1st Place

2nd Place

3rd Place

4th Place

5th Place

2003 SLOGAN CONTEST WINNERS

It’s Your Future. VOTE For It!

— SSgt Stephanie Csornok, USAF, Misawa, Japan

Our Country, Our Leaders, Our Choice! VOTE!

— SSgt Trevor P. Allen, USMC, Okinawa, Japan

Decide Tomorrow Today. VOTE!

— HMC Noel D. Gravina, USN, Great Lakes, Illinois

Celebrate Your Freedom! Vote!!

— Sylvia D. Johnson, Civilian, U.S. Consulate, Sydney, Australia

Red, White, and Blue, Our Nation’s Freedom Depends On You, Vote!

— Mary Jane Carty, Civilian, Ft. Detrick, Maryland
2004–05 Voting Assistance Guide

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2004–05 Voting Assistance Guide

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Assistance for citizens covered by the

Uniformed and Overseas Citizens Absentee Voting Act 

(42 U.S. Code 1973ff)

Publication ID#: VAG 04-05
This 2004-05 Voting Assistance Guide has been prepared by the staff of the Federal Voting

Assistance Program, Department of Defense, Washington, D.C.

Appendix E— Probable State Income Tax Liability, an interpretive tabulation of State Income

Tax Liability, was prepared by the Congressional Research Service of The Library of Congress.

We wish to acknowledge the advice and assistance received from the Secretaries of State,

Directors of Elections and their staffs of the jurisdictions covered by this Guide, the

Congressional Research Service of The Library of Congress and the Department of Defense

Graphics Department for their support.

Questions or comments concerning any aspect of this publication can be directed to: Director,

Federal Voting Assistance Program, Department of Defense, Washington Headquarters

Services, 1155 Defense Pentagon, Washington, D.C. 20301-1155 or by e-mail to

vote@fvap.ncr.gov.

Cover design is by

Irina T. Lee

University of Maryland

College Park, Maryland
2004–05 Voting Assistance Guide

i

TABLE OF CONTENTS

Introduction Purpose and Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Sources of Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Chapter One The Federal Voting Assistance Program . . . . . . . . . . . . . . . . . . . . . . . . . . 3

1. The Federal Voting Assistance Program (FVAP) at Work . . . . . . . . . . . 3

2. Helping U.S. Citizens to Vote . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

3. Online/E-mail Assistance from the FVAP . . . . . . . . . . . . . . . . . . . . . . . . 3

4. The Important Role of the Voting Assistance Officer (VAO). . . . . . . . . . 3

5. The Voting Assistance Guide: The Principal Source for Voting

Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

6. The Federal Post Card Application (FPCA) . . . . . . . . . . . . . . . . . . . . . . 4

7. The Federal Write-In Absentee Ballot (FWAB). . . . . . . . . . . . . . . . . . . . 4

8. Secure Electronic Registration and Voting Experiment (SERVE) . . . . . 4

9. Ten Major Resources To Help the Voting Assistance Officer (VAO) . . . 5

10. How to Contact the FVAP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Chapter Two Instructions For Voting Assistance Officers . . . . . . . . . . . . . . . . . . . . . . . . 7

Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1. The Uniformed and Overseas Citizens Absentee Voting Act

(UOCAVA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

2. The Absentee Voting Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

3. Registration and Ballot Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

4. Requirements for Voting, Establishing Voting Residence

and Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

5. Completing the Federal Post Card Application (FPCA) . . . . . . . . . . . . . 9

6. Mailing the FPCA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

7. Electronic Transmission of Election Materials . . . . . . . . . . . . . . . . . . . 11

8. Ballot Receipt and Late Counting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

9. Ballot Delays. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

10. Marking and Mailing the Ballots . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

11. The Federal Write-In Absentee Ballot (FWAB). . . . . . . . . . . . . . . . . . 12

12. State Special Write-In Absentee Ballot. . . . . . . . . . . . . . . . . . . . . . . . 12

13. Voting In Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

14. Late Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

15. Reporting Irregularities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

16. FVAP Submits Reports to the President and Congress . . . . . . . . . . . 13

17. Other Ways to Obtain a Ballot and Vote. . . . . . . . . . . . . . . . . . . . . . . 13

18. Providing Information on Candidates . . . . . . . . . . . . . . . . . . . . . . . . . 13

19. VAO Restrictions on Distributing Partisan Information . . . . . . . . . . . . 14

20. How to Implement a Voting Assistance Plan . . . . . . . . . . . . . . . . . . . 14
2004–05 Voting Assistance Guide

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21. The Scope of a Civilian Voting Assistance Plan . . . . . . . . . . . . . . . . . 15

22. The Scope of a Military Installation Voting Assistance Plan . . . . . . . . 15

23. Problems Experienced in Processing FPCAs by Local

Election Officials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

24. Collecting and Sharing Best Practices and Lessons Learned . . . . . . 17

25. Guidance for Submitting Best Practices and Lessons Learned . . . . . 17

Sample Forms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Chapter Three State Absentee Registration and Voting Procedures . . . . . . . . . . . . . . . . 27

Alabama . . . . . . . . . . . . . . . . . . 29

Alaska . . . . . . . . . . . . . . . . . . . . 33

American Samoa . . . . . . . . . . . 39

Arizona . . . . . . . . . . . . . . . . . . . 43

Arkansas. . . . . . . . . . . . . . . . . . 49

California. . . . . . . . . . . . . . . . . . 53

Colorado . . . . . . . . . . . . . . . . . . 61

Connecticut. . . . . . . . . . . . . . . . 67

Delaware. . . . . . . . . . . . . . . . . . 75

District of Columbia. . . . . . . . . . 81

Florida. . . . . . . . . . . . . . . . . . . . 85

Georgia . . . . . . . . . . . . . . . . . . . 93

Guam . . . . . . . . . . . . . . . . . . . 101

Hawaii . . . . . . . . . . . . . . . . . . . 105

Idaho. . . . . . . . . . . . . . . . . . . . 109

Illinois . . . . . . . . . . . . . . . . . . . 113

Indiana . . . . . . . . . . . . . . . . . . 117

Iowa . . . . . . . . . . . . . . . . . . . . 123

Kansas . . . . . . . . . . . . . . . . . . 131

Kentucky . . . . . . . . . . . . . . . . . 135

Louisiana. . . . . . . . . . . . . . . . . 139

Maine . . . . . . . . . . . . . . . . . . . 143

Maryland . . . . . . . . . . . . . . . . . 151

Massachusetts . . . . . . . . . . . . 157

Michigan . . . . . . . . . . . . . . . . . 163

Minnesota . . . . . . . . . . . . . . . . 167

Mississippi. . . . . . . . . . . . . . . . 171

Missouri. . . . . . . . . . . . . . . . . . 175

Montana . . . . . . . . . . . . . . . . . 183

Nebraska . . . . . . . . . . . . . . . . 187

Nevada . . . . . . . . . . . . . . . . . . 195

New Hampshire . . . . . . . . . . . 199

New Jersey. . . . . . . . . . . . . . . 207

New Mexico . . . . . . . . . . . . . . 211

New York . . . . . . . . . . . . . . . . 215

North Carolina. . . . . . . . . . . . . 219

North Dakota. . . . . . . . . . . . . . 223

Ohio . . . . . . . . . . . . . . . . . . . . 229

Oklahoma . . . . . . . . . . . . . . . . 233

Oregon . . . . . . . . . . . . . . . . . . 239

Pennsylvania . . . . . . . . . . . . . 245

Puerto Rico. . . . . . . . . . . . . . . 251

Rhode Island. . . . . . . . . . . . . . 255

South Carolina . . . . . . . . . . . . 259

South Dakota . . . . . . . . . . . . . 265

Tennessee . . . . . . . . . . . . . . . 269

Texas . . . . . . . . . . . . . . . . . . . 275

 Utah . . . . . . . . . . . . . . . . . . . . 281

Vermont . . . . . . . . . . . . . . . . . 287

Virginia . . . . . . . . . . . . . . . . . . 295

Virgin Islands . . . . . . . . . . . . . 303

Washington. . . . . . . . . . . . . . . 307

West Virginia. . . . . . . . . . . . . . 313

Wisconsin . . . . . . . . . . . . . . . . 317

Wyoming. . . . . . . . . . . . . . . . . 321

Appendix A 2004 Primary Elections by State. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325

Appendix B 2004 Presidential and State Primaries By Month . . . . . . . . . . . . . . . . . . 327

Appendix C Electronic Transmission of Election Materials. . . . . . . . . . . . . . . . . . . . . 329
2004–05 Voting Assistance Guide

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To Send the FPCA by Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329

To Receive the Absentee Ballot by Fax . . . . . . . . . . . . . . . . . . . . . . . . . 329

To Return the Voted Absentee Ballot by Mail. . . . . . . . . . . . . . . . . . . . . 329

To Return the Voted Absentee Ballot by Fax . . . . . . . . . . . . . . . . . . . . . 329

Assistance Available. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330

Appendix D Uniformed And Overseas Citizens Absentee

Voting Act (UOCAVA) . . . . . . . . . . . . . . . . . . . . . . . . 335

Appendix E Probable State Income Tax Liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341

Appendix F Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
2004–05 Voting Assistance Guide

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1

INTRODUCTION

Purpose and Scope

This edition of the Voting Assistance Guide is designed to

help the following persons participate in U.S. primary and

general elections during 2004 and 2005 even though they

may not be able to vote in person at the polls:

 Members of the U.S. Uniformed Services, which

includes the Army, Navy, Air Force, Marine Corps,

Coast Guard, and the Commissioned Corps of the

Public Health Service and the National Oceanic and

Atmospheric Administration;

 Members of the U.S. merchant marine;

 Family members of the above;

 U.S. Citizens residing outside the U.S.

Sources of Assistance

Absentee voting information in this Guide is current

through September 2003. Procedures or primary election

dates that change after publication will be updated through

the Federal Voting Assistance Program’s (FVAP) World

Wide Web site at www.fvap.gov as they are received.

These changes are also disseminated by voting news

releases distributed to voting assistance personnel in all

Federal government departments and agencies with voting

assistance programs. The same channels are used to

disseminate information about special and other elections.

In addition, the Voting Information Center (VIC) provides a

24 hour recorded service with information on current and

upcoming elections, recorded messages from incumbent

U.S. Senators, U.S. Representatives, State Governors and

State Chief Election Officials. Approximately thirty days

prior to an election, messages from Congressional and

Gubernatorial candidates are also available. The VIC

telephone numbers are (800) 438-8683, (703) 588-1343 or

DSN 425-1343. The VIC can also be called toll-free from

overseas on any of the numbers listed on the inside back

cover.

Each Military Department, the Coast Guard, and the

Department of State has a Voting Action Officer to assist

installation and unit Voting Assistance Officers and

Embassy/Consulate Voting Assistance Officers with any

questions or problems they may have concerning voting.

The information below will help you contact your Service

Voting Action Officer.

ARMY

Mr. James Davis

HQDA (TAPC-PDO-IP)

ATTN: Army Voting Action Officer

Hoffman Building #2, Room 3S49

200 Stovall Street

Alexandria, VA 22332-0474

DSN 221-4530

(703) 325-4530

FAX (703) 325-4532

davisj@hoffman.army.mil

NAVY

LT Brian Campbell

Navy Personnel Command

(PERS-660

5720 Integrity Drive

ATTN: Voting Action Officer

Millington, TN 38055-8600

DSN 882-5672

1-866-UASKNPC (827-5672)

FAX (901) 874-2785

DSN FAX 882-2785

MILL_NavyVote@navy.mil

AIR FORCE

LtCol Lee Shick

HQ AFPC/DPSF

550 C Street West Ste 3

Randolph AFB TX 78150

(210) 565-3514

1-866-229-7074

(Select options 4, then 6 from menu)

DSN 665-3514

FAX (210) 565-2543

DSN FAX 665-2543 

Lee.Shick@randolph.af.mil

MARINE CORPS

GySgt Kenneth B. Warford

HQMC, M&RA

ATTN: Voting Action Officer

Manpower & Reserve Affairs Code 

(MRP)

3280 Russell Road

Quantico, VA 22134-5103

(703) 784-9511

DSN 278-9511

FAX (703) 784-9827

FAX DSN 278-9827

warfordkb@manpower.usmc.mil

COAST GUARD

YNCS Lori McNaught

U.S. Coast Guard

2100 2nd Street S.W., Room 5500

Washington, D.C. 20593-0001

(202) 267-1636

FAX (202) 267-4823

LMcNaught@comdt.uscg.mil

DEPARTMENT OF STATE

Mr. Jack Markey, Chief VAO

Office of Overseas Citizens Services

2100 Pennsylvania Avenue, N.W., 

4th Floor

Washington, D.C. 20037

(202) 736-4937

FAX (202) 647-6201

Markeyjd@state.gov

Ms. Bonita Harris, Deputy VAO

(202) 647-5435

Harrisbg@state.gov
2004–05 Voting Assistance Guide

2

THE BASIC ABSENTEE VOTING PROCESS

Step 1

Citizen completes and mails the

Federal Post Card Application Form (SF-76)

* In order to receive an absentee ballot

in a timely manner, it is imperative for

citizens to keep their local election

official informed of address changes.

Step 2

Local Election Official approves Registration request or

requests further information

Step 3

Local Election Official mails absentee ballot*

Step 4

Citizen votes and mails the absentee ballot to the

Local Election Official in time to meet state deadlines
3

CHAPTER ONE

THE FEDERAL VOTING ASSISTANCE PROGRAM

1. The Federal Voting Assistance 

Program (FVAP) at Work

The Director, Federal Voting Assistance Program (FVAP),

in the Department of Defense, is responsible for

administering the Uniformed and Overseas Citizens

Absentee Voting Act (UOCAVA) on behalf of the Secretary

of Defense who is the Presidential designee for the Federal

functions of the law. 

Specifically, the mission of the FVAP is to:

 inform and educate U.S. citizens worldwide of their

right to vote, 

 foster voting participation,

 protect the integrity of, and enhance, the electoral

process at the Federal, state and local levels.

In carrying out the responsibilities of the UOCAVA, the

FVAP provides information and materials to these citizens

to help ensure their enfranchisement and promote

understanding and participation in the democratic process.

Program activities range from the development of the

universal Federal Post Card Application (FPCA or SF 76)

which is accepted by all 55 U.S. states and territories and

serves as simultaneous application for voter registration

and/or an absentee ballot; to the production and worldwide

distribution of print, broadcast and electronic voter

education and information services; to developing and

maintaining a working relationship with U.S. states,

territories and other Federal government agencies to

simplify the registration and absentee voting processes.

2. Helping U.S. Citizens to Vote

The Federal government has

assisted certain absentee voters

since 1942. The Uniformed and

Overseas Citizens Absentee Voting

Act (UOCAVA) requires that the

states and territories allow certain

groups of citizens to register and

vote absentee in elections for Federal offices. In addition,

many states and territories have developed their own laws

allowing citizens covered by the UOCAVA to register and

vote absentee in state and local elections as well. 

U.S. citizens covered by the UOCAVA include:

 Members of the U.S. Uniformed Services (on active

duty) and merchant marine

 Their family members 

 U.S. citizens residing outside the U.S.

Further details on the UOCAVA are in Chapter 2 and the

complete text of the Act is located in Appendix D. The

UOCAVA covers over six million potential voters

worldwide.

3. Online/E-mail Assistance from 

the FVAP

The Federal Voting Assistance

Program’s (FVAP) website at

www.fvap.gov provides voting

related information and

resources for UOCAVA citizens.

In order to maximize the use of

the Internet, the FVAP’s main

objective is to provide as much

current information on-line as possible to help increase the

knowledge of UOCAVA citizens so that they may be able to

participate in the democratic process.

The website also provides downloadable forms and all of

the FVAP’s informational materials in electronic format to

include this Voting Assistance Guide, current and backissues of the Voting Information News newsletter and voting

news releases as well as links to Federal government

agencies and Congress, various U.S. citizen organizations

overseas, Secretaries of State/Directors of Elections, state

and local government organizations and other pertinent

sites containing election information. 

E-mail access to the FVAP staff is provided directly through

vote@fvap.ncr.gov.

The World Wide Web and the Internet are the most effective

and efficient ways to disseminate information as they allow

citizens to be supported on a real-time basis regardless of

their geographic location. 

4. The Important Role of the Voting 

Assistance Officer (VAO)

The UOCAVA requires each Federal department and agency

with personnel covered by the UOCAVA to have a voting

assistance program. Department of Defense Directive

1000.4 and the Secretary of Defense’s biennial Voting

Action Plan establish policy and guidelines for carrying out

an effective voting assistance program. 

Voting Assistance Officers (VAOs) are critical to the

success of these programs. These individuals, both military

and civilian, are responsible for providing accurate

nonpartisan voting information and assistance to all of the

citizens that they are appointed or volunteered to help. They
The Federal Voting Assistance Program 2004–05 Voting Assistance Guide

4

aid in ensuring that citizens understand their voting rights

and how to vote absentee under the UOCAVA.

The U.S. Uniformed Services have an extensive chain-ofcommand support mechanism for their VAOs. The

Department of State offers voting assistance through its

Embassy and Consulate VAOs to all U.S. citizens outside

the United States. At the same time, many U.S. citizen

organizations and corporations outside the United States

designate and support VAOs to assist their members,

employees and other U.S. citizens living abroad.

5. The Voting Assistance Guide: 

The Principal Source for Voting

Information

This Voting Assistance Guide is the primary source of

information in carrying out a successful voting assistance

program and is designed for use by both military and

civilian UOCAVA citizens in their effort to register and vote

absentee. For ease of use, these instructions and guidelines

are organized alphabetically by state and territory in

Chapter 3.

6. The Federal Post Card 

Application (FPCA)

The FPCA is a postage-paid (within

U.S. postal system, including APO

and FPO addresses) postcard for use

by absentee voters covered under

the UOCAVA. The UOCAVA

requires the design of a single

postcard form to serve all states and

territories both as an absentee voter

registration application and an

absentee ballot application. Chapter

2 contains general instructions for

completing the FPCA. The extent and manner of its use,

however, is controlled by state and territorial law and

sometimes by local procedure. Because of varying state

procedures, the citizen should refer to the specific

instructions for their state or territory in Chapter 3 to

determine how to complete and submit the FPCA carefully

and accurately to the proper election official.

Most states also accept the on-line Federal Post Card

Application (OFPCA) form which is available on the FVAP

website at www.fvap.gov. See Chapter 2 for details.

It is important to note that VAOs should order and stock

four FPCAs for each citizen for whom they are responsible.

By January 15th of each calendar year, FPCAs should be

delivered in-hand to eligible voters and their voting age

dependents. In addition, FPCAs should be provided to

citizens outside the U.S. by August 15th of even-numbered

years and to citizens within the U.S. by September 15th of

even-numbered years. Remind citizens to send in a new

FPCA each time they move.

7. The Federal Write-In Absentee 

Ballot (FWAB)

The Federal Write-In Absentee Ballot (FWAB) is a backup

ballot available if a citizen outside the United States

(including APO and FPO addresses) does not receive the

regular absentee ballot from the state after having made a

timely application for the ballot. The FWAB is used to vote

for Federal offices (President/Vice President, U.S. Senator,

U.S. Representative, Delegate or Resident Commissioner)

in general elections. Some states now allow military and

overseas citizens to use the FWAB in elections other than

general elections or for offices other than Federal offices.

Again, the citizen should consult Chapter 3 of the Guide for

specific state or territorial requirements. Connecticut is not

required to, but currently does accept the FWAB.

The FWAB is valid only when all criteria for its use have

been met. Chapter 2 contains specific criteria for use of the

FWAB. Also, a sample FWAB, with instructions, can be

found on pages 19-26 of this Guide.

VAOs should order and stock at least one FWAB for each

citizen for whom they are responsible.

8. Secure Electronic Registration 

and Voting Experiment (SERVE)

Congress has mandated the

SERVE project be

conducted to gather data and

make recommendations

regarding the use of the

Internet for registration and

voting as an alternative to

the by-mail absentee voting process. FVAP is conducting

SERVE with volunteer states and localities to explore the

use of technology to maximize access to the polls for our

Uniformed Services personnel and overseas citizens. 

Several States are participating in this initiative and are

listed on the SERVE website (www.serveusa.gov). FVAP

encourages all eligible Uniformed Services personnel, their

dependents and overseas citizens from the participating

states to use SERVE to register and vote in 2004. SERVE

will enable these citizens to register to vote, track their

registration status, vote their ballots and have them counted

in their home jurisdictions from anywhere in the world on a

computer with Internet access.

FVAP is working closely with State and local election

officials to build a secure system and ensure that the

19

FEDERAL POST CARD APPLICATION (FPCA) SF 76, REVISED 1995

FPCA, SF 76, Rev. 1995 — Application Side

(After completion, fold to the inside and seal before mailing.) NSN 7640-00-634-5053

WARNING: Knowingly presenting false information in this application could result in criminal sanctions.

PRIVACY ACT STATEMENT

AUTHORITY: 42 USC 1973ff, “Title 1 - Registration and

Voting By Absent Uniformed Services Voters and

Overseas Voters in Elections for Federal Office.”

PRINCIPAL PURPOSE: Serves as an application for

registration or request for absentee ballot for all persons

covered by the Uniformed and Overseas Citizens

Absentee Voting Act.

DISCLOSURE: Voluntary; however, failure to provide the

necessary information may keep the pertinent jurisdiction

from processing this request and may prevent you from

voting absentee.

MAILING INSTRUCTIONS: Self-address small post card

to your current address. Fold so that large post card is on

outside; seal; complete “TO” and upper left corner on

large post card, and mail. DO NOT STAPLE OR APPLY

TAPE TO SEAL.

Type or legibly print all applicable information. Sign the

form.

SPECIFIC INSTRUCTIONS FOR COMPLETION

Complete the state, county, and city/township section at

the top of the large postcard. Note that your state may

require a separate FPCA for each election. Consult a

Voting Assistance Officer or your state section in the

Voting Assistance Guide for further information.

Standard Form 76 (Back)

(Rev. 10-95)

1. APPLICANT INFORMATION. Item 1.c. This information is

requested from some states for statistical purposes by the

Department of Justice in their enforcement of the Voting Rights

Act and the National Voter Registration Act. Enter Information for

1.a. through 1.f. For block 1.f., provide identification form and

number of that form. For example: passport 0000, State

Department 0000, driver’s license 0000, birth certificate 0000.

2. I LAST VOTED or PLACE OF LAST REGISTRATION. Provide

as much information as possible for the location where you last

voted. This is not necessarily your last residence. Do not leave

blank. Enter N/A if not applicable or if you are a first time voter.

3. VOTING RESIDENCE. Province address where you

ACTUALLY LIVED. Your right to vote in your state and

determination of voting precinct depend on your physical

residence while you were within the state. If your voting residence

address does not contain a street name, you may provide a Rural

Route number and box number, but DO NOT USE A POST

OFFICE BOX NUMBER. A Post Office Box is not a residence

address. If using Rural Route number, include specific location of

residence. Examples of voting residence: military home of record;

permanent home address in U.S.; locality or state where you paid

taxes, however long ago it may have been. It would be helpful if

you list a name and telephone number of a local contact in the

Remarks Section in the event the local election official has a

question concerning the application.

4. MAIL ABSENTEE BALLOT TO. Provide the complete mailing

address where you wish to receive your absentee ballot. Be sure

to include APO or FPO (if applicable) and ZIP Code. If you will

have a new address by the time registration forms or the ballot will

be sent to you, be sure to list the new address.

5. YOUR FAX NUMBER. You complete fax number (country and

city code) is required if you or the local election official will be

transmitting any of your election materials by fax. Members of the

U.S. Military are requested to provide their commercial as well as

DSN number (write “DSN” as a prefix if a DSN number is

provided). Faxing is available in some states, for limited purposes

only. If your state allows you to submit this form by fax

(IMPORTANT: CONSULT VOTING ASSISTANCE OFFICER OR

VOTING ASSISTANCE GUIDE FOR FURTHER

(Specific Instructions are continued on reverse.)

(fold to inside)

Election Official name and complete address U.S. Postage Paid

39 USC 3406

PAR AVION

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST-CLASS MAIL

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

Applicant name and complete address

TO:

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF s

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) MMDDY Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (Do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

(X only one: a, b, c or d) c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

MMDDY Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.
2004–05 Voting Assistance Guide The Federal Voting Assistance Program

5

integrity of the electoral process is maintained. The SERVE

system will be available early in 2004 for Uniformed

Services personnel and overseas citizens to submit voter

registration applications and absentee ballot requests in

participating States for the November 2nd Presidential

election.

SERVE is the latest in a series of technology initiatives

undertaken by FVAP as part of its mission to improve

access to the polls for overseas citizens and Uniformed

Services personnel. A small-scale proof-of-concept pilot

program, Voting Over the Internet, was successfully

conducted for the 2000 election. Eighty-four voters located

in 21 states and 11 countries were the first citizens ever to

register and cast their ballots over the Internet to their

voting jurisdictions in Florida, Texas, South Carolina and

Utah in a Presidential election. This project was awarded

the Excellence.Gov award in 2003. SERVE is building on

the knowledge and experience FVAP and participating

States gained in this ground breaking project.

At the conclusion of SERVE, a report will be sent to

Congress on the reliability, affordability, and security of

Internet registration and voting on a large scale for

UOCAVA citizens.

9. Ten Major Resources To Help 

the Voting Assistance Officer 

(VAO)

As a civilian or military VAO, there are ten major resources

available to help carry out an effective, nonpartisan voter

registration and absentee ballot awareness program. These

resources can truly enable you to perform your role at a

peak level. They are:

a. Website - www.fvap.gov

The FVAP website contains this Guide, all of the

FVAP’s informational materials, the on-line FPCA,

and links to state election sites, federal government

sites and overseas U.S. citizen organizations. The

website is updated regularly and contains the latest

information.

b. Ombudsman Service

The Ombudsman Service puts

VAOs, citizens and local election

officials directly in touch with the

FVAP via e-mail, telephone or

fax. Call toll-free in the U.S. at: 1-

800-438-VOTE (8683), DSN

(military) 425-1584 or Commercial (703) 588-

1584 and fax (703) 588-0108. International tollfree phone numbers are listed on the inside back

cover and on the FVAP website at www.fvap.gov.

The e-mail address is vote@fvap.ncr.gov.

c. Electronic Transmission Service (ETS)

The Electronic Transmission

Service faxes election

materials (FPCAs, blank

ballots, voted ballots, other

election materials) where

allowed by state law, between

the local election official and

the absentee voter when

conditions do not allow for timely receipt and

return of these materials via the postal system.

Because procedures vary from state-to-state,

consult the state pages in Chapter 3 and Appendix

C for details.

If electronic transmission is allowed by your state

or territory, the FVAP recommends faxing using

the following numbers: (703) 693-5527; DSN

(military) 223-5527 or 1-800-368-8683.

International toll-free fax numbers are listed on the

inside back cover. If a citizen experiences technical

problems when faxing the FPCA or ballot, citizens

may contact the FVAP via the Ombudsman Service

(see above).

After faxing, most states request that the citizen

mail the original completed and signed FPCA, or

voted ballot to the local election official.

d. DoD Voting Information Center (VIC) 

The VIC is an automated telephone system which

contains election information. The system is

maintained and operated by the FVAP, and allows

citizens to connect directly to the office of their

U.S. Senator, U.S. Representative, State Governor

and State Chief Election Official. Additionally,

approximately 30 days prior to an election, the

FVAP invites all candidates for the offices of U.S.

President, U.S. Senator, U.S. Representative and

State Governor to leave campaign messages for

UOCAVA citizens. 

The VIC also serves as a means for military VAOs

to communicate with their Service Voting Action

Officer, and civilian VAOs to communicate with

the Department of State Voting Action Officer. The

VIC has speech recognition technology for callers

using a rotary telephone. The VIC can be reached

toll-free in the U.S. at 1-800-438-VOTE (8683),

DSN (military) 425-1343, commercial (703) 588-

1343 or by using the international toll-free

numbers listed on the inside back cover and on

the FVAP website at www.fvap.gov.

e. Voting News Releases

These are time-sensitive periodic news releases

that inform and educate VAOs and UOCAVA

citizens about the latest critical information on
The Federal Voting Assistance Program 2004–05 Voting Assistance Guide

6

absentee registration and voting procedures and on

issues effecting their ability to register and vote.

For example, if a state or territory makes a change

to its procedures or election dates during the year,

or a special election for a Federal office is called, a

news release would be issued to alert citizens of

these events. 

The voting news releases are sent directly via email to VAOs. Releases are also available on the

FVAP website at www.fvap.gov.

f. Voting Information News Newsletter

This is a monthly newsletter

published by the FVAP which

contains up-to-date

information on elections,

absentee registration and

voting procedures, a “To Do”

list for VAOs, and other voting related matters that

may affect UOCAVA citizens. The newsletter is

sent primarily to all civilian and military VAOs by

e-mail or regular mail. It is also available on the

FVAP website at www.fvap.gov.

g. Training

A training workshop presentation is available for

VAOs at the FVAP’s website at www.fvap.gov.

There are two versions of the workshop. One

focuses on the duties and responsibilities of VAOs

in the Uniformed Services, while the other version

is for VAOs at Embassies and Consulates as well

as U.S. citizen organizations and corporations

outside the United States. The training highlights

instructions for completing the forms,

responsibilities of the VAO and the resources

available to conduct a successful voting assistance

program. An online E-Learning Training and

Certification program is also available (see the

FVAP website for additional information).

h. Election Dates Poster and Motivational Posters

The Election Dates poster lists the dates for

Federal office and state primaries, runoff elections

and the general election. Best of all, this poster has

a place at the bottom for the VAO’s name,

telephone number and E-mail address. VAOs

should display the poster so individuals will know

how to contact them. 

To help promote voter awareness, the FVAP also

provides motivational posters. These are posters

that contain an inspirational theme used to promote

interest in voting.

Military VAOs receive the posters

through their normal distribution

channels. Overseas citizens can

pick-up the posters from Embassy

and Consulate VAOs as well as

order them directly from the FVAP. 

i. Get Out the Vote Campaign.

Produced by the FVAP, in cooperation with The

Advertising Council, this campaign consists of

motivational public service announcements

encouraging citizens to vote. These are available in

print, audio and video formats for use in local

media worldwide. Call the FVAP for details.

j. Chain of Command (Military) or Embassy and

Consulate (Civilian) VAO Support 

As a military VAO, make certain your Installation

telephone operator has your name and telephone

number and that you know the names and

telephone numbers of VAOs in your chain of

command. A complete list of Service Voting

Action Officers can be found on page 1 of this

Guide.

As a civilian Voting Assistance Officer (VAO),

know the names and telephone numbers of voting

officers at your closest U.S. Embassy or Consulate.

Discuss your voting efforts with Embassy and

Consulate VAOs and work together to develop an

effective voting assistance program for all U.S.

citizens in your community.

10. How to Contact the FVAP

The Federal Voting Assistance Program (FVAP) can be

reached at:

Director, Federal Voting Assistance Program

Department of Defense

Washington Headquarters Services

1155 Defense Pentagon

Washington, D.C. 20301-1155

World Wide Web: www.fvap.gov

E-mail: vote@fvap.ncr.gov

U.S., Canada, Guam, Puerto Rico, Virgin Islands Toll-free:

1-800-438-VOTE (8683)

Fax: 1-800-368-8683

Commercial: (703)-588-1584

DSN (military): 425-1584 

Fax: (703) 588-0108

DSN (military) Fax: 425-0108

International toll-free numbers are listed on the inside back

cover and the FVAP website at www.fvap.gov.
7

CHAPTER TWO

INSTRUCTIONS FOR VOTING ASSISTANCE OFFICERS

Overview

This chapter provides more specific information and

instructions on:

1. The Uniformed and Overseas Citizens Absentee Voting

Act (UOCAVA)

2. The Absentee Voting Process

3. Registration and Ballot Request

4. Requirements for Voting, Establishing Voting

Residence and Registration

5. Completing the Federal Post Card Application (FPCA)

6. Mailing the FPCA

7. Electronic Transmission of Election Materials

8. Ballot Receipt and Late Counting

9. Ballot Delays

10. Marking and Mailing the Ballots

11. The Federal Write-In Absentee Ballot (FWAB)

12. State Special Write-In Absentee Ballot

13. Voting in Person

14. Late Registration

15. Reporting Irregularities

16. FVAP Reports to the President and Congress

17. Other Ways to Obtain a Ballot and Vote

18. Providing Information on Candidates & Issues

19. VAO Restrictions on Distributing Partisan Information

20. How to Implement a Voting Assistance Plan

21. The Scope of a Civilian Voting Assistance Plan

22. The Scope of a Military Installation Voting Assistance

Plan

23. Problems Experienced in processing FPCAs by Local

Election Officials

1. The Uniformed and Overseas 

Citizens Absentee Voting Act

(UOCAVA)

UOCAVA allows certain U.S. citizens to vote absentee. The

UOCAVA applies to:

 Members of the U.S. Uniformed Services (on active

duty) and merchant marine,

 Their family members, and

 U.S. citizens residing outside the U.S.

Members of the U.S. Uniformed

Services or merchant marine and their

family members may vote absentee

while away from their place of voting

residence, wherever stationed, inside or

outside the United States.

The UOCAVA also applies to U.S.

citizens residing outside the United States and its territories.

These citizens may vote in the state or territory where they

last resided immediately prior to departing the United

States, even if many years have elapsed and the citizen

maintains no residence in the state or territory and the intent

to return to that state or territory may not be certain. Many

states and territories permit these citizens to vote in

elections for Federal offices only, although some states will

send a ballot containing local and state offices as well. 

The UOCAVA provides that voting for Federal offices shall

not affect the determination of the voter’s place of residence

for purposes of any tax imposed under Federal, state or

local law. Liability for state income tax, however, may be

incurred in some states by voting absentee in state or local

elections. To assess the probability of incurring state taxes

on income earned outside the United States, see Appendix E

and consult legal counsel for details.

The Federal Voting Assistance Program (FVAP) encourages

citizens to bring problems encountered in the voting

process to the attention of the Embassy or Consulate Voting

Assistance Officers. If a problem cannot be resolved

locally, then contact the FVAP.

A complete text of the UOCAVA is in Appendix D.

2. The Absentee Voting Process

The absentee voting process permits citizens covered by the

Uniformed and Overseas Citizens Absentee Voting Act

(UOCAVA), who will be away from their local polling VOTE places on election day, to vote through the mail or an

It’s your Future. s your Future.

for it!
Instructions For Voting Assistance Officers 2004–05 Voting Assistance Guide

8

alternative method. Absentee voters should request their

ballots at least 60 days before the election whenever

possible to allow enough by-mail transit time. 

In order to register and/or vote absentee, an eligible U.S.

citizen must carefully and accurately complete a Federal

Post Card Application (FPCA) and then submit it to the

proper election official. Specific instructions for completing

the FPCA for each state and territory are contained in

Chapter 3.

United States citizens are afforded full voting assistance at

all U.S. Embassies and Consulates. They may also use APO

and FPO facilities, including the Department of State

pouch, to mail FPCAs and other voting materials back to

the U.S. Finally, it is important to note that U.S. citizens

overseas may receive voting assistance at military

installations, at the discretion of the installation

Commanding Officer. 

The two major political parties in the United States

(Democratic and Republican) have branches in many

countries throughout the world. Further information

concerning overseas political activities by either the

Democratic or Republican Party may be obtained by

contacting:

Democrats Abroad

430 South Capitol Street, S.E.

Washington, DC 20003

Phone: (202) 863-8103

Fax: (202) 863-8063

E-mail: info@democratsabroad.org

Website:www.democratsabroad.org

Republicans Abroad International

209 Pennsylvania Avenue, SE

Washington, DC 20003

Phone: (202) 608-1423

Fax: (202) 608-1431

General Information E-mail: 

mail@republicansabroad.org

Voting Information E-mail: 

Vote2004@republicansabroad.org

Website: www.republicansabroad.org

You may link to the above organizations through the FVAP

Website at www.fvap.gov.

3. Registration and Ballot Request

Persons who are away from their legal voting residence

must follow the guidelines of their state or territory for

voting absentee. Chapter 3 describes these requirements in

detail. In addition, citizens and VAOs are urged to note

deadlines carefully. These dates vary from state to state.

Consult Chapter 3 for the proper method to complete the

FPCA to request registration and a ballot from each state

and territory.

4. Requirements for Voting, 

Establishing Voting Residence

and Registration

A. Citizenship and Age

All states and territories prescribe two voter requirements:

 A voter must be a citizen of the United States on the

date of the election in which he or she wishes to vote;

and

 A voter must be at least 18 years old on election day

in order to vote. Some states permit a 17-year- old to

vote in primary elections if he or she will be 18 by the

date of the general election.

B. Voting Residence

The issue of voting residence is complex. Even in states

where laws clearly define criteria for determining a person’s

voting residence, the final determination is generally up to

each local election official.

The UOCAVA allows citizens outside the United States (not

affiliated with the Uniformed Services) to vote in the state

or territory where they last resided immediately prior to

departing the United States, even if many years have

elapsed, and the voter maintains no residence in the state or

territory, and the intent to return to that state or territory

may not be certain. 

For members of the Uniformed Services and their family

members, in most states the legal voting residence is

defined as where they have, or have had, physical presence

at the location and, the intent to remain or return.

If a citizen is uncertain about his or her current legal voting

residence, the citizen should examine his or her connections

or ties to the state or territory in question and consult with

legal counsel. Further, voting assistance personnel advising

citizens of their proper voting residence or registration

status should consult legal counsel.

C. Questions to Help Establish Voting 

Residence

The following questions may aid voting assistance

personnel in advising citizens on voting residence:

 Where have you registered to vote?

 Where have you voted?
2004–05 Voting Assistance Guide Instructions For Voting Assistance Officers

9

 What state or territory has issued you a driver’s

license, any other license or identification card?

 Where is your motor vehicle registered?

 Where is your home or home of record?

 What state or territory are you from?

 Where did you live before coming here?

 Where did you live immediately before leaving the

United States?

 Where does your family live?

 Where do your parents live?

 Where do you own property?

 Where do you engage in any businesses?

 Where do you have bank accounts?

 Where are you a member of any organization?

D. Registration

In some states, registration may not be necessary to vote. If

there is any doubt about registration status, the FVAP

advises citizens to apply early for registration. Chapter 3

addresses specific registration requirements and

information for each state and territory.

E. Questions to Help Establish Current 

Registration

Voter registration can be affected or cancelled for several

reasons: not voting for a period of time, changed residence

since the last registration or election, changed name since

the last registration or election, or changing political party

preference since the last registration.

This set of questions should aid in the determination of

current registration: 

 Are you registered to vote?

 Where and when did you register?

 Where and when have you voted? (See Chapter 3 for

state or territory provisions on cancellation of

registration for not voting.)

 Have you changed your address since you last

registered?

 Have you changed your name since you last registered

or voted?

 Have you changed your party affiliation since you last

registered?

The FVAP ombudsman service can help individuals by

contacting their local election official for registration status.

5. Completing the Federal Post 

Card Application (FPCA)

In order to register, and/or request an absentee ballot, an

eligible U.S. citizen must carefully and accurately complete

an FPCA before submitting it to the proper election official.

However, the extent and manner of FPCA usage is

controlled by state and territory law and sometimes by local

procedure. Because of varying state and territory

procedures, the citizen should refer to Chapter 3 when

completing the FPCA. 

A. State and Local Treatment of the 

FPCA

In all states and territories, the FPCA serves as a valid

request for registration and/or absentee ballot for those

citizens entitled to use it regardless of whether they have

registered prior to the submission of the FPCA. For such

citizens, registration is either waived or considered

accomplished upon submission of the FPCA requesting a

ballot.

A few states may also require submission of their own

registration form for permanent registration. Usually the

local election official will send this form with the ballot.

Refer to individual state procedures in Chapter 3. 

B. On-Line Federal Post Card 

Application (OFPCA)

The OFPCA is an alternative to

the card stock FPCA. The

OFPCA is being provided as a

convenience and as a timesaving alternative when you

cannot get the postage-paid (in

U.S. Mails including APO and FPO addresses) cardstock

FPCA through other means and so that you will not miss

the opportunity to register or make timely request for a

ballot. Unlike the postage-paid cardstock FPCA, users of

the OFPCA must affix postage on the envelope before

mailing the form. Most states and territories accept the

OFPCA. Check the FVAP website at www.fvap.gov for a

list of states that do accept the form. If you send the

OFPCA to a state or territory that does not accept it, your

application may not be processed.

The form can be filled-in on-line, printed out, signed, dated,

placed in an envelope with the proper postage and mailed to

the appropriate local election official.

Note: You are entitled to get the postage-paid FPCA which

may be requested from a VAO or the FVAP.

C. Deadline for Submitting the FPCA

In about half the states and territories, the deadline for

submitting the FPCA is the same for all those entitled to use

it, regardless of whether or not the citizen is on the voter
Instructions For Voting Assistance Officers 2004–05 Voting Assistance Guide

10

registration rolls for that state or territory. In the remainder

of the states and territories there will be two deadlines: one

for the registered voter and one for the nonregistered voter.

In the latter category of states, the

nonregistered voter usually must submit

the FPCA to the local election official by

the state’s or territory’s deadline for voter

registration (usually about 30 days prior

to the election). The registered voter may

have a later deadline. The citizen should

refer to his or her state or territory in Chapter 3 for further

details.

Every registered citizen is strongly urged to submit the

FPCA so that it is received by the election official at least

45 days prior to the election. Unregistered citizens are

urged to submit the FPCA so that it arrives at least 60 days

prior to the election. This helps to ensure timely delivery of

the ballot to the citizen. 

In all states and territories, one FPCA will secure for the

applicant both primary and general election ballots for

Federal offices for an entire calendar year. The Help

America Vote Act of October 2002 has extended the

effective period of the FPCA through two regularly

scheduled general elections for federal office. However, due

to the transient nature of many UOCAVA citizens, FVAP

continues to recommend that each citizen submit an FPCA

to their state of legal residence in January of each year and

again each time there is a change in the citizen’s mailing

address. 

D. FPCA Completion Instructions 

(Revised 1995)

Type or print all information in dark (black preferred) ink.

Refer to Chapter 3 for particular items required by each

state and territory to complete the FPCA and see page 19

for a depiction of the form. Fill in state, county, city or

township of voting residence at the top of the form and all

other required items in accordance with the following

instructions (by item number):

1. Applicant Information — Full name; sex; race; date

of birth; social security number; and other

identification number (state drivers license or ID card,

passport).

2. I Last Voted or Place of Last Registration —Enter

year; county, city or township; state; voter registration

number (if known).

3. Voting Residence — Enter complete voting residence.

If you use a rural route number, be as descriptive as

possible so that election officials can determine your

proper voting district and which ballot to send you.

4. Mail Absentee Ballot To — Provide the complete

mailing address where you want the ballot delivered.

Include all international codes and country name.

5. Your Fax Number — Provide your fax number. Refer

to Chapter 3 to determine which forms states and

territories allow to be faxed. 

Note: Even if the state does not accept faxing of

official election materials, FVAP recommends you

include a fax number here in case the local election

official needs to contact you.

6. Political Party Affiliation — Enter information here

as required by your state or territory to vote in a

primary election.

7. Remarks — Use this space to provide any

information which may assist local election officials in

contacting you and processing the application.

Providing your e-mail address or the name and

telephone number of a local contact person, a maiden

name or other name used, will help the local election

official. Also, if you are requesting a state special

write-in absentee ballot, indicate the reason for it, or if

required by your state, place a gummed label (from

Chapter 3) here. If a gummed label is used, write any

necessary contact information on a separate piece of

paper and attach to the FPCA.

8. Affirmation By Applicant — Read items a through d

and mark the appropriate box with an X. In most

states, marking a, b or c will entitle you to receive a

full ballot from the state or territory. Marking b or c

generally means that at some future time you intend to

reside again in that state or territory. Marking box d

generally indicates that you were a resident of the state

or territory before departing the U.S. and your intent to

return at some time in the future may be uncertain.

Marking block d applies for a ballot for Federal offices

only (if one is printed by the state or territory). 

If you reside outside the U.S. and wish to avoid

classifying yourself as a state resident for tax

purposes, mark block 8 d. If the state sends a full

ballot because it does not print a separate ballot for

Federal offices only, you may vote the full ballot.

Check with legal counsel if you have specific tax

related questions.

Read items e - h and use block i and j (Signature of

Applicant and Date) to sign and date this application.

9. Witness/Notary Address And Signature — Consult

Chapter 3 to determine which election materials may

require a witness or notary. If more space is required to

complete this, use Item 7 (Remarks) or a separate

piece of paper attached to the FPCA.

The FPCA also contains a small postcard on which the

applicant should include a return address. This will enable

the local election official to contact the applicant. If the

FPCA is incorrect or lacks any information necessary to
2004–05 Voting Assistance Guide Instructions For Voting Assistance Officers

11

process the form, the local election official may return the

postcard or contact the citizen by e-mail, telephone or fax

explaining what information is needed to complete the

registration and/or ballot request. 

While pre-1995 versions of the FPCA may still be in

circulation, the FVAP recommends use of the 1995 revision

only, due to changes in state requirements.

6. Mailing the FPCA

The citizen should mail the FPCA in sufficient time to

comply with all state or territory deadlines. The citizen

should be certain that he/she allows enough time to receive,

vote, and return an absentee ballot in time for it to be

counted. 

