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 approximately 30 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. One request is deemed sufficient for two (2) regularly scheduled general elections.
Please complete the form below to request absentee ballots. If you have any
questions about this form, please e-mail us at absenteeballot@browardsoe.org
| Voter Information: |
| * |
Voter's First Name: |
|
|
Voter's Middle Name: |
|
| * |
Voter's Last Name: |
|
| * |
Voter's Birth Date (mm/dd/yyyy): |
|
| * |
Broward County Residence Address (No PO Box): |
|
|
Voter's Apt, Lot, or Unit Number: |
|
| * |
Voter's City: |
|
| * |
Voter's ZIP Code: |
|
| |
|
|
| |
| * One of the following two items must be provided. |
|
Voter's E-mail Address: |
|
|
Voter's Facsimile Number: |
|
| |
|
Voter's Daytime 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: |
|
Name: |
|
|
Address: |
|
|
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 whom you are a legal guardian. |
| |
Absentee Status:
Military/Dependent Overseas
Civilian Overseas
|
| |
| 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. |
| |
|
|
| |
| |