The date of the completion of the emergency video notarization notarial
certificate.
(3) The last and first name of each principal.
(4) The type of notarial act performed.
(5) The type of document notarized or proceeding performed.
(6) The type of acceptable form of identification presented including, if
applicable, the issuing agency and identification number on the identification
presented.
(7) The type of video conference technology used during the emergency video
notarization.
(8) A statement that the notary and each principal could see and hear each other.
(9) Whether any other person was present with the principal at the time of
signature and if so, the name of that person.
(k) A third party involved in a transaction that utilizes an emergency video notarization
may require additional information to be included in the journal kept by the notary under
subsection (j) of this section such as inclusion of a recording in the notary's journal or the method
Senate Bill 704 Session Law 2020-3 Page 33

used by the notary to determine that a wet-signed original document is the same as the faxed or
electronically submitted document.
(l) As a public official, a notary shall maintain the confidentiality of a principal's
documents at all times.
(m) The Secretary may issue interpretive guidance or issue emergency or temporary rules
as necessary to ensure the integrity of the emergency video notarization measures provided for
in this section.
(n) This section shall expire at 12:01 A.M. on August 1, 2020; provided, however, all
notarial acts made in accordance with this section and while this section is in effect shall remain
effective and shall not need to be reaffirmed."
SECTION 4.1.(d) This section is effective when it becomes law.
EMERGENCY VIDEO WITNESSING

SECTION 4.2.(a) Chapter 10B of the General Statutes is amended by adding a new
Article to read:
"Article 3.
"Video Witnessing During State of Emergency.
"§ 10B-200. Applicability.
(a) This Article applies to the witnessing and signature of all records, as defined in
G.S. 10B-3(19), signed, by a principal physically located in the State of North Carolina, on or
after the effective date of this act.
(b) This Article expires August 1, 2020.
(c) No action described in this Article constitutes a notarial act, as defined in
G.S. 10B-3(11), and no action described in this Article is governed by Article 1 or 2 of this
Chapter.
"§ 10B-201. Emergency video witnessing.
(a) Notwithstanding any general or special law to the contrary, any person who witnesses
the signature of a record through video conference technology shall be considered an "in-person"
witness, and the record shall be considered to have been signed by the principal signer "in the
presence of" such witness, if the video conference technology allows for direct, real-time audio
and video interaction between each principal signer and the witness.
(b) Notwithstanding any general or special law to the contrary, an attesting witness to a
record shall be considered to have signed such record in the presence of the principal signer, if
all of the following are satisfied:
(1) The signature of the principal signer is witnessed by the attesting witness in
accordance with the requirements of subsection (a) of this section.
(2) The attesting witness immediately thereafter signs such record while the video
conference technology still allows for direct, real-time audio and video
interaction between the principal signer and the attesting witness.
(c) Any record witnessed pursuant to this section shall contain all of the following:
(1) A conspicuous statement indicating that the record was witnessed by one or
more witnesses physically located in the State of North Carolina pursuant to
this Article.
(2) The county in which each remote witness was physically located when
witnessing execution of the record.
(3) The county in which each principal signer was physically located during the
witnessed execution of the record.
(d) Notwithstanding any general or special law to the contrary, absent an express
prohibition in a legal document against signing in counterparts, any record witnessed pursuant to
this Article may be signed in counterpart, which counterparts, when combined, shall create a
single original record."
Page 34 Session Law 2020-3 Senate Bill 704

EXHIBIT 12
North Carolina Absentee Application and

Certificate, made available by Pitt County,
North Carolina

Injunction

Absentee Application and Certificate
Fraudulently or Falsely completing this form is a Class 1 felony under Chapter 163 of the N.C. General Statutes
The following people are PROHIBITED from signing the Witnesses' Certification:
For all voters: a candidate, UNLESS the candidate is the voter’s near relative;
For voters who are patients or residents of a hospital, clinic, nursing home, or adult care home: (1) an owner, manager, director, or employee of that
facility; (2) an individual who holds any federal, State, or local elective office; and (3) an individual who holds office in a State, congressional district, county or precinct political
party or organization, or who is a campaign manager or treasurer for any candidate or political party.
Voter’s Certification (Required) Witnesses’ Certification

I am applying for an absentee ballot • I am a duly qualified voter, regis- Option 1: Two (2) Witnesses
tered as an affiliate of the political party indicated on this application (Required Unless a Notary Public is the Witness)
Affix NON-BARCODE • All information represented on this application is correct • I am entitled
I certify that: • I am at least 18 years old • I am not disqualified from witnessing the ballot as
to vote in this election • If I am an Unaffiliated voter voting in a primary
election, I am voting in the party primary indicated on the attached described in the WARNING on the flap of this envelope • The Voter marked the enclosed ballot in
Label HERE label • If the party indicated is (UNA), I am voting a nonpartisan ballot. my presence, or caused it to be marked in the Voter’s presence according to his/her instruction •
The Voter signed this Absentee Application and Certificate, or caused it to be signed • I respected
I further certify that I marked the enclosed ballot (or it was marked for the secrecy of the ballot and the Voter’s privacy, unless I assisted the Voter at his/her request
me according to my instructions) in the presence of: [complete Voter Assistant Certification section].
Witness #1 Witness #2
two (2) witnesses who are at least 18 years of age and who are not
disqualified by law to witness the casting of my absentee ballot (the
Affix BARCODE witnesses must complete the Option 1 of the Witnesses’ Certification)
Signature (Required) Signature (Required)
OR
a notary public (the notary must complete Option 2 of the Witnesses’
Label HERE Certification) Street Address (Required) Street Address (Required)
X City, State and Zip (Required) City, State and Zip (Required)
Signature of Voter (Required) Date
Board Approval Date Date Date
Name Correction (if applicable) Option 2: Notary Public as Witness

Second Primary Request or Runoff Request (Required Unless Two Witnesses Provided)
In the event that a Second Primary (or Runoff Election) is called,
I request that an absentee application and ballot be issued to me Voter Assistant Certification (if applicable)
I certify that: on the ____________ day of ____________________________, 20 ________, the Voter:
and mailed to me. (Check the box to receive eligible ballots.) I certify that: • The voter requested my assistance • I assisted the _________________________________________ personally appeared before me, was positively
Voter by marking the ballot only according to the Voter’s instruction;
and/or I assisted the Voter in completing the Absentee Application and identified, and in my presence, the Voter marked the enclosed ballot, or caused it to be marked in the Voter’s
Annual Request for Illness/Disability presence according to his/her instruction • The Voter signed this Absentee Application and Certificate, or
Due to continued or expected illness or disability, I request that Certificate • I assisted the Voter only in the Voter’s presence • I am
this application be a request for absentee ballots for any other the Voter’s near relative or verifiable legal guardian, or I am providing caused it to be signed • I am at least 18 years old • I am not disqualified from witnessing the ballot as
elections to be held this calendar year in which I am eligible to assistance because a near relative or legal guardian is unavailable to described in the WARNING on the flap of this envelope • I respected the secrecy of the ballot and the privacy
participate. (Check the box to receive eligible ballots.) assist the Voter. of the Voter, unless I assisted the Voter at his/her request [complete Voter Assistant Certification section].
NOTE: A notary may not charge any fee for witnessing and affixing a notarial seal to an absentee ballot application or certificate. [G.S. § 10B-30].
Signature of Voter (if applicable) Name of Assistant Address of Assistant STATE OF _________________________________
X SEAL
COUNTY OF ________________________________
Address where application and ballots should be mailed Signature of Assistant Date Notary Public Commission Expiration Date
NCSBE v2018.02
EXHIBIT 13
Federal Write-in Absentee Ballot, made available by

the Federal Voting Assistance Program

Injunction

Federal Write-In Absentee Ballot Use this form if you are:
If you do not receive your absentee ballot in enough time to meet
your state’s deadlines, use this ballot as a backup. If you send in this
ballot and receive your state’s ballot later, you should fill out and On active duty in the Uniformed
return your state ballot as well. Your election office will count only one Services or Merchant Marine
ballot.
An eligible spouse or dependent
The following require you to register and request an absentee ballot
before filling out this form: AL, AS, AR, CT, FL, GU, HI, ID, IL, IN, KS, A U.S. citizen living outside the
LA, NH, NJ, NM, NY, PA, PR, RI, SD, TX, WI, WV, and WY. If your state United States
or territory is listed, complete a Federal Post Card Application (FPCA)
online at FVAP.gov.
If you already registered and requested a ballot, send in the Voter

Information page and the Official Backup Ballot.
Please be aware that some states will accept this form as

registration and as an absentee ballot request for future elections.
You can vote wherever you are. This is how.

1. Fill out your Voter Information page completely and accurately.
• Your U.S. voting residence address is used to determine where Agency Disclosure Statement
you are eligible to vote absentee. For military voters, it is The public reporting burden for this collection of
usually your last address in your state of legal residence. For information is estimated to average 15 minutes per
overseas citizens, it is usually the last place you lived before response, including time to review instructions,
moving overseas. You do not need to have any current ties gathering and maintaining the data needed,
and completing and reviewing the collection of
with this address. DO NOT write a PO Box # in section 2. information. Send comments regarding this burden
• Most states allow you to provide a Driver’s License number or estimate or any other aspect of this collection of
information, including suggestions for reducing the
the last 4 digits of your SSN. Some states require a full SSN. burden to: Department of Defense, Washington
See your state’s guidelines at FVAP.gov. Headquarters Services, Executive Services
Directorate, Information Management Division, 4800
• If you cannot receive mail at your mailing address, please Mark Center Dr., East Tower, Suite 03F09, Alexandria,
specify a mail forwarding address. VA 22350-3100. [OMB Control #0704-0502].
Respondents should be aware that notwithstanding
• Most states require you to specify a political party to vote in
any other provision of law, no person shall be subject
primary elections. This information may be used to register to any penalty for failing to comply with a collection of
you with a party. information if it does not display a currently valid OMB
control number. DO NOT RETURN YOUR FORM TO
• Section 6 Requirements: Alabama requires two witness THE ADDRESS ABOVE.
signatures; Alaska, Virginia and Wisconsin, require one
witness signature; Puerto Rico requires your mother’s and Privacy Advisory
father’s first name; Vermont requires a voter’s oath. Additional
state instructions can be found at FVAP.gov. When completed, this form contains personally
identifiable information and is protected by the
• Remember to sign the bottom of the Voter Information page! Privacy Act of 1974, as amended.
2. Carefully fill out and seal your Official Backup Ballot.

• DO NOT sign your ballot or include any personal information.
Keep your ballot anonymous.
• If using a self-sealing form, remove the adhesive liner, fold and
seal tightly.
• If you printed out the form, fold the voted ballot and seal it in an
envelope marked “ballot enclosed”.
3. Assemble your documents for mailing.

• Put your Voter Information page and Official Backup Ballot into
the mailing envelope.
• You can find the address for your election office at FVAP.gov. Questions?
• All states accept this form by mail, but they vary on email and
fax. See your state’s rules in the Voting Assistance Guide online Email vote@fvap.gov
at FVAP.gov.

Voter Information Have you already registered and
requested an absentee ballot?
Federal Write-In Absentee Ballot (FWAB) Some states allow you to use this form to register and request
ballots for future elections. Visit FVAP.gov for more details.
Print clearly in blue or black ink, please see back for instructions.
1. Who are you? Pick one.

