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

Vote by Mail (Absentee) Ballot Request Form

If you are a member of the military or a military dependent and are living outside Palm Beach County (stateside or overseas), or are a civilian voter living overseas, please use the Military/Overseas Absentee Ballot Request Form.

Under Florida law, all qualified voters are permitted to vote by mail (absentee). This request is valid for one(1) registered voter only.

Please complete the form below to request a vote by mail ballot. If you have any questions about this form, please call us at (561) 656-6200

To track the status of your vote by mail ballot request from the time you submit it until the voted ballot is returned to our office, go to our free Online Ballot tracking system and follow the easy directions.

Notice: Information provided on this form is exempt from public disclosure except that it is available upon request to canvassing boards, election officials, political parties, registered political committees and committes of continuous existence, and candidates facing opposition in an upcoming election for political purposes only (ยง 101.62(3) F.S.)

(* Denotes a required field)

Voter's 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.
Voter ID Number (if available):
  Mail ballot to: (if different from residence address)

IMPORTANT - Vote by mail ballots are not forwardable, nor can they be held at the post office. If your ballot is returned to us as undeliverable, all requests on file will be canceled.
Voter's E-mail Address:
Voter's Daytime Phone:
Requester's Information:
You may only request absentee ballots for yourself and your immediate family, which is defined as your spouse, child, parent, grandparent, sibling, spouse's child, parent, grandparent, sibling, or legal guardian. If making this request for someone other than yourself, F.S. 101.62 requires you to provide the following information about yourself:
Requester's Name:
Requester's Address:

Requester's Driver's License Number (if available):
Requester's Relationship to Voter:
Absentee Ballots Requested:
One request is sufficient to receive an absentee ballot for all elections through the end of the calendar year of the second ensuing regularly scheduled general election.