Registered Voters as of 04/20/2014 REP:235,442 DEM:366,189 Other:234,704 Total:836,335

Overseas Absentee Ballot Request

This request is valid for only one (1) registered voter. If you are a qualified overseas registered voter, ballots will be mailed only for the elections checked. Ballots are mailed 45 days prior to each election to those voters that have requested an absentee ballot. Overseas voters are defined by Florida Statutes as members of the uniformed services, members of the Merchant Marine of the United States, or other citizens of the United States and the District of Columbia, who are qualified and registered to vote as provided by law. If you are not an overseas voter, please use the regular Absentee Ballot Request Form to make your request.

Please complete the form below to request absentee ballots. If you have any questions about this form, please e-mail us at

(* Denotes a required field)

Voter Information:
*  Voter's First Name:
Voter's Middle Name:
*  Voter's Last Name:
*  Voter's Birth Date (mm/dd/yyyy):
*  Palm Beach County Residence Address (No PO Box):
Voter's Apt, Lot, or Unit Number:
*  Voter's City:
*  Voter's ZIP Code:
Check if this is a change of your Palm Beach County residence address.
Check if you do not have a permanent residence address in Palm Beach County and are living outside of the county but intend to remain a permanent resident of the county. (If this applies to you, enter 240 South Military Trail, West Palm Beach, FL 33415 in the above address fields.)
* One of the following two items must be provided.
Voter's E-mail Address:
Voter's Facsimile Number:
Voter's Evening Phone:
Voter ID Number (if available):
*  Overseas Mailing Address

Check if this is your permanent mailing address
If you are making this request for someone other than yourself, you must give the following information about yourself:

Driver's license number (if available):
Relationship to person whose ballot you are requesting:
You may only request absentee ballots for yourself and your immediate family, which is defined as your spouse, child, parent, grandparent, or sibling, or your spouse's child, parent, grandparent, or sibling, and a person for who you are legal guardian.
Absentee Status:
Absentee Ballots Requested:
A special request for a facsimile or electronic absentee ballot must be made for each specific election.

Check method you would like ballots transmitted to you (select only one)
By mail
By e-mail
By facsimile
If your mailing address, facsimile, phone number or e-mail address changes, be sure and notify our office immediately.