For absent Uniformed I am on active duty in the Uniformed Services or Merchant Marine -OR- I am an eligible spouse or dependent.
Service members, their I am a U.S. citizen living outside the country, and I intend to return.
families, and citizens I am a U.S. citizen living outside the country, and my intent to return is uncertain.
residing outside the
United States. I am a U.S. citizen living outside the country, and I have never lived in the United States.
Female
Last name Suffix (Jr., II) Sex
Male
First name Previous names (if applicable)
Middle name Birth date (MM/DD/YYYY) / /
Social Security Number Driver’s license or State ID #
2. What is your U.S. voting residence address?

Your voting materials will not be sent to this address. See instructions on other side of form.
Street address Apt #

City, town, village State
County ZIP
3. Where are you now? You MUST give your CURRENT contact information.
Your mailing address. (Different from above) Your mail forwarding address. (If different from mailing address)
4. What is your contact information? This is so election officials can reach you about your request.
Provide the country code and area code with your phone and fax number. Do not use a Defense Switched Network (DSN) number.
Email: Phone:
Alternate email: Fax:
5. What are your preferences for future elections?
A. Do you want to register and B. How do you want to Mail C. What is your
Yes
request a ballot for all elections receive voting materials Email or online political party for
you are eligible to vote in? No from your election office? Fax primary elections?
6. What additional information must you provide?

The following need more information: Alabama, Alaska, Puerto Rico, Vermont, Virginia and Wisconsin, see back for instructions. Additional
state instructions can be found at FVAP.gov.
7. You must read and sign this statement.

I swear or affirm, under penalty of perjury, that:
The information on this form is true, accurate, and complete to the best of my knowledge. I understand that a material misstatement of fact in
completion of this document may constitute grounds for conviction of perjury.
I am a U.S. citizen, at least 18 years of age (or will be by the day of election), eligible to vote in the requested jurisdiction, and
I am not disqualified to vote due to having been convicted of a felony or other disqualifying offense, nor have I been adjudicated mentally
incompetent; or if so, my voting rights have been reinstated; and
I am not registering, requesting a ballot, or voting in any other jurisdiction in the United States, except the jurisdiction cited in this voting form.
In voting, I have marked and sealed this ballot in private and have not allowed any person to observe the marking of this ballot, except those
authorized to assist voters under State and Federal law.
Sign here X Today’s date

(MM/DD/YYYY)
/ /
This information is for official use only. Any unauthorized release may be punishable by law. Previous editions are obsolete. Standard Form 186 (Rev.04-2019), OMB No. 0704-0502

Official Backup Ballot Vote by writing the NAME or PARTY of the
candidates you choose. To find out about
Federal Write-In Absentee Ballot (FWAB) specific federal candidates and races go to
Print clearly in blue or black ink.
FVAP.gov.
Instructions
• This ballot can be used to vote for federal offices.

• DO NOT write your name or any identifying number (SSN, driver’s license) on this ballot.
• Photocopy this page if you require additional room for candidates or ballot initiatives.
• If you are voting in American Samoa, Guam, Puerto Rico, or the U.S. Virgin Islands, you may vote for Delegate or
Resident Commissioner, and in presidential primaries.
• State laws vary about using the FWAB for other offices like Governor or Mayor. Learn more online at FVAP.gov.
Federal offices
President and Vice President
U.S. Senator
U. S. Representative, Delegate, or
Resident Commissioner to Congress
Non-federal offices
Office Candidate name Political party
Ballot initiatives or other items
Standard Form 186 (Rev.04-2019), OMB No. 0704-0502

Official Ballot
Federal Write-In Absentee Ballot
Private
Fold your ballot and keep it private. Put it in the envelope.

Before you seal this envelope:
STOP
1. Sign and fold your Voter Information page.
2. Fold and seal your Official Backup Ballot.
3. Put both inside this envelope, and mail it
to your election office. The address can be
found at FVAP.gov.
1
Voter
Information Voter
Information
Fold in half
2
Ballot Official Ballot
Private
Fold and seal
3
Voter
Information
Official Ballot
Private
Mailing
Envelope
For election officials:

This is an official Federal Write-In Absentee Ballot
authorized by 52 U.S.C. § 20301.
If you have questions about it, contact your State officials.

U.S. Postage Paid
39 USC 3406
PAR AVION
From
(Your name and mailing address.)
International airmail postage is required if not mailed using the

U.S. Postal Service, APO/FPO/DPO system, or diplomatic pouch.
I have enclosed my ballot for the __ /____ election.

MM YYYY
OFFICIAL ABSENTEE BALLOTING MATERIAL – FIRST CLASS MAIL
NO POSTAGE NECESSARY IN THE U.S. MAIL – DMM 703.8.0
To
(Fill in the address of your election office. The address can be found online at FVAP.gov.)

EXHIBIT 14
Recommendations for Election Polling Locations,

published by the CDC

Injunction

Coronavirus Disease 2019 (COVID-19)
Recommendations for Election Polling Locations

Interim guidance to prevent spread of coronavirus disease 2019 (COVID-19)
Updated March 27, 2020
Summary of changes:
Encourage moving election polling locations away from long term care facilities and facilities housing older persons to
minimize COVID-19 exposure among older individuals and those with chronic medical conditions.
Updated EPA COVID Disinfectant link.
Background
There is much to learn about the novel coronavirus (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19). Based on
what is currently known about SARS-CoV-2 and about similar coronaviruses, spread from person-to-person happens most
frequently among close contacts (within about 6 feet). This type of transmission occurs via respiratory droplets. Transmission
of SARS-CoV-2 to persons from surfaces contaminated with the virus has not been documented. Transmission of coronavirus
in general occurs much more commonly through respiratory droplets than through contact with contaminated surfaces.
Current evidence suggests that SARS-CoV-2 may remain viable for hours to days on surfaces made from a variety of materials.
Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for prevention of COVID-19 and other viral
respiratory illnesses in election polling locations.
Purpose
This guidance provides recommendations on the routine cleaning and disinfection of polling location areas and associated
voting equipment (e.g., pens, voting machines, computers). It suggests actions that polling station workers can take to reduce
the risk of exposure to COVID-19 by limiting the survival of the virus in the environment. This guidance will be updated if
additional information becomes available.
De nitions:
Community settings (e.g. polling locations, households, schools, daycares, businesses) encompass most non-healthcare
settings and are visited by the general public.
Cleaning refers to the removal of dirt and impurities including germs from surfaces. Cleaning alone does not kill germs.
But by removing them, it decreases the number of germs and therefore any risk of spreading infection.
Disinfecting kills germs on surfaces. Disinfecting works by using chemicals to kill germs on surfaces. This process does
not necessarily clean dirty surfaces or remove germs. But killing germs remaining on a surface after cleaning further
reduce any risk of spreading infection.
Actions for elections o cials in advance of election day

Encourage voters to use voting methods that minimize direct contact with other people and reduce crowd size at
polling stations.
Encourage mail-in methods of voting if allowed in the jurisdiction.
Encourage early voting, where voter crowds may be smaller throughout the day. This minimizes the number of
individuals a voter may come in contact with.
Encourage drive-up voting for eligible voters if allowed in the jurisdiction.
Encourage voters planning to vote in-person on election day to arrive at o -peak times. For example, if voter
crowds are lighter mid-morning advertise that in advance to the community

crowds are lighter mid-morning, advertise that in advance to the community.
Encourage relocating polling places from nursing homes, long-term care facilities, and senior living residences,
to minimize COVID-19 exposure among older individuals and those with chronic medical conditions.
Consider additional social distancing and other measures to protect these individuals during voting.
Preventive actions polling workers can take

Stay at home if you have fever, respiratory symptoms, or believe you are sick
Practice hand hygiene frequently: wash hands often with soap and water for at least 20 seconds. If soap and water
are not readily available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
Practice routine cleaning of frequently touched surfaces: including tables, doorknobs, light switches, handles, desks,
toilets, faucets, sinks, etc.
Disinfect surfaces that may be contaminated with germs after cleaning: A list of products with EPA-approved
emerging viral pathogens claims  is available. Products with EPA-approved emerging viral pathogens claims are
expected to be e ective against the virus that causes COVID-19 based on data for harder to kill viruses. Follow the
manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and
contact time, use of personal protective equipment).
Clean and disinfect voting-associated equipment (e.g., voting machines, laptops, tablets, keyboards) routinely. Follow
the manufacturer’s instructions for all cleaning and disinfection products.
Consult with the voting machine manufacturer for guidance on appropriate disinfection products for voting
machines and associated electronics.
Consider use of wipeable covers for electronics.
If no manufacturer guidance is available, consider the use of alcohol-based wipes or spray containing at least
70% alcohol to clean voting machine buttons and touch screens. Dry surfaces thoroughly to avoid pooling of
liquids.
Preventive action polling stations workers can take for themselves and the general
public
Based on available data, the most important measures to prevent transmission of viruses in crowded public areas
include careful and consistent cleaning of one’s hands. Therefore:
Ensure bathrooms at the polling station are supplied adequately with soap, water, and drying materials so visitors
and sta can wash their hands..
Provide an alcohol-based hand sanitizer with at least 60% alcohol for use before or after using the voting machine or
the nal step in the voting process. Consider placing the alcohol-based hand sanitizer in visible, frequently used
locations such as registration desks and exits.
Incorporate social distancing strategies, as feasible.Social distancing strategies increase the space between
individuals and decrease the frequency of contact among individuals to reduce the risk of spreading a disease.
Keeping individuals at least 6 feet apart is ideal based on what is known about COVID-19. If this is not feasible, e orts
should be made to keep individuals as far apart as is practical. Feasibility of strategies will depend on the space
available in the polling station and the number of voters who arrive at one time. Polling station workers can:
Increase distance between voting booths.
Limit nonessential visitors. For example, poll workers should be encouraged not to bring children, grandchildren,
etc. with them as they work the polls.
Remind voters upon arrival to try to leave space between themselves and others. Encourage voters to stay 6 feet
apart if feasible. Polling places may provide signs to help voters and workers remember this.
Discourage voters and workers from greeting others with physical contact (e.g., handshakes). Include this
reminder on signs about social distancing.
Recommendations for processing mail-in ballots

Workers handling mail in ballots should practice hand hygiene frequently

g p yg q y
No additional precautions are recommended for storage of ballots
References
Community Mitigation Guidance for COVID-19 Response in the United States:
Nonpharmaceutical Interventions for Community Preparedness and Outbreak Response
Handwashing: Clean Hands Save Lives
Protect Yourself & Your Family
Page last reviewed: March 10, 2020

EXHIBIT 15
The 2014 EAC Election Administration and Voting

Survey Comprehensive Report (Table 39), published
by the U.S. Election Assistance Comm’n

Injunction

U.S. ELECTION ASSISTANCE COMMISSION

THE 2014 EAC ELECTION ADMINISTRATION AND VOTING SURVEY COMPREHENSIVE REPORT
2014 Election Administration and Voting Survey

