Application for Absentee Ballot

Ballots may be requested up to 180 days prior to the election. I hereby request a ballot be issued to me for the following election:

March 24, 2020 - Presidential Preference Primary

Select one ballot

Democratic

Republican

For Elderly and Disabled Voters ONLY:

You may choose to complete one application and receive a ballot for the Presidential Preference Primary, General Primary, General Primary Runoff (if any), General Election, and General Election Runoff (if any) by checking one of the following boxes.

I am 65 years of age or older.

I have a physical disability.

May 19, 2020 - General Primary Election

Select one ballot

Democratic

Republican

For Elderly and Disabled Voters ONLY:

You may choose to complete one application and receive a ballot for the Presidential Preference Primary, General Primary, General Primary Runoff (if any), General Election, and General Election Runoff (if any) by checking one of the following boxes.

I am 65 years of age or older.

I have a physical disability.

May 19, 2020 - General Nonpartisan Election

For Elderly and Disabled Voters ONLY:

You may choose to complete one application and receive a ballot for the Presidential Preference Primary, General Primary, General Primary Runoff (if any), General Election, and General Election Runoff (if any) by checking one of the following boxes.

I am 65 years of age or older.

I have a physical disability.

July 21, 2020 - General Primary Election Runoff

For Elderly and Disabled Voters ONLY:

You may choose to complete one application and receive a ballot for the Presidential Preference Primary, General Primary, General Primary Runoff (if any), General Election, and General Election Runoff (if any) by checking one of the following boxes.

I am 65 years of age or older.

I have a physical disability.

July 21, 2020 - General Nonpartisan Election Runoff

For Elderly and Disabled Voters ONLY:

You may choose to complete one application and receive a ballot for the Presidential Preference Primary, General Primary, General Primary Runoff (if any), General Election, and General Election Runoff (if any) by checking one of the following boxes.

I am 65 years of age or older.

I have a physical disability.

Name as registered Required

Date of birth Required

GA DL or ID# (optional)

Last four digits of SSN(optional)

Street # and name Required

Apt / Suite / Other

City Required

State

Zip Required

If this name and/or address doesn't match the information on file, please update my record.

Street # and name

Apt / Suite / Other

City

State

Zip

Are you requesting a ballot for another voter?

You may apply on behalf of another person only in the following circumstances: In the case of a voter temporarily residing out of the county or a physically disabled voter residing within the county, application may be made by mother, father, grandparent, brother, sister, aunt, uncle, spouse, son, daughter, niece, nephew, grandchild, son-in-law, daughter-in-law, mother-in-law, father-in-law, brother-in-law, sister-in-law of the age of 18 or over.

No

Yes

Text Verification Required

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Application for Absentee Ballot

Application for Official Absentee by Mail Ballot

Election Date:

Voter Information:

Residential Address as registered (no P.O. Box)

Mail ballot to my temporary out-of-county address (or alternate address for physically disabled voter):

Signature Information: