Vote Absentee!
September 24th, 2008
 If you are not changing your voter registration to the county you currently reside in, use the following form to request an absentee ballot. It must be returned to the election commission in your county.
Request for an Absentee Ballot
Complete the following and mail, fax, or hand deliver to your election commission office.
1. Print name__________________________________________________________
2. Address on voter registration ___________________________________________
___________________________________________________________________
3. Mail my absentee ballot to the following address (only if the voter will be out of the
county of registration for the entire voting period)
___________________________________________________________________
___________________________________________________________________
4. Social Security Number _______________ 5. Date of birth _________________
6. Telephone number ___________________
7. My reason for voting absentee (select one)
ô€€€ Age 65 or over
ô€€€ Outside county during the entire voting period
ô€€€ Military or living overseas
ô€€€ Full-time student outside county of registration
ô€€€ Medically unable to vote in person
ô€€€ Residence in a licensed facility providing permanent care outside county
ô€€€ Jury duty in a Federal or state court
ô€€€ Physical disability and an inaccessible polling place
ô€€€ Hospitalization
ô€€€ Caretaker of a person who is hospitalized, ill, or disabled
ô€€€ Candidate for office in the election
ô€€€ Election official/worker
ô€€€ Religious observance during the entire voting period
ô€€€ Commercial driver out of the county during entire voting period
I wish to vote in the State General Election on Tuesday, November 4, 2008.
Signature of voter ___________________________
Important note to voter: This absentee ballot request is only a request. To have your
vote count, you must submit this request, receive your absentee ballot, mark it, and
mail it to your local election commission. Once your election commission issues
your absentee by-mail ballot, you can ONLY vote by mail.
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