The FPCA does not require

postage if mailed in the U.S.

postal system, which includes

all U.S. military post offices

(APO/FPO) overseas as well as

diplomatic pouches. Many

Embassies and Consulates have

access to U.S. military post

offices. Those that have access will accept the FPCA and

give it to the U.S. military post office where it will be

mailed with no postage required. The FPCA may also be

sent postage-free through the diplomatic pouch at

Embassies and Consulates. However, the diplomatic pouch

may not have a regular pick-up schedule. If you are mailing

election materials from overseas and do not have access to a

U.S. Embassy/Consulate or an APO/FPO address, please

affix the proper postage necessary to get the materials into

the U.S. postal system. In some cases it might be better to

pay for either the international mails or private air courier

services.

Consular officers at Embassies or Consulates can provide

the best mailing advice for citizens.

7. Electronic Transmission of 

Election Materials

Transmitting voting materials by

mail may not allow for the timely

receipt and return of materials.

When such conditions exist,

possibly preventing an individual

from voting, electronic transmission

may be possible. However, a VAO

should first refer to Chapter 3 to

determine if a state or territory permits faxing of official

voting materials, and if so, which voting materials a state or

territory may allow to be faxed.

When faxing an application, voted ballot, or other election

materials, the FVAP recommends use of one of its

Electronic Transmission Service (ETS) numbers. These

numbers are: DSN (military) 223-5527; 1-800-368-8683;

or (703) 693-5527. Overseas citizens with questions may

reach the FVAP by using the international toll-free numbers

listed on the inside back cover and on the FVAP website at

www.fvap.gov.

Citizens should fax the FPCA or ballot in private. If a

VAO’s assistance is required, his or her role is to perform

these duties in an official capacity and to protect the

integrity of the electoral process and the confidentiality of

the voter and his or her vote. Most states that permit faxing

of the voted ballot require the voter to sign a waiver of his

or her right of a secret ballot.

Separate transmissions and/or cover sheets should be used

for each FPCA or ballot sent. Also, after faxing, most states

request that the citizen mail the completed FPCA or voted

ballot to the local election official at the appropriate state or

territory address listed in Chapter 3. 

Appendix C explains the fax process and contains a cover

sheet which can be duplicated for use when faxing election

materials.

8. Ballot Receipt and Late 

Counting

Some absentee ballots may arrive too late for the voter to

execute the ballot, get it witnessed or notarized if required,

and mail it to the local election official so that it arrives by

the indicated deadlines. It is always advisable to vote the

ballot and return it as soon as possible, even if the citizen

believes it will not arrive in time to be counted. Some states

and territories (see Chapter 3) allow for counting beyond

election day if the ballot is postmarked on or before the date

of the election. If the citizen’s state or territory is not among

those that allow late counting, the citizen should mail the

ballot anyway. The FVAP has initiated court actions in the

past which required some states to count absentee ballots

received past normal deadlines.

Whenever possible, especially for states and territories

which allow late ballot counting, citizens should ask the

postal clerk to hand stamp the envelope verifying the

ballot’s mailing date.

9. Ballot Delays

The possibility that local election officials may not receive

the necessary information to print absentee ballots until

close to election day can be a problem for absentee voters.

One major cause of delay in preparing and mailing ballots

is litigation by candidates to be placed on the ballot or to
Instructions For Voting Assistance Officers 2004–05 Voting Assistance Guide

12

remove an opponent’s name from the ballot, or because of

objections to the format of the ballot.

Through communication with state and local election

officials, the FVAP is often able to anticipate which states

or localities may not be able to mail ballots in a timely

manner. This information will be transmitted, as available,

to voting assistance personnel through department and

agency Voting Assistance Officers.

10. Marking and Mailing the Ballots

State or local election districts send the

ballot with complete instructions for

marking and returning the ballot. Frequently

these instructions call for a procedure that

requires the service of a VAO or other

individual. 

Caution should be taken not to compromise the voter’s right

to the secrecy of the ballot.

11. The Federal Write-In Absentee 

Ballot (FWAB)

The FWAB is a back-up ballot that can be used by

UOCAVA citizens in general elections for Federal offices

under three very specific conditions. To be eligible for this

ballot, a citizen must:

1. Be located outside the United States, including APO

and FPO addresses.

2. Apply for a regular ballot early enough so that the

appropriate local election official receives the request

at least 30 days before the election. 

3. Not have received the requested regular absentee

ballot from the state.

The FWAB must be received by the local election official

not later than the deadline for receipt of absentee ballots

under state or territory law. Connecticut is not required by

law to accept the FWAB, but currently does accept it.

Some states now allow the FWAB to be used by military

and overseas citizens in elections other than general

elections, for offices other than Federal offices, or from

within the U.S. Therefore, it is important to consult Chapter

3 of this Guide regarding use of the FWAB. Also, the FVAP

may take legal action or enter into an ad hoc agreement

with a state to allow expanded use of this pre-positioned

ballot. The FVAP will notify VAOs regarding any changes

to the parameters governing the use of the FWAB through

the Voting Information News newsletter, voting news

releases and the on-line edition of this Guide.

Note: A sample Federal Write-In Absentee Ballot, (SF 186)

with instructions can be found on pages 19-26.

12. State Special Write-In Absentee 

Ballot

Several states provide a state special write-in absentee

ballot to assist citizens, such as submariners, missionaries,

Peace Corps personnel and other individuals in extremely

isolated areas, who know before the election they will be

unable to use their state’s regular absentee voting

procedures due to lack of regular mail service. It should not

be confused with the Federal Write-In Absentee Ballot. 

The eligibility requirements for a state special write-in

absentee ballot are set by the individual states and can be

found in the various state and territory pages in Chapter 3.

Generally, state special write-in absentee ballots include

state, local, and federal offices.

13. Voting In Person

Citizens who live within the United

States may be able to register and

vote where they live. This generally

applies to eligible members of the

U.S. Uniformed Services and their

family members regardless of

whether they live on or off a

military installation. In short, any

qualified person who can satisfy a

state’s or territory’s legal residence requirement can register

and vote in that state or jurisdiction.

Registering to vote at your new place of legal residence will

cancel your registration at your previous residence and may

cause you to incur state or local tax liabilities at the new

residence. For those who may be able to choose to vote

absentee in one state or territory or in person in another, tax

consequences and other legal effects of changing voting

residence should be considered. Voters should consult legal

counsel when making these decisions.

If stateside, the VAO should contact local election officials

where the installation is located, have available telephone

numbers and become familiar with registration procedures

in order to assist military and dependents who vote locally.

The FVAP can provide contact information for these

offices. 

Many states and territories have systems of mail

registration. These states permit applicants to register by

mailing a state prescribed form in lieu of in-person

registration. Many of these forms are available online. The

FVAP website (www.fvap.gov) has links to state and

territory election web sites.
2004–05 Voting Assistance Guide Instructions For Voting Assistance Officers

13

Some localities operate mobile registration units as a

convenience to citizens. Others expand registration

opportunities through different methods. For additional

information on registration in a particular community,

citizens and voting assistance personnel may contact state

or local election officials. VAOs at the department or

agency level are also able to provide assistance in these

matters.

14. Late Registration

Many members of the U.S. Uniformed Services and

overseas citizens go through a transition period when they

first leave the Uniformed Services or return home from

overseas employment and may not know where they will

take up permanent residence. Others may move to a new

location and not meet the state’s residency requirements.

Sometimes the date of discharge or return from overseas,

and a state’s registration requirement may disenfranchise a

recently discharged military member, their eligible family

members or overseas citizens. Some states have special

procedures to allow these persons to register and vote.

In most of these cases, the registration is only valid for the

next election.

Chapter 3 of this Guide includes information on those states

which allow late registration. Each year states and

territories pass legislation to facilitate voting by military

members and overseas citizens. If the Guide does not

indicate that the state or territory allows late registration, the

citizen can check the on-line version of this Guide at

www.fvap.gov or contact the local election official to see if

the state or territorial laws have changed to allow late

registration. 

15. Reporting Irregularities

Voting Assistance Officers (VAO) should report any

irregularities in the voting process to their department or

agency headquarters VAO. These will be further reported to

the FVAP and appropriate action will be taken.

The FVAP strongly encourages voting assistance personnel

to make suggestions for “best practices” to include

improvements to absentee voting procedures, this Guide,

and other FVAP materials. See Section 24 and 25 of this

chapter for more information

16. FVAP Submits Reports to the 

President and Congress

The FVAP conducts periodic surveys of voting assistance

personnel and is required by law to submit a report to the

President and Congress. The surveys are designed to

measure the effectiveness of the voting assistance program

and the availability and use of informational support

materials at any given time during the election year. Voting

assistance personnel are encouraged to discuss all aspects of

the program with the FVAP at any time. 

17. Other Ways to Obtain a Ballot 

and Vote

A. Proxy Procedure

Several states and territories allow individuals other than

the prospective voter to act on the voter’s behalf to register

the voter and/or request an absentee ballot for the citizen;

however, under no circumstance may a person cast a ballot

on behalf of another person. Refer to the appropriate state

or territory in Chapter 3 for more details.

B. In Person at the Polls

A citizen who is able to vote in person in

his or her own district of legal residence

should take advantage of the opportunity.

Voting in person does not necessarily

preclude registering by absentee process.

In some states, applying for an absentee

ballot will not automatically rule out

voting at the polls. A few states even permit someone who

has already marked and returned an absentee ballot to vote

in person, thereby nullifying the absentee ballot.

18. Providing Information on 

Candidates

Voting motivation programs should

encourage people to vote and inform

them that voting is a civic responsibility

rather than a legal obligation.

It is the Voting Assistance Officer’s

responsibility to inform the citizen about

the procedures to follow in order to vote.

It is the citizen’s responsibility to obtain

information about candidates and issues.

Some of the best sources for citizens to obtain such

information are hometown newspapers, newspapers with

national circulation, magazines, radio and television, and

information obtained directly from the political party and

campaign committee offices supporting a particular

political candidate or proposal. The DoD Voting

Information Center (VIC) provides information on

candidates. Citizens may call 1-800-438-VOTE (8683),

(703) 588-1343 or DSN (military) 425-1343 to reach the

DoD VIC. Overseas citizens may call the VIC by using the
Instructions For Voting Assistance Officers 2004–05 Voting Assistance Guide

14

international toll-free numbers listed on the inside back

cover and on the FVAP website at www.fvap.gov. 

Other sources of information about candidates for members

of the military and their family members include Armed

Forces Radio and Television Service (AFRTS), Stars and

Stripes, the American Forces Information Service (AFIS),

as well as newspaper articles and features distributed for

military editors and used by the American Forces Press and

Publications Service (AFPPS).

English language newspapers and periodicals published

overseas also include information about candidates and

issues. Many of the above sources are also available on the

world wide web.

19. VAO Restrictions on 

Distributing Partisan Information

The VAO must not provide

partisan information on candidates

and issues to civilians, military

personnel or their family

members, but may refer citizens to

the above sources of information.

Further, VAOs are not to distribute

any literature from candidates or

partisan organizations.

Organizations become partisan when they endorse or imply

endorsement of candidates or identify with issues in a

campaign. Military VAOs should contact the FVAP and

also obtain the Commanding Officer’s approval before

distributing literature from any outside organization.

The Department of Defense’s policy regarding the

maintenance of political neutrality is stated in DoD

Directive 5410.18:

“The Armed Forces and the Defense Establishment belong

to all the American people... Department of Defense

support of and participation in events and activities in the

civilian domain will reflect that fact... [and such] support

and participation must not directly or indirectly (a) endorse

or selectively benefit or favor, or appear to endorse or

selectively benefit or favor any private individual, group,

corporation (whether profit or nonprofit), religion, sect or

sectarian group, quasi-religious or ideological movement,

fraternal organization, political organization, or commercial

venture, or (b) be associated with the solicitation of votes in

a political election.” 

Military VAOs should refer to DoD 1344.10 “Political

Activities by Members of the Armed Forces on Active

Duty”. Overseas citizens VAOs should refer to the Hatch

Act, Title 5 U.S.C. Sec. 7321.

20. How to Implement a Voting 

Assistance Plan

The Military and Embassy/Consulate Voting Assistance

Officer (VAO) has the important responsibility of providing

accurate, nonpartisan voting information and assistance to

the individual attempting to register and vote. The

organization and effectiveness of a VAO may very well

determine whether a citizen will understand how to

participate in the process. Each VAO can accomplish his/

her voting assistance plan by holding informational classes

and informal discussions concerning voting and the

responsibilities of a concerned citizenry.

When developing a local voting assistance plan, the VAO

should consider the following:

 Visit the FVAP’s website at www.fvap.gov.

 Help U.S. citizens to register and obtain a ballot.

 Encourage them to learn about the candidates, the

issues and to vote.

 Distribute all voting materials and information in a

timely manner.

 Make certain you have at least four FPCAs for each

person for whom you are responsible. This will

provide a sufficient supply to cover eligible

dependants, change of address forms, deployments

and new arrivals to your section of responsibility. 

 Make certain you have at least one FWAB for each

person you are responsible for.

 Hold a voting information briefing or voter

registration drive for the citizens you are responsible

for assisting.

 Display the 2004 Election Dates poster, and put your

name, telephone number and e-mail address on the

bottom. In addition, display motivational posters.

 Get the FVAP voting news releases and distribute this

information widely.To subscribe, e-mail request to

vote@fvap.ncr.gov.

 Make use of the valuable information available to you

in the Voting Information News newsletter and make it

available to others. Extract information from this

newsletter and make it available to your local media

for coverage. FVAP highly encourages the duplication

and redistribution of the newsletter. To subscribe, email request to vote@fvap.ncr.gov. 

 Include the youth (18 - 25 age group) in your voting

assistance program. This group has statistically shown

lower voter participation. Don’t forget 3rd shift

workers. If you are an overseas VAO, include

American Organizations, associations and

corporations in your absentee voting activities. If you

are a military VAO, include tenant organizations.

 Encourage use of the DoD Voting Information Center.
2004–05 Voting Assistance Guide Instructions For Voting Assistance Officers

15

 Download, duplicate and circulate copies of the FVAP

pamphlet titled, How To Do It! Vote Absentee from the

FVAP website.

 Utilize the motivational Get Out The Vote Public

Service Announcements in print, audio and video

format in local media.

 Use the Ombudsman Service when necessary. If you

cannot find answers locally or through your Services

Voting Action Officer, contact FVAP.

 Review the military or civilian on-line training at

www.fvap.gov for advice and suggestions.

21. The Scope of a Civilian Voting 

Assistance Plan

Many U.S. citizen organizations and

corporations outside the U.S. have

designated a Voting Assistance Officer

(VAO) for a two-year tenure. This

VAO will serve as the organization's

primary point of contact to work with

the FVAP to carry out an effective

voting assistance effort for the 2004-05 election years, and

if so designated, for future election years.

The FVAP will provide the necessary materials for

organizing and directing the organization's voting assistance

program. Those materials include: a 2004-05 Voting Action

and Information Support Plan outlining a schedule of action

for the election year and a Voting Assistance Kit which

contains all the essential materials for an effective voting

assistance program.

VAOs will also receive FVAP voting news releases and the

monthly Voting Information News newsletter.

VAO’s responsibilities will include:

 Expanding citizen outreach within the local

community to include direct contact with civic groups,

American Chambers of Commerce, colleges and

universities, and similar organizations of U.S. citizens.

 Serving as coordinator for the FVAP's on-site

workshops.

 Planning and ensuring that overseas U.S. citizens,

including eligible family members, are informed of

current registration and voting procedures and the

importance of participating in the democratic process.

 Conducting non-partisan voter registration drives.

Overseas Citizens Voter’s Week, July 4 through July

10, 2004 is an excellent time to get the word out, as

U.S. citizens gather for Independence Day activities.

 Ensuring in-hand delivery of FPCAs to overseas U.S.

citizens not later than August 15, 2004. 

 Submit a summary to the Director, FVAP, not later

than December 2004, on the voter outreach efforts

conducted during the election year, “best practices”

found and lessons learned.

22. The Scope of a Military 

Installation Voting Assistance Plan

Each Commanding

Officer (CO) has the

overall responsibility

for the operation of a

successful voting

assistance program

within the command.

Usually, the CO will appoint an officer to act as Voting

Assistance Officer (VAO) to organize and direct the

command’s voting assistance program. The command’s

VAO will ensure that each subordinate unit and

organization appoints, on orders or in writing, an officer,

senior civilian employee or non-commissioned officer to

organize and direct voting assistance activities within each

unit or organization.

COs should conduct orientation briefings with unit VAOs

prior to the start of primary elections. These briefings are

intended to prepare unit VAOs for their duties and to ensure

that voting assistance materials are on hand prior to the

commencement of the 2004-05 command voting assistance

program. 

A minimum of four FPCAs and one FWAB should be

available for each person, including unit personnel and

eligible family members.

In addition, the CO is required to plan and ensure that

briefings of military personnel, their eligible family

members, and civilian employees in overseas locations, and

their eligible family members, are scheduled at the

installation and/or unit level. The briefings should inform

all these individuals of current registration and voting

procedures and the importance of voting.

The following officials are involved in carrying out the

voting assistance program: 

 Commanding Officer — The CO must emphasize the

voting program in staff meetings, other command

meetings, briefings and daily communications with

those on the installation. He or she must communicate

support of the program and encourage staff

participation and involvement throughout the

command.

 Installation Voting Assistance Officer — IVAOs

should act as a focal point on military installations in

coordinating voting assistance support on their

installation. IVAOs should maintain a roster of all unit

VAOs on the installation (including tenant
Instructions For Voting Assistance Officers 2004–05 Voting Assistance Guide

16

organizations), establish communications with these

VAOs and provide necessary materials and support.

 Unit Voting Assistance Officers

— VAOs have an opportunity to

personalize a command’s voting

assistance efforts. Success of a

voting assistance program in any

election year may well depend

upon the availability and quality of service that unit

Voting Assistance Officers provide their personnel and

their family members.

 Legal Assistance Officer — Legal questions which

cannot be answered by the unit VAO should be

referred to the command’s legal staff.

 Public Affairs/Information Officer — This officer

ensures that voting information is included in

installation or unit publications such as newspapers,

newsletters, daily bulletins, other printed media, where

applicable, and Armed Forces Radio and Television

Service. The Public Affairs Officer and the VAO

should coordinate the activities for Armed Forces

Voters Week (September 3-11, 2004).

 Inspector General (IG) — The IG, acting on behalf

of the CO, has an interest in any program which

concerns the rights of personnel and family members

and helps to ensure that VAOs are trained and

equipped to give assistance to citizens in the

command. The IG periodically reviews organization

voting assistance programs to ensure compliance with

DoD and Service directives and regulations.

 Chaplain — As a respected member and leader in the

military community, the chaplain can be of help in

disseminating reminders and information to members

of the community.

 Publications, Supply or Distribution Officer — This

officer ensures that installation and tenant unit VAOs

receive copies of this Guide and other voting program

informational materials. These materials include a

minimum of four FPCAs, and one FWAB, for each

member of the unit or command and their eligible

family members. 

In addition to normal distribution of informational

material, the FVAP may disseminate additional voting

materials throughout the election year. It is essential

that distribution officers notify VAOs immediately

upon receipt of these items.

 Officers-in-Charge — VAOs should contact Officers

in charge of exchanges, commissaries, special services

activities, medical and dental facilities, education

centers, family centers, etc., to coordinate the display

of voting information materials and for participation in

Armed Forces Voters Week activities (September 3-11,

2004).

 Installation Telephone Supervisor — The VAO

should ensure that the installation Voting Assistance

Officer’s name, location, and phone number are

known to the telephone operators so that inquiries

regarding voting assistance may be referred to the

appropriate person.

 In addition to these officials, a resourceful VAO will

make use of the many organizations that perform local

service functions such as:

Spouses’ Club — This organization performs many

service functions for the community and is always

responsive to worthy community projects.

Boy/Girl Scouts, and Other Youth Groups —These

organizations carry out numerous citizenship-oriented

service projects. Contact the installation officer who

serves as the local scout leader.

Veterans and Service Organizations — The Veterans

of Foreign Wars, the American Legion, the Noncommissioned Officers Association and the League of

Women Voters are typical of organizations that

perform important community services and are eager

to be of assistance. Contact local leaders.

23. Problems Experienced in 

Processing FPCAs by Local

Election Officials

Redesign of the FPCA in 1995 and subsequent educational

and training efforts have substantially reduced the incidence

of FPCA processing problems encountered by local

election officials. The most common issues cited by Local

Election Officials are:

 No signature

 No, or inadequate, voting residence address

 Illegible or inadequate mailing address (i.e., where the

ballot is to be sent)

 Application sent to the incorrect jurisdiction

 Failure to indicate Party preference for primary

elections

 Illegible handwriting

 FPCA received too late

 Required areas of FPCA not complete

 No Date-of-Birth given

 FPCA not witnessed or notarized (where required)

VAOs can help reduce these processing problems by

advising citizens about the proper way to fill out an FPCA.

Local Election Officials must determine the citizen’s

eligibility to vote based solely on information provided on

the FPCA, and if there are questions or additional

information is required, they need enough time and the
2004–05 Voting Assistance Guide Instructions For Voting Assistance Officers

17

correct contact information (e-mail, telephone, fax or

mailing address) to resolve the issue.

24. Collecting and Sharing Best 

Practices and Lessons Learned

The FVAP Best Practices Program

supports developing, collecting,

sharing and implementing of Voting

Assistance Officer’s (VAOs) best

practices and lessons learned

worldwide. The objective of the

program is to enhance lines of

communication among VAOs at all

levels to facilitate global sharing of

best practices and lessons learned

while enabling tailored local best practices based on

organizational voting assistance programs and lessons

learned from successes and mistakes.

As you provide absentee voting assistance, look at your

voting assistance program, processes and procedures. You

will find that there are some things you are doing very well

with excellent results that others could use to improve

awareness and participation among the UOCAVA citizens

you assist.

The Best Practices Report from each of the Services are

displayed on the FVAP website. Lessons learned are

disseminated through the Voting Information News

newsletter.

25. Guidance for Submitting Best 

Practices and Lessons Learned

VAO sources of information used to generate best practices

and lessons learned may include, but are not limited to, the

following:

 Personal Experiences as a VAO

 Assessments, audits and appraisals

 Training evaluations

 Operational Readiness Reviews

 Critiques, analysis and investigations

 Process improvement initiatives

 VAO training

 Voting activities such as registration drives

A best practice or lessons learned should contain five basic

elements:

 A clear statement of the practice or lesson

 A background summary of how the practice was

developed or the lesson was learned

 Benefits of using the practice or lesson, and suggestion

how the practice or lesson may be used in the future

 Contact information for additional detail

 Key entry information to aid review (see FVAP

website)

Uniformed Services Installation and U.S. embassies and

consulates’ VAOs should submit best practices and lessons

learned through e-mail to their Service Voting Action

Officer (SVAO). Overseas citizen organization VAOs and

individuals may submit their best practices directly to the

FVAP via e-mail, vote@fvap.ncr.gov. For additional

information on guidelines for submitting best practices and

lessons learned, please visit the FVAP website at

www.fvap.gov.
Instructions For Voting Assistance Officers 2004–05 Voting Assistance Guide

18
19

SAMPLE FORMS

FEDERAL POST CARD APPLICATION (FPCA) SF 76, REVISED 1995

FPCA, SF 76, Rev. 1995 — Application Side

(After completion, fold to the inside and seal before mailing.) NSN 7640-00-634-5053

WARNING: Knowingly presenting false information in this application could result in criminal sanctions.

