FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW...
Transcript of FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW...
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AFSCME1625 L Street, NWWashington, DC 20036
AFSCME2001
Sign up to Vote by Mail today. Application attached.
W H E N
AFSCMEMEMBERS VOTEOUR COMMUNITIES ARE STRONGEST
BALLOT-BY-MAIL & PERMANENT EARLY VOTING LIST REQUEST FORMFORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y LA LISTA PERMANENTE DE VOTACIÓN TEMPRANA
Use this form: (1) to request a ballot-by-mail for the Primary and/or General Election; or (2) to be added to the Permanent Early Voting List (PEVL) and automatically receive a ballot-by-mail for every election. Complete, sign, and return this form by mail, fax, or email to your County Recorder (contact information: azsos.gov/county-election-info). Your request must be received by 5:00 p.m. on the 11th day before the election to receive a ballot-by-mail for that election.
Use este formulario: (1) para solicitar una boleta-por-correo; o (2) para ser incluido en la Lista Permanente de Votación Temprana y recibir automáticamente una boleta-por-correo para cada elección. Llene, firme, y devuelva por correo, email, o fax este formulario al Registrador de su Condado (datos de contacto: azsos.gov/county-election-info). Para recibir una boleta-por-correo para una election, el Registrador de su Condado debe recibir su solicitud antes de las 5:00 p.m., 11 dias antes del dia de la elección.
* Starred boxes are required. / Cajas con un asterisco son obligatorios.
First and Last Name / Nombre y Apellido
Provide your place of birth, driver’s license #, or last 4 digits of SSN# Proporcione su lugar de nacimiento, # de licencia, o los cuatros dígitos pasados de su # de seguridad social
Residence Address / Domicilio Residencial
County of Residence / Condado de Domicilio
Questions? / ¿Preguntas? 1-877-THE-VOTE or [email protected]
Mailing Address (if different from residence address) / Dirección Postal (si es diferente a su domicilio)
Date / Fecha Phone Number / Número de Teléfono
Date of Birth / Fecha de Nacimiento Email Address / Correo Electrónico
Check this box if you request the County Recorder change your residence and mailing address on your registration record to the ones listed above. / Marque esta casilla si solicita al Registrador del Condado que cambie su domicilio y dirección postal en su registro electoral a los que están enumerados arriba.
Former address / Dirección anterior
Check this box if you request the County Recorder change your name on your registration record to the one listed above. / Marque esta casilla si usted solicita que el Registrador de su Condado cambie su nombre en su registro electoral por el que aparece arriba.
Former name / Nombre anterior
Primary Election Ballot Selection: Select a party or nonpartisan ballot for the Primary Election. This will not change your voter registration to this political party affiliation. / Selección de boleta para la Elección Primaria: Seleccione una boleta de un partido politico o una boleta no partidista para la Elección Primaria. Esta selección no cambiara su registro de votante a esta afiliación del partido politico.
Green (Pima County Voters Only) Verde (Sólamente para los Votantes del Condado de Pima)
Democratic Demócrata
Municipal-Only: NonpartisanSólo Municipal: No partidista
Republican Republicano
I am requesting a ballot for: / Estoy solicitando una boleta para:*1
2
3
*5
*6
7
8
*9
*11
12
*13
10
4
Every Election. I authorize the County Recorder to include my name on the PEVL and automatically send me a ballot-by-mail for each election I am eligible for. / Todas las Elecciones. Autorizo al Registrador del Condado a incluir mi nombre en la Lista Permanente de Votación Temprana y a enviarme automáticamente una boleta-por-correo para cada elección para la cual yo sea elegible.
Primary & General ElectionAmbas Eleccciones: Primaria y General
Primary Election OnlySólamente para la Elección Primaria
General Election Only Sólamente para la Elección General
By signing below, I swear or affirm that I am a registered voter in my county of residence and that the above information is true and correct. / Al firmar abajo, yo juro o afirmo que soy un votante registrado en mi condado de residencia y que la información anterior es verdadera y corecta.
