Absentee Ballot Request Form

Notice: If you are an overseas voter or are requesting an absentee ballot for an overseas voter, please use the Overseas Absentee Ballot Request Form.

Absentee ballot requests are valid through the next General Election unless individual elections are specified. Absentee ballots are mailed approximately 35-45 days prior to each election (mailing dates will vary for municipal elections).

ABSENTEE BALLOTS CANNOT BE FORWARDED
If you will not be at your PalmBeach2 address, please complete the MAIL BALLOT TO portion of this form with the address where the ballot should be mailed.

( * Denotes a required field)

* For whom are you making this Absentee Ballot request?
Immediate Family Myself
Voter Information:
* Voter's First Name:
Voter's Middle Initial:
* Voter's Last Name:
* Voter's Birth Date(mm/dd/yyyy):
* PalmBeach2 County Residence Address(No PO Box):
Voter's Apt, Lot, or Unit Number:
* Voter's City:
* Voter's ZIP Code:
Voter's Email Address:
Voter's Daytime Phone:
Voter ID Number(if available):


Mail Ballot to: (if different from above)

Street, PO Box, Rural Route:
Apartment, Lot, or Unit Number:
City:
State:
ZIP Code:

:

Street, PO Box, Rural Route:
Apartment, Lot, or Unit Number:
City, State, ZIP Code:

Absentee Status:
Civilian Overseas Military/Dependent Overseas Military/Dependent Stateside Not Applicable

Absentee ballots requested:

*All Elections (thru 2016)

* Individual Elections