PRIVACY ACT STATEMENT

AUTHORITY: 42 USC 1973ff, “Title 1 - Registration and

Voting By Absent Uniformed Services Voters and

Overseas Voters in Elections for Federal Office.”

PRINCIPAL PURPOSE: Serves as an application for

registration or request for absentee ballot for all persons

covered by the Uniformed and Overseas Citizens

Absentee Voting Act.

DISCLOSURE: Voluntary; however, failure to provide the

necessary information may keep the pertinent jurisdiction

from processing this request and may prevent you from

voting absentee.

MAILING INSTRUCTIONS: Self-address small post card

to your current address. Fold so that large post card is on

outside; seal; complete “TO” and upper left corner on

large post card, and mail. DO NOT STAPLE OR APPLY

TAPE TO SEAL.

Type or legibly print all applicable information. Sign the

form.

SPECIFIC INSTRUCTIONS FOR COMPLETION

Complete the state, county, and city/township section at

the top of the large postcard. Note that your state may

require a separate FPCA for each election. Consult a

Voting Assistance Officer or your state section in the

Voting Assistance Guide for further information.

Standard Form 76 (Back)

(Rev. 10-95)

1. APPLICANT INFORMATION. Item 1.c. This information is

requested from some states for statistical purposes by the

Department of Justice in their enforcement of the Voting Rights

Act and the National Voter Registration Act. Enter Information for

1.a. through 1.f. For block 1.f., provide identification form and

number of that form. For example: passport 0000, State

Department 0000, driver’s license 0000, birth certificate 0000.

2. I LAST VOTED or PLACE OF LAST REGISTRATION. Provide

as much information as possible for the location where you last

voted. This is not necessarily your last residence. Do not leave

blank. Enter N/A if not applicable or if you are a first time voter.

3. VOTING RESIDENCE. Province address where you

ACTUALLY LIVED. Your right to vote in your state and

determination of voting precinct depend on your physical

residence while you were within the state. If your voting residence

address does not contain a street name, you may provide a Rural

Route number and box number, but DO NOT USE A POST

OFFICE BOX NUMBER. A Post Office Box is not a residence

address. If using Rural Route number, include specific location of

residence. Examples of voting residence: military home of record;

permanent home address in U.S.; locality or state where you paid

taxes, however long ago it may have been. It would be helpful if

you list a name and telephone number of a local contact in the

Remarks Section in the event the local election official has a

question concerning the application.

4. MAIL ABSENTEE BALLOT TO. Provide the complete mailing

address where you wish to receive your absentee ballot. Be sure

to include APO or FPO (if applicable) and ZIP Code. If you will

have a new address by the time registration forms or the ballot will

be sent to you, be sure to list the new address.

5. YOUR FAX NUMBER. You complete fax number (country and

city code) is required if you or the local election official will be

transmitting any of your election materials by fax. Members of the

U.S. Military are requested to provide their commercial as well as

DSN number (write “DSN” as a prefix if a DSN number is

provided). Faxing is available in some states, for limited purposes

only. If your state allows you to submit this form by fax

(IMPORTANT: CONSULT VOTING ASSISTANCE OFFICER OR

VOTING ASSISTANCE GUIDE FOR FURTHER

(Specific Instructions are continued on reverse.)

(fold to inside)

Election Official name and complete address U.S. Postage Paid

39 USC 3406

PAR AVION

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST-CLASS MAIL

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

Applicant name and complete address

TO:

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF s

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) MMDDY Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (Do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

(X only one: a, b, c or d) c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

MMDDY Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.
Sample Forms 2004–05 Voting Assistance Guide

20 FPCA, SF 76, Rev. 1995 — Mailing Side

SPECIFIC INSTRUCTIONS FOR COMPLETION (Continued) SOURCES OF ASSISTANCE

5. YOUR FAX NUMBER. (Continued) INFORMATION, you must 

fax this form ONLY to one of the following numbers: (800) 368-

8683 or (703) 693-5527 or DSN (military) 223-5527. If your state 

does NOT allow you to submit this form by fax, DO NOT transmit 

this form by fax, as it will not be processed.

6. POLITICAL PARTY AFFILIATION. This information is required 

by most states in order to vote in primary elections. In most 

states, if you do not complete this section, you will not be sent a 

ballot for primary elections. Consult your individual state section 

in the Voting Assistance Guide for more specific information 

regarding your state’s policy. Political party affiliation is not 

required if you live in Alaska (unless you are voting in a 

Republican party primary), American Samoa, Guam, Hawaii, 

Idaho, Michigan, Minnesota, Montana, North Dakota, Vermont, 

Washington or Wisconsin, in order to vote in a primary election. 

You need not complete this section if your voting residence is in 

those states. If you want to indicate no affiliation or enrollment in 

a political party, write “unaffiliated.”

7. REMARKS. Provide any information which may assist local 

election officials in approving this application, such as maiden 

name, name and telephone number of a local contact person, 

etc. If you are requesting the special state write-in ballot, 

indicate here the reason you are requesting the special state 

write-in ballot, I.e. you are in an isolated are with sporadic mail 

service, submarine duty, etc. In Colorado, you must indicate if 

you are a native born or naturalized citizen of the United States.

8. AFFIRMATION BY APPLICANT. Place an X in only one block: 

8a., b., c., or d. In most states, marking a., b. or c will get you a 

full ballot. Marking b. or c , generally means that at some future 

time you intend to reside again in that state. Marking block d. 

generally means that you were a resident of the state before 

departing the U.S., and your intent to return at some time in the 

future is uncertain. Marking block d. applies for a Federal ballot 

only (if one is printed by the state). Federal law provides that no 

tax liability may be imposed based on exercising you right to 

vote in Federal elections. If you are a civilian citizen residing 

outside the U.S. and wish to avoid classifying yourself as a state 

resident for tax purposes, you should mark block 8d. If the state 

sends a full ballot because it does not print a separate Federal 

ballot, you may vote the full ballot.

(fold to outside)

Block 8.f. In some states, a criminal conviction for a felony or certain 

misdemeanors, or an adjudication of mental incompetency 

disqualifies a person from voting, unless there has been a 

reinstatement of voting rights if required by state law.

Block 8.i. Sign at the X. Provide the date you completed the form.

9. WITNESS/NOTARY. Not all states require completion of this item. 

Consult your state section of the Voting Assistance Guide or your 

Voting Assistance Officer for your state’s requirements. If you 

require more space to complete this item, use Item 7, Remarks.

Assistance and information regarding the use and 

completion of this form, as well as specific state information 

may be obtained from military Unit Voting Assistance 

Officers, U.S. Embassy and Consular Voting Assistance 

Officers, or organizations of U.S. citizens overseas.

The Voting Assistance Guide contains voting information on 

a state-by-state basis for those eligible to use this form. The 

Guide is also available for purchase from the 

Superintendent of Documents, U.S. Government Printing 

Office, Washington, D.C. 20402-1575.

NOTE TO ELECTION OFFICIAL

This is a return post card for your use. Please mark and fill in applicable items, sign your name,

add your return address on reverse side, and return to the applicant.

THIS ACKNOWLEDGES RECEIPT OF YOU POST CARD REGISTRATION AND ABSENTEE BALLOT REQUEST.

You will be sent an absentee ballot for the election(s).

Your ballot(s) will be mailed approximately

Your application is incomplete. Please provide the following information to complete your application:

Your application could not be processed. Item(s) must be completed.

Please resubmit a new application with all required items completed.

A separate application must be submitted for each election.

Other comments

Signature Title Date Signed

Applicant name and complete address U.S. Postage Paid

39 USC 3406

PAR AVION

Standard Form 76 (Rev. 10-95)

Issued under 42 U.S.C. 1973FF et seq.

76-114

1988 edition may be used.

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST-CLASS MAIL

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

TO:
2004–05 Voting Assistance Guide Sample Forms

21

19

FEDERAL POST CARD APPLICATION (FPCA) SF 76, REVISED 1995

FPCA, SF 76, Rev. 1995 — Applic tion Side

(After completion, fold to the inside nd se l before m iling.) NSN 7640-00-634-5053

WARNING: Knowingly presenting f lse inform tion in this pplic tion could result in crimin l s nctions.

PRIVACY ACT STATEMENT

AUTHORITY: 42 USC 1973ff, “Title 1 - Registr tion nd

Voting By Absent Uniformed Services Voters nd

Overse s Voters in Elections for Feder l Office.”

PRINCIPAL PURPOSE: Serves s n pplic tion for

registr tion or request for bsentee b llot for ll persons

covered by the Uniformed nd Overse s Citizens

Absentee Voting Act.

DISCLOSURE: Volunt ry; however, f ilure to provide the

necess ry inform tion m y keep the pertinent jurisdiction

from processing this request nd m y prevent you from

voting bsentee.

MAILING INSTRUCTIONS: Self- ddress sm ll post c rd

to your current ddress. Fold so th t l rge post c rd is on

outside; se l; complete “TO” nd upper left corner on

l rge post c rd, nd m il. DO NOT STAPLE OR APPLY

TAPE TO SEAL.

Type or legibly print ll pplic ble inform tion. Sign the

form.

SPECIFIC INSTRUCTIONS FOR COMPLETION

Complete the st te, county, nd city/township section t

the top of the l rge postc rd. Note th t your st te m y

require sep r te FPCA for e ch election. Consult

Voting Assist nce Officer or your st te section in the

Voting Assist nce Guide for further inform tion.

St nd rd Form 76 (B ck)

(Rev. 10-95)

1. APPLICANT INFORMATION. Item 1.c. This inform tion is

requested from some st tes for st tistic l purposes by the

Dep rtment of Justice in their enforcement of the Voting Rights

Act nd the N tion l Voter Registr tion Act. Enter Inform tion for

1. . through 1.f. For block 1.f., provide identific tion form nd

number of th t form. For ex mple: p ssport 0000, St te

Dep rtment 0000, driver’s license 0000, birth certific te 0000.

2. I LAST VOTED or PLACE OF LAST REGISTRATION. Provide

s much inform tion s possible for the loc tion where you l st

voted. This is not necess rily your l st residence. Do not le ve

bl nk. Enter N/A if not pplic ble or if you re first time voter.

3. VOTING RESIDENCE. Province ddress where you

ACTUALLY LIVED. Your right to vote in your st te nd

determin tion of voting precinct depend on your physic l

residence while you were within the st te. If your voting residence

ddress does not cont in street n me, you m y provide Rur l

Route number nd box number, but DO NOT USE A POST

OFFICE BOX NUMBER. A Post Office Box is not residence

ddress. If using Rur l Route number, include specific loc tion of

residence. Ex mples of voting residence: milit ry home of record;

perm nent home ddress in U.S.; loc lity or st te where you p id

t xes, however long go it m y h ve been. It would be helpful if

you list n me nd telephone number of loc l cont ct in the

Rem rks Section in the event the loc l election offici l h s

question concerning the pplic tion.

4. MAIL ABSENTEE BALLOT TO. Provide the complete m iling

ddress where you wish to receive your bsentee b llot. Be sure

to include APO or FPO (if pplic ble) nd ZIP Code. If you will

h ve new ddress by the time registr tion forms or the b llot will

be sent to you, be sure to list the new ddress.

5. YOUR FAX NUMBER. You complete f x number (country nd

city code) is required if you or the loc l election offici l will be

tr nsmitting ny of your election m teri ls by f x. Members of the

U.S. Milit ry re requested to provide their commerci l s well s

DSN number (write “DSN” s prefix if DSN number is

provided). F xing is v il ble in some st tes, for limited purposes

only. If your st te llows you to submit this form by f x

(IMPORTANT: CONSULT VOTING ASSISTANCE OFFICER OR

VOTING ASSISTANCE GUIDE FOR FURTHER

(Specific Instructions re continued on reverse.)

(fold to inside)

Election Offici l n me nd complete ddress U.S. Post ge P id

39 USC 3406

PAR AVION

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST-CLASS MAIL

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

Applic nt n me nd complete ddress

TO:

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA)

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF s

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This inform tion is required

by most st tes to send you b llot for prim ry elections. See

instructions.)

. TYPED OR PRINTED NAME (L st, First, Middle Initi l) b.SEX c. RACE

d. DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (p ssport, ID c rd) 7. REMARKS (Provide ddition l inform tion which will ssist loc l

election offici ls in determining your eligibility to register nd vote.

See instructions.) MMDD Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not le ve this section bl nk. See instructions.)

.YEAR b. COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For milit ry, leg l residence. For overse s civili ns, l st

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

. LAST DAY OF RESIDENCY

MMDD Y Y

b. NUMBER AND STREET (Do not use Post Office Box)

8. AFFIRMATION BY APPLICANT

(X only one: , b, c or d) c. CITY, TOWN OR VILLAGE d.STATE I swe r/ ffirm, under pen lty of perjury, th t I m: (See instructions)

. member of the Uniformed Services or merch nt m rine on

ctive duty, or n eligible spouse or dependent.

e. COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. U.S. citizen tempor rily residing outside the U.S.

c. U.S. citizen overse s by virtue of employment or

ccomp nying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (M iling ddress where you w nt the b llot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I m U.S. Citizen, eligible to vote in the bove jurisdiction, nd

subscribe to ny required st te/loc l o th or st tement.

f. I h ve not been convicted of felony or other disqu lifying offense

or been djudic ted ment lly incompetent, or if so, my voting rights

h ve been reinst ted.

g. I m not registering, requesting b llot, or voting in ny other

jurisdiction in the U.S.

h. The inform tion on this form is true nd complete.

i. SIGNATURE OF APPLICANT j. DATE

MMDD Y Y

5. YOUR FAX NUMBER (If this pplic tion is f xed, include ll intern tion l prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

(If required by st te l w)

DATE SIGNED

MMDD Y Y

The inform tion cont ined herein is for offici l use only. Any un uthorized rele se of this inform tion m y be punish ble by l w.

2004–05 Voting Assist nce Guide

20

FPCA, SF 76, Rev. 1995 — M iling Side

SPECIFIC INSTRUCTIONS FOR COMPLETION (Continued) SOURCES OF ASSISTANCE

5. YOUR FAX NUMBER. (Continued) INFORMATION, you must

f x this form ONLY to one of the following numbers: (800) 368-

8683 or (703) 693-5527 or DSN (milit ry) 223-5527. If your st te

does NOT llow you to submit this form by f x, DO NOT tr nsmit

this form by f x, s it will not be processed.

6. POLITICAL PARTY AFFILIATION. This inform tion is required

by most st tes in order to vote in prim ry elections. In most

st tes, if you do not complete this section, you will not be sent

b llot for prim ry elections. Consult your individu l st te section

in the Voting Assist nce Guide for more specific inform tion

reg rding your st te’s policy. Politic l p rty ffili tion is not

required if you live in Al sk (unless you re voting in

Republic n p rty prim ry), Americ n S mo , Gu m, H w ii,

Id ho, Michig n, Minnesot , Mont n , North D kot , Vermont,

W shington or Wisconsin, in order to vote in prim ry election.

You need not complete this section if your voting residence is in

those st tes. If you w nt to indic te no ffili tion or enrollment in

politic l p rty, write “un ffili ted.”

7. REMARKS. Provide ny inform tion which m y ssist loc l

election offici ls in pproving this pplic tion, such s m iden

n me, n me nd telephone number of loc l cont ct person,

etc. If you re requesting the speci l st te write-in b llot,

indic te here the re son you re requesting the speci l st te

write-in b llot, I.e. you re in n isol ted re with spor dic m il

service, subm rine duty, etc. In Color do, you must indic te if

you re n tive born or n tur lized citizen of the United St tes.

8. AFFIRMATION BY APPLICANT. Pl ce n X in only one block:

8 ., b., c., or d. In most st tes, m rking ., b. or c will get you

full b llot. M rking b. or c , gener lly me ns th t t some future

time you intend to reside g in in th t st te. M rking block d.

gener lly me ns th t you were resident of the st te before

dep rting the U.S., nd your intent to return t some time in the

future is uncert in. M rking block d. pplies for Feder l b llot

only (if one is printed by the st te). Feder l l w provides th t no

t x li bility m y be imposed b sed on exercising you right to

vote in Feder l elections. If you re civili n citizen residing

outside the U.S. nd wish to void cl ssifying yourself s st te

resident for t x purposes, you should m rk block 8d. If the st te

sends full b llot bec use it does not print sep r te Feder l

b llot, you m y vote the full b llot.

(fold to outside)

Block 8.f. In some st tes, crimin l conviction for felony or cert in

misdeme nors, or n djudic tion of ment l incompetency

disqu lifies person from voting, unless there h s been

reinst tement of voting rights if required by st te l w.

Block 8.i. Sign t the X. Provide the d te you completed the form.

9. WITNESS/NOTARY. Not ll st tes require completion of this item.

Consult your st te section of the Voting Assist nce Guide or your

Voting Assist nce Officer for your st te’s requirements. If you

require more sp ce to complete this item, use Item 7, Rem rks.

Assist nce nd inform tion reg rding the use nd

completion of this form, s well s specific st te inform tion

m y be obt ined from milit ry Unit Voting Assist nce

Officers, U.S. Emb ssy nd Consul r Voting Assist nce

Officers, or org niz tions of U.S. citizens overse s.

The Voting Assist nce Guide cont ins voting inform tion on

st te-by-st te b sis for those eligible to use this form. The

Guide is lso v il ble for purch se from the

Superintendent of Documents, U.S. Government Printing

Office, W shington, D.C. 20402-1575.

NOTE TO ELECTION OFFICIAL

This is return post c rd for your use. Ple se m rk nd fill in pplic ble items, sign your n me,

dd your return ddress on reverse side, nd return to the pplic nt.

THIS ACKNOWLEDGES RECEIPT OF YOU POST CARD REGISTRATION AND ABSENTEE BALLOT REQUEST.

You will be sent n bsentee b llot for the election(s).

Your b llot(s) will be m iled pproxim tely

Your pplic tion is incomplete. Ple se provide the following inform tion to complete your pplic tion:

Your pplic tion could not be processed. Item(s) must be completed.

Ple se resubmit new pplic tion with ll required items completed.

A sep r te pplic tion must be submitted for e ch election.

Other comments

Sign ture Title D te Signed

Applic nt n me nd complete ddress U.S. Post ge P id

39 USC 3406

PAR AVION

St nd rd Form 76 (Rev. 10-95)

Issued under 42 U.S.C. 1973FF et seq.

76-114

1988 edition m y be used.

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST-CLASS MAIL

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

TO:

Place return address here

Complete and sign application

Then...

Turn the FPCA over and,

Place return address here

Address FPCA to correct local election

official as indicated in each State in 

Chapter 3 of the Guide.

19

FEDERAL POST CARD APPLICATION (FPCA) SF 76, REVISED 1995

FPCA, SF 76, Rev. 1995 — Applic tion Side

(After completion, fold to the inside nd se l before m iling.) NSN 7640-00-634-5053

WARNING: Knowingly presenting f lse inform tion in this pplic tion could result in crimin l s nctions.

PRIVACY ACT STATEMENT

AUTHORITY: 42 USC 1973ff, “Title 1 - Registr tion nd

Voting By Absent Uniformed Services Voters nd

Overse s Voters in Elections for Feder l Office.”

PRINCIPAL PURPOSE: Serves s n pplic tion for

registr tion or request for bsentee b llot for ll persons

covered by the Uniformed nd Overse s Citizens

Absentee Voting Act.

DISCLOSURE: Volunt ry; however, f ilure to provide the

necess ry inform tion m y keep the pertinent jurisdiction

from processing this request nd m y prevent you from

voting bsentee.

MAILING INSTRUCTIONS: Self- ddress sm ll post c rd

to your current ddress. Fold so th t l rge post c rd is on

outside; se l; complete “TO” nd upper left corner on

l rge post c rd, nd m il. DO NOT STAPLE OR APPLY

TAPE TO SEAL.

Type or legibly print ll pplic ble inform tion. Sign the

form.

SPECIFIC INSTRUCTIONS FOR COMPLETION

Complete the st te, county, nd city/township section t

the top of the l rge postc rd. Note th t your st te m y

require sep r te FPCA for e ch election. Consult

Voting Assist nce Officer or your st te section in the

Voting Assist nce Guide for further inform tion.

St nd rd Form 76 (B ck)

(Rev. 10-95)

1. APPLICANT INFORMATION. Item 1.c. This inform tion is

requested from some st tes for st tistic l purposes by the

Dep rtment of Justice in their enforcement of the Voting Rights

Act nd the N tion l Voter Registr tion Act. Enter Inform tion for

1. . through 1.f. For block 1.f., provide identific tion form nd

number of th t form. For ex mple: p ssport 0000, St te

Dep rtment 0000, driver’s license 0000, birth certific te 0000.

2. I LAST VOTED or PLACE OF LAST REGISTRATION. Provide

s much inform tion s possible for the loc tion where you l st

voted. This is not necess rily your l st residence. Do not le ve

bl nk. Enter N/A if not pplic ble or if you re first time voter.

3. VOTING RESIDENCE. Province ddress where you

ACTUALLY LIVED. Your right to vote in your st te nd

determin tion of voting precinct depend on your physic l

residence while you were within the st te. If your voting residence

ddress does not cont in street n me, you m y provide Rur l

Route number nd box number, but DO NOT USE A POST

OFFICE BOX NUMBER. A Post Office Box is not residence

ddress. If using Rur l Route number, include specific loc tion of

residence. Ex mples of voting residence: milit ry home of record;

perm nent home ddress in U.S.; loc lity or st te where you p id

t xes, however long go it m y h ve been. It would be helpful if

you list n me nd telephone number of loc l cont ct in the

Rem rks Section in the event the loc l election offici l h s

question concerning the pplic tion.

4. MAIL ABSENTEE BALLOT TO. Provide the complete m iling

ddress where you wish to receive your bsentee b llot. Be sure

to include APO or FPO (if pplic ble) nd ZIP Code. If you will

h ve new ddress by the time registr tion forms or the b llot will

be sent to you, be sure to list the new ddress.