Table 39. Number and Ages of Poll Workers
State Election Number of Under 18 18 to 25 26 to 40 41 to 60 61 to 70 71 and Over Balance (See Notes)
Juris. in Poll Workers
Survey Total Cases Total Pct. Total Pct. Total Pct. Total Pct. Total Pct. Total Pct. Total Pct.
Alabama 67 0 … … … … … … 0 …
Alaska 1 2,716 1 … … … … … … 2,716 100.0
Arizona 15 9,203 14 183 2.0 129 1.4 314 3.4 715 7.8 1,983 21.5 2,220 24.1 3,659 39.8
Arkansas 75 8,443 72 0 0.0 28 0.3 112 1.3 429 5.1 755 8.9 851 10.1 6,268 74.2
California 58 81,146 57 9,101 11.2 6,930 8.5 7,743 9.5 20,883 25.7 15,578 19.2 12,266 15.1 8,645 10.7
Colorado 64 3,974 64 99 2.5 69 1.7 180 4.5 798 20.1 1,047 26.3 525 13.2 1,256 31.6
Connecticut 169 4,423 169 … … … … … … 4,423 100.0
Delaware 3 4,060 3 481 11.8 168 4.1 199 4.9 1,017 25.0 723 17.8 608 15.0 864 21.3
District of Columbia 1 1,743 1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1,742 99.9
Florida 67 41,902 67 80 0.2 830 2.0 1,984 4.7 9,079 21.7 10,005 23.9 10,916 26.1 9,008 21.5
Georgia 159 16,379 150 369 2.3 928 5.7 1,432 8.7 4,323 26.4 5,262 32.1 3,730 22.8 335 2.0
Hawaii 4 5,423 4 … … … … … … 5,423 100.0
Idaho 44 5,134 44 19 0.4 111 2.2 319 6.2 1,489 29.0 1,824 35.5 1,372 26.7 0 0.0
Illinois 110 44,537 105 … … … … … … 44,537 100.0
Indiana 92 18,308 78 233 1.3 384 2.1 749 4.1 2,330 12.7 2,473 13.5 1,946 10.6 10,193 55.7
Iowa 99 8,613 99 … … … … … … 8,613 100.0
Kansas 105 7,187 105 … … … … … … 7,187 100.0
Kentucky 120 14,940 120 … … … … … … 14,940 100.0
Louisiana 64 16,900 64 … … … … … … 16,900 100.0
Maine 500 5,082 490 29 0.6 86 1.7 376 7.4 1,497 29.5 1,728 34.0 1,366 26.9 0 0.0
Maryland 24 22,639 24 130 0.6 935 4.1 1,816 8.0 8,444 37.3 7,100 31.4 4,214 18.6 0 0.0
Massachusetts 351 13,164 351 … … … … … … 13,164 100.0
Michigan 83 31,546 83 928 2.9 1,445 4.6 2,241 7.1 9,024 28.6 10,234 32.4 7,674 24.3 0 0.0
Minnesota 87 28,665 87 … … … … … … 28,665 100.0
Mississippi 82 6,721 56 0 0.0 48 0.7 921 13.7 439 6.5 405 6.0 290 4.3 4,618 68.7
Missouri 116 15,931 114 150 0.9 192 1.2 388 2.4 2,457 15.4 3,536 22.2 3,376 21.2 5,832 36.6
Montana 56 3,809 56 15 0.4 54 1.4 205 5.4 977 25.6 1,462 38.4 1,096 28.8 0 0.0
Nebraska 93 6,976 93 69 1.0 68 1.0 334 4.8 1,543 22.1 2,318 33.2 2,644 37.9 0 0.0
Nevada 17 4,455 17 209 4.7 114 2.6 258 5.8 1,146 25.7 1,209 27.1 965 21.7 554 12.4
247 • A REPORT TO THE 114TH CONGRESS • JUNE 30, 2015

2014 Election Administration and Voting Survey

Table 39. Number and Ages of Poll Workers (continued)
Election Number of Under 18 18 to 25 26 to 40 41 to 60 61 to 70 71 and Over Balance (See Notes)
Juris. in Poll Workers
State Survey Total Cases Total Pct. Total Pct. Total Pct. Total Pct. Total Pct. Total Pct. Total Pct.
New Hampshire 320 2,392 320 … … … … … … 2,392 100.0
New Jersey 21 21,142 17 … … … … … … 21,142 100.0
New Mexico 33 3,550 33 … … … … … … 3,550 100.0
New York 62 57,812 62 … … … … … … 57,812 100.0
North Carolina 100 19,296 100 239 1.2 403 2.1 1,105 5.7 5,919 30.7 6,927 35.9 4,703 24.4 0 0.0
North Dakota 53 1,910 53 … … … … … … 1,910 100.0
Ohio 88 41,524 88 1,524 3.7 1,888 4.5 1,777 4.3 9,825 23.7 10,002 24.1 8,252 19.9 8,256 19.9
Oklahoma 77 6,241 77 0 0.0 36 0.6 108 1.7 922 14.8 2,059 33.0 3,116 49.9 0 0.0
Oregon 36 0 … … … … … … 0 …
Pennsylvania 67 0 … … … … … … 0 …
Rhode Island 39 3,797 39 … … … … … … 3,797 100.0
South Carolina 46 13,489 46 1,153 8.5 … … … … … 12,336 91.5
South Dakota 66 1,597 28 … 6 0.4 27 1.7 195 12.2 276 17.3 426 26.7 667 41.8
Tennessee 95 15,079 95 136 0.9 411 2.7 691 4.6 3,211 21.3 5,113 33.9 4,508 29.9 1,009 6.7
Texas 254 31,542 231 91 0.3 149 0.5 508 1.6 1,397 4.4 1,988 6.3 1,853 5.9 25,556 81.0
Utah 29 10,974 29 … … … … … … 10,974 100.0
Vermont 246 2,678 246 13 0.5 13 0.5 63 2.4 602 22.5 756 28.2 344 12.8 887 33.1
Virginia 133 18,321 130 648 3.5 422 2.3 1,021 5.6 5,042 27.5 5,818 31.8 3,911 21.3 1,459 8.0
Washington 39 235 37 0 0.0 8 3.4 10 4.3 85 36.2 97 41.3 25 10.6 10 4.3
West Virginia 55 9,455 55 0 0.0 168 1.8 569 6.0 1,577 16.7 1,486 15.7 973 10.3 4,682 49.5
Wisconsin 3,589 32,815 3,589 397 1.2 451 1.4 1,450 4.4 6,974 21.3 12,598 38.4 10,733 32.7 212 0.6
Wyoming 23 2,061 23 19 0.9 18 0.9 55 2.7 481 23.3 814 39.5 423 20.5 251 12.2
American Samoa 1 356 1 … … … … … … 356 100.0
Guam 1 290 1 0 0.0 76 26.2 79 27.2 98 33.8 33 11.4 4 1.4 0 0.0
Puerto Rico 0 0 … … … … … … 0 …
Virgin Islands 1 351 1 … … … … … … 351 100.0
Sum of Above 8,200 730,926 7,889 16,315 2.2 16,568 2.3 27,034 3.7 102,918 14.1 115,609 15.8 95,330 13.0 357,151 48.9
States Included 31 31 31 31 31 31 42
Question D3 D4a D4b D4c D4d D4e D4f calc

TABLE 39. NUMBER AND AGES OF POLL WORKERS
Questions D3, D4. Number of poll workers used and age category.
Question D3
Arizona Maricopa County also hired 116 citizen board Indiana One jurisdiction commented that its poll worker total
troubleshooters that do not serve as polling place includes Election Day and satellite workers.
board workers but are assigned several specific
polling place locations to assist the board workers at
these locations with any issues that come up on
Election Day. This quantity of additional workers
(116) is NOT reflected in the Maricopa’s D3 grand
total.
California One county noted that its D3 figure does not include Minnesota One county noted that their figure for D3 is an estimate.
reserve workers and couriers (46 cases). Another
county commented that its D3 figure includes poll
workers and rover/super rovers.
DC The DC Board of Elections tracks the ages of poll New Minimum required.
workers by percentage, rather than number. Hampshire
Florida Bay County lost a large number of poll workers Texas Three jurisdictions reported that their D3 figures
midcycle and had to continually recruit additional included only Election Day workers, while four
workers. jurisdictions indicated that their totals included both
workers for both Election Day and early voting. One
jurisdiction commented that its Election Day workers
were the same as its early voting workers. Another
jurisdiction noted that its total included workers who
were exclusively ballot board, central count, temporary
workers, security, or IT. One jurisdiction included both
typical and student election workers in its count. One
jurisdiction commented that its figure for D3 is an
estimate. One jurisdiction commented, “Double the total
of D3a if primary, there is never less than three persons at
a polling place, if a particular polling place is heavy
Hispanic then an interpreter is added, even if there is an
interpreter at the main election office.”

Vermont One jurisdiction reported that it held 2-hour shifts Wyoming One jurisdiction indicated that its total for D3 includes
for four ballot workers throughout the day, and its polling place workers, absentee board members, test
total also includes BCA counters. A different board members, canvass board members, and alternate
jurisdiction noted that its D3 total does not include workers.
one individual who came to help count only.
Another jurisdiction indicated that its total includes
both volunteer and paid vote counters (hand count
town). One jurisdiction indicated that its total
includes the town clerk and the assistant town clerk,
while a different jurisdiction reported that it did not
include its town clerk or assistant town clerk in its
total. One jurisdiction noted that its total does not
include the people who helped count votes.

TABLE 39. NUMBER AND AGES OF POLL WORKERS
Questions D3, D4. Number of poll workers used and age category.
Question D4
Arkansas One jurisdiction commented that most of its Indiana The average age of poll workers in Clay County was 60.58.
election workers are over 40 years old, while Another jurisdiction estimated that the average age of its
another jurisdiction commented that most of its poll workers was between 45 and 70; two other
election workers are between 61 and 70 years old. jurisdictions estimated the average age to be between 45
and 60. One jurisdiction commented that it “had a lot
more [poll workers] over 71, but they could not work. This
includes alternates.” Another jurisdiction reported that its
oldest poll worker was 88 years old. Two jurisdictions
reported that their average poll worker ages skewed high.
Arizona Maricopa County implemented a student poll Louisiana Data not available.
workers program back in 2008. Since its inception, it
has realized a steady increase in participation
among students. For the 2014 election, of the 3,848
workers in Maricopa County, over 152 of these
board workers were students.
California Thirteen counties indicated that the poll worker Minnesota Minnesota does not collect age data.
data was unavailable for certain groups of poll
workers; one county indicated that it did not have
age data for any poll workers. One jurisdiction
noted that it was entirely vote by mail, so it did not
have any poll workers.
Colorado Seven jurisdictions commented that poll worker age New Data not available.
information was unavailable. One jurisdiction Hampshire
commented that it had 31 student judges, but
otherwise, it does not track by age.

