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A piece of paper or multiple card stock on which voter selections are either hand marked or printed, depending on the particular voting system.

Paper Ballots in the States: Paper ballots are the most common ballot format used in the states today. In the 2020 general election, the only states to not use hand-marked paper ballots include Arkansas, Delaware, Georgia, Louisiana and South Carolina. Although most states still primarily use paper ballots, all states offer Ballot Marking Devices or Direct Recording Electronic voting systems for voters with disabilities in accordance with the Help America Vote Act of 2002.

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