X
Independent Voters Only
Sólamente para los Votantes Independientes
To update your registration
Para actualizar su registro
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FIRST-CLASS MAILU.S. POSTAGE
PAIDRC
IMB-POSTAGE
Fold here and tape with two pieces on the top edge near the left and right hand edges.
This November public service workers must stand together, and in 2020 you can vote by mail safely and securely from the comfort of your own home. Voting by mail will help make sure all our voices are heard in this election.
If you haven’t already requested a ballot, fill out the attached form.
Clip out the form, fold it, and mail to your local election office (the postage is prepaid). Make sure to return your application promptly.
Once you receive your ballot, mark your vote, and mail back in immediately.
AFSCME URGES YOU TO
VOTE BY MAILSO ALL OUR VOICES ARE HEARD
VISIT AFSCME.ORG/VBM TO UTILIZE OUR SECURE VOTE BY MAIL TOOL.
VOTING BY MAIL IS: SAFESECUREAND EFFECTIVE
1
2
3
Return Address Line 1Return Address Line 2Return Address Line 3
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AFSCME1625 L Street, NWWashington, DC 20036
AFSCME2001
Sign up to Vote by Mail today. Application attached.
W H E N
AFSCMEMEMBERS VOTEOUR COMMUNITIES ARE STRONGEST
First Name: Middle Name/Initial: Last Name:
Date of Birth: / / (required)
FLORIDA RESIDENCE ADDRESS (REQUIRED)Street Address: Apt/Unit/Lot:
City: State: Zip Code:
PERMANENT MAILING ADDRESS (IF DIFFERENT FROM RESIDENCE ADDRESS)Street Address: Apt/Unit/Lot:
City: State: Zip Code:
BALLOT REQUEST IS FOR (SELECT CHOICE THAT APPLIES)
All elections for which I am eligible to vote through the calendar year of the second regularly scheduled general election (2022).
Specific Election (current year):
ALTERNATIVE MAILING ADDRESS (IF DIFFERENT FROM RESIDENTIAL/MAILING ADDRESS)Note: If "All Elections" was selected above, all ballots will be mailed to the alternative mailing address unless otherwise specified below.
Specific Election:
Alt. Mailing Address: Apt/Unit/Lot:
City: State/Country: Zip Code:
REQUEST BY IMMEDIATE FAMILY MEMBER OR LEGAL GUARDIAN FOR VOTERA voter can designate an immediate family member (the designee's spouse or the parent, child, grandparent, or sibling of the designee or of the designee's spouse) or the voter's legal guardian to request the ballot on their behalf. The following additional information is required for the request:
I have been instructed by the voter to make this request.
Requester's Name: Relationship to the Voter (Required):
Requester's Complete Address:
Requester's Driver's License Number (if available)
SIGNATURE REQUIRED:
VOTE-BY-MAIL BALLOT REQUEST FORM
![Page 4: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/4.jpg)
FIRST-CLASS MAILU.S. POSTAGE
PAIDRC
IMB-POSTAGE
Fold here and tape with two pieces on the top edge near the left and right hand edges.
This November public service workers must stand together, and in 2020 you can vote by mail safely and securely from the comfort of your own home. Voting by mail will help make sure all our voices are heard in this election.
If you haven’t already requested a ballot, fill out the attached form.
Clip out the form, fold it, and mail to your local election office (the postage is prepaid). Make sure to return your application promptly.
Once you receive your ballot, mark your vote, and mail back in immediately.
AFSCME URGES YOU TO
VOTE BY MAILSO ALL OUR VOICES ARE HEARD
VISIT AFSCME.ORG/VBM TO UTILIZE OUR SECURE VOTE BY MAIL TOOL.