New York New York does not capture demographic Vermont One jurisdiction commented that all of its poll workers
information regarding poll workers. appear to be over 40 years old. Another jurisdiction noted
that its figures for QD4 were mostly estimates. A fourth
jurisdiction indicated that the individual who came in to
count was in the 61 to 70 age range category.
South Age data not available for poll workers 18 years of Washington One jurisdiction commented that its figures for D4 do not
Carolina age and older. include permanent staff, only temporary staff hired
specifically to work at an accessible voting center.
South One jurisdiction indicated that it did not have age West Virginia One jurisdiction estimated its age breakdown to be 10%
Dakota data for 12 of its poll workers. for 26–40, 70% for 41–60, and 20% for 61–70. Another
jurisdiction indicated that its responses for D4 are
approximate totals. Two jurisdictions commented that
the majority of its poll workers were between 41 and 60
years of age.
Texas One jurisdiction reported that it does not collect age Wyoming One jurisdiction reported that its oldest worker was 84,
data. Another jurisdiction reported that it included and its youngest worker was 35. Another jurisdiction
age counts for both Election Day and early voting commented that “most will be unable to serve in 2 years.”
election workers. One jurisdiction indicated that it A third jurisdiction reported that it had one student
only had age data available for its student election judge, but it does not track the ages of its other poll
workers; similarly, another jurisdiction commented, workers.
“While no exact figures are readily available, the
bulk of election workers are in the older three
groupings, with a handful of younger adults and six
student clerks.” One jurisdiction reported that most
of its poll workers are over 65 years of age. Two
jurisdictions reported that their D4 figures were
estimates.

EXHIBIT 16
Voting Rights and Election Administration in North

Carolina: Field Hearing Before the Subcomm. on
Elections of the H. Comm. on House Administration
(Apr. 18, 2019)

Injunction

Testimony of Tomas Lopez
Executive Director, Democracy North Carolina
Before the Committee on House Administration, Subcommittee on Elections,

U.S. House of Representatives
Field Hearing on Voting Rights and Election Administration in North Carolina

April 18, 2019
Chair Fudge, Ranking Member Davis, and Members:
Thank you for the opportunity to submit this testimony for your field hearing on voting rights
and election administration in North Carolina, and to share the experiences of this state’s voters, who in
recent years have been subjected to consistent attacks on voting access and deliberate, extreme racial
and partisan gerrymanders. These measures have undermined both the ability for voters to participate in
elections and the effectiveness of participation itself— by design. North Carolina’s experience
underscores the necessity of congressional action to both restore the full protections of the Voting Rights
Act and establish new standards to facilitate meaningful access to the political process.
My name is Tomas Lopez, and I am the executive director of Democracy North Carolina. We are
a nonpartisan, nonprofit organization that works to, among other goals, protect the right to vote in our
state. As part of this work, we seek to bring North Carolinians – especially historically underrepresented
people of color – into the political process and encourage their participation and leadership through
voting, monitoring the election process, and issue advocacy. We also author original research on
election administration, help coordinate a statewide nonpartisan poll monitoring and voter assistance
network, and advocate for policies and practices that we believe will increase voter access and
participation. Prior to this position, I was a voting rights attorney at the Brennan Center for Justice at
NYU School of Law, where I litigated voting rights cases in the federal courts, contributed to research
on election law and administration, and supported election reform efforts in several states.
This submission addresses several issues:

• Repeated efforts to restrict voting access through several means, including strict
photo identification requirements and reductions to early voting;
• The voting experience in North Carolina, especially as to voters subjected to
dysfunction and intimidation;
• The perpetuation of false narratives regarding voter fraud; and
• Extreme racial and partisan gerrymandering.
Many of these issues are the results of a concerted, years-long effort to limit voter participation and
impact for the sake of short-term, perceived political advantage. All damage the vitality of our state and
its democracy by harming the public’s ability to meaningfully take part in the political process.

the case. As written, the law requires universities, colleges, and community colleges to attest under
penalty of perjury as to citizenship verification procedures outside of the scope of their work and within
the scope of existing procedures under state and federal law, and imposes other administrative
challenges that discouraged North Carolina campuses from complying, such as requiring that school
staff take ID photographs themselves and modify their ID documentation.5 From the passage of the
legislation, institutions were given less than three months to determine their ability to comply with these
requirements and submit their attestation letters to state officials. As of this submission, 37 community
colleges, colleges, and universities out of over 100 eligible institutions submitted documentation to the
State Board of Elections in order to have their student ID cards approved for voting use in 2020. Of
those, 11 campuses were denied – 10 constituent universities of the University of North Carolina
system, including the flagship in Chapel Hill, and one HBCU. The General Assembly is currently
considering legislation that would modify these requirements, including by removing the attestation
requirement for institutions; that measure passed the North Carolina House, but faces uncertain
prospects in the Senate.6
We are concerned that, in practice, the ID law will work in much the same way as its
predecessor— by imposing both a formal barrier for eligible voters, and an informal one that deters
them from casting ballots due to confusion, misinformation, misapplication of the law, or intimidation.
Indeed, the introduction of student IDs as another potentially-eligible ID for voting, but one that requires
the institution to receive pre-approval by the State Board of Elections, increases the likely impact of
both of these barriers on young voters in 2020.
Reductions to Early Voting
Restrictions to early voting have been another hallmark voter suppression tactic since 2013,
when H589 cut a week off of North Carolina’s early voting period. North Carolina county boards of
elections (BOEs) hold significant power over voting access in this state through their ability to set
polling locations, determine early voting schedules, and train poll workers on current law. During the
2014 and 2016 election cycles, these county bodies implemented changes to local election procedures
that resulted in reduced access for voters of color:
• In 2014, the Lincoln County Board of Elections passed an early voting plan that reduced voting
hours from 2010, a move that was overridden by the State Board of Elections. As a result, hours
had to be added to the early voting site in Lincolnton, the county seat – something the BOE chair
strongly objected to because “it would have been favorable to the Democratic Party.” Although
only 13% of the county population lives in Lincolnton, it is the home of 31% of the county’s
African American voters.7
• In 2014, over the objections of community members, the Forsyth County Board of Elections
adopted an early voting plan that moved early voting sites outside of the urban center of
Winston-Salem, where the majority of Black voters live, to whiter, more conservative suburbs.
The plan removed an early voting site from Winston Salem State University, a HBCU that had
been an early voting location in 2012, 2010, and 2008, and did not replace it with any other sites
5
N.C.G.S. § 163A-1145.2.
6
House Bill 646 (2019).
7
Sharon McCloskey, “Lincoln County voters fight for hours at early voting sites,” The Progressive Pulse (NC Policy Watch),
Oct. 31, 2014, http://pulse.ncpolicywatch.org/2014/10/31/lincoln-county-voters-fight-for-hours-at-early-voting-sites/.
3

in eastern Winston-Salem, although multiple alternatives were suggested. “Our African
American community has been hurt,” testified a local Democratic party official before the BOE.8
• In 2014 and 2016, the Chavis Heights Community Center precinct in Southeast Raleigh in Wake
County demonstrated the effect that having out-of-precinct voting available as an option and its
correct implementation by precinct officials can have on access for voters of color. In 2014,
when North Carolina did not have out-of-precinct voting in place, our poll monitors counted over
300 voters, mostly African-American, turned away from the poll and sent to other polling
locations. In many cases, voters told monitors they would not be able to get to another polling
place – one person had used their last money on bus fare to Chavis Heights.9 In 2016, when out-
of-precinct voting was permitted following the Fourth Circuit’s ruling, poll monitors reported
that the chief judge at the polling place refused to offer provisional ballots to out-of-precinct
voters. When voters demanded an out-of-precinct provisional, as was their right, precinct
officials discouraged them from casting a ballot, saying, “it won’t count anyway.”10
• In 2016, in an attempt to blunt the impact of the Fourth Circuit’s decision to restore the first
week of early voting, many of the Republican-led county BOEs adopted early voting plans with
fewer hours and sites during the first restored week. There were dramatic reductions in early
voting hours in Guilford (-660), Mecklenburg (-282), Brunswick (-165), Craven (-141), Johnston
(-124), Robeson (-121), and Jackson (-113) counties. Of those, Guilford, Craven, and Robeson
counties were previously covered under Section 5 of the Voting Rights Act, and Mecklenburg
and Johnston have significant Black voting populations, 33% and 16% of all registered voters (as
of October 22, 2016) respectively.
A second troubling development is a June 2018 law, S325, which mandates a 12-hour early
voting schedule during the week and requires those same hours across all sites.11 While uniformity may
present theoretical benefits, the extended 12-hour day required by S325 has in practice increased the
costs of early voting for counties and, in turn, reduced the total availability of early voting, particularly
weekend hours.
North Carolina law requires counties to make early voting available at a minimum of one
location and permits counties to establish additional early voting locations. In past cycles counties,
especially in low-resourced areas, made early voting available at different times across a variety of
locations during the early voting window— for instance, by having some sites open only on the
weekends, or offering Sunday voting at only one or two locations. The 2018 law makes this impossible
by requiring that counties keep any given early voting site open on the same days and same hours as all
others. Additionally, the mandatory 12-hour weekday schedule forces counties to staff sites at hours
when voters do not typically vote, thus reducing the total number of sites counties can afford to staff
without increasing the number of usable voting hours.
This has produced several consequences in practice:12

• 43 counties reduced the number of early voting sites in 2018 compared to 2014.
8
Meghann Evans, “Forsyth elections board approves early voting plan” Winston-Salem Journal, July 22, 2014,
http://www.journalnow.com/news/local/forsyth-elections-board-approves-early-voting-plan/article_7cbf2a6a-11d3-11e4-
b1fa-001a4bcf6878.html.
9
Isela Gutierrez and Bob Hall, Democracy North Carolina, Alarm Bells from Silenced Voters (June 2015),
https://democracync.org/wp-content/uploads/2017/06/SilencedVoters.pdf.
10
Isela Gutierrez, Democracy North Carolina, From the Voter’s View: Lessons from the 2016 Election (January 2018),
https://democracync.org/wp-content/uploads/2018/01/PostElectionReport_DemNC_web.pdf.
11
S.L. 2018-112. As originally written, the statute removed the final Saturday of early voting beginning in 2018; this was
subsequently postponed.
12
Democracy North Carolina has compiled these figures for use in this submission and in future reporting.
4

• 51 counties reduced the number of weekend days offered.
• 67 counties – over two-thirds of North Carolina’s 100 counties – reduced the number of
weekend hours.
• Of the eight counties where a majority of voters are Black, four reduced sites, seven
reduced weekend days, and all eight reduced the number of weekend hours during early
voting. None saw increases in sites or weekend options.
• A ProPublica and WRAL analysis of Early Voting sites elimination found that about 1 in
5 rural voters saw the distance to an Early Voting site increase by more than a mile— and
in some counties, like Halifax, the average distance between voters and Early Voting
sites increased by as much as 6 miles.13
Despite these reductions, North Carolina voters turned out in impressive number in last year’s midterm
election. But high overall turnout does not necessarily mean widespread or equitable access. Indeed, the
three counties where turnout rates (the percentage of registered voters who cast ballots) decreased
compared to 2014 are telling. Two were Jones and Pamlico, which received federal assistance after
Hurricane Florence. The other was Halifax, the site of this field hearing, which had three Early Voting
locations in 2012, 2014, and 2016, but only one in 2018. Halifax also saw the greatest increase in the
average distance from voters to Early Voting Sites due to S325.
Elimination of the Last Saturday of Early Voting
Starting in 2019, S325 also eliminates the popular final Saturday of early voting for all future
elections. It was traditionally the only weekend voting day offered in all 100 counties, and the turnout
numbers bore that out— that day has traditionally been one of the highest turnout days of the entire
voting period, despite the fact that many counties keep sites open for shorter periods that day than during
the work week. We anticipate that this will result in the majority of North Carolina counties having no
weekend Early Voting options, which are crucial for voters who work Monday through Friday. Without
the last Saturday in 2018, 63 counties would have had no weekend option for voters to cast their ballots.
Or, if weekend hours are offered, they will be offered at a minimal number of sites, which would be
especially harmful to rural voters in sprawling counties without public transportation.
And in addition to being hugely popular with voters overall, this last Saturday has been
disproportionately used by Black voters in North Carolina at the statewide level and in a sizable majority
of the state’s 100 counties in the last five election cycles. In 2018, Black voters made up 22% of
registered voters, but 27% of those who cast ballots on the last Saturday of Early Voting.
The Voting Experience in North Carolina
As in many states, election administration challenges affect voting access in North Carolina by
making voting a more complicated and intimidating experience than it needs to be. We have observed
this in action through our voter protection program; during every major election year, we work closely
with partner organizations to recruit, train, and place hundreds of volunteer poll monitors at polling
locations across the state. These poll monitors survey voters departing locations, and assist those who
report problems by connecting them to a hotline locally staffed by volunteer attorneys. In 2018, the
program’s 800 volunteers were present at 279 precincts in 55 counties on Election Day: a total that
amounted to 1 in 10 polling places in the state. We use the information they collect to report on the
voting experience and inform our policy recommendations.
13
Tyler Dukes, “Early voting changes hit NC rural voters hardest. But will it matter in 2018?” WRAL, Nov. 1, 2018,
https://www.wral.com/early-voting-changes-hit-nc-rural-voters-hardest-but-will-it-matter-in-2018-/17959224/.
5

