Application for Official Absentee by Mail Ballot

A completed application must be downloaded, signed and returned to us to receive an absentee ballot.

Election Date:

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:

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.

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.

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:

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.

Text to Identify Refresh CAPTCHA
Cancel