5. YOUR FAX NUMBER. You complete f x number (country nd

city code) is required if you or the loc l election offici l will be

tr nsmitting ny of your election m teri ls by f x. Members of the

U.S. Milit ry re requested to provide their commerci l s well s

DSN number (write “DSN” s prefix if DSN number is

provided). F xing is v il ble in some st tes, for limited purposes

only. If your st te llows you to submit this form by f x

(IMPORTANT: CONSULT VOTING ASSISTANCE OFFICER OR

VOTING ASSISTANCE GUIDE FOR FURTHER

(Specific Instructions re continued on reverse.)

(fold to inside)

Election Offici l n me nd complete ddress U.S. Post ge P id

39 USC 3406

PAR AVION

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST-CLASS MAIL

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

Applic nt n me nd complete ddress

TO:

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA)

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF s

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This inform tion is required

by most st tes to send you b llot for prim ry elections. See

instructions.)

. TYPED OR PRINTED NAME (L st, First, Middle Initi l) b.SEX c. RACE

d. DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (p ssport, ID c rd) 7. REMARKS (Provide ddition l inform tion which will ssist loc l

election offici ls in determining your eligibility to register nd vote.

See instructions.) MMDD Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not le ve this section bl nk. See instructions.)

.YEAR b. COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For milit ry, leg l residence. For overse s civili ns, l st

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

. LAST DAY OF RESIDENCY

MMDD Y Y

b. NUMBER AND STREET (Do not use Post Office Box)

8. AFFIRMATION BY APPLICANT

(X only one: , b, c or d) c. CITY, TOWN OR VILLAGE d.STATE I swe r/ ffirm, under pen lty of perjury, th t I m: (See instructions)

. member of the Uniformed Services or merch nt m rine on

ctive duty, or n eligible spouse or dependent.

e. COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. U.S. citizen tempor rily residing outside the U.S.

c. U.S. citizen overse s by virtue of employment or

ccomp nying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (M iling ddress where you w nt the b llot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I m U.S. Citizen, eligible to vote in the bove jurisdiction, nd

subscribe to ny required st te/loc l o th or st tement.

f. I h ve not been convicted of felony or other disqu lifying offense

or been djudic ted ment lly incompetent, or if so, my voting rights

h ve been reinst ted.

g. I m not registering, requesting b llot, or voting in ny other

jurisdiction in the U.S.

h. The inform tion on this form is true nd complete.

i. SIGNATURE OF APPLICANT j. DATE

MMDD Y Y

5. YOUR FAX NUMBER (If this pplic tion is f xed, include ll intern tion l prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

(If required by st te l w)

DATE SIGNED

MMDD Y Y

The inform tion cont ined herein is for offici l use only. Any un uthorized rele se of this inform tion m y be punish ble by l w.

Applicant name and complete address U.S. Postage Paid

39 USC 3406

PAR AVION

Standard Form 76 (Rev. 10-95)

Issued under 42 U.S.C. 1973FF et seq.

76-114

1988 edition may be used.

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST-CLASS MAIL

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

TO:

Applicant name and complete address U.S. Postage Paid

39 USC 3406

PAR AVION

Standard Form 76 (Rev. 10-95)

Issued under 42 U.S.C. 1973FF et seq.

76-114

1988 edition may be used.

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST-CLASS MAIL

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

TO:

Then...

Turn the FPCA over again and,

Fold along perforated

line bottom to top in half

Then...remove the strip

to expose adhesive and

seal the FPCA shut.

Do not use staples...then mail.

FPCA, SF76, ALL EDITIONS

FOLDING AND MAILING INSTRUCTIONS
Sample Forms 2004–05 Voting Assistance Guide

22
2004–05 Voting Assistance Guide Sample Forms

23

FEDERAL WRITE-IN ABSENTEE BALLOT (FWAB)

SF 186, Revised 1995

FEDERAL WRITE-IN ABSENTEE BALLOT

FOR GENERAL ELECTIONS

Instructions to the Voter

Please read instructions before completion. If you have any questions, consult your Unit Voting Assistance Officer

or Embassy/Consulate Voting Assistance Officer or the Voting Assistance Guide.

TO OPEN, FOLD AND TEAR ALONG PERFORATION

1. Tear perforation at left. Separate and remove the Mailing Envelope on the back of this 

package.

2. Complete, sign and date the Voter’s Declaration/Affirmation on the Mailing Envelope as 

follows:

VOTER INFORMATION.

Enter information for 1.a. through 1.e. For Block 1.d., provide identification form and 

number of that form. For example: passport 0000, State Department 0000, driver’s 

license 0000, birth certificate 0000.

VOTING RESIDENCE.

Block 2. Enter complete legal voting residence address, in as much detail as possible, 

where you ACTUALLY LIVED. Your right to vote in your state and determination of your 

voting precinct depend on the physical location of your residence while you were in the 

state. DO NOT USE A POST OFFICE BOX NUMBER. A Post Office Box number is not 

a residence address. In an area with street names and numbers, this information is 

required. In an area with no street names, indicate route name and number and box 

number. Also provide any additional information necessary to physically describe your 

residence location. This voting residence address must be the same as the voting 

residence on the application you previously submitted for your regular absentee ballot.

CURRENT COMPLETE MILITARY OR OVERSEAS ADDRESS.

Block 3. Enter information which indicates your physical location outside the United 

States. APO/FPO addresses are considered to be outside the United States. Some 

states allow you to mail this ballot from inside the United States. Consult your state 

pages in the Voting Assistance Guide. This address must be different from the 

address in Block 2.

WITNESS(ES).

Some states require a notary or witness(es) for absentee ballots. Consult your Voting 

Assistance Officer or the Voting Assistance Guide to determine the requirements of your 

state.

3. Separate the Ballot and Security Envelope and follow instructions.

4. Complete the Ballot as follows:

Voting Procedure: For each office for which you vote, write in either a candidate’s 

name or political party designation. President and Vice President run as a team and 

your vote must be for members of the same party. For other offices, you may vote for 

members of different parties for each office indicated. “Senator” means U.S. Senator; 

“Representative” means U.S. Congressman or Congresswoman. See Voting Assistance 

Guide for Special Provisions implemented by your state, and possible use of 

“ADDENDUM” section.

5. Detach, fold and insert the ballot into the Security Envelope. Remove tape from the 

Security Envelope and seal. NOTE: ONLY THE BALLOT SHOULD BE PLACED IN THE 

SECURITY ENVELOPE.

6. Insert the sealed Security Envelope into the Mailing Envelope. Remove the tape from 

the Mailing Envelope and seal.

7. If mailed in a foreign postal system, international airmail postage must be affixed. Enter 

your name and current complete military or overseas mailing address in the “FROM” 

section on the Mailing Envelope. Enter the name and mailing address of the proper city, 

township, village, county or state election official in the “TO” section on the Mailing 

Envelope. Consult the Voting Assistance Guide for correct address. This must be the 

same election official where you sent your application for an absentee ballot. No 

postage is necessary if mailed within APO/FPO or U.S. postal system.

Standard Form 186 (OCT 95) NSN-7540-01-218-4384

PRIVACY ACT STATEMENT

AUTHORITY: 42 USC 1973ff, “Title 1 - Registration and Voting By Absent 

Uniformed Services Voters and Overseas Voters in Elections for 

Federal Office.”

PRINCIPAL PURPOSE: Serves as a Federal Write-In Absentee Ballot for general elections or 

other elections provided by law or special provisions for all persons 

covered by the Uniformed and Overseas Citizens Absentee Voting 

Act (UOCAVA).

DISCLOSURE: Voluntary; however failure to furnish requested personal information 

may result in the Federal Write-In Absentee Ballot not being 

recognized and therefore not counted.

Standard Form 186 (OCT 95) 
Sample Forms 2004–05 Voting Assistance Guide

24

REMOVE TAPE ON REVERSE AND FOLD HERE TO SEAL

OFFICIAL FEDERAL WRITE-IN ABSENTEE BALLOT 

SECURITY ENVELOPE 

(ONLY PUT VOTED BALLOT

INSIDE THIS ENVELOPE) 

Standard Form 186 (Oct 95)

DETACH HERE, FOLD AND INSERT INTO SECURITY ENVELOPE

OFFICIAL FEDERAL WRITE-IN ABSENTEE BALLOT 

PRESIDENT/VICE PRESIDENT

U.S. SENATOR(S)*

U.S. REPRESENTATIVE/DELEGATE**/RESIDENT COMMISSIONER**

* Legal residents of the District of Columbia may vote only for President/Vice President and Delegate.

** Legal residents of American Samoa, Guam, Puerto Rico, and the Virgin Islands may vote only for nonvoting Delegate or Resident Commissioner to the Congress.

ADDENDUM 

Some states allow the Federal Write-In Absentee Ballot to be used by military and overseas civilian voters 

in elections other than general elections or for offices other than Federal offices. Consult your state 

section in the Voting Assistance Guide to determine your state’s policy. If you are eligible to use this ballot 

to vote for offices/candidates other than those listed above, please indicate in the spaces provided below, 

the office for which you wish to vote (for example: Governor, Attorney General, Mayor, State Senator, 

etc.), and the name and/or party affiliation of the candidate for whom you wish to vote.

OFFICE CANDIDATE NAME or PARTY AFFILIATION

Standard Form 186 (Oct 95)
2004–05 Voting Assistance Guide Sample Forms

25

FROM:

(Voter name and current complete military or overseas mailing address) U.S. Postage Paid

39 USC 3406

REMOVE TAPE ON REVERSE AND FOLD HERE TO SEAL

PAR AVION

OFFICIAL ABSENTEE BALLOTING MATERIAL - FIRST CLASS MAIL

Standard Form 186 (OCT 95)

Issued under Public Law 99-410

186-102

1988 edition may be used.

MAILING ENVELOPE

VOTER

NO POSTAGE NECESSARY IN THE U.S. MAILS - DMM E080

BEFORE YOU SEAL THIS MAILING ENVELOPE, CHECK THE FOLLOWING:

















1.Complete the Voter’s Declaration/Affirmation (on back of this envelope).

2.Sign and date the Voter’s Declaration/Affirmation

3.Vote your Ballot.

4.Put your voted Ballot in the Security Envelop, remove tape and seal Security Envelope

5.Put the sealed Security Envelope in the Mailing Envelope.

6.Remove tape and seal the Mailing Envelope.

7.Put your name and current complete military or overseas mailing address in the

“FROM” section.

8.Put address of proper election official in the “TO” section of this envelope. This address

must be the same local election official address where you previously submitted your

regular absentee ballot application.

International airmail postage is required if not mailed in the U.S. Postal system or APO/

FPO System, or Diplomatic Pouch.

NOW, YOU ARE READY TO MAIIL THIS ENVELOPE!

TO:

 VOTER’S DECLARATION/AFFIRMATION 

General Information Enter state, county, city/township/village where you are eligible to vote.

Ballot for the State of _______________ County of 

________________________________

City/Township/Village of _______________ s INSTRUCTIONS TO ELECTION OFFICIALS

This is an official Federal Write-In Absentee 

Ballot (FWAB) authorized by 42 USC 1973 ff-2.

1.Upon receipt of this ballot, examine the voter’s

declarations. If it appears that the voter is eligible

to vote in your jurisdiction and has applied in a

timely fashion for a regular absentee ballot, or

this requirement has been waived by appropriate

authority, then this ballot is valid unless you

receive the voted regular absentee ballot in time

for it to be counted. This ballot should be handled

in the same manner as required by state law for

other absentee ballots. If this ballot is to be

counted, deposit the voted ballot in the ballot box

without examining the voter’s choices.

2.The oath on this ballot is self-executing and need

not be notarized or witnessed, unless required by

state law.

3.Unless provided by law, or special provisions

have been made, this ballot should not be

counted if:

a.It was submitted from within the United States (an

APO/FPO address is considered outside the

U.S.); or

b.This voter’s application for a regular absentee

ballot was received by you less than 30 days

prior to the election; or

c. This voter’s completed regular absentee ballot

was received by you by the state deadline for

receipt of absentee ballots; or

d. This ballot is not received by the state deadline

for receipt of voted absentee ballots.

 1. VOTER INFORMATION 

a.TYPED OR PRINTED NAME

(Last) (First) (Middle

Initial)

b.SEX e.SOCIAL SECURITY NUMBER

– –

d.OTHER IDENTIFICATION NUMBER (Passport or other ID Card) d.DATE OF BIRTH

MMDDY Y

 2. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last residence in county/jurisdiction in U.S.)

a.NUMBER AND STREET (If rural route, include specific location of residence. Do not use Post Office box.) b.CITY, TOWNSHIP OR VILLAGE

c. COUNTY OR PARISH d. STATE e.ZIP CODE (9-digit, if known) f. LAST DATE OF

RESIDENCY

– MMDDY Y

3. CURRENT COMPLETE MILITARY OR OVERSEAS ADDRESS 

4. I swear or affirm, under the penalty of perjury, that: 

a.I am a United States citizen, and eligible to vote

in the above jurisdiction (Item 2).

b.I have not been convicted of a felony or other

disqualifying offense or been adjudicated

mentally incompetent, or if so, my voting rights

have been reinstated, if required by state law.

c. I am not registering, requesting a ballot or voting

in any other jurisdiction in the U.S.

d.My application for a regular absentee ballot was mailed in time to be

received by the local election official 30 days prior to this election, or

this requirement has been waived by appropriate authority.

e.I have not received the requested ballot.

f. I understand that if my regular absentee ballot is received by the

local election official in time to be counted, that ballot will be counted

and this write-in ballot will be voided.

g.I have voted and sealed this ballot in private and have not

allowed any person to observe the marking of this ballot,

except for those authorized to assist voters under state or

Federal law. I have not been influenced.

h.I have mailed this ballot from outside the United States, or

my state has made special provisions to allow me to mail

this ballot from inside the U.S.

i. The information on this form is true and complete.

WITNESS(ES) SIGNATURE AND ADDRESS (if required by law) APPLICATION SIGNATURE (Sign here) DATE SIGNED

X MMDDY Y

Standard Form 186 (OCT 95)
Sample Forms 2004–05 Voting Assistance Guide

26

MAILING INSTRUCTIONS

✺✭✵✷✾✭✄✼✩✸✭✄✷✶✄✺✭✾✭✺✻✭✄✩✶✬✄✮✷✴✬✄✰✭✺✭✄✼✷✄✻✭✩✴

✷✮✮✱✫✱✩✴✄✮✭✬✭✺✩✴✄✿✺✱✼✭✏✱✶✄✩✪✻✭✶✼✭✭✄✪✩✴✴✷✼

✻✭✫✽✺✱✼❁✄✭✶✾✭✴✷✸✭

☛✷✶✴❁✄✸✽✼✄✾✷✼✭✬✄✪✩✴✴✷✼

✱✶✻✱✬✭✄✼✰✱✻✄✭✶✾✭✴✷✸✭☞✄

✾✭✄✼✩✸✭✄✷✶✄✺✭✾✭✺✻✭✄✩✶✬✄✮✷✴✬✄✰✭✺✭✄✼✷✄✻✭✩✴

✷✮✮✱✫✱✩✴✄✮✭✬✭✺✩✴✄✿✺✱✼✭✏✱✶✄✩✪✻✭✶✼✭✭✄✪✩✴✴✷✼✄

✻✭✫✽✺✱✼❁✄✭✶✾✭✴✷✸✭✄

☛✷✶✴❁✄✸✽✼✄✾✷✼✭✬✄✪✩✴✴✷✼

✱✶✻✱✬✭✄✼✰✱✻✄✭✶✾✭✴✷✸✭☞✄

✻❲❉◗●❉❯●✄✮❘❯
✄✔✛✙✄☛✷❋❲✄✜✘☞

✬✭✼✩✫✰✄✰✭✺✭✎✄✮✷✴✬✄✩✶✬✄✱✶✻✭✺✼✄✱✶✼✷ ✻✭✫✽✺✱✼❁ ✭

Step 1

Read instructions carefully before sealing 

envelopes.

Step 2

Write in candidate or party of choice on the 

appropriate line and detach.

Step 3

Detach security envelope and insert write-in 

ballot. Seal security envelope.

Step 4

Insert sealed security envelope containing 

write-in ballot into mailing envelope.

Step 5

Address mailing envelope to proper city, 

town or county voting official.

Step 6

Write in your mailing address.

Step 7

Before mailing, use voter check list on 

mailing envelope

Mailing Instructions

First, complete Voter's Declaration/Affirmation

section on reverse side of mailing envelope and

then sign. Have it witnessed (if required).

✺✭✵✷✾✭✄✼✩✸✭✄✷✶✄✺✭✾✭✺✻✭✄✩✶✬✄✮✷✴✬✄✰✭✺✭✄✼✷✄✻✭✩✴

✷✮✮✱✫✱✩✴✄✮✭✬✭✺✩✴✄✿✺✱✼✭✏✱✶✄✩✪✻✭✶✼✭✭✄✪✩✴✴✷✼✄

✻✭✫✽✺✱✼❁✄✭✶✾✭✴✷✸✭✄

☛✷✶✴❁✄✸✽✼✄✾✷✼✭✬✄✪✩✴✴✷✼

✱✶✻✱✬✭✄✼✰✱✻✄✭✶✾✭✴✷✸✭☞✄

✻❲❉◗●❉❯●✄✮❘❯
✄✔✛✙✄☛✷❋❲✄✜✘☞

✬✭✼✩✫✰✄✰✭✺✭✎✄✮✷✴✬✄✩✶✬✄✱✶✻✭✺✼✄✱✶✼✷✄✻✭✫✽✺✱✼❁✄✭✶✾✭✴✷✸✭

✷✮✮✱✫✱✩✴✄✮✭✬✭✺✩✴✄✿✺✱✼✭✏✱✶✄✩✪✻✭✶✼✭✭✄✪✩✴✴✷✼✄

✸✺✭✻✱✬✭✶✼✒✾✱✫✭✄✸✺✭✻✱✬✭✶✼

✽✑✻✑✄✻✭✶✩✼✷✺☛✻☞✌

✽✑✻✑✄✺✭✸✺✭✻✭✶✼✩✼✱✾✭✒✬✭✴✭✯✩✼✭✌✌✒✺✭✻✱✬✭✶✼✄✫✷✵✵✱✻✻✱✷✶✭✺✌✌

✌✄✴❍❏❉❖✄❯❍❱▲●❍◗❲❱✄❘■✄❲❑❍✄✬▲❱❲❯▲❋❲✄❘■✄✫❘❖❳
❊▲❉✄
❉❭✄❨❘❲❍✄❘◗❖❭✄■❘❯✄✸❯❍❱▲●❍◗❲✒✾▲❋❍✄✸❯❍❱▲●❍◗❲✄❉◗●✄✬❍❖❍❏❉❲❍✑

✌✌✄✴❍❏❉❖✄❯❍❱▲●❍◗❲❱✄❘■✄✩
❍❯▲❋❉◗✄✻❉
❘❉✎✄✯❳❉
✎✄✸❳❍❯❲❘✄✺▲❋❘✎✄❉◗●✄❲❑❍✄✾▲❯❏▲◗✄✱❱❖❉◗●❱✄
❉❭✄❨❘❲❍✄❘◗❖❭✄■❘❯✄◗❘◗✏

❨❘❲▲◗❏✄✬❍❖❍❏❉❲❍✄❘❯✄✺❍❱▲●❍◗❲✄✫❘

▲❱❱▲❘◗❍❯✄❲❘✄❲❑❍✄✫❘◗❏❯❍❱❱✑

✩✬✬✭✶✬✽✵✄

✻❘
❍✄❱❲❉❲❍❱✄❉❖❖❘❩✄❲❑❍✄✮❍●❍❯❉❖✄✿❯▲❲❍✏✱◗✄✩❊❱❍◗❲❍❍✄✪❉❖❖❘❲✄❲❘✄❊❍✄❳❱❍●✄❊❭✄
▲❖▲❲❉❯❭✄❉◗●✄❘❨❍❯❱❍❉❱✄❋▲❨▲❖▲❉◗✄❨❘❲❍❯❱✄

▲◗✄❍❖❍❋❲▲❘◗❱✄❘❲❑❍❯✄❲❑❉◗✄❏❍◗❍❯❉❖✄❍❖❍❋❲▲❘◗❱✄❘❯✄■❘❯✄❘■■▲❋❍❱✄❘❲❑❍❯✄❲❑❉◗✄✮❍●❍❯❉❖✄❘■■▲❋❍❱✑✄✫❘◗❱❳❖❲✄❭❘❳❯✄❱❲❉❲❍✄

❱❍❋❲▲❘◗✄▲◗✄❲❑❍✄✾❘❲▲◗❏✄✩❱❱▲❱❲❉◗❋❍✄✯❳▲●❍✄❲❘✄●❍❲❍❯
▲◗❍✄❭❘❳❯✄❱❲❉❲❍➯❱✄❙❘❖▲❋❭✑✄✱■✄❭❘❳✄❉❯❍✄❍❖▲❏▲❊❖❍✄❲❘✄❳❱❍✄❲❑▲❱✄❊❉❖❖❘❲✄

❲❘✄❨❘❲❍✄■❘❯✄❘■■▲❋❍❱✒❋❉◗●▲●❉❲❍❱✄❘❲❑❍❯✄❲❑❉◗✄❲❑❘❱❍✄❖▲❱❲❍●✄❉❊❘❨❍✎✄❙❖❍❉❱❍✄▲◗●▲❋❉❲❍✄▲◗✄❲❑❍✄❱❙❉❋❍❱✄❙❯❘❨▲●❍●✄❊❍❖❘❩✎✄

❲❑❍✄❘■■▲❋❍✄■❘❯✄❩❑▲❋❑✄❭❘❳✄❩▲❱❑✄❲❘✄❨❘❲❍✄☛■❘❯✄❍❬❉
❙❖❍✢✄✯❘❨❍❯◗❘❯✎✄✩❲❲❘❯◗❍❭✄✯❍◗❍❯❉❖✎✄✵❉❭❘❯✎✄✻❲❉❲❍✄✻❍◗❉❲❘❯✎✄

❍❲❋✑☞✎✄❉◗●✄❲❑❍✄◗❉
❍✄❉◗●✒❘❯✄❙❉❯❲❭✄❉■■▲❖▲❉❲▲❘◗✄❘■✄❲❑❍✄❋❉◗●▲●❉❲❍✄■❘❯✄❩❑❘
✄❭❘❳✄❩▲❱❑✄❲❘✄❨❘❲❍✑