EXHIBIT 17
Bipartisan Furor as North Carolina Election Law

Shrinks Early Voting Locations by Almost 20
Percent (Sept. 24, 2018), written by
Blake Peterson and published by ProPublica

Injunction

NORTH CAROLINA
Bipartisan Furor as North Carolina Election

Law Shrinks Early Voting Locations by
Almost 20 Percent
Nearly half of the state’s counties are shutting down polling places, in
part because of a law passed in June.
by Blake Paterson, Sept. 24, 2018, 5 a.m. EDT
A voter at a polling place in Raleigh, North Carolina, in 2012. County election o icials
across the state say a new law setting polling hours has hamstrung their ability to best
serve voters. (Shawn Rocco/Raleigh News & Observer/MCT via Getty Images)
In June, the North Carolina General Assembly passed legislation

mandating that all early voting sites in the state remain open for uniform
hours on weekdays from 7 a.m. to 7 p.m., a move supporters argued would
reduce confusion and ultimately make early voting easier and more
accessible.
But with the start of early voting only weeks away, county election officials
across the state — who previously had control over setting polling hours in
their jurisdictions — say the new law has hamstrung their ability to best
serve voters. Some officials in rural counties say they’ve had to shrink the
number of early voting locations to accommodate the law’s longer hour
requirements and stay within their budgets.

A ProPublica analysis of polling locations shows that North Carolina’s 2018
midterm election will have nearly 20 percent fewer early voting locations
than there were in 2014. Nearly half of North Carolina’s 100 counties are
shutting down polling places, in part because of the new law. Poorer rural
counties, often strapped for resources to begin with, are having a
particularly difficult time adjusting to the new requirement.
The closure of polling locations increases the time it takes for voters to
travel to the polls, and it could result in lower turnout, making matters
worse for a state already dealing with Hurricane Florence. Early voting in
North Carolina begins on Oct. 17.
We interviewed more than two dozen county election officials across North
Carolina. None said they were in favor of the new law, and none said they
were contacted by state lawmakers for counsel on the legislation. Some
referred to the policy as “overkill,” a waste of resources and an “unfunded
mandate,” particularly burdensome for cash-strapped counties.
“We know our county. We know when most people go to vote early. The 12-
hour, 7-a.m.-to-7-p.m. requirement just ties our hands when coming up
with a catered approach that fits our county best,” said Steve Stone, the
Republican chair of the Robeson County Board of Elections.
Republican state lawmakers, who championed the new law, argue that the
consistency it provides will eliminate uncertainty among voters and
expand early voting by increasing hours and allowing those who work full-
time jobs to vote before or after work.
“The purpose of the uniformity is to make it easier and more convenient

and more accessible for the voter to participate,” said David Lewis, a state
representative who supported the bill. “I think that access to the polls,
access to the ballots in a uniform fashion, is more important than poll
worker or election worker convenience.”
Lewis says the law has led to an increase in the number of aggregate
polling hours across the state. Indeed, polls for early voting will be open
49,696 hours in 2018, a substantial jump from the 25,887 hours offered in
2014, according to a preliminary analysis from the North Carolina State
Board of Elections & Ethics Enforcement.
But according to Robert Stein, a professor of political science at Rice

University, aggregate hours are not nearly as important a factor to voter
access as the number of early voting locations offered by a county.
“There is a lot of good research to suggest that when it comes to having a

positive effect on early voting turnout, the important things are not the
hours of operation but the location of the polling place and the distance
and travel time it takes a voter to get there,” Stein said.

For many counties, the trade-off
for more polling hours is fewer
early voting locations. Take
Gaston County, near Charlotte. In
2014, the county opened one main
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polling place at 8 a.m. and three
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According to Adam Ragan, the Boss.
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The county originally planned to
open five early voting locations,
but with the new policy it can now
only afford to operate three.
While county election officials

from both parties have expressed near uniform discontent over the new
requirements, state lawmakers were split along partisan lines on the
measure, with support coming exclusively from GOP lawmakers.
“It will put a strain on local boards,” Democratic Rep. Marcia Morey said on
the floor of the North Carolina House of Representatives. “We need local
flexibility, not the strong arm of the state for political purposes to suppress
the vote.”
North Carolina’s Democratic Gov. Roy Cooper originally vetoed the bill,
writing in a statement that “we should be making it easier for people to
vote, not harder,” but GOP state lawmakers have veto-proof majorities in
both chambers of the General Assembly and handily overrode the veto.
In addition to setting uniform polling hours, the original legislation also

eliminated the final Saturday of early voting, a day that historically

attracts a large number of black voters, opening legislators up to further
charges of voter suppression.
Republican lawmakers subsequently backed off on this and restored the

popular voting day. Lewis acknowledged the move was a mistake, though
he said it had been proposed to give counties more time prepare for
Election Day. Still, given the sordid history of voting rights violations in
North Carolina, many Democrats remain skeptical of GOP lawmakers’
dedication to expanding access to early voting.
“I do not see it as an isolated event, but rather a part of a larger voter

suppression effort,” said Al Daniels, a Democratic member of the Bladen
County Board of Elections, of the uniform-hours law. “I see it as anti-voter,
period.”
In 2013, the GOP-led General Assembly passed far-reaching legislation in

the name of combating voter fraud that cut back on early voting,
established a photo ID requirement and did away with pre-registration of
high school students, same-day registration and out-of-precinct voting. A
federal appeals court struck down the law, labeling it an unconstitutional
attempt to “target African Americans with almost surgical precision.”
The 2013 law was passed in the wake of the Supreme Court decision in
Shelby County v. Holder, which weakened a provision of the Voting Rights
Act that had required a handful of jurisdictions — including parts of North
Carolina — to submit voting law changes to the federal government to
determine whether those changes had a discriminatory effect or purpose.
Now, laws like North Carolina’s uniform-voting legislation don’t need to be
given preclearance from the federal government before they can take
effect.
“Given the context of the GOP legislature, it makes you want to raise your
eyebrows that this just wasn’t some neutral requirement to have consistent
voting hours around the state,” said Philip Lehman, the Democratic vice
chair of Durham County’s Board of Elections and a former member of the
state’s General Assembly.
Other arguments in favor of the law have only advanced suspicion of

lawmakers’ motives. State Sen. Ralph Hise, one of a dozen Republican
sponsors of the bill, said in an interview with ProPublica that the law was
meant, in part, to rein in partisan maneuvering on county election boards.
He said that, in previous elections, certain counties would strategically
leave specific early voting sites open for longer to “impact the election.”
When asked to provide an example of such conduct, during the interview
and subsequently, however, Hise did not do so.
The new law came as a surprise to many local election officials who had
already finalized their budgets. Elections in North Carolina, unlike some
other states, are funded entirely at the county level, leaving some

administrators scrambling to figure out how to work within the confines of
their budgets while accommodating the new law.
“I’m a full-fledged Republican and a Republican supporter, and I’m just

disappointed in the General Assembly for not reaching out to election
officials in the state and asking, ‘What do you think would work well for
this early voting law?’” said Stone, the chair of the Robeson County Board
of Elections.
The law appears to have exacerbated the divide between urban and rural
counties, putting a greater strain on poorer, less populous counties, which
often have smaller budgets, fewer full-time employees and an older voting
population that is less willing to volunteer for what could be a 12-hour poll
worker shift.
Take Bladen County. When it approved its operating budget this year,
election officials set aside funds for four early voting sites. Though
sparsely populated, Bladen County is large — the state’s fourth biggest by
area — and local election administrators wanted to provide ample access
to voters across the region.
Their plan had precedent. In every statewide election over the past decade,
Bladen voters could cast their ballots at one of four early voting locations
spread out across the county. Now, with the strict hours requirement,
Bladen County can only afford to staff and operate one early voting site.
“We’re a small county and the law has affected us pretty badly,” said Bobby
Ludlum, the GOP chair of Bladen County’s Board of Elections.
Wealthier, more populous counties appear to be doing better at weathering

the changes. Still, election officials acknowledged that the law may
adversely affect their rural counterparts.
“One size does not necessarily fit all,” said Michael Dickerson, the
nonpartisan director of elections in Mecklenburg County, North Carolina’s
most populous. “I’m very fortunate in this county. I’ve got over a million
people living here, so we can find poll workers.”
The legislation has contributed to an already chaotic and uncertain year

for election administrators in North Carolina. In addition to the difficulties
they will encounter getting elections up and running in a state dealing
with a major natural disaster, election officials are still scrambling to deal
with man-made crises. A federal court in late August ruled that the state’s
congressional maps were unconstitutionally gerrymandered and ordered
they be redrawn immediately, sparking widespread confusion among
election officials on whether the general election would move forward as
planned. The court later clarified that the current maps should be used for
the coming election.

