Online Absentee Ballot Request Form

Online Absentee Ballot Request Form
Please be advised that Absentee Ballot Requests expire at the end of the calendar year and are NOT valid for elections after December 31 of the year the request was made.

Please fill out all required fields in the form (marked with an *). Failing to do so will prevent delivery of your absentee ballot.


Last Name*                          First Name*

            

Date of Birth*                       Last Four (4) Digits of Social Security Number*
           
MM/DD/YYYY

Residential Address*


Mail Ballot to*


To change your Party Affiliation: Present a valid photo ID at our office or at the polls on Election Day.

Daytime Phone Number*


Email Address


Please check any of the following boxes if they apply:
Domestic Military
Overseas Military
Overseas Citizen

Please indicate which election(s) you wish to receive an absentee ballot for: (Required)*
 General Only

Questions? Call 307-872-3733