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Application for Absent Voter's Ballot |
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Please complete and return to your Township, City or Village clerk according to the written instructions under Step 2 on the portion to the right. Do NOT return it to the county clerk.
For the Primary election, to be held on August 4, 1998
Complete the following blanks which are applicable to you:
I, __________________________, a duly qualified and registered elector of the _____________ precinct of the township of _____________ or the village of ___________________ or of the ___________ ward of the city of ____________________________, in the county of ________________ and state of Michigan, make application for an official ballot, or ballots, to be voted by me at the election as requested in this application. |
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The statuatory grounds on which I base my request are (check one applicable reason):
[ ]I expect to be absent from the community in which I am registered for the entire time the polls are open on election day.
[ ]I am physically unable to attend the polls without the assistance of another.
[ ]I cannot attend the polls because of the tenets of my religion.
[ ] I have been appointed an election precinct inspector in a precinct other than the precinct where I reside.
[ ]I am 60 years of age or older.
[ ]I cannot attend the polls because I am confined to jail awaiting arraignment or trial.
Send absent voter's ballot to me at:My registered address:
______________________________________________
print full nameprint full name
______________________________________________
street no. or r.r.street no. or r.r.
______________________________________________
post officestate/zippost officestate/zip
I declare the following statements to be true.
______________________________________________
signature of absent voterdate |
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Instructions for Applicants for Absentee Voter Ballots
Step 1 After completely filling out the application, sign and date the application in the place deisgnated. Your signature must appear on the application or you will not receive an absent voter ballot.
Step 2 Deliver the application by 1 of the following methods: |
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(a) Place the application in an envelope addressed to the appropriate clerk and place the necessary postage upon the return envelope and deposit it in the United States mail or with another public postal service, express mail service, parcel post service, or common carrier.
(b) Deliver the application personally to the office of the clerk, to the clerk, or to an authorized assistant of the clerk.
(c) In either (a) or (b), a member of the immediate family of the voter including a father-in-law, mother-in-law, brother-in-law, sister-in-law, son-in-law, daughter-in-law, grandparent, or grandchild or a person residing in the voter's household may mail or deliver the application to the clerk for the applicant.
(d) In the event an applicant cannot return the application in any of the above methods, the applicant may select any registered elector to return the application. The person returning the application must sign and return the certificate below. |
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Certificate of Authorized Registered Elector Returning Absent Voter Ballot Application
I certify that my name is ________________________, my address is _________________________, and my date of birth is _________\_______\__________; that I am delivering the absent voter ballot application of ______________________________ at his or her request; that I did not solicit or request to return the application; that I have not made any markings on the application; that I have not altered the application in any way; that I have not influenced the applicant; and that I am aware that a false statement in this certificate is a violation of Michigan election law.
________________ ___________________________________
Date Signature |
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Warning
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 above 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 office of the clerk 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.ww |
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