A separate series of court battles over ballot language delayed the
preparation and printing of election ballots, and the reduced timeline has
left little flexibility in case ballots need to be reprinted. Adding to all of
this, federal prosecutors in early September issued subpoenas to 44 county
election boards asking that millions of voter records be handed over to
immigration authorities by the end of the month.
While North Carolina has a handful of consequential congressional races

in this fall’s election — the Cook Political Report rates four as competitive
— most officials who spoke to ProPublica worry about how the early-voting
changes and other laws might affect 2020, when the swing state will vote
for president, governor and senator.
“It seems that every time we have an election, the rules are different,” said
Jake Quinn, a Democratic member of the Buncombe County Board of
Elections.
“We’re looking at different district boundaries, or we have to have voter

IDs, or you can’t vote out of precinct, or the hours have to be changed. This
is a problem. When you change the rules for voting every single election,
some people are going to get discouraged by that,” he said. “All of this is
very destabilizing.”
Filed under: Politics
Blake Paterson
Blake Paterson is the reporting fellow for ProPublica’s Electionland project.
blake.paterson@propublica.org @blakepater

EXHIBIT 18
Letter from Yancey County Board of Elections to

Karen Brinson Bell

Injunction

Gary Boone, Chairman
Julia Tipton, Secretary
Charles Mccurry, Member
Brenda Wilson, Member
Joey Miller, Member
Mary Beth Tipton, Director
Yancey County Board of Elections

P.O. Box 763 · 30 East US Hwy 19E By-Pass· Burnsville, NC 28714
Phone: (828) 682-3950 · Fax: (828) 682-2209
E-mail: boe@yanceycountync.gov
Ms. Brinson Bell,
I am writing to request a temporary transfer of voters for the June 23 CD11 Primary. The Board and I want
to bring to your attention several reasons for making this request, share our thoughts behind requesting the
transfers and explain our game plan for making the June 23 CD11 Primary a successful and safe election for our
voters in Yancey County.
First of all, due to the pandemic of COVID 19 and a large number of our poll workers bei ng the high risk age,
we do not have enough people to cover all of our normal 11 precincts. Second, our local school board has asked
that we not use schools as polling locations. They are preparing and delivering breakfast and lunch for our children
during this outbreak and want to keep the risk of contamination down as much as possible. Currently 4 of our
polling site are located in schools. Third, our county's budget is under a lot strain due to the unforeseen cost of
a
COVID 19 and there is no way to predict how much cost they will incur before this is over. Fourth, couple of our
polling locations are in small buildings. Green Mountain and Brush Creek could not hold 3 judges and comply with
the 6 ft. order. When you add voter~ to these two places, with all safety measures in place, there is still no way to
vote and be in compliance. Last, we do not anticipate a large in person voter turnout. I have attached along with
this letter the statics for the past Second Primaries in Yancey County. You will see that the three polling locations
will meet our voter's needs.
The minute we received news of a Second Primary we began planning on how we could successfully hold a
safe election. It is our main goal to protect our voter's rights and do so while keeping everyone involved in the
process as safe as possible. We divided our voters out into three separate parts, West Yancey, Central Yancey and
East Yancey. Once we got that division settled our goal was to narrow it down to largest and most central polling
location within the three divisions. West Yancey polling location was decided to be in Cane River Precinct. One
reason being Prices Creek is located in a school, both Egypt and Ramseytown vote in the same small fire station.
When the school system closed down Bee Log Elementary School that was the only place we had for Egypt voters
to vote. Cane River voters vote in a new fire station with a 4000 sq. ft. meeting room. Central Yancey was decided
to be in Burnsville, but the current Burnsville polling place is in a school. We contacted the Town of Burnsville who
is going to allow us to use t heir recently bu ilt Town Center. The Burnsville Town Center is located within the
Burnsville precinct, all the Municipal Elections are held there. Each eligible voter in the Burnsville precinct will
receive notification of the temporary move. Jacks Creek precinct is located in a school, Green Mountain votes in a
small voting house that is a 12' x 14' building and Pensacola is located in a small fire station. The transfer of these
voters into Burnsville will make the largest polling location we will have so the 4500 sq. ft. ofthe Town Center will
ensure everyone is safe. East Yancey polling location was our easiest to determine. Crabtree Precinct is located in
the middle of both South Toe and Brush Creek voters. Crabtree voters vote in a new fire department that has a
3800 sq. ft meeting room. South Toe is located in a school and Brush Creek vote in a small community center

where space will be an issue. We have really looked at every possible scenario and feel that these three polling
locations will best serve our voter's, citizens and poll worker's safety with as little travel time as possible.
Each precinct will be kept separately in the polling locations. Ballots will be printed by precinct and D5200
will be burned to read all precincts into one tabulator. We will be using labels and ATV forms, which will be kept in
separate books for each precinct. There will be one OVRD laptop in each polling location to look up the voter and
locate their precinct. This will keep all lines moving smoothly and help keep confusion down as well. Once their
precinct is located the voter will proceed to the check in station to state their name and verify their information.
When the voter signs the ATV form they will go to the ballot station to receive their appropriate ballot. They were
some concern from board members about voters getting the wrong ballot, so along with the barcode scanners we
will use our 1-Stop workers at the ballot stations in all three polling locations. They are use to handling multiple
ballot styles at 1-Stop and will require little to no training.
We are all in this together and want what's best for everyone involved in the election process. The Yancey
County Board of Elections feel the temporary transfer of voters will help ease the struggle of finding poll workers,
allow for both poll workers and voters to have enough space to be safe, and help with the financial side as well.
Sincerely,
Mary Beth ~ipton, Director

EXHIBIT 19
Letter from Madison County Board of Elections to

Karen Brinson Bell

Injunction

MADISON COUNTY BOARD OF ELECTIONS
5707 US 25-70 HWY P.O. Box 142
Marshall, NC 28753
Phone: 828-649-3731
Email: madison.boe@madisoncountync.gov
April 16, 2020
Karen Brinson Bell, Executive Director

North Carolina State board of Elections
430 N Salisbury Street
Raleigh, NC 27603
Dear Executive Director Brinson Bell,
The COVID 19 pandemic and urgent need to protect the public and poll workers from spread of the virus
during the June 23, 2020 2"d Republican Primary Election compels the Board of Elections to request
voter transfers and changes in precinct polling locations to minimize COVID 19 exposure, reduce the risk
of disease transmission during in-person voting, and to assist other county entities with providing much
needed COVID 19 related services and facilities needs during this time.
In developing its plan, the Board of Elections consulted with poll workers and other county leadership
and departments to gather needed information and consider the challenges that are directly tied to
COVID 19 risks and responses. Key points of the discussion and plan development are as follows:
• Of Madison County's 12 precincts, 4 precinct polling sites (Hot Springs, Mars Hill, North
Marshall, and Walnut) are located within schools. Madison County Schools Superintendent Will
Hoffman requested that we obtain other non-essential sites as polling locations if at all possible
as 3 of the 5 schools are providing 1,600 meals per day for delivery and pickup for children and
sending supplemental food home to family on yellow buses. He continues that all schools are
providing remote online learning material for 2,300 students for pick up and drop off and
providing Wifi access for students and families in school parki ng lots. Additionally one school is
producing protective masks for county health care providers. He concluded by adding that it is
uncertain whether th e school year will be extended or remained closed beyond May 15.
5 precinct polling sites (Beech Glen, Ebbs Chapel, Grapevine, Laurel, and Spring Creek) are
located within senior meal sites, all of which are currently preparing and packing meals for
pickup and delivery for senior citizens who otherwise would go without. Polling sites at these
locations will require a major disruption to this critical service as sites w ill need to be cleaned
and set up prior to Election Day and deep cleaned and vacated on the day following. Using
senior meal sites for polling sites also presents a high risk activity that could result in COVID 19

contamination and transmission among one of our most vulnerable populations. As a result, the
Community Services Director is requesting that we obtain other non-essential sites as polling
locations if at all possible and is communicating with the County Manager and County Health
Director regarding the risks.
Of the 3 remaining precincts Sand Mush and South Marshall Precincts are located in vacant
county owned buildings and Revere Rice Cove is a privately organized community center.
The Sandy Mush Precinct Building does not contain sufficient area (approximately 190 square ft)
for COVID related social distancing standards and there are no other potential polling sites
available in the community thus requiring a temporary precinct transfer of voters and change in
poliing site. An adjacent precinct transfer is not feasible as both adjacent precincts also are
requiring temporary transfer of voters and polling site changes. The only option is to transfer
Sandy Mush voters to the nearby North Marshall Precinct and utilize its polling site on Election
Day.
The Ebbs Chapel Precinct cannot be transferred to an adjacent precinct as the adjacent precincts
(Grapevine and Beech Glen) are senior meal sites and requiring voter transfers and polling site
changes. The only option is to transfer the Ebbs Chapel voters to the nearby Mars Hill Precinct
and utilize its polling site on Election Day.
The remaining Revere Rice Cove Precinct has only 99 voters that are eligible to vote in this
election, and had less than 10 voters cast a ballot in the last comparable second primary
election dated June 7, 2016.
Important to note is that aside from the schools and senior meal sites, Madison County Board of
Elections has extremely limited options for adequate polling sites even during the best of times,
and county entities must coordinate and share its limited facilities and meeting venues,
especially during times of crisis.
• No less important is the challenge COVID 19 presents in the county's ability to recruit and train
poll workers. Additional training will now be required for poll workers in proper sanitation and
social distancing procedures. Finding facilities and venues with enough space to train groups of
poll workers will be challenging to say the least and require multiple bookings.
The majority of Madison County poll workers is over the age of 65 and considered high risk for
complications if they contract the virus. Even though 90 percent of them currently indicate they
will be available to work during the June 23'' 2°' Primary Election, the reality remains that many
of them will choose not to serve as Election Day approaches and COVID 19 is still a threat.

The need to minimize the number of poll workers needed across the county and/or in a given
polling site at any given time is paramount to implement social distancing requirements and to
reduce the chance of transmission or contamination.
• Madison County is a poor county with very limited resources and capacity to generate income.
The response to COVID 19 is draining the county's coffer. County departments have been asked
to delay payments, put a hold on ordering supplies, and cancel travel plans, among other
directives to help extend the county's capacity to respond to the COVID 19 crisis.
• Finally, the Board of Elections reviewed data and considered the likelihood of a low voter
turnout (less than 400 Republican and Unaffiliated voters across the county in the last
comparable 2°' Primary on June 7, 2016 (See attached report.)
After much consideration and discussion of the aforementioned information and challenges, the
Board of Elections began to look closely at utilizing its 3 early one stop voting sites during this election
as a means to provide an adequate number of safe voting environments that minimize the risk of
transmission of the virus and staff them with an adequate number of trained and experienced poll
workers. It is also noteworthy to add that county level Republican Party leadership has been
consulted by Board of Election members and agreed with implementing the following plan to:
• Establish 3 strategically located, consistent voting sites across the county for both early one stop
and Election Day in-person voting that does not interfere with the critical needs of other county
services or compromises the health, safety, and wellbeing of our citizens and that provides the
greatest opportunity to provide safe, convenient in-person voting for this election. The selected
sites have been utilized successfully as municipal election and early one stop voting sites for
several years and county voters are familiar with them and their locations;
• Open the 3 voting sites for 14 days of voting including Election Day and spread out the in-person
voter traffic over the greatest amount of time thus mitigating the need for large venues on
Election Day that are now unavailable in our county due to COVID 19 issues;
• Maintain consistent early one stop voting and Election Day sites to reduce confusion regarding
the polling site locations on Election Day;
• Utilize the same trained and experienced judges and poll workers for both early one-stop voting
and Election Day, thus providing seamless experiences in all election activities and sanitation
procedures across all 3 sites and eliminating the need to recruit and train more poll workers.
The judges and poll workers have been identified, contacted, and agreed to staff the plan if
approved, contingent upon being provided proper Personal Protective Equipment [PPE) and the
implementation of proper sanitation and social distancing procedures;