VOTING BY MAIL IS: SAFESECUREAND EFFECTIVE
1
2
3
Return Address Line 1Return Address Line 2Return Address Line 3
![Page 5: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/5.jpg)
AFSCME1625 L Street, NWWashington, DC 20036
AFSCME2001
Sign up to Vote by Mail today. Application attached.
W H E N
AFSCMEMEMBERS VOTEOUR COMMUNITIES ARE STRONGEST
Iowa Driver’s License or Non-Operator ID Number: OR
FOR OFFICE USE ONLY
Y��� N��� ��� D��� �� B����
Middle
Suffix
ID N�����
Y��� I��� R���������� A������ You must be registered to vote in the county to receive an absentee ballot. If you are registered to vote in the county, this form will be used to update
your voter registration if the information provided on this form is different than the information on your registration record.
Home Street Address (include apt, lot, etc. if applicable)
City Zip County
W���� Y��� A������� B����� S����� B� M����� If different than above
Mailing Address/P.O. Box
Phone Email
General Primary City/School Special: OR
DO NOT ADD THIS INFORMATION TO MY VOTER RECORD
Elec�on Date:
Check one poli�cal party Democra�c Republican
R�������� A�������� Powers of a�orney do not have legal authority to request an absentee ballot on behalf of another.
I swear or affirm that I am the person named above and I am a registered voter or I am entitled to register at the address listed on this form. I am eligible to receive and vote an absentee ballot for the election indicated above.
Signature: X Date
STATE OF IOWA OFFICIAL ABSENTEE BALLOT REQUEST FORM
City State Zip
Country (other than USA)
CCoommpplleettee oonnee
Date of Birth (month, day, year)
First
Last
Voters who do not appear in the Iowa Dept. of Transporta�on’s Driver’s License or Non-Operator ID files are mailed an Iowa Voter Iden�fica�on Card at the �me of registra�on. Any voter may request a Voter Iden�fica�on Card.
/ /
/ /
C������ I��� Important
P������ E������� O���
E������� D��� �� T���Choose only one elec�on
Revised July 2020
Four-digit Voter PIN (found only on Voter Iden�fica�on Card):
ABSENTEE BALLOT REQUEST FORM INSTRUCTIONSA registered voter may make written application to their County Auditor for an absentee ballot. A written application for a mailed absentee ballot must be received by the voter's County Auditor no later than 5:00 p.m. 10 days before a General Election or 11 days before any other election.
In order to receive an absentee ballot, a registered voter MUST provide the following necessary information:
1. Name2. Date of birth3. Iowa residential address4. Voter Verification Number (ID Number)
- Iowa Driver's License or Non-Operator ID Number OR- Four digit Voter PIN located on the voter's Iowa Voter ID Card- Any voter may request an Iowa Voter ID Card by contacting their County
Auditor's Office5. The name OR date of the election for which you are requesting an absentee ballot6. Party affiliation - only required for Primary Elections, which are held in even numbered
years7. Signature
All voters are encouraged to provide their phone number and/or email address in the event their County Auditor needs to confirm any information on the request form.
If you have questions about absentee voting, please contact your County Auditor.
![Page 6: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/6.jpg)
FIRST-CLASS MAILU.S. POSTAGE
PAIDRC
IMB-POSTAGE
Fold here and tape with two pieces on the top edge near the left and right hand edges.
This November public service workers must stand together, and in 2020 you can vote by mail safely and securely from the comfort of your own home. Voting by mail will help make sure all our voices are heard in this election.
If you haven’t already requested a ballot, fill out the attached form.
Clip out the form, fold it, and mail to your local election office (the postage is prepaid). Make sure to return your application promptly.
Once you receive your ballot, mark your vote, and mail back in immediately.
AFSCME URGES YOU TO
VOTE BY MAILSO ALL OUR VOICES ARE HEARD
VISIT AFSCME.ORG/VBM TO UTILIZE OUR SECURE VOTE BY MAIL TOOL.