✷✮✮✱✫✭ ✫✩✶✬✱✬✩✼✭✄✶✩✵✭✄❘❯✄✸✩✺✼❁✄✩✮✮✱✴✱✩✼✱✷✶

✻❲❉◗●❉❯●✄✮❘❯
✄✔✛✙✄☛✷❋❲✄✜✘☞

✺✭✵✷✾✭✄✼✩✸✭✄✷✶✄✺✭✾✭✺✻✭✄✩✶✬✄✮✷✴✬✄✰✭✺✭✄✼✷✄✻✭✩✴

✷✮✮✱✫✱✩✴✄✮✭✬✭✺✩✴✄✿✺✱✼✭✏✱✶✄✩✪✻✭✶✼✭✭✄✪✩✴✴✷✼✄

✻✭✫✽✺✱✼❁✄✭✶✾✭✴✷✸✭✄

☛✷✶✴❁✄✸✽✼✄✾✷✼✭✬✄✪✩✴✴✷✼

✱✶✻✱✬✭✄✼✰✱✻✄✭✶✾✭✴✷✸✭☞✄

✻❲❉◗●❉❯●✄✮❘❯
✄✔✛✙✄☛✷❋❲✄✜✘☞

✮✺✷✵✢

☛✾❘❲❍❯✄◗❉
❍✄❉◗●✄❋❳❯❯❍◗❲✄❋❘
❙❖❍❲❍✄
▲❖▲❲❉❯❭✄❘❯✄❘❨❍❯❱❍❉❱✄
❉▲❖▲◗❏✄❉●●❯❍❱❱☞ ✽✑✻✑✄✸❘❱❲❉❏❍✄✸❉▲●

✖✜✄✽✻✫✄✖✗✓✙

✺✭✵✷✾✭✄✼✩✸✭✄✷✶✄✺✭✾✭✺✻✭✄✩✶✬✄✮✷✴✬✄✰✭✺✭✄✼✷✄✻✭✩✴

✸✩✺✄✩✾✱✷✶

✷✮✮✱✫✱✩✴✄✩✪✻✭✶✼✭✭✄✪✩✴✴✷✼✱✶✯✄✵✩✼✭✺✱✩✴✄✏✄✮✱✺✻✼✄✫✴✩✻✻✄✵✩✱✴

✻❲❉◗●❉❯●✄✮❘❯
✄✔✛✙✄☛✷✫✼✄✜✘☞

✱❱❱❳❍●✄❳◗●❍❯✄✸❳❊❖▲❋✄✴❉❩✄✜✜✏✗✔✓

✔✛✙✏✔✓✕

✔✜✛✛✄❍●▲❲▲❘◗✄
❉❭✄❊❍✄❳❱❍●✑

✵✩✱✴✱✶✯✄✭✶✾✭✴✷✸✭

✾✷✼✭✺

✶✷✄✸✷✻✼✩✯✭✄✶✭✫✭✻✻✩✺❁✄✱✶✄✼✰✭✄✽✑✻✑✄✵✩✱✴✻✄✏✄✬✵✵✄✭✓✛✓

✪✭✮✷✺✭✄❁✷✽✄✻✭✩✴✄✼✰✱✻✄✵✩✱✴✱✶✯✄✭✶✾✭✴✷✸✭✎✄✫✰✭✫✳✄✼✰✭✄✮✷✴✴✷✿✱✶✯✢

❺

❺

❺

❺

❺

❺

❺

❺

✔✑✫❘
❙❖❍❲❍✄❲❑❍✄✾❘❲❍❯➯❱✄✬❍❋❖❉❯❉❲▲❘◗✒✩■■▲❯
❉❲▲❘◗✄☛❘◗✄❊❉❋◆✄❘■✄❲❑▲❱✄❍◗❨❍❖❘❙❍☞✑

✕✑✻▲❏◗✄❉◗●✄●❉❲❍✄❲❑❍✄✾❘❲❍❯➯❱✄✬❍❋❖❉❯❉❲▲❘◗✒✩■■▲❯
❉❲▲❘◗

✖✑✾❘❲❍✄❭❘❳❯✄✪❉❖❖❘❲✑

✗✑✸❳❲✄❭❘❳❯✄❨❘❲❍●✄✪❉❖❖❘❲✄▲◗✄❲❑❍✄✻❍❋❳❯▲❲❭✄✭◗❨❍❖❘❙✎✄❯❍
❘❨❍✄❲❉❙❍✄❉◗●✄❱❍❉❖✄✻❍❋❳❯▲❲❭✄✭◗❨❍❖❘❙❍

✘✑✸❳❲✄❲❑❍✄❱❍❉❖❍●✄✻❍❋❳❯▲❲❭✄✭◗❨❍❖❘❙❍✄▲◗✄❲❑❍✄✵❉▲❖▲◗❏✄✭◗❨❍❖❘❙❍✑

✙✑✺❍
❘❨❍✄❲❉❙❍✄❉◗●✄❱❍❉❖✄❲❑❍✄✵❉▲❖▲◗❏✄✭◗❨❍❖❘❙❍✑

✚✑✸❳❲✄ ❭❘❳❯✄ ◗❉
❍✄ ❉◗●✄ ❋❳❯❯❍◗❲✄ ❋❘
❙❖❍❲❍✄ 
▲❖▲❲❉❯❭✄ ❘❯✄ ❘❨❍❯❱❍❉❱✄ 
❉▲❖▲◗❏✄ ❉●●❯❍❱❱✄ ▲◗✄ ❲❑❍

➩✮✺✷✵➫✄❱❍❋❲▲❘◗✑

✛✑✸❳❲✄❉●●❯❍❱❱✄❘■✄❙❯❘❙❍❯✄❍❖❍❋❲▲❘◗✄❘■■▲❋▲❉❖✄▲◗✄❲❑❍✄➩✼✷➫✄❱❍❋❲▲❘◗✄❘■✄❲❑▲❱✄❍◗❨❍❖❘❙❍✑✄✼❑▲❱✄❉●●❯❍❱❱


❳❱❲✄❊❍✄❲❑❍✄❱❉
❍✄❖❘❋❉❖✄❍❖❍❋❲▲❘◗✄❘■■▲❋▲❉❖✄❉●●❯❍❱❱✄❩❑❍❯❍✄❭❘❳✄❙❯❍❨▲❘❳❱❖❭✄❱❳❊
▲❲❲❍●✄❭❘❳❯

❯❍❏❳❖❉❯✄❉❊❱❍◗❲❍❍✄❊❉❖❖❘❲✄❉❙❙❖▲❋❉❲▲❘◗✑

✱◗❲❍❯◗❉❲▲❘◗❉❖✄❉▲❯
❉▲❖✄❙❘❱❲❉❏❍✄▲❱✄❯❍❚❳▲❯❍●✄▲■✄◗❘❲✄
❉▲❖❍●✄▲◗✄❲❑❍✄✽✑✻✑✄✸❘❱❲❉❖✄❱❭❱❲❍
✄❘❯✄✩✸✷✒

✮✸✷✄✻❭❱❲❍
✎✄❘❯✄✬▲❙❖❘
❉❲▲❋✄✸❘❳❋❑✑

✶✷✿✎✄❁✷✽✄✩✺✭✄✺✭✩✬❁✄✼✷✄✵✩✱✱✴✄✼✰✱✻✄✭✶✾✭✴✷✸✭☎

✼✷✢

1

2

2

3 3

3

4

5

6

7

Do not use staples!
27

CHAPTER THREE

STATE ABSENTEE REGISTRATION AND VOTING PROCEDURES

Alabama. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Alaska . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

American Samoa . . . . . . . . . . . . . . . . . . . . . . 39

Arizona. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Arkansas . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

California . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Colorado . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Connecticut . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Delaware . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

District of Columbia . . . . . . . . . . . . . . . . . . . . 81

Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Guam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101

Hawaii . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105

Idaho . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

Illinois. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

Indiana . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

Kansas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

Kentucky . . . . . . . . . . . . . . . . . . . . . . . . . . . 135

Louisiana . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

Maine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143

Maryland . . . . . . . . . . . . . . . . . . . . . . . . . . . 151

Massachusetts. . . . . . . . . . . . . . . . . . . . . . . 157

Michigan. . . . . . . . . . . . . . . . . . . . . . . . . . . . 163

Minnesota . . . . . . . . . . . . . . . . . . . . . . . . . . 167

Mississippi . . . . . . . . . . . . . . . . . . . . . . . . . . 171

Missouri . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

Montana . . . . . . . . . . . . . . . . . . . . . . . . . . . 183

Nebraska. . . . . . . . . . . . . . . . . . . . . . . . . . . 187

Nevada . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195

New Hampshire. . . . . . . . . . . . . . . . . . . . . . 199

New Jersey . . . . . . . . . . . . . . . . . . . . . . . . . 207

New Mexico. . . . . . . . . . . . . . . . . . . . . . . . . 211

New York. . . . . . . . . . . . . . . . . . . . . . . . . . . 215

North Carolina. . . . . . . . . . . . . . . . . . . . . . . 219

North Dakota. . . . . . . . . . . . . . . . . . . . . . . . 223

Ohio. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229

Oklahoma . . . . . . . . . . . . . . . . . . . . . . . . . . 233

Oregon . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239

Pennsylvania. . . . . . . . . . . . . . . . . . . . . . . . 245

Puerto Rico . . . . . . . . . . . . . . . . . . . . . . . . . 251

Rhode Island. . . . . . . . . . . . . . . . . . . . . . . . 255

South Carolina . . . . . . . . . . . . . . . . . . . . . . 259

South Dakota . . . . . . . . . . . . . . . . . . . . . . . 265

Tennessee . . . . . . . . . . . . . . . . . . . . . . . . . 269

Texas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275

 Utah . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281

Vermont. . . . . . . . . . . . . . . . . . . . . . . . . . . . 287

Virginia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295

Virgin Islands. . . . . . . . . . . . . . . . . . . . . . . . 303

Washington . . . . . . . . . . . . . . . . . . . . . . . . . 307

West Virginia. . . . . . . . . . . . . . . . . . . . . . . . 313

Wisconsin . . . . . . . . . . . . . . . . . . . . . . . . . . 317

Wyoming . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
State Absentee Registration and Voting Procedures 2004–05 Voting Assistance Guide

28
29

ALABAMA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A You are requested to fill out this box. This data is

requested from some states by the Department of Justice in

their enforcement of the Voting Rights Act and the National

Voter Registration Act. Enter the choice that best describes

you from the following list: AI = American Indian or

Alaskan Native; AP = Asian or Pacific Islander not Native

Hawaiian; B = Black, not of Hispanic Origin; H = Hispanic;

M = Multi-racial; NH = Native Hawaiian; W = White, not

of Hispanic Origin; O = Other.

B The last four digits of your Social Security number

OR your Alabama Driver's License number is required for

voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

C Do not leave blank. Enter not applicable if not

applicable or if you are a first time voter.

D Provide the complete street address of your Alabama

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.”

E Print the complete address where you want your ballot

sent - usually your current mailing address. 

F If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections. 

G Check ONE box. 

H You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

H

C

E

G
Alabama 2004–05 Voting Assistance Guide

30

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Alabama and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and apply for an absentee ballot, send a

completed FPCA to the Board of Registrars so that it

arrives not later than 10 days before the election. 

If you are registered and only wish to request an absentee

ballot, send a completed FPCA to the absentee election

manager so that it arrives not less than five days before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by 5:00

p.m. on the day prior to the election.

Local absentee election managers begin mailing ballots 40

days before an election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: The absentee ballot return

envelope contains an affidavit which must be sworn to

before a commissioned officer, notary or other person

authorized to administer oaths, or two witnesses (18 years

or older).

E. Electronic Transmission of FPCAs 

and Ballots

Alabama does not allow electronic transmission of the

FPCA, the blank absentee ballot or the voted absentee

ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens

and residents of Alabama, or overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Alabama.

 persons employed or studying outside the U.S. (for

local, state and Federal office ballots)

 spouses and dependents of the above (for local, state

and Federal office ballots)

 overseas electors (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and apply for an absentee ballot, send a

completed FPCA to the Board of Registrars so that it

arrives not later than 10 days before the election. 

If you are registered and only wish to request an absentee

ballot, send a completed FPCA to the absentee election

manager so that it arrives not less than five days before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by 5:00

p.m. on the day prior to the election.

Local absentee election managers begin mailing ballots 40

days before an election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: The absentee ballot return

envelope contains an affidavit which must be sworn to

before a commissioned officer, notary or other person
2004–05 Voting Assistance Guide Alabama

31

authorized to administer oaths, or two witnesses (18 years

or older).

E. Electronic Transmission of FPCAs 

and Ballots

Alabama does not allow electronic transmission of the

FPCA, the blank absentee ballot or the voted absentee

ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony (unless civil rights restored),

or judged mentally incompetent (unless disabilities

removed) may not register or vote.

B. Cancellation of Registration

Persons may be stricken from the voter list if they no longer

possess the qualifications for voting.

C. Action on Registration Requests

A registration certificate is sent. 

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Alabama shall provide you with the

reason(s) for the rejection. Persons denied registration may

appeal to the circuit court. Consult a legal assistance officer

or civilian counsel for assistance.

E. Where To Send It

If you are registering and applying for an absentee ballot,

mail the FPCA to the Board of Registrars at the county of

voting residence, as listed below. 

If you are only requesting an absentee ballot, mail the

FPCA request to the Absentee Election Manager at the

county of voting residence, as listed below.

County County Seat Zip Code

Autauga 134 N. Court St., Prattville 36067-3048

Baldwin P.O. Box 1488, Bay Minette 36507-1488

Barbour 1 Court Square, Clayton 36016-3034

Bibb 455 Walnut St., Centreville 35042-2325

Blount 220 2nd Ave. E., Oneonta 35121-1747

Bullock 217 N. Prairie St., Union Springs 36089-1600

Butler 700 Court Sq., Greenville 36037-2308

Calhoun 1702 Noble St. Ste. 103, Anniston 36201-3841

Chambers 18 Alabama Ave. E., Lafayette 36862-1745

Cherokee 100 Main St., Centre 35960-1510

Chilton 500 2nd Ave. N., Clanton 35045-3421

Choctaw 117 S. Mulberry Ave., Ste. 9, Butler 36904-2557

Clarke 117 Court St., Grove Hill 36451-3294

Clay P.O. Box 1120, Ashland 36251-1120

Clebume 120 Vickory St. Ste. 207, Heflin 36264-1199

Coffee 2 County Complex, New Brockton 36351-9791

Colbert 201 N. Main St., Tuscumbia 35674-2060

Conecuh P.O. Box 347, Evergreen 36401-0347

Coosa P.O. Box 218, Rockford 35136-0218

Covington 1 Court Sq., Andalusia 36420-3913

Crenshaw 301 S. Glenwood Ave., Luverne 36049-2006

Cullman 500 2nd Ave. SW, Cullman 35055-4155

Dale 1 E. Court Sq., Ozark 36360-1443

Dallas 105 Lauderdale St., Selma 36701-4614

De Kalb 111 Grand Ave. SW Ste. 200, Ft. Payne 35967-1991

Elmore P.O. Box 280, Wetumpka 36092-0005

Escambia 314 Belleville Ave., Brewton 36426-2015

Etowah 800 Forest Ave., Gadsden 35901-3663

Fayette 1030 1st Ave. NE, Fayette 35555-2603

Franklin 410 Jackson Ave. N., Russellville 35653-2363

Geneva 200 N. Commerce St., Geneva 36340-2002

Greene 400 Morrow Ave., Eutaw 35462-1109

Hale 1001 Main St., Greensboro 36744-1572

Henry 101 Court Sq. Ste A, Abbeville 36310-2135

Houston 462 N. Oates St., Dothan 36303-4537

Jackson Courthouse, Scottsboro 35768

Jefferson 716 Richard Arrington Jr. Blvd. N., Birmingham 35203-0100

Lamar P.O. Box 338, Vernon 35592-0338

Lauderdale 200 S. Court St., Florence 35630-5610

Lawrence 750 Main St. Ste 1, Moulton 35650-1553

Lee 219 S. 9th St., Opelika 36801-4926

Limestone 310 W. Washington St., Athens 35611-2597

Lowndes P.O. Box 65, Hayneville 36040-0065

Macon 101 E. Northside St., Tuskegee 36083-1735

Madison 100 Northside Sq., Huntsville 35801-4800

Marengo 101 E. Coats Ave., Linden 36748-1500

Marion 132 Military St. S., Hamilton 35570-5570

Marshall 424 Blount Ave., Guntersville 35976-1102

Mobile 205 Government St., Mobile 36602-2613

Monroe P.O. Box 8, Monroeville 36461-0008

Montgomery 100 S. Lawrence St., Montgomery 36104-4209

Morgan 302 Lee St. NE, Decatur 35601-1999

Perry P.O. Box 478, Marion 36756-0478

Pickens P.O. Box 460, Carrollton 35447-0460

Pike P.O. Box 1147, Troy 36081-1147

Randolph P.O. Box 249, Wedowee 36278-0249

Russell 501 14th St., Phenix City 36867-5142

St. Clair 129 5th Ave., Ashville 35953-3231

Shelby P.O. Box 467, Columbiana 35051-0467

Sumter P.O. Box 70, Livingston 35470-0070

Talladega P.O. Box 755, Talladega 35161-0755

Tallapoosa 125 N. Broadnax St., Dadeville 36853-1318

Tuscaloosa 714 Greensboro Ave., Tuscaloosa 35401-1859

Walker 1801 3rd Ave. S., Jasper 35501-5374

Washington P.O. Box 146, Chatom 36518-0146

Wilcox 100 Broad St., Camden 36726-1756

Winston P.O. Box 147, Double Springs 35553-0147

County County Seat Zip Code

Don’t Be Speechless. Vote

by Shirley Bangs, Civilian, Fairchild AFB, Washington
Alabama 2004–05 Voting Assistance Guide

32
33

ALASKA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number OR

your Alaska Driver's License number OR your Alaska State

Identification Card number is required for voter registration. If

you do not possess any of these identifications, the State shall

assign a number that will serve to identify you for voter

registration purposes.

B If you are an overseas citizen, you must provide your

passport or identity card number in Item 1.f.

C Do not leave blank. Enter “N/A” if not applicable or if you

are a first time voter.

D Provide the complete street address of your voting

residence. Your eligibility to vote and determination of your

voting precinct depend on the physical location of your

residence while you were in the state. A post office box, rural

route number, general delivery, etc., are not sufficient. If there is

no street address, give a specific identifying description, such as

a highway name and milepost, trailer park and space number,

subdivision name, etc., in Item 7. 

IMPORTANT: When registering by mail from outside the State

of Alaska, you must enclose proof of Alaska residency (such as a

copy of a current Alaska driver’s license, leave and earnings

statement or any other type of documentation showing Alaska

residency) with the FPCA.

E If you want your ballot sent by mail, print the complete

address. Be sure to advise the Division of Elections in writing if

your mailing address changes from the time of the request for a

ballot to the time of mailing the ballot. If you wish to vote by

fax, please indicate so and write the number where you want an

application faxed. (See instructions at I.B and II.B) 

F You must write the name of your political party affiliation

(Example: Democrat, Republican, Alaskan Independence,

Libertarian or any other recognized political party) or write

“undeclared” or “non-partisan”. For the primary election, if you

are a registered non-partisan or undeclared, you must indicate

which party ballot you want to vote. If you are currently

registered and want to change your political party affiliation, you

must submit a completed FPCA which includes your new party

preference to the local election official not later than 30 days

prior to the election.

G It is mandatory to give any former name under which you

were registered in Alaska.

H OPTIONAL

I You must sign and date the FPCA. When signing, you are

swearing or affirming that the information provided is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A B

D

F

H

I

C

G

E
Alaska 2004–05 Voting Assistance Guide

34

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Alaska and members of the Uniformed Services

and their family members. Uniformed Services are defined

as the U.S. Armed Forces, merchant marine, commissioned

corps of the Public Health Service and the National Oceanic

and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered voter, the Division of Elections

must receive your FPCA request for registration and a

ballot at least 30 days before the election. To register from

outside the State, you must enclose proof of Alaska

residence with the FPCA.

If you are a registered voter and submit a ballot request by

mail, the Division of Elections must receive it not less than

7 days before the election.

If you are a registered voter, you may submit a ballot

request to vote by fax beginning 15 days before a primary

or general election. A separate application must be

submitted for each election. Fax voting should only be used

if you miss the by-mail application deadline. To vote

absentee by fax, you must apply on a different application.

The absentee by fax application must be requested directly

from the Division of Elections and must be returned to them

no later than 5 p.m. Alaska time on the day before the

election.

C. Casting Your Vote

Ballot Return Deadline: If returning by mail, the envelope

must be postmarked on or before election day and returned

by mail service equal to first class. Be sure to sign and date

the Ballot Envelope. Ballots mailed from outside the U.S.

or from a military APO or FPO address must be received

not later than 15 days after the election. Ballots mailed from

other addresses must be received not later than 10 days after

the election.

If returning by fax, the ballot must be received on or before

8 p.m. (Alaska time) on election day.

Absentee by-mail ballots are available at least 22 days

before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: If the ballot is returned by mail,

the signature on the voter’s certificate on the envelope must

be witnessed, and signed and dated by the witness.

If the ballot is returned by fax, the voter must sign a

statement waiving his right to a secret ballot and an oath as

to his identity. The oath must be witnessed, and signed and

dated by the witness.

A commissioned or non-commissioned officer, or other

person qualified to administer oaths, can serve as a witness.

When an authorized official is not available, two U.S.

citizens 18 years or older may witness.

E. Electronic Transmission of FPCAs 

and Ballots

 Alaska allows you to send the FPCA for registration

and absentee ballot request by fax. After faxing,

submit the FPCA by mail. See instructions in section

B above.

 Alaska allows you to receive the blank ballot by fax

for primary and general elections only.

 Alaska allows you to return the voted ballot by fax for

primary and general elections only. See instructions in

section C above.

Fax the FPCA and voted ballot to: 

Absentee Staff

Division of Elections

(907) 465-3807

Refer to Appendix C for specific instructions for sending

election materials electronically. You may also use one of

the following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.
2004–05 Voting Assistance Guide Alaska

35

F. Special Write-In Absentee Ballot

In addition to mailing a regular ballot, Alaska mails a

special write-in absentee ballot 60 days before the election

to any voter who has requested an absentee by-mail ballot

and is living, working, or traveling outside the U.S. at the

time of the election. You may request the state special

write-in ballot at any time during the calendar year by

mailing an FPCA. You may not use fax to request or receive

this special ballot.

In Item 7 of the FPCA, place one of the state special writein labels from Section III.E. If no labels are available,

write in Item 7: “I expect to be living, working, or traveling

outside the U.S. at the time of the election. I request a

special write-in absentee ballot.”

Vote the ballot by writing in a party preference or the names

of specific candidates. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Alaska and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Alaska.

 Alaska residents temporarily residing outside the U.S.

(for local, state and Federal office ballots)

 overseas electors (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered voter, the Division of Elections

must receive your FPCA request for registration and a

ballot at least 30 days before the election. To register from

outside the State, you must enclose proof of Alaska

residence with the FPCA.

If you are a registered voter and submit a ballot request by

mail, the Division of Elections must receive it not less than

7 days before the election.