• Secure and dedicate the polling sites to be used solely as polling sites across both the early one
stop and Election Day in-person voting windows, thus reducing the need to deep clean, equip,
and prepare additional COVID 19 compliant Election Day sites;
• Implement proper procedures and equipment to minimize the number of voters and poll
workers in a given site at a given time so that social distancing and sanitation requirements can
be observed. Some of the systems under consideration are barriers/shields at check-in stations,
pagers or burner phones for voters that may choose to wait in the car rather than stand in line,
floor spacers, line dividers, disposable pens for marking ballots, sanitizing surface areas before
each voter, and the use of table spacers between voters and staff;
• Provide 3 judges of election at each site on Election Day and 2 early one stop voting poll workers
at each site at all times during early voting.
• Provide sites on Election Day with a ring binder that will contain 30-up labels for the 4 assigned
precincts (separated) and one OVRD laptop that will be available for voter lookup and street
searches (if needed). Additionally, each site will have one tabulator coded to accept ballots
from all 4 of the assigned precincts;
• Notify all affected voters of the temporary precinct transfers and polling site changes for this
election through a USPS mailing alert and the local newspaper; and
• Save the county $8,650.00 (when compared with the cost of 1 early voting one stop site and 12
precincts) in much needed funds for other critical non-election related COVID 19 expenses (see
attached budget comparison worksheet).
In closing, the Board of Elections believes this plan will provide the best opportunity to provide highly
trained staff, a safe voting environment, and the greatest opportunity for in-person voting during this
election, and that it has no other viable options other than sequester buildings and/or disrupt other
critically needed county services during the COVID 19 crisis. Further, the plan will maximize the limited
resources and funding available to the county for both election and non-election related COVID 19
needs. Any consideration you give the plan is greatly appreciation. Please do not hesitate to contact
the Board of Elections if you have questions or to provide feedback.
e~
Respectfully yours,
"M,
,CERA,N~~
Director of Electio ns

EXHIBIT 20
Letter from the Director of the Jackson County

Board of Elections to Karen Brinson Bell

Injunction

,fACKSON COUNTY
BOARD OF ELECTIONS
876 SKYLAND DR, SUITE 1
SYLVA,NC28779
Pl!ONE 828-586-7538 • FAX 828-586-1951
04/29/2020
Karen Brinson
State Board of Elections Executive Director
Dear Mrs. Brinson:
The Jackson County Board of Elections is requesting to temporary transfer voterdor the
05/23/2020 2nd Primary to ensure safe practices with a sufficient number of precinct workers.
No one can predict the health environment in the next several months and each county may
have possible fluctuating conditions. The Board feels they can eliminate some of the chances of
inadequate staffing on Election Day by combining locations, even if conditions deteriorate only
days before Election Day.
The polling locations were also chosen for their open areas inside and immediately outside the
voting enclosures that will allow for appropriate social distancing while completing the voting
process.
Thank You,
Lisa Lovedahl
Director
Jackson County

EXHIBIT 21
Request by Macon County Board of Elections to

Temporarily Transfer Voters to Another Precinct

Injunction

MACON COUNTY
BOARD OF ELECTIONS
5 WEST MAIN STREET, FRANKLIN, NC 28734
PHONE: 828-349-2034 FAX: 828-349-2557
Date: April 23, 2020
ATTENTION: NCSBOE
SUBJECT: Resolution to combine the Voters from 12 Precincts {North Franklin, South Franklin, East
Franklin, lotla, Union 1 Millshoa!, Ellijay, Sugarfork, Smithbridge, Cartoogechaye,
Burningtown and Cowee) into 1 Precinct for the June 23'd 2020 2nd Primary Election due
to the COVlD-19 virus
This Resolution states that the Board Members of the Macon County Board of Elections has
urianimously voted on this day, Thursday, April 23'd, 2020 to combine North Franklin, South Frankf!n,
East Franklin, lotla, Union, Millshoal 1 Ellijay, Sugarfork, Smithbridge, Cartoogechaye, Burningtown and
Cowee Precincts, for the Second Primary Election to be held on Tuesday, June 23rd, 2020. Voters wlll
vote at the Robert Carpenter Building (the Community Building). The Community Building ls a central
location in Macon County used for the Union Precinct on Election Day in other Elections; it is also used
to hold One-Stop Early Voting prior to alt Elections. lt is located at 1288 Georgia Road, Franklin, NC
28734,
A notice will be given to the Voters in Macon County in our local newspapers and we will also be sending
a postcard by mail to all voters that are eligible to vote in the above Election.
) .
Kathy Tinsley I/
L-~ ~t/a'/::~/\4 \!lvwc; ~
//"\ Chairman
Gary Dills ~ / Vice Chairman
Jeffrey Grnette
John Vanhook Member
Lynne Garrison

Complete a separate form for each transfer polling place. _Attach a map of all precincts and mark which
precinct polling place will be open~ and which polling p/ace(s) will be transferred.
REQUEST TO TRANSFER VOTERS WITHIN COUNTY (COMPLETE TABLE BELOW)

PCTl PCT 2 PCT3
Yes D No Yes D No
[j],{e, D No DYes D No DYesDNo
,i,. G
Revised 2020.04
~ NJi!RTH CAR()UNA
~ s1:i1c1\borrdtiflHOOhim>

REQUEST TO TEMPORARILY TRANSFER VOTERS TO ANOTHER PRECINCT
2020 SECOND PRIMARY
~ 1/d 3/a-t)~()
Resolution was adopted on ----''--,,f-"--1.,..._.."---"-----
When such a resolution has been adopted by the county board of elections to I w!J.1.provide separate:
assign voters from more than one precinct to the same precinct, then the r0'AlV labels
county board of elections shall maintain separate registration and voting 0 OVRD laptop
records, .. . , so as to properly identify the precinct in which such voters reside. OOther_ __ _
Ballots will be coded by style and actual precinct will be recorded on ballots
D Ballots will be coded by precinct
The board shall give 45 days' notice thereof prior to the next primary or election
{Check to confirm all methods of notice that you will use to comply with this requirement):
~ i c e shall be given by advertisement in a newspaper having general circulation in the county;
~osting a copy of the resolution at the courthouse door and at the office of the county board of elections;
lB""~ by mailing a copy of the resolution to the chairman of every political party in the county.
~Notice will additionally be made on a radio or television station or both, but such notice shall be in addition
tot ewspaper and other required notice.
No later than 30 days prior to the primary or election, the county board of elections shall mail a notice of
precinct change to each registered voter who as a result of the change will be assigned to a different voting
place.
I have provided the SBOE with a copy of the board resolution/agreement. Other supporting information is
at~ed describing why this request is being made.
~I have entered the contest AND all candidates in Election Setup.
~
County •
s;gnatu"LJ#~~/
Director's
Date
APPROVED BY
~ ;{d,f
::::CTOR
ren Brinson ~
Revised 2020.04

Macon County Board of Elections
5 WEST MAIN STREET, FRANKLIN, NC 28734
PHONE: 828-349-2034 FAX: 828-349-2557
EMAIL: mthibault@maconnc.org
May 8, 2020
Ms. Karen Brinson Bell, Executive Director
North Carolina State Board of Elections
430 Salisbury Street - Raleigh, North Carolina 27601
REQUEST FOR CONSOLIDATION(S) AND COLLABORATION OF AVAILABLE RESOURCES IN

RESPONSE TO THE COVID 19 PANDEMIC
Dear Executive Director Brinson Bell:
Macon County Board of Elections Board Members (approved April 23, 2020), Macon County
Manager, Derek Roland, and Board of Elections staff are in agreement that the COVID 19
pandemic causes an emergency plan of action to be initiated for the upcoming Second Primary
Election. Our ultimate goal is to ensure voter validation, maintain safe voting environments,
and create a cost-effective managenient process that results in a successful election experience
for everyone. We have assessed the data and voting history which is based on the
deliberations described below.
• Macon County plans to combine our original fifteen (15) precincts into three (3) for
voters on Election Day, June 23, 2020. Many of the current precincts are located in
community centers or public buildings of which are dosed due to COVlD 19. In addition
the majority of these smaller community sites have less than 200 square feet of
designated voter space, which does not allow standard social distancing requirements.
• North Franklin Precinct- is located in the downstairs of the Franklin Town Hall building
in a room less than 200 square feet of space, not enough space for the social distancing.

4 of the poll workers out of the 5 that we use on Election Day are in the high risk
category and in good contentious we could not allow them to work.
• South Franklin Precinct- is located in a small room off of the entrance of the Macon County
library; it is Jess than 200 square feet of space, not enough space for the social distancing. 3 of
the poll worker's are in the high risk category.
• East Franklin Precinct- is located in the Environmental building in Franklin and the building has
less than 200 square feet of space, not enough space for social distancing. 2 of the poll workers
are in the high risk category.
• lotla Precinct- is located in a small room in the Macon County Airport and has less than 200
square feet of space. 3 of the poll workers are in the high risk category. 2 are willing to work on
Election Day if it is held in a larger location.
• Millshoal Precinct- is located in a Community Center in Franklin. The facility is over 100 years
old. It has less than 200 square feet of space, not enough space for social distancing. All 5 of
the poll workers we use on Election Day is this precinct are over the age of 75 and are in the
high risk category.
• Ellijay Precinct- is located in a small room above the Cullasaja Fire department. The room has
less than 200 square feet of space, not enough space for social distancing. 3 of the poll workers
are over the age of75 and are in the high risk category.
• Sugarfork Precinct-is located in the old Pine-Grove School house. This building is over
100 years old and has less than 100 square feet of space, not enough for social
distancing. 2 of the poll workers are over the age of 75.
• Smithbridge Precinct- is located in a room above the Otto Fire department; this room is
closed due to COVID-19 concerns.
• Cartoogechaye Precinct- is located in a room off of the Macon Fire and Rescue; this room is
closed due to COVID-19 concerns.

• Burningtown Precinctw is located in an old Fire department; this room is dosed due to COVID-
19 concerns.
• Cowee Precinct· is located in a room in the old Cowee School. This room is less than 200
square feet of space, not enough space for social distancing. 4 ofthe 5 poll workers are over the
age of75 and are at high risk.
• Our plan is to combine North Franklin, South Franklin, and East Franklin, lotla, Union,
Millshoal, Ellijay, Sugarfork, Smithbridge, Cartoogechaye, Burningtown and Cowee
communities and set up a central voting location in the Macon County Robert Carpenter
Community Center located at 1288 Georgia Road, Franklin, NC. This location is now used
for Macon County as an early voting site and is used on Election Day for the Union
precinct. The site is approximately 2500 square feet. It has recently been renovated
and meets the social distancing requirements, accommodates driVe·in voting as needed,
and ensures a manageable and _safe election operation during this unprecedented
COVJD 19 pandemic.
• We will combine the Highlands and Flats precincts based on their geographic proximity
to vote at the Highlands Civic Center located at 600 N. 4th Street, Highlands, NC
28741. These two precincts are approximately nine minutes apart. Based on the 2016
primary voter statistics, these two precincts made up 4.'9% of votes. In the 2016 second
Primary the Flats precinct had 34 ballots cast on Election Day. The Civic Center site has
1500 square feet which is ample room for social distancing requirements.
• The Nantahala precinct will remain separate as that area is remote and only 565 voters
are located in the Nantahala community. The 2016 primary voter statistics shows 3.9%
of votes came from Nantahala.
• The Macon County Board of Elections recent research reflects out of our 103 poll
workers, 73 are willing to serve only if social distancing protocols and proper PPE
supplies are available. The remaining 30 poll workers fall into the high~risk category for
virus contraction, and by combining precincts we would have ample workers to cover all

voting sites. These poll workers are already trained in election procedures and would
only require minimal COVID 19 sanitation procedure training.
• Operating fifteen (15) precincts creates a burdensome budget issue that affects both the
Macon County Board of Elections finances and the county budget as well. Currently our
BOE budget that expires June 30, 2020, is at 85-100% of its maximum spending costs
due to concurrent expenses as a result of the COVID 19 pandemic. In addition we had
the expense of the postponement of the Second Primary and cost of ballots that were
printed, only to be discarded. Combining the precincts will maximize overall voting
operations and eliminate budget shortfalls.
• Macon County consists of a high percentage of retirees who are abiding by the
Governor's stay-at-home orders and have not left their homes since the COVID 19
pandemic began. We have had an increase in phone calls in the past few weeks
requesting Absentee by Mail ballots. I predict the majority of our voters will use the
One-Stop Early Voting or Absentee by mail for this particular election due to the
pandemic risks.
• If our plan is approved our staff on Election Day will have separate area books, labels,
and machines (MlOO) for each of the precincts in the two temporary precincts.
• Voters will be notified of precinct changes in the local newspaper's and by a mass post
card mailing. Our BOE website and social media announcements-will be kept up to date
so voters can understand the changes in effect and stay informed of voting details and
announcements.
Combining the precincts is a logical solution for several reasons:
1) Combining precincts will minimize COVID 19 exposure and ensure maximum safety
of voters and workers;
2) The plan will utilize facility locations that meet safety standards and social
distancing requirements;