VOTING BY MAIL IS: SAFESECUREAND EFFECTIVE
1
2
3
Return Address Line 1Return Address Line 2Return Address Line 3
![Page 7: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/7.jpg)
AFSCME1625 L Street, NWWashington, DC 20036
AFSCME2001
Sign up to Vote by Mail today. Application attached.
W H E N
AFSCMEMEMBERS VOTEOUR COMMUNITIES ARE STRONGEST
2020 Michigan Absent Voter Ballot Application
First Name M.I. Last Name County ❑City❑Township
Street Address Jurisdiction
MI City Zip Year of Birth
( ) Email Address Phone #
Enter your information as it appears on your voter registration. Your email address and phone number help your clerk contact you if there is a problem with your application or ballot. They are used only for election purposes and providing them is optional.
Select election(s) to receive ballot (required):NNoovveemmbbeerr 33, 2020 General Election AAuugguusstt 44, 2020 Primary
Both 22002200 Elections
Future Elections: Complete to join permanent list
I want to vote absentee in all future elections. Automatically send me an application for every election.
I certify that I am a United States citizen and a qualified and registered elector of the Michigan city or township listed above, and I apply for an official ballot, to be voted by me in the election(s) checked above, and the statements in this application are true.
X / / Voter’s Signature (Voter must sign - power of attorney is not acceptable) DateWARNING: You must be a United States citizen to vote. If you are not a United States citizen, you will not be issued an absent voter ballot. A person making a false statement in this absent voter ballot application is guilty of a misdemeanor. It is a violation of Michigan election law for a person other than those listed in the instructions to return, offer to return, agree to return, or solicit to return your absent voter ballot application to the clerk. An assistant authorized by the clerk who receives absent voter ballot applications at a location other than the clerk’s office must have credentials signed by the clerk. Ask to see his or her credentials before entrusting your application with a person claiming to have the clerk’s authorization to return your application.
Want your ballot mailed to different address than you wrote above? [USPS won’t forward it] Aug 4 Primary Date leaving for this address:
/ / Date of return:
/ /
Nov 3 General Date leaving for this address:
/ / Date of return:
/ /
Street Address Street Address
City State Zip City State Zip
Return this to your city/township clerk. Find their contact info at Michigan.gov/Vote.
Complete only if helping a voter return application
Certificate of Authorized Registered Elector Assisting in Returning Application: I certify that my name is _________________________________________, date of birth is ____/____/____ and address is _________________________________________________________; that I am delivering the absent voter ballot application of _______________________________________at his or her request; I did not solicit or request to return the application or make any markings on or alter it; I did not influence the applicant; I understand that a false statement in this certificate is a violation of Michigan election law.X_______________________________________ ____/____/____
Signature of person assisting the voter Date
S E E O T H E R S I D E F O R M O R E I N S T R U C T I O N S
Complete
Sign
Other
Check
Return
Check
5
4
3
1
2
Clerk’s Use Only Primary General
Wd/Pct Mailed / / Returned / / Mailed / / Returned / /
Filed / / Ballot No: Clerk Ballot No: Clerk
![Page 8: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/8.jpg)
FIRST-CLASS MAILU.S. POSTAGE
PAIDRC
IMB-POSTAGE
Fold here and tape with two pieces on the top edge near the left and right hand edges.
This November public service workers must stand together, and in 2020 you can vote by mail safely and securely from the comfort of your own home. Voting by mail will help make sure all our voices are heard in this election.
If you haven’t already requested a ballot, fill out the attached form.
Clip out the form, fold it, and mail to your local election office (the postage is prepaid). Find your clerk's address at mvic.sos.state.mi.us/clerk
Once you receive your ballot, mark your vote, and mail back in immediately.
AFSCME URGES YOU TO
VOTE BY MAILSO ALL OUR VOICES ARE HEARD
VISIT AFSCME.ORG/VBM TO UTILIZE OUR SECURE VOTE BY MAIL TOOL.
