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Request For Missouri Absentee Ballot PL 107-252 - Missouri

Request For Missouri Absentee Ballot Form. This is a Missouri form and can be used in Elections Secretary Of State .
 Fillable pdf Last Modified 3/4/2005
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REQUEST FOR MISSOURI ABSENTEE BALLOT I, _________________________________, do hereby request an absentee ballot for the (print name) _________________________________________Election. For identification purposes, the last four digits of my social security number are __________. If the election is a primary election, please print the name of the political party ballot you wish to receive ____________ . If you registered by mail and this is your first time voting you must provide a copy of current valid photo identification or a copy of a current utility bill, bank statement, government check, paycheck, or government hows your name and address. document that s Reason for requesting an absentee ballot: ______(1) Absence on Election Day from the jurisdiction of the election authority in which registered to vote ______(2) Incapacity of confinement due to illness or physical disability, including a person who is primarily responsible for the physical care of a person who is incapacitated or confined due to illness or disability; ______(3) Religious belief or practice ______(4) Employment as an election authority, as a member of an election authority, or by an election authority at a location other than your polling place ______(5) Incarceration, provided all qualifications for voting are retained Address where I am registered to vote: _____________________________________________ (Street address) _____________________________________________ (City, State, Zip Code) Address where ballot is to be mailed: _____________________________________________ (Street address) _____________________________________________ (City, State, Zip Code) Telephone number: _________________________________ (Include area code) I do solemnly swear that all statements made on this application are true to the best of my knowledge and belief. ________________________________________________ ______________ Signature of Registered Voter Date Mail this completed form to your local election authority. The appropriate address can be found on the Missouri Secretary of S tates web site. Missouri law requires that requests for absentee ballots must be received by 5:00 p.m. on the Wednesday prior to Election Day i f the ballot is to be mailed. The deadline for absentee voting in person in the office of the election authority is 5:00 p.m. on the day before the election. If you registered by mail and this is your first time voting you must provide a copy of current valid photo identification or a copy of a current utility bill, bank statement, government check, paycheck, or government document that shows your name and address. 115.279, 115.284.5 (4/03) PL 107-252
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