If you are a registered voter, you may submit a ballot

request to vote by fax beginning 15 days before a primary

or general election. A separate application must be

submitted for each election. Fax voting should only be used

if you miss the by-mail application deadline. To vote

absentee by fax, you must apply on a different application.

The absentee by fax application must be requested directly

from the Division of Elections and must be returned to them

no later than 5 p.m. Alaska time on the day before the

election.

C. Casting Your Vote

Ballot Return Deadline: If returning by mail, the envelope

must be postmarked on or before election day and returned

by mail service equal to first class. Be sure to sign and date

the Ballot Envelope. Ballots mailed from outside the U.S.

or from a military APO or FPO address must be received

not later than 15 days after the election. Ballots mailed from

other addresses must be received not later than 10 days after

the election.

If returning by fax, the ballot must be received on or before

8 p.m. (Alaska time) on election day.

Absentee by-mail ballots are available at least 22 days

before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: If the ballot is returned by mail,

the signature on the voter’s certificate on the envelope must

be witnessed, signed and dated by the witness.

If the ballot is returned by fax, the voter must sign a

statement waiving his right to a secret ballot and an oath as

to his identity. The oath must be witnessed, and signed and

dated by the witness.

A commissioned or non-commissioned officer, or other

person qualified to administer oaths, can serve as a witness.

When an authorized official is not available, two U.S.

citizens 18 years or older may witness.

E. Electronic Transmission of FPCAs 

and Ballots

 Alaska allows you to send the FPCA for registration

and absentee ballot request by fax. After faxing,

submit the FPCA by mail. See instructions in section

B above.

 Alaska allows you to receive the blank ballot by fax.

 Alaska allows you to return the voted ballot by fax for

primary and general elections only. See instructions in

section C above.

Fax the FPCA and voted ballot to: 

Absentee Staff

Division of Elections

(907) 465-3807
Alaska 2004–05 Voting Assistance Guide

36

Refer to Appendix C for specific instructions for sending

election materials electronically. You may also use one of

the following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

In addition to mailing a regular ballot, Alaska mails a

special write-in absentee ballot 60 days before the election

to any voter who has requested an absentee by-mail ballot

and is living, working, or traveling outside the U.S. at the

time of the election. You may request the state special

write-in ballot at any time during the calendar year by

mailing an FPCA. You may not use fax to request or receive

this special ballot.

In Item 7 of the FPCA, place one of the state special writein labels from Section III.E. If no labels are available,

write in Item 7: “I expect to be living, working, or traveling

outside the U.S. at the time of the election. I request a

special write-in absentee ballot.” 

Vote the ballot by writing in a party preference or the names

of specific candidates. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony involving moral turpitude

may not register or vote unless civil rights have been

restored. A copy of unconditional discharge papers must be

included with the application. 

B. Action on Registration Requests

Notice of acceptance or denial is sent.

C. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Alaska shall provide you with the

reason(s) for the rejection. The citizen will be given the

opportunity to reapply or otherwise correct the deficiency.

Persons denied registration may contact the Division of

Elections or consult a legal assistance officer or civilian

counsel.

D. Where To Send It

Mail the FPCA to:

Absentee Staff

Division of Elections

P.O. Box 110017

Juneau, AK 99811-0017

Catch The Fever! Choice Is Contagious! VOTE!!!

by SSgt Kimberly T. Beynum, Anchorage, Alaska
ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”

E. STATE SPECIAL WRITE-IN BALLOT

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

ALASKA (WRITE-IN BALLOT)

“I expect to be living, working, or traveling outside the United States at the

time of election. I request a special write-in absentee ballot.”
Alaska 2004–05 Voting Assistance Guide

38
39

AMERICAN SAMOA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Social Security number is required. If you do not

have a Social Security number, your American Samoa

Driver’s License number is required for voter registration.

If you do not possess either of these identifications,

American Samoa shall assign a number that will serve to

identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete address of your American

Samoa voting residence. This address must be different

from the one provided in item 4 and must be within

American Samoa.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in item 3. 

E If you use this form to register, you must write here:

1. your age, 

2. your place of current employment and

3. a statement that the residence listed in item 3 was

acquired with the intent to make American Samoa

your legal residence.

F Check ONE box.

G You must sign and date the FPCA. If using the FPCA

to register, it must be signed by a notary public,

commissioned officer, consular officer or other authorized

person.

H If you are not yet registered, a notary public,

commissioned officer, consular officer, or other authorized

person must complete this section.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

M M D D Y Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

H

A
American Samoa 2004–05 Voting Assistance Guide

40

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of American Samoa and members of the

Uniformed Services and their family members. Uniformed

Services are defined as the U.S. Armed Forces, merchant

marine, commissioned corps of the Public Health Service

and the National Oceanic and Atmospheric Administration.

(Consult Section B below for ballot type eligibility).

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see below for eligibility and also Chapter 2).

You must register in person to vote a ballot for local offices.

You may register absentee to vote a ballot for Federal

offices only.

If you are an unregistered citizen, the Chief Election Officer

must receive your FPCA not later than 4:30 p.m., 30 days

before the election.

If you are a registered citizen, the chief election officer

must receive your FPCA between 75 and 15 days before the

election.

C. Casting Your Vote

Ballot Return Deadline: Return your voted ballot so that it

arrives at the Election Office by 1:30 p.m. on election day.

Local election officials mail ballots as soon as official

ballots are printed and available, and if your request for

absentee ballot was sent no later than 15 days before the

election.

Due to its territorial status, American Samoa does not send

representatives to the U.S. Senate or directly participate in

the election of the President and Vice President of the U.S.

At the Federal level, only a Delegate to the House of

Representatives is elected.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: Must be sworn to by a notary public, commissioned

officer, consular officer or other authorized person.

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

 American Samoa allows you to send the FPCA for

registration and absentee ballot by fax. After faxing,

submit the FPCA by mail.

 American Samoa does not allow you to receive the

blank ballot by fax.

 American Samoa does not allow you to return the

voted ballot by fax. 

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

The following procedures apply to persons who are U.S.

citizens, residents of American Samoa and overseas

citizens. The term “overseas citizen(s)” means a U.S.

citizen who resides outside the U.S. and (but for such

residence) would be qualified to vote in American Samoa.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see below for eligibility) and also Chapter 2.

You must register in person to vote a ballot for local offices.

You may register absentee to vote a ballot for Federal

offices only.

If you are an unregistered overseas citizen, the Chief

Election Officer must receive your FPCA not later than

4:30 p.m., 30 days before the election. 
2004–05 Voting Assistance Guide American Samoa

41

If you are a registered overseas citizen, the chief election

officer must receive your FPCA between 75 and 15 days

before the election.

C. Casting Your Vote

Ballot Return Envelope: Return your voted ballot so that it

arrives at the Election Office by 1:30 p.m. on election day.

Local election officials mail ballots as soon as official

ballots are printed and available, and if your request for

absentee ballot was sent no later than 15 days before the

election.

Due to its territorial status, American Samoa does not send

representatives to the U.S. Senate or directly participate in

the election of the President and Vice President of the U.S.

At the Federal level, only a Delegate to the House of

Representatives is elected.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: Must be sworn to by a notary public, commissioned

officer, consular officer or other authorized person.

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

 American Samoa allows you to send the FPCA for

registration and absentee ballot by fax. After faxing,

submit the FPCA by mail.

 American Samoa does not allow you to receive the

blank ballot by fax.

 American Samoa does not allow you to return the

voted ballot by fax. 

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use only the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons under guardianship, found incompetent, or

convicted of a felony may not register or vote. Felons may

vote if restored to civil rights or on good behavior for two

years from the date of conviction or release from prison,

whichever is later.

B. Cancellation of Registration

Registration is canceled for failure to vote in two

consecutive elections.

C. Action on Registration Request

No notice of registration is sent.

D. Action If Registration Is Denied

Persons denied registration may appeal to the board of

registration. Consult a legal assistance officer or civilian

counsel. Upon denial of your voter registration application

or absentee ballot request, American Samoa shall provide

you with the reason(s) for the rejection.

E. Where To Send It

Mail the FPCA to:

Chief Election Officer

American Samoa Government

P.O. Box 3970

Pago Pago, American Samoa 96799 

Who Wins? You Do, Vote.

by SSgt Nicole Velsor, USAF, Arizona
American Samoa 2004–05 Voting Assistance Guide

42
43

ARIZONA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Arizona Driver’s License or Non-operating

Identification License or the last four digits of your Social

Security number is required for voter registration. If you do

not possess either of these identifications, the State shall

assign a unique number that will serve to identify you for

voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Arizona

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “2 miles past Highway _____, across the

street from the ___________ gas station.” This address

must be different from the one provided in Item 4 and must

be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E If you do not list a party affiliation or if you register as

independent or with a party that does not have primary

election ballot status you may designate the ballot of a party

that does have representation on the ballot and vote that

ballot (Example: Democrat, Republican). Please designate

the party ballot you wish to request for the primary in Item

7 (Remarks).

If you are currently registered and want to change your

political party affiliation or you have previously declined to

indicate a political party, you must submit a completed

FPCA to the local election official not later than 29 days

before election day.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Arizona 2004–05 Voting Assistance Guide

44

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Arizona and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are a registered citizen, the County Recorder must

receive your FPCA request not later than 5 p.m. on the

Friday before the election.

If you are an unregistered citizen residing temporarily

outside the state, the County Recorder must receive your

FPCA request for registration anytime before 7 p.m. on

election day. 

If you are an unregistered citizen residing within the state,

the County Recorder must receive your FPCA request for

registration not later than 29 days before the election. 

C. Casting Your Vote

Ballot Return Deadline: Return your voted ballot so that it

arrives at the County Recorder’s office not later than 7 p.m.

on election day. 

Local election officials mail ballots approximately 15 days

before the Presidential Preference Election. Ballots are

mailed approximately 33 days before all other elections.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Arizona allows you to send the FPCA application for

registration and absentee ballot requests by fax. After

faxing, submit the FPCA by mail.

 Arizona allows you to receive the blank ballot by fax.

 Arizona allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Early Ballot

Arizona provides a state special write-in early ballot

available 36 days before the Presidential preference

election, 60 days before all other primary elections and 50

days before the general election if you are a member of the

Armed Forces, merchant marine, or a spouse or dependent

of these and cannot vote an early ballot during the normal

voting period.

You may use an FPCA to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.E. If no labels are available,

in Item 7 write: “Due to military or other contingencies that

preclude normal mail delivery, I cannot vote an early ballot

during the normal early voting period. I request a special

write-in early ballot.”

You may not request this special write-in ballot earlier than

90 days before the election. You may vote the ballot by

writing in the names of specific candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Arizona and overseas citizens. The term

“overseas citizen(s) means a U.S. citizen who resides

outside the U.S., and who was qualified to register, except

for age, in Arizona immediately prior to his/her departure

from Arizona.

 Arizona residents temporarily residing outside the

U.S. 

 overseas citizens 
2004–05 Voting Assistance Guide Arizona

45

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are a registered Arizona resident temporarily residing

outside the U.S., the County Recorder must receive your

FPCA request not later than 5 p.m. on the second Friday

before the election. 

If you are an unregistered Arizona resident temporarily

residing outside the U.S., the County Recorder must receive

your FPCA request not later than 29 days before the

election. 

If you are an overseas citizen who is not required to

register, the County Recorder must receive your FPCA

ballot request not later than 5 p.m. on the Friday before the

election. 

C. Casting Your Vote

Ballot Return Deadline: Return your voted ballot so that it

arrives at the County Recorder’s office not later than 7 p.m.

on election day.

Local election officials mail ballots approximately 15 days

before the Presidential Preference Election. Ballots are

mailed approximately 33 days before all other elections.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Arizona allows you to send the FPCA application for

registration and early ballot requests by fax. After

faxing, submit the FPCA by mail.

 Arizona allows you to receive the blank ballot by fax.

 Arizona allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Early Ballot

Arizona provides you with a state special write-in early

ballot available 36 days before the Presidential Preference

Election, 60 days before all other primary elections and 50

days before the general election if you are overseas and

cannot vote an early ballot during the normal voting period.

You may use an FPCA to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III. If no labels are available, in

Item 7 write: “Due to military or other contingencies that

preclude normal mail delivery, I cannot vote an early ballot

during the normal early voting period. I request a special

write-in early ballot.”

You may not request this special write-in ballot earlier than

90 days before the election. You may vote the ballot by

writing in the names of specific candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of treason or a felony (unless civil rights

restored), and persons adjudicated as incapacitated as

defined in A.R.S. 14-5101, may not register or vote.

B. Action on Registration Requests

Notice of registration is sent. The County Recorder must

notify the applicant within 10 business days of receipt if his

or her application cannot be read or is missing required

information.

C. Action If Registration Is Denied

No formal appeal process exists. If denied registration,

consult a legal assistance officer or civilian counsel. Upon

denial of your voter registration application or absentee

ballot request, Arizona shall provide you with the reason(s)

for the rejection.

D. Where To Send It

Mail the FPCA to the County Recorder, county of voting

residence, as listed below:

County County Seat Zip Code

Apache PO Box 425, Saint Johns 85936-0425

Cochise PO Box 184, Bisbee 85603-0184

Coconino 110 East Cherry Avenue, Flagstaff 86001-4696

Gila 1400 East Ash Street, Globe 85501-1496

Graham 921 Thatcher Boulevard, Safford 85546-2858

Greenlee PO Box 1625, Clifton 85533-1625

La Paz 1112 Joshua Avenue, Suite 201, Parker 85344-5755

Maricopa 111 South 3rd Avenue, #103, Phoenix 85003-2225

Mohave PO Box 70, Kingman 86401-0070

Navajo PO Box 668, Holbrook 86025-0668
Arizona 2004–05 Voting Assistance Guide

46

Pima 115 North Church, Tucson 85701-1199

Pinal PO Box 848, Florence 85232-0848

Santa Cruz 2150 North Congress Drive, Nogales 85621-1090

Yavapai 1015 Fair Street, Room 228, Prescott 86305-1852

Yuma 410 South Maiden Lane, Yuma 85364-2311

County County Seat Zip Code

Pick The Winning Team, VOTE

by Sgt Joshua L. Davis, USMC, Yuma, Arizona
ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”

E. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

ARIZONA

“Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an early ballot during the normal early voting period. I request a

special write-in early ballot.”
Arizona 2004–05 Voting Assistance Guide

48
49

ARKANSAS

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas. 

A Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

B Provide the complete street address of your Arkansas

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or township where you claim

legal voting residence.

C Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3.

D If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican). Political party affiliation is not

required if only requesting absentee ballots for general

elections. State your political party preference each time

you request an absentee ballot for a primary election.

E Check ONE box. 

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E
Arkansas 2004–05 Voting Assistance Guide

50

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Arkansas and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Registration is waived.

To request an absentee ballot, mail or fax a completed

FPCA to the local election official so that it arrives not later

than 7 days before the election. You may also use a letter or

postcard which contains substantially the same information

as the FPCA. If application is delivered by designated

bearer, it must be received by close of business on the day

before the election.

C. Casting Your Vote

Ballot Return Deadline: Your ballot must be executed not

later than the date of the election and returned to the local

election official so that it arrives by 5:00 p.m ten calendar

days after the election.

Local election officials mail ballots approximately 25 days

before an election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Arkansas allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail.

 Arkansas does not allow you to receive the blank

ballot by fax.

 Arkansas does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Arkansas and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Arkansas.

 citizens of the U.S. temporarily residing outside the

territorial limits of the U.S. and the District of

Columbia and their spouses and dependents when

residing with or accompanying them (for local, state

and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Registration is waived.

To request an absentee ballot, mail or fax a completed

FPCA to the local election official so that it arrives not later

than 7 days before an election. You may also use a letter or

postcard which contains substantially the same information

as the FPCA. If application is delivered by designated

bearer, it must be received by close of business the day

before the election.

C. Casting Your Vote

Ballot Return Deadline: Your ballot must be executed not

later than the date of the election, signed, dated, postmarked
2004–05 Voting Assistance Guide Arkansas

51

and mailed by election day and received by the local

election official by 5:00 p.m. ten calendar days after the

election.

Local election officials mail ballots approximately 25 days

before an election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Arkansas allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail.

 Arkansas does not allow you to receive the blank

ballot by fax.

 Arkansas does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting 

Persons convicted of crimes of felonies, unless the sentence

has been pardoned or discharged; persons having been

adjudged mentally incompetent specifically as to the right

to vote by a court of competent jurisdiction; persons who

have not reached the age of eighteen (18) years of age on or

before election day, may not register or vote.

B. Cancellation of Registration

Registration is canceled when a voter fails to vote in two (2)

consecutive Federal elections and fails to respond to a

notice of cancellation. However, registration is waived for

citizens defined in Sections I & II.

C. Action If Registration or Absentee 

Ballot Request Is Denied

A registration notice is sent. If Arkansas rejects your voter

registration application or absentee ballot request, Arkansas

shall provide you with the reason(s) for the rejection.

D. Where To Send It

Mail the FPCA to the County Clerk in the county of your

legal voting residence, as listed below:

County County Seat Zip Code

Arkansas 101 Court Square, Dewitt 72042-2050

Ashley 215 East Jefferson Street, Hamburg 71646-3007

Baxter #1 E. Seventh St., Mountain Home 72653-4468

Benton 215 East Central, Bentonville 72712-5373

Boone 100 North Main Street, Harrison 72601-4228

Bradley 101 Est Cedar Street, Warren 71671-2744

Calhoun Post Office Box 1175, Hampton 71744-1175

Carroll 210 West Church Street, Berryville 72616-4222

Chicot 108 Main Street, Lake Village 71653-1965

Clark 401 Clay Street, Arkadelphia 71923-6100

Clay 151 South Second Avenue, Piggot 72454-2618

Cleburne 301 West Main St., Heber Springs 72543-3016

Cleveland Post Office Box 368, Rison 71665-0368

Columbia 1 Court Square, Magnolia 71753-3599

Conway 117 South Moose Street, Morrilton 72110-3400

Craighead 511 South Main Street, Jonesboro 72403-2849

Crawford 300 Main Street, Van Buren 72965-5765

Crittenden 100 Court Square, Marion 72364-1850

Cross 705 East Union Street, Wynne 72396-3039

Dallas 206 West Third Street, Fordyce 71742-3250

Desha Post Office Box 218, Arkansas City 71630-0218

Drew 210 South Main Street, Monticello 71655-4731

Faulkner 801 Locust Street, Conway 72032-5358

Franklin 211 West Commerical, Ozark 72949-3213

Fulton Post Office Box 485, Salem 72576-9473

Garland 501 Ouachita Street, Hot Springs 71901-5161

Grant 103 West Center Street, Sheridan 72150-2493

Greene 320 West Court Street, Paragould 72450-4300

Hempstead 400 South Washington Street, Hope 71802-5045

Hot Spring 210 Locust Streets, Malvern 72104-3791

Howard 421 North Main Street, Nashville 71852-2008

Independence 192 East Main St., Batesville 72501-5510

Izard Post Office Box 95, Melbourne 72556-0095

Jackson 208 Main Street, Newport 72112-3329

Jefferson 100 East Barraque Street, Pine 

Bluff

71611-4318

Johnson 215 West Main Street, Clarksville 72830-3009

Lafayette #2 Courthouse Square, Lewisville 71845-8801

Lawrence 315 West Main, Walnut Ridge 72476-1937

Lee 15 East Chestnut Street, Marianna 72360-2342

Lincoln 300 South Drew Street, Star City 71667-5104

Little River 351 North Second, Ashdown 71822-2747

Logan 25 West Walnut Street, Paris 72855-3239

Lonoke 301 North Center Street, Lonoke 72086-2890

Madison Post Office Box 37, Huntsville 72740-0037

Marion Post Office Box 385, Yellville 72687-0385

Miller 400 Laural Street, Texarkana 71854-5249

Mississippi 200 West Walnut Street, Blytheville 72315-2831

Monroe 123 Madison, Clarendon 72629-2742

Montgomery Post Office Box 369, Mount Ida 71957-0369

Nevada 215 East 2nd Street, S., Prescott 71857-2136

Newton Post Office Box 410, Jasper 72641-0410

Ouachita 145 Jefferson Street, Camden 71701-3994

Perry 310 West Main Street, Perryville 71216-0358

Phillips 620 Cherry Street, Helena 72342-3306

Pike Post Office Box 219, Murfreesboro 71958-0219

Poinsett 401 Market Street, Harrisburg 72432-1900

Polk 507 Church Avenue, Mena 71953-3258

Pope 100 West Main Street, Russellville 72801-3723
Arkansas 2004–05 Voting Assistance Guide

52

Prairie Post Office Box 1011, Des Arc 72040-1011

Pulaski 201 South Broadway, Little Rock 72203-2321

Randolph 107 West Broadway, Pocahontas 72455-3412

Saint Francis 313 South Izard Street, Forest City 72335-3856

Saline 200 North Main Street, Benton 72015-3781

Scott 100 West First Street, Waldron 72958-7103

Searcy Post Office Box 998, Marshall 72650-0998

Sebastian 35 South Sixth Street, Fort Smith 72902-2442

Sevier 115 North Third Street, De Queen 71832-2852

Sharp 718 Ash Flat Drive, Ash Flat 72513-9103

Stone 107 West Main St., Mountain View 72560-9610

Union 101 N. Washington St., El Dorado 71730-5661

Van Buren 451 Main Street, Clinton 72031-6905

Washington 280 North College Ave., Fayetteville 72701-4279

White 300 North Spruce, Searcy 72143-7720

Woodruff 500 North Third Street, Augusta 72006-2020

Yell Post Office Box 219, Danville 72833-0219

County County Seat Zip Code

Vote! Democracy Thrives On It.

by CTMC Karl F. Sitler, USN, Washington, D.C.
53

CALIFORNIA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

or your California Driver’s License number is required for

voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your California

voting residence. A post office box is not acceptable. If

your address includes a rural route, describe its location.

For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E Print the name of the political party (i.e., Democratic,

Republican, American Independent, Green, Libertarian,

Natural Law or Peace and Freedom), write “Decline to

State,” or write in the name of a non-qualified political

body. If you do not complete Item 6, you will be registered

“Decline to State.” California law allows voters who

“decline to state” an affiliation with a qualified political

party or who affiliate with a non-qualified political party to

vote in the primary election of any qualified political party

that files a notice with the Secretary of State allowing them

to do so. Visit www.ss.ca.gov to learn which political

parties are allowing nonaffiliated voters to participate in

their primary election. If you are currently registered and

want to make changes, you must submit a completed FPCA

to your local elections official not later than 15 days before

the election.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

D

F

G

A
California 2004–05 Voting Assistance Guide

54

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed ServicesYou must sign and date the FPCA. When signing, you are swearing or affirming that the information is true and correct.These procedures apply to persons who are U.S. citizens, residents of California and members of the Uniformed Services and their family members. 