VOTING BY MAIL IS: SAFESECUREAND EFFECTIVE
1
2
3
Clerk: Elections
![Page 9: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/9.jpg)
AFSCME1625 L Street, NWWashington, DC 20036
AFSCME2001
Sign up to Vote by Mail today. Application attached.
W H E N
AFSCMEMEMBERS VOTEOUR COMMUNITIES ARE STRONGEST
2020 Minnesota Absentee Ballot Application Apply online at https://www.mnvotes.org ORComplete lines 1 through 7 below. Please print clearly. Return this application as soon as possible. Ballots must be returned by election day to be counted.Important: Active duty military and overseas voters should not use this application. See the other side for more information.
1. absentee ballots requested for the following election(s) (if no election is marked, a ballot will be mailed for the next election only)
2/11 Special Election 3/10 Township Election
4/14 Special Election 5/12 Special Election
8/11 Primary Election 11/3 General Election
Both 8/11 & 11/3 Elections Other (specify date):
2. last name or surname first name middle name suffix
3. date of birth (mm/dd/yyyy) county where you live phone number
email address
4. mark all boxes that apply:I have a MN-issued driver’s license or MN ID card. The number is:
I have a social security number. The last four digits are: XXX-XX-I do not have a MN-issued driver’s license, MN-issued ID card or a social security number.
Your identification number will be compared to the one on your absentee ballot envelope.
5. address where you live (residence) apt. city MN
zip code
6. address where your absentee ballot should be sent apt. city state zip code
7. I certify that I:
am completing this application on my own behalf; will be at least 18 years old on election day; am a citizen of the United States; will have resided in Minnesota for 20 days immediately preceding election day; maintain residence at the address given on this application form; am not under court-ordered guardianship in which the court order revokes my right to vote; have not been found by a court to be legally incompetent to vote; have the right to vote because, if I have been convicted of a felony, my felony sentence has expired (been completed) or I
have been discharged from my sentence; and have read and understand this statement: The above information is accurate, and I sign this application form under penalty
of perjury, a felony punishable by not more than 5 years imprisonment, a fine of not more than $10,000, or both.
school district
precinct reg non-reg
official use only received date initials
ballot issued date reg non-reg
Primary
General received date initials
ballot issued date type
M C HCF
type
M C HCF
repl. date: reason replaced
rejected lost spoiled never received
repl. date: reason replaced
rejected lost spoiled never received
See other side for special instructions for voters with disabilities or power of attorney.
sign here: X__________________________ date ____/____/____
- -
![Page 10: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/10.jpg)
FIRST-CLASS MAILU.S. POSTAGE
PAIDRC
IMB-POSTAGE
Fold here and tape with two pieces on the top edge near the left and right hand edges.
This November public service workers must stand together, and in 2020 you can vote by mail safely and securely from the comfort of your own home. Voting by mail will help make sure all our voices are heard in this election.
If you haven’t already requested a ballot, fill out the attached form.
Clip out the form, fold it, and mail to your local election office (the postage is prepaid). Make sure to return your application promptly.
Once you receive your ballot, mark your vote, and mail back in immediately.
AFSCME URGES YOU TO
VOTE BY MAILSO ALL OUR VOICES ARE HEARD
VISIT AFSCME.ORG/VBM TO UTILIZE OUR SECURE VOTE BY MAIL TOOL.
VOTING BY MAIL IS: SAFESECUREAND EFFECTIVE
1
2
3
Return Address Line 1Return Address Line 2Return Address Line 3
![Page 11: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/11.jpg)
AFSCME1625 L Street, NWWashington, DC 20036
AFSCME2001
Date of Birth
State Zip Code
X X
2020 STATE ABSENTEE BALLOT REQUEST FORM (Read the instructions before completing this form. Items in red are required.)
FRAUDULENTLY OR FALSELY COMPLETING THIS FORM IS A CLASS I FELONY UNDER CHAPTER 163 OF THE NC GENERAL STATUTES
1 Vo
ter I
nfor
mat
ion
Last Name First Name Middle Name Suffix
/ /
Previous Last Name Previous First Name Previous Middle Name NC DL or ID Number Last Four Digits of Social Security number
Current NC Residential Street Address
City County
Have you lived at this address for 30 or more days? Yes No
If “No”, date moved?