3) All parties will combine resources and minimize financial burdens to the Board of
Elections and Macon County;
4) The proposed plan will protect poll workers and cover voting sites with qualified
workers who only need minimal training within an urgent timeline;
5) All parties agree that this plan meets the NC State Board of Elections Emergency
Executive Order requirements.
Please feel free to contact me if you need further justification. I look forward to your approval
of our plan to temporarily transfer voters and ensure a safe and efficient election during the
June 23, 2020 Second Republican Primary in Macon County.
As we follow social distancing practices during this extraordinary situation across our state and
our nation, may we all stay safe and face the future with valuable and historical lessons
learned.
Sincerely,
Melanie Thibault
Macon County Board of Elections Director

EXHIBIT 22
State Board, DMV Partner to Expand Online Voter

Registration Service (Mar. 30, 2020),
published by the
N.C. State Board of Elections

Injunction

Press Releases
N�RTH CAROLINA
Release: IMMEDIATE
Date: 3/30/2020
State Board, DMV Partner to Expand Online Voter

Registration Service
Raleigh, N.C. - The State Board of Elections and N.C. Division of Motor Vehicles have launched a service to
allow NCDMV customers to apply to register to vote or update existing voter registration information online.
This is a standalone service that does not require the user to complete a NCDMV transaction, such as a license
renewal or duplicate, at the same time.
The free service comes at a time when many county boards of elections have limited access or are closed to the
public, and while residents are being asked to stay home because of the spread of COVID-19.
Existing NCDMV customers with a North Carolina driver's license or NCDMV-issued ID may apply to register to
vote or update voter address or political party information through the NCDMV Voter Registration web 1;2ag.§.... The
application currently does not allow voters to change their name.
All voter registration services are free.
"We're excited for this new service. It's another way we can help North Carolina voters while we practice
social distancing," said Karen Brinson Bell, executive director of the State Board of Elections.
"The NCDMV already offered online voter registration services to customers completing transactions,"
said NCDMV Commissioner Torre Jessup. "It made sense to collaborate with the State Board of Elections to
now offer that same process without requiring a transaction so we could provide a valuable and
convenient service for North Carolinians."
https://www.ncsbe.gov/Press-Releases?udt_2226_param_detail=2195 2/3
Press Releases
Individuals using the online process will authorize the signature NCDMV has on file for them to be affixed to their
voter registration application.
NCDMV's vendor, Paylt, is hosting the service. A link to the voter registration service also is available through the
State Board of Elections' website here: htti;is://www.ncsbe.gov/Voters/Registering-to-Vote .
County boards of elections will continue to confirm the eligibility of online registrants through standard
procedures, including verification mailings.
Eligible North Carolina residents who are not NCDMV customers must still fill out a paper voter registration form
and return it to their county board of elections to register to vote or make changes to their voter registration.
To check your N.C. voter registration, go here: htti;is://vt.ncsbe.gov/RegLkuP-L_.
###
Media Kits
Topic Link to Portal
Congressional District 9 Hearing
Link
Copyright (c) 2020 NCSBE I Privacy Statement I Terms Of Use
https://www.ncsbe.gov/Press-Releases?udt_2226_param_detail=2195 3/3
EXHIBIT 23
North Carolina's COVID-19 Response for

Individuals and Families, N.C. Dep't of Health and
Human Services

Injunction

Select Language T
NCDHHS COVID-19
Individuals and Families
Stay Home, Save Lives

North Carolina has moved into a Safer At Home Phase 2
(https://www.nc.gov/covid-19/staying-ahead-curve). as outlined in Executive Order 141
(https://files.nc.gov/govemor/documents/files/E0141-Phase-2.pdf). Phase 2 Lifts the Stay At Home order
moving into a Safer At Home recommendation. especially for people at high risk
{/information/individuals-families-communities/individuals-higher-risk). for serious
illness. Teleworking is also urged when possible. Read the FAQ�
(https://files.nc.gov/govemor/documents/files/Phase-2-FAQ.pdf) for more information.
View What Phase 2 Means for NC (https://files.nc.gov/covid/documents/Phases

List.pdf)
Staying healthy
There are some common sense measures
(https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html?
CDC_ AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-
ncov%2Fprepare%2Fprevention.html)
everyone can take to protect themselves and others from the spread of respiratory illnesses
Like COVID-19.
• Avoid close contact with people who are sick and put distance between yourself and
other people.
• SUP-P-Orting Individuals with Autism Through Uncertain Times
(https://afirm.fpg.unc.edu/supporting-individuals-autism-through-uncertain-times) is a free UNC
toolkit available in multiple Languages that includes resources
(https://afirm.fpg.unc.edu/sites/afirm.fpg.unc.edu/files/covid
resources/Supporting%20Individuals%20with%20Autism%20through%20Uncertian%20Times%20Full%20l
for families and caregivers supporting individuals, including young children, with autism
spectrum disorder.
Coping with Stress
• HeLP-ing Children CoP-e with Changes Resulting from COVID-19

(https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and
crisis/health-crisis-resources/helping-children-cope-with-changes-resulting-from-covid-19)
from the National Association of School Psychologists provides tips on helping families
adjust to a "new normal."
• The Parent/Caregiver Guide to HeLP-ing Families CoP-e with the Coronavirus Disease
(https://www.nctsn.org/sites/default/files/resources/fact-sheet/outbreak_factsheet_1.pdt) from the
National Child Traumatic Stress Network includes age-appropriate tips for helping
children cope with stress and uncertainty.
• TiP-S for Parents during Times of Trauma

(https://parentsasteachers.org/news/2020/4/1/tips-for-parents-during-times-of-trauma) , available from
Parents As Teachers, outlines ways caregivers can maintain routines and respond to
children's needs. Parents and caregivers can also search
(https://parentsasteachers.org/program-locator-1) for a Parents As Teachers program in their area.
Parenting & Caregiving Courses, Training, & Online Communities
• American Academy of Pediatrics (https://www.healthychildren.org/English/Pages/default.aspx) has

information on children and coronavirus and helpful parenting tips.
• TriP-Le P Online
(https://www.triplep-parenting.com/nc-en/fmd-help/triple-p-online/toddlers-to-tweens/?
itb=d9a5cf487c8317dba2cc8fafcf8al 8a8&gclid=CjwKCAjwhODOBRAQEiwAK7JHmFQLtNt33zO_ffnaO�
is a free parenting course that provides flexible, practical ways to develop skills,
strategies and confidence to handle any parenting situation. The course now includes a
Parenting During COVID-19 module and tip sheets. Resources are available in English and
Spanish.
• Prevent Child Abuse NC provides resources (https://preventchildabuse.org/coronavirus-resources/)

for staying connected, remaining active and engaged as a family, and managing stress and
anxiety.


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IN THE UNITED STATES DISTRICT COURT

FOR THE MIDDLE DISTRICT OF NORTH CAROLINA

DEMOCRACY NORTH CAROLINA, THE

Case 1:20-cv-00457-WO-JLW Document 7 Filed 06/04/20 Page 1 of 10

7.3(d) for leave of the Court to exceed the word limits in

the local rules and extend the permitted length of Plaintiffs’

memorandum in support of their motion for preliminary

injunction, and of Defendants’ response in opposition to that

motion, to 15,000 words, and Plaintiffs’ reply memorandum to

7,500 words. In support of this motion, the parties state as

1. Plaintiffs filed this suit on May 22, 2020, raising

statutory and constitutional challenges to the

enforcement of provisions of North Carolina’s Election

Code, Chapter 163 of the North Carolina General

Statutes, in the context of the COVID-19 pandemic.

Plaintiffs allege in their complaint that restrictions

on voter registration, mail-in absentee ballots, in-

person early voting, and Election Day administration in

the context of the COVID-19 pandemic unduly burden

Plaintiffs’ right to vote in violation of the First and

Fourteenth Amendments, Title II of the Americans with

Disabilities Act, 42 U.S.C. §§ 12131, et seq., and

Section 504 of the Rehabilitation Act, 29 U.S.C. § 794.

Case 1:20-cv-00457-WO-JLW Document 7 Filed 06/04/20 Page 2 of 10

Defendants’ administration and enforcement of N.C. Gen.

Stat. Gen. Stat. §§ 163-82.6(d) and 163-82.20(g), (h)

(imposing 25-day voter registration deadlines); N.C.

Gen. Stat. § 163-230.2(c), (e), and (e1) (imposing

restrictions on absentee ballot request assistance);

N.C. Gen. Stat. § 163-231(a) (imposing the double-

witness certification requirement); N.C. Gen. Stat. §

163-227.6(c) (requiring uniform hours in precincts);

and N.C. Gen. Stat. § 163-42(b) (requiring a majority

of poll workers to come from the precinct in which they

serve) (collectively, the “Challenged Provisions”), and

the Defendants’ failure to expand voter registration

via online portals available through DHHS services,

failure to establish contactless drop boxes for

absentee ballots, and to establish mechanisms for

requesting absentee ballots by phone, email, and

online, failure to establish mechanisms to cure

deficient absentee ballot requests and absentee

ballots, failure to allow for submission of Federal

Write-in Absentee Ballots (“FWAB”) from domestic

civilian voters, failure to provide Personal Protective

Case 1:20-cv-00457-WO-JLW Document 7 Filed 06/04/20 Page 3 of 10

in-person voting, and failure to establish a more

accessible, centralized way in which voters and

advocates can monitor precinct consolidation (and thus

advocate against harmful precinct consolidations), in

the context of the pandemic, taken individually or in

combination, violate the First and Fourteenth

Amendments to the U.S. Constitution, as enforced

through 42 U.S.C. § 1983.

3. In Count Two, Plaintiffs allege that Defendants’

administration and enforcement of N.C. Gen. Stat. § 163-

230.2(c), (e), and (e1) (imposing restrictions on

absentee ballot request assistance), N.C. Gen. Stat. §

163-231(a) (imposing the double-witness certification

requirement), and failure to expand voter registration

via online portals available through DHHS services,

establish contactless drop boxes for absentee ballots,

establish mechanisms for requesting absentee ballots by

phone, email, and online, in the context of the pandemic