/ /
Provide your mailing address if you do not receive mail at your residential address.
2 Ab
sent
ee V
otin
g In
form
atio
n
Absentee Mailing Address (where you would like your ballot sent)
Mailing City State Zip Code
Near Relative or Legal Guardian Request: If you are requesting an absentee ballot on behalf of a near relative or for someone for whom you are the legal guardian, provide your name, relationship to the voter (see instructions), address and contact information. Near Relative or Legal Guardian’s Name Your Relationship to Voter
Near Relative or Legal Guardian’s Address City State Zip Code
Voter Assistance: If the voter received assistance completing this form due to blindness, disability, or inability to read or write and no near relative or legal guardian of the voter was available, list the name and address of the person assisting the voter with completing this form. Voter Assistant’s Name
Address City State Zip Code
If voter is a patient in a hospital, clinic, nursing home or rest home, does voter need assistance with voting and returning the ballot? Yes No If Yes, what is the name and address of the hospital or facility?
3 M
ilitar
y &
Ove
rsea
s
Are you an absentee military or overseas voter? If so, select the best option below that describes your absentee status: Member of the Uniformed Services or Merchant Marine on active duty or eligible spouse/dependent and currently absent from county of residence U.S. citizen outside the United States
Provide the address where you are currently stationed or living overseas. Send your ballot by mail? (provide address)
Send your ballot by email? (provide email address) Send your ballot by fax? (provide #)
4
Voter’s Signature Near Relative or Legal Guardian Signature (if applicable)
Date Date
SBOE 2020.04
OR
E-mail Phone
Please provide your email address or a telephone number in case we have a question concerning this request.
Election Date: November 3, 2020
Check if you would like to request absentee ballots for all elections held during this calendar year in which you are eligible to vote due to continued or expected illness or disability.
Sign up to Vote by Mail today. Application attached.
W H E N
AFSCMEMEMBERS VOTEOUR COMMUNITIES ARE STRONGEST
![Page 12: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/12.jpg)
FIRST-CLASS MAILU.S. POSTAGE
PAIDRC
IMB-POSTAGE
Fold here and tape with two pieces on the top edge near the left and right hand edges.
This November public service workers must stand together, and in 2020 you can vote by mail safely and securely from the comfort of your own home. Voting by mail will help make sure all our voices are heard in this election.
If you haven’t already requested a ballot, fill out the attached form.
Clip out the form, fold it, and mail to your local election office (the postage is prepaid). Make sure to return your application promptly.
Once you receive your ballot, mark your vote, and mail back in immediately.
AFSCME URGES YOU TO
VOTE BY MAILSO ALL OUR VOICES ARE HEARD
VISIT AFSCME.ORG/VBM TO UTILIZE OUR SECURE VOTE BY MAIL TOOL.
VOTING BY MAIL IS: SAFESECUREAND EFFECTIVE
1
2
3
Return Address Line 1Return Address Line 2Return Address Line 3
![Page 13: FORMULARIO DE SOLICITUD PARA LA BOLETA-POR-CORREO Y …€¦ · AFSCME 1625 L Street, NW Washington, DC 20036 AFSCME2001 Sign up to Vote by Mail today. Application attached. AFSCMEWHEN](https://reader034.fdocuments.us/reader034/viewer/2022051917/60090e5ad2806b15025e7337/html5/thumbnails/13.jpg)
AFSCME1625 L Street, NWWashington, DC 20036
AFSCME2001
Sign up to Vote by Mail today. Application attached.
W H E N
AFSCMEMEMBERS VOTEOUR COMMUNITIES ARE STRONGEST
Use black ink
Print your name Please print your name exactly as you registered to vote. 1
Last name
First name
Jr Sr II Ill IV (circle if applicable)
Middle name or initial
About youPhone and email are optional and used if information is missing on this form.
2Birth date M M / D D / Y Y Y Y
Phone - - Email
Your addressPlease print your address exactly as you registered to vote.
3
Address (not P.O. Box) Apt. number
City/Town State PA Zip code
Municipality County
Ward (if known) Voting district (if known)
I have lived at this address since:
Where to mail ballot? 4
Same as above Address or P.O. Box
City/Town State Zip code
IdentificationIf you have a PennDOT number,you must use it. If not, please provide the last four digits of your Social Security number. See “Necessary Identification” on Page 2.
5
PA driver's license or PennDOT ID card number
Last four digits of your Social Security number X X X - X X -
I do not have a PA driver’s license or a PennDOT ID card or a Social Security number.
Declaration6
I declare that I am eligible to vote by mail-in ballot at the forthcoming primary or election; that I am requesting the ballot of the party with which I am enrolled according to my voter registration record; and that all of the information which I have listed on this mail-in ballot application is true and correct.
Voter signature here X Date
Annual mail-in requestSee “What is an annual mail-in ballot request?” for more information.
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If you would like to apply to receive mail-in ballots for the remainder of this year and if you would like to automatically receive an annual application for mail-in ballots each year, please indicate below.
I would like to receive mail-in ballots this year and receive annual applications for mail-in ballots each year.
Help with this formComplete this section if you are unable to sign the declaration in Section 6.
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I hereby state that I am unable to sign my application for a mail-in ballot without assistance because I am unable to write by reason of my illness or physical disability. I have made or have received assistance in making my mark in lieu of my signature.
Mark of voter X Date
Address of witness
Signature of witness X
DOS-12/2019
Pennsylvania Application for Mail-In Ballot
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FIRST-CLASS MAILU.S. POSTAGE
PAIDRC
IMB-POSTAGE
Fold here and tape with two pieces on the top edge near the left and right hand edges.
This November public service workers must stand together, and in 2020 you can vote by mail safely and securely from the comfort of your own home. Voting by mail will help make sure all our voices are heard in this election.
If you haven’t already requested a ballot, fill out the attached form.
Clip out the form, fold it, and mail to your local election office (the postage is prepaid). Make sure to return your application promptly.
Once you receive your ballot, mark your vote, and mail back in immediately.
AFSCME URGES YOU TO
VOTE BY MAILSO ALL OUR VOICES ARE HEARD
VISIT AFSCME.ORG/VBM TO UTILIZE OUR SECURE VOTE BY MAIL TOOL.
VOTING BY MAIL IS: SAFESECUREAND EFFECTIVE
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Return Address Line 1Return Address Line 2Return Address Line 3
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AFSCME1625 L Street, NWWashington, DC 20036
AFSCME2001
Sign up to Vote by Mail today. Application attached.
W H E N
AFSCMEMEMBERS VOTEOUR COMMUNITIES ARE STRONGEST
EL-121 | Rev 2020-06 | Wisconsin Elections Commission, P.O. Box 7984, Madison, WI 53707-7984 | 608-266-8005 | web: elections.wi.gov | email: [email protected]
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Wisconsin Application for Absentee Ballot (Municipal Clerk) If in-person voter, check here:
Absentee ballots may also be requested at MyVote.wi.gov
Confidential Elector ID# (HINDI - sequential #) (Official Use Only)
WisVote ID # (Official Use Only)
Ward No.
Detailed instructions for completion are on the back of this form. Return this form to your municipal clerk when completed. • You must be registered to vote before you can receive an absentee ballot. You can confirm your voter registration at https://myvote.wi.gov
PHOTO ID REQUIRED, unless you qualify for an exception. See instructions on back for exceptions.
VOTER INFORMATION
1 Municipality
County
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Last Name
First Name
Middle Name
Suffix (e.g. Jr, II, etc.)
Date of Birth (MM/DD/YYYY)
Phone
Fax
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Residence Address: Street Number & Name
Apt. Number
City
State & ZIP
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Fill in the appropriate circle – if applicable (see instructions for definitions): Military Permanent Overseas Temporary Overseas
I PREFER TO RECEIVE MY ABSENTEE BALLOT BY: (Ballot will be mailed to the address above if no preference is indicated. Absentee ballots may not be forwarded.)
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Mailing Address: Street Number & Name
VOTE IN CLERK’S OFFICE
Apt. Number
City State & ZIP
Care Facility Name (if applicable)
C / O (if applicable)
FAX
Fax Number For Military and Overseas Voters Only
Voter must have a computer and printer when receiving a ballot by fax or email. Voted ballots must be returned by mail. EMAIL Email Address
For Military and Overseas Voters Only
I REQUEST AN ABSENTEE BALLOT BE SENT TO ME FOR: (mark only one)
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The election(s) on the following date(s): ____________________________________________________________________________ All elections from today’s date through the end of the current calendar year (ending 12/31). For indefinitely-confined voters only: I certify that I am indefinitely confined because of age, illness, infirmity or disability and request absentee ballots be sent to me automatically until I am no longer confined, or I fail to return a ballot. Anyone who makes false statements in order to obtain an absentee ballot may be fined not more than $1,000 or imprisoned not more than 6 months or both. Wis. Stats. §§ 12.13(3)(i), 12.60(1)(b).
TEMPORARILY HOSPITALIZED VOTERS ONLY (please fill in circle)
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I certify that I cannot appear at the polling place on election day because I am hospitalized, and appoint the following person to serve as my agent, pursuant to Wis. Stat. § 6.86(3).
Agent Last Name
Agent First Name
Agent Middle Name
AGENT: I certify that I am the duly appointed agent of the hospitalized absentee elector, that the absentee ballot to be received by me is received solely for the benefit of the above named hospitalized elector, and that such ballot will be promptly transmitted by me to that elector and then returned to the municipal clerk or the proper polling place.
Agent Signature
X
Agent Address
ASSISTANT DECLARATION / CERTIFICATION (if required)
I certify that the application is made on request and by authorization of the named elector, who is unable to sign the application due to physical disability.
Agent Signature
X
Today’s Date
VOTER DECLARATION / CERTIFICATION (required for all voters)
I certify that I am a qualified elector, a U.S. Citizen, at least 18 years old, having resided at the above residential address for at least 28 consecutive days immediately preceding this election, not currently serving a sentence including probation or parole for a felony conviction, and not otherwise disqualified from voting. Please sign below to acknowledge that you have read and understand the above.
Voter Signature
X
Today’s Date
Instructions
Town
Village
City
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FIRST-CLASS MAILU.S. POSTAGE
PAIDRC
IMB-POSTAGE
Fold here and tape with two pieces on the top edge near the left and right hand edges.
This November public service workers must stand together, and in 2020 you can vote by mail safely and securely from the comfort of your own home. Voting by mail will help make sure all our voices are heard in this election.
If you haven’t already requested a ballot, fill out the attached form.
Clip out the form, fold it, and mail to your local election office (the postage is prepaid). Find your clerk's address at myvote.wi.gov/en-us/VoteAbsentee
Once you receive your ballot, mark your vote, and mail back in immediately.
AFSCME URGES YOU TO
VOTE BY MAILSO ALL OUR VOICES ARE HEARD
VISIT AFSCME.ORG/VBM TO UTILIZE OUR SECURE VOTE BY MAIL TOOL.
VOTING BY MAIL IS: SAFESECUREAND EFFECTIVE
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Clerk: Elections