Uniformed Services are defined as the U.S. Armed Forces, merchant marine, commissioned corps of the Public Health Service and the National Oceanic and Atmospheric Administration.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Alaska and members of the Uniformed Services

and their family members. Uniformed Services are defined

as the U.S. Armed Forces, merchant marine, commissioned

corps of the Public Health Service and the National Oceanic

and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered citizen, complete and sign the

FPCA and return it to the county election official. It must be

received not later than 15 days before the election. 

If you are already registered, you may use the FPCA form

or submit a letter to the county election official to request a

full ballot (local, state, Federal offices). Your request must

be received not later than 7 days before the election.

If you send a letter, you must provide your name as

registered, voting residence address, address to which the

absentee ballot should be sent, and the name and date of the

election. You must sign and date the letter.

C. Casting Your Vote

Ballot Return Deadline: Return your voted ballot so that it

arrives at the county elections office by the close of polls

(8:00 p.m.) on election day.

Local election officials begin mailing ballots approximately

29 days before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 California allows you to send the FPCA application

for registration and absentee ballot by fax. After

faxing, submit the FPCA by mail.

 At the discretion of the county elections official, a

blank ballot will be faxed.

 California does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

California provides a state special absentee voter ballot if

you cannot vote an absentee ballot during the normal

absentee voting period because of military or other

contingencies which preclude normal mail delivery. This

ballot is available 60 days before the election to both

registered voters and citizens eligible to vote but not yet

registered.

To request this special ballot, place one of the special

absentee labels from Section III.G in Item 7 of the FPCA.

You must state the reason(s) why you cannot vote using

normal mail delivery. If no labels are available, write in

Item 7: “I cannot vote an absentee ballot during the normal

absentee voting period due to military or other

contingencies that preclude normal mail delivery. {Specify

reason(s).}I request a special absentee ballot.”

The elections official will provide a list of all the candidates

qualified by the 60th day before the election as well as the

measures to be voted on. You vote the ballot by writing in

the names of the candidates you select.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of California or overseas citizens. The term

“overseas citizen(s)” means a United States citizen who

resides outside the United States and (but for such

residence) would be qualified to vote in California.

 California residents temporarily residing outside the

U.S. 
2004–05 Voting Assistance Guide California

55

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered citizen, complete and sign the

FPCA and return it to the county election official. It must be

received not later than 15 days before the election. 

If you are already registered, you may use the FPCA form

or submit a letter to the county election official to request a

full ballot (local, state, Federal offices). Your request must

be received not later than 7 days before the election.

If you send a letter, you must provide your name as

registered, voting residence address, address to which the

absentee ballot should be sent, and the name and date of the

election. You must sign and date the letter.

C. Casting Your Vote

Ballot Return Deadline: Return your voted ballot so that it

arrives at the county elections office by the close of polls

(8:00 p.m.) on election day. 

Local election officials begin mailing ballots approximately

29 days before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 California allows you to send the FPCA application

for registration and absentee ballot by fax. After

faxing, submit the FPCA by mail.

 At the discretion of the county elections official, a

blank ballot will be faxed. 

 California does not allow you to return the voted ballot

by fax. 

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

California provides a state special absentee voter ballot if

you cannot vote an absentee ballot during the normal

absentee voting period because of military or other

contingencies which preclude normal mail delivery. This

ballot is available 60 days before the election to both

registered voters and citizens eligible to vote but not yet

registered.

To request this special ballot, place one of the special

absentee labels from Section III.G in Item 7 of the FPCA.

You must state the reason(s) why you cannot vote using

normal mail delivery. If no labels are available, write in

Item 7: “I cannot vote an absentee ballot during the normal

absentee voting period due to military or other

contingencies that preclude normal mail delivery. {Specify

reason(s).}I request a special absentee ballot.”

The elections official will provide a list of all the candidates

qualified by the 60th day before the election as well as the

measures to be voted on. You vote the ballot by writing in

the names of the candidates you select.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons who are not U.S. citizens, are not 18 years of age,

are currently imprisoned or on parole for a felony

conviction or persons judged mentally incompetent, may

not register or vote. 

B. Cancellation of Registration

Registration is permanent only when a state Affidavit of

Registration is filed with the county elections official. It can

be cancelled for specified reasons, including a change of

residence address. 

C. Action on Registration Request

When the FPCA is used for registration, notice of

acceptance or denial is sent by the elections official. 

D. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, California shall provide you with

the reason(s) for the rejection. Any person notified that

registration has been denied should correct all deficiencies

and resubmit the request. If a second denial is received,

consult a legal assistance officer or civilian counsel.
California 2004–05 Voting Assistance Guide

56

E. Late Registration

(1) If a registered voter is unable to appear at his/her polling

place because of being recalled to service after the final day

for applying for an absentee voter’s ballot, but before 5 p.m.

on the day before the election, he/she may appear before the

elections official and apply for an absentee ballot. The

ballot may be voted at the official’s office or elsewhere and

returned before the close of the polls on election day.

(2) Discharged military personnel and civilians outside the

U.S. who return to their county of residence following the

close of the registration period for the upcoming election

may apply in person to the elections official for permission

to register and vote in the election. You must provide

documentary proof that your release was after the

registration closing date.

F. Where To Send It

Mail FPCA to the voting official in your county of voting

residence as listed below.

County Address Zip Code

Alameda Registrar of Voters

1225 Fallon St. Room G1

Oakland, CA 94612-4229

Alpine County Clerk

PO Box 158

Markleeville, CA 96120-0158

Amador Registrar of Voters

500 Argonaut Lane

Jackson, CA 95642-9534

Butte County Clerk

25 County Center Dr.

Oroville, CA 95965-3375

Calaveras County Clerk, Elections Department

891 Mountain Ranch Road

San Andreas, CA 95249-9709

Colusa County Clerk-Elections

546 Jay St.

Colusa, CA 95932

Contra Costa County Clerk

524 Main St.

Martinez, CA 94553-0027

Del Norte County Clerk-Recorder-Elections

981 H Street Room 160

Crescent City, CA 95531-3415

El Dorado Registrar of Voters

2850 Fairlane Ct.

Placerville, CA 95667-8001

Fresno County Clerk

2221 Kern St.

Fresno, CA 93721-2600

Glenn County Clerk-Elections

516 W. Sycamore St., 2nd Floor

Willows, CA 95988-2746

Humboldt County Clerk-Elections

3033 H St., #20

Eureka, CA 95501-4483

Imperial County Clerk, Courthouse

940 W. Main St., Rm.202

El Centro, CA 92243-2865

Inyo County Clerk-Elections

168 N. Edwards

Independence, CA 93526-0606

Kern County Clerk Elections Office

1115 Truxtan Avenue

Bakersfield, CA 93301-4639

Kings County Clerk, Government Center

1400 W. Lacey Blvd.

Hanford, CA 93230-5997

Lake County Clerk-Elections

255 N. Forbes St., #209

Lakeport, CA 95453-4748

Lassen County Clerk-Elections

220 S. Lassen St.

Susanville, CA 96130-4397

Los Angeles Registrar-Recorder/County Clerk

12400 Imperial Highway

Norwalk, CA 90650-8350

Madera County Clerk-Elections

209 W. Yosemite Ave.

Madera, CA 93637-3596

Marin County Clerk-Recorder

3501 Civic Center Dr., # 152

San Rafael, CA 94913-3904

Mariposa County Clerk-Elections

4982 10th St.

Mariposa, CA 95338

Mendocino County Clerk-Elections

501 Low Gap Road, Room 1020

Ukiah, CA 95482-3738

Merced County Clerk-Elections

2222 M St., Rm. 14

Merced, CA 95340-3780

Modoc County Clerk-Elections

204 Court St.

Alturas, CA 96101-0131

Mono County Clerk-Elections

Bryant St. Annex II

Bridgeport, CA 93517

Monterey Registrar of Voters

1370 South Main St. #B

Salinas, CA 93901-1848

Napa County Clerk

900 Coombs St., Room 256

Napa, CA 94559-2946

Nevada County Clerk

10433 Willow Valley Road, Suite E

Nevada City, CA 95959-2367

Orange Registrar of Voters

PO Box 11298

Santa Ana, CA 92711-1298

Placer County Registrar of Voters

2954 Richardson Dr.

Auburn, CA 95603

Plumas County Clerk

520 Main Street, Room 102

Quincy, CA 95971-9366

Riverside Registrar of Voters

2724 Gateway Drive

Riverside, CA 92507-0918

Sacramento Registrar of Voters

3700 Branch Center Rd.

Sacramento, CA 95827-3892

San Benito County Clerk, Court House

440 Fifth St., Room 206 

Hollister, CA 95023-3843

San Bernardino Registrar of Voters

777 E. Rialto Ave.

San Bernardino, CA 92415-0770

San Diego Registrar of Voters

5201 Ruffin Rd, #I

San Diego, CA 92123

San Francisco Elections, City Hall -

1 Dr. Carlton B. Goodlett Place, Rm 48

San Francisco, CA 94102-4635

San Joaquin Registrar of Voters

212 N San Joaquin St.

Stockton, CA 95201

San Luis Obispo County Clerk-Elections

1144 Monterey St., Suite A

San Luis Obispo, CA 93408-3237

San Mateo County Clerk - Registrar

40 Tower Rd.

San Mateo, CA 94402-4098

Santa Barbara County Clerk-Elections, Courthouse

1100 Anacapa St., Basement

Santa Barbara, CA 93101

County Address Zip Code
2004–05 Voting Assistance Guide California

57

Santa Clara Registrar of Voters

1555 Berger Dr., Bldg. 2

San Jose, CA 95112

Santa Cruz County Clerk

701 Ocean St., Rm. 210

Santa Cruz, CA 95060-4076

Shasta County Clerk-Elections

1643 Market Street

Redding, CA 96001

Sierra County Clerk-Elections

PO Drawer D, Courthouse, Rm II

Downieville, CA 95936-0398

Siskiyou County Clerk-Elections

311 4th St., Rm 201

Yreka, CA 96097

Solano Registrar of Voters

510 Clay Street

Fairfield, CA 94533-5625

Sonoma County Clerk-Elections

435 Fiscal Dr.

Santa Rosa, CA 95403

Stanislaus County Clerk-Elections

1021 “I” Street, Suite 101

Modesto, CA 95354-2331

Sutter County Clerk-Elections

433 Second Street

Yuba City, CA 95991

Tehama County Clerk-Elections

444 Oak St., Rm C

Red Bluff, CA 96080-0250

Trinity County Clerk-Elections

P.O. Box 1215

Weaverville, CA 96093

Tulare County Registrar of Voters

221 S Mooney Blvd., Room G-28

Visalia, CA 93291-4596

Tuolumne County Clerk

2 S. Green St.

Sonora, CA 95370-4696

Ventura County Clerk-Elections

800 S. Victoria Ave., L-1200

Ventura, CA 93009-1200

Yolo County Clerk-Registration

625 Court St., Rm. B 05

Woodland, CA 95776

Yuba County Clerk, Courthouse

935 14th Street

Marysville, CA 95901-5793

County Address Zip Code

Stand For Something! VOTE

by Major Edward O’Neal, Jr., Edwards AFB, California
California 2004–05 Voting Assistance Guide

58
CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”

G. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

CALIFORNIA

“I cannot vote an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal mail delivery.

(specify reason(s).) I request a special absentee ballot.”
California 2004–05 Voting Assistance Guide

60
61

COLORADO

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

AND your Colorado Driver's License number are required

for voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter

C Provide the complete street address of your Colorado

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence. If you have changed your name since the last

time you registered or voted, write your previous name in

Item 7.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections. If you

have previously declined to indicate a political party and

you now want to vote in a primary election, you must

submit a completed FPCA which includes your new

political party affiliation to the local election official not

later than 29 days before the election.

F Indicate if you are a native-born or naturalized citizen. 

G Check ONE box.

H You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

D

G

D

F

H

A
Colorado 2004–05 Voting Assistance Guide

62

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Colorado and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered citizen, the County Clerk and

Recorder must receive your FPCA not later than 29 days

before the election. 

If you are a registered citizen, the County Clerk and

Recorder must receive your FPCA no later than the close of

business on the Friday immediately proceeding the

election; if you wish to receive the absentee ballot by mail,

the FPCA must be received no later than the close of

business on the Tuesday immediately preceding the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office by 7 p.m. on election day.

Local election officials mail ballots approximately 30 days

before the primary election and not later than 30 days

before the general election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Colorado allows you to fax in the FPCA to register

and to request an absentee ballot, but you must mail in

the original FPCA after faxing it.

 Colorado allows you to receive the blank ballot by fax.

 Colorado allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

If you reside outside the U.S., Colorado provides a state

special write-in absentee ballot if you cannot vote a regular

absentee ballot during the normal absentee voting period

because of military or other contingencies which preclude

normal mail delivery.

This ballot is available 60 days before an election and you

can use the FPCA to request it. In Item 7 of the FPCA place

one of the labels from Section III.F or write: “I cannot vote

an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal

mail delivery (specify reasons). I request a special absentee

ballot.”

You may vote the ballot by writing in the names of the party

or specific candidates you wish to vote for. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Colorado and overseas citizens. The term

“overseas citizen(s)” means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in Colorado.

 civilian employees of the U.S. Government serving

overseas and their spouses and dependents when

residing with or accompanying them (for local, state

and Federal office ballots)

 members of religious groups or welfare agencies who

are officially attached to and serving with the U.S.

Armed Forces and their spouses and dependents (for

local, state and Federal office ballots)

 Colorado residents temporarily residing outside the

U.S. (for local, state and Federal office ballots) 
2004–05 Voting Assistance Guide Colorado

63

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered citizen, the County Clerk and

Recorder must receive your FPCA not later than 29 days

before the election. 

If you are a registered citizen, the County Clerk and

Recorder must receive your FPCA not earlier than January

1 immediately preceding the election and no later than the

Friday before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot so that it arrives at the

local elections office by 7 p.m. on election day. 

Local election officials mail ballots approximately 30 days

before the primary election and not later than 30 days

before the general election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Colorado allows you to fax in the FPCA to register

and to request an absentee ballot, but you must mail in

the original FPCA after faxing it.

 Colorado allows you to receive the blank ballot by fax.

 Colorado allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

If you reside outside the U.S., Colorado provides a state

special write-in absentee ballot if you cannot vote a regular

absentee ballot during the normal absentee voting period

because of military or other contingencies which preclude

normal mail delivery.

This ballot is available 60 days before an election and you

can use the FPCA to request it. In Item 7 of the FPCA place

one of the labels from Section III.F or write: “I cannot vote

an absentee ballot during the normal absentee voting period

due to military or other contingencies that preclude normal

mail delivery (specify reasons). I request a special absentee

ballot.”

You may vote the ballot by writing in the names of the party

or specific candidates you wish to vote for. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted and serving any part of their sentence in

detention or confinement in a correctional facility or on

parole may not register or vote. 

B. Cancellation of Registration

All registered voters are mailed a voter information card not

more than 29 days before and no more than 30 days after a

primary election. These cards are non-forwardable.

Those voters whose cards are returned as undeliverable to

the County Clerk and Recorder’s office will be placed on

the inactive list. A registered voter who fails to vote in a

general election will also be placed on the inactive list. At

any time before January 10 after any general election,

voters who are recorded as “Inactive” will be sent a voter

continuance card. If the voter does not complete and return

the continuance card within 60 days and if the voter has

been designated “Inactive” for two general elections, then

the voter’s registration will be cancelled. 

C. Action on Registration Requests

Within two (2) business days after receipt of the

application, the County Clerk and Recorder shall notify

each applicant of the disposition of the application by nonforwardable mail.

D. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Colorado shall provide you with the

reason(s) for the rejection. If registration is denied, resubmit

the application, correcting any deficiencies. If a second

denial is received, consult a legal assistance officer or

civilian counsel.
Colorado 2004–05 Voting Assistance Guide

64

E. Where To Send It

Mail the FPCA to the County Clerk and Recorder, county

of voting residence, as listed below:

County County Seat Zip Code

Adams 450 S. 4th Avenue, Suite 200

Brighton 80601-3195

Alamosa Box 630

Alamosa 81101-0630

Arapahoe 5334 S. Prince

Littleton 80166-0211

Archuleta Box 2589

Pagosa Springs 81147-2589

Baca 741 Main

Springfield 81073-1548

Bent Box 350

Las Animas 81054-0350

Boulder 1750 33rd St., Suite. 100

Boulder 80306-2546

Broomfield 1 DesCombes Drive

Broomfield 80020-2495

Chaffee Box 699

Salida 81202-0699

Cheyenne Box 567

Cheyenne Wells 80810-0567

Clear Creek Box 2000

Georgetown 80444-2000

Conejos Box 127

Conejos 81129-0127

Costilla Box 308

San Luis 81152-0308

Crowley 110 E. 6th Street, Suite 202

Ordway 81063-1092

Custer Box 150

Westcliffe 81252-0150

Delta 501 Palmer, Suite 211

Delta 81416-1764

Denver Denver Election Commission,

200 West 14th Ave., Denver 80204-2621

Dolores Box 58

Dove Creek 81324-0058

Douglas P.O. Box 1360

Castle Rock 80104-1360

Eagle Box 537

Eagle 81631-0537

Elbert Box 37

Kiowa 80117-0037

El Paso Box 2007

Colorado Springs 80901-2007

Fremont 615 Macon Avenue, Room 102

Canon City 81212-3381

Garfield 109 8th Street, Suite 200

Glenwood Springs 81601-3303

Gilpin Box 429

Central City 80427-0429

Grand P.O. Box 120

Hot Suphur Springs 80451-0120

Gunnison 221 N. Wisconsin St., Suite C

Gunnison 81230-2433

Hinsdale Box 9

Lake City 81235-0009

Huerfano 401 Main Street, Suite 204

Walsenburg 81089-2085

Jackson Box 337

Walden 80480-0337

Jefferson 100 Jefferson County Pkwy., Suite 2560

Golden 80419-2560

Kiowa Box 37

Eads 81036-0037

Kit Carson Box 249

Burlington 80807-0249

Lake Box 917

Leadville 80461-0917

La Plata Box 519

Durango 81302-0519

Larimer Box 1547

Fort Collins 80522-1547

Las Animas Box 115

Trinidad 81082-0115

Lincoln Box 67

Hugo 80821-0067

Logan 315 Main Street, Suite 3

Sterling 80751-4357

Mesa Box 20000

Grand Junction 81502-5009

Mineral Box 70

Creede 81130-0070

Moffat 221 W. Victory Way

Craig 81625-2716

Montezuma 109 W. Main, Room 108

Cortez 81321-3189

Montrose Box 1289

Montrose 81402-1289

Morgan Box 1399

Fort Morgan 80701-1399

Otero Box 511

La Junta 81050-0511

Ouray Box C

Ouray 81427-0615

Park Box 220

Fairplay 80440-0220

Phillips 221 S. Interocean Avenue

Holyoke 80734-1521

Pitkin 530 E. Main Street, Suite 101

Aspen 81611-1948

Prowers 301 S. Main St., Suite. 210

Lamar 81052-2868

Pueblo Box 878

Pueblo 81002-0878

Rio Blanco Box 1067

Meeker 81641-1067

Rio Grande Box 160

Del Norte 81132-0160

Routt Box 773599

Steamboat Springs 80477-3599

Saguache Box 176

Saguache 81149-0176

San Juan Box 466

Silverton 81433-0466

San Miguel Box 548

Telluride 81435-0548

Sedgwick Box 50

Julesburg 80737-0050

Summit Box 1538

Breckenridge 80424-1538

Teller Box 1010

Cripple Creek 80813-1010

Washington Box L

Akron 80720-1553

Weld Box 459

Greeley 80632-0459

Yuma 310 Ash St., Suite. F

Wray 80758-1850

County County Seat Zip Code

Your Opinion + Your Vote = Democracy in Action!

by TSgt Josephine Ann Smith, USAF, Beale AFB, California
COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”

F. STATE SPECIAL WRITE-IN LABLES

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

COLORADO

“I cannot vote an absentee ballot during the normal absentee voting period

due to military and other contingencies that preclude normal mail delivery

(specify reasons). I request a special absentee ballot.”
Colorado 2004–05 Voting Assistance Guide

66
67

CONNECTICUT

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your Connecticut Driver's License number is required

for voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your

Connecticut voting residence. A post office box is not

sufficient. If your address includes a rural route, describe its

location in Item 7. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be different from the one

provided in Item 4 and must be within the town or township

where you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections. If you are

currently enrolled in one political party and change to

another political party, you will have rights in no party for

three months from the date of filing your change of political

party.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
Connecticut 2004–05 Voting Assistance Guide

68

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Connecticut and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

To register and request an absentee ballot, send your

completed FPCA to the local Town Clerk so that it arrives

not later than 5 p.m. on the day before the election. You

may use the same FPCA to register and apply for an

absentee ballot. 

If you are already registered and wish to request an

absentee ballot only, send your completed FPCA to the

local Town Clerk so that it arrives anytime before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

election office before the close of polls on election day.

The local election official will send you a blank write-in

absentee ballot which includes a list of all candidates and

questions on the ballot approximately 30 days before the

primary election and approximately 45 days before the

general election.

Regular absentee ballots are available 21 days before the

primary and 31 days before the general election.

If you are outside the U.S. and you have not received your

state ballot in a timely manner, you may also use the

Federal Write-In Absentee Ballot. See instructions below.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Connecticut allows you to send the FPCA for absentee

ballot request by fax. If you are using the FPCA to

register, you may fax the FPCA but you must also mail

the original FPCA separately to the local Town Clerk

so that it arrives before 5:00 p.m. on the day before the

election. 

 Connecticut does not allow you to receive the blank

ballot by fax.

 Connecticut does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

A state special blank write-in absentee ballot is available

beginning 90 days before an election to Armed Forces

members and their spouses and dependents accompanying

them who, due to military contingencies, are unable to

follow the regular absentee application process.

Vote this ballot by writing in the names of specific

candidates and their offices.

Use the FPCA to request this state special write-in ballot. In

Item 7 of the FPCA, place one of the state special write-in

labels from Section III.H. If no labels are available, write in

Item 7: “Due to military contingencies, I am unable to

follow the regular absentee ballot application process. I

request a special write-in absentee ballot.”

You may request the state special write-in ballot at any time

and it is available 90 days before the general election.

G. Federal Write-In Absentee Ballot

Connecticut is not required to accept the FWAB, but in

1996 began accepting it only for federal elections.

For further instructions on the FWAB, see instructions in

Chapter 2, page 12.

H. Application for Ballot by Proxy

If you are a member of the Armed Forces or merchant

marine, or the spouse or dependent of a member residing

where the member is stationed, anyone may ask the Town

Clerk to send you registration materials and/or a ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
2004–05 Voting Assistance Guide Connecticut

69

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Connecticut and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the Unites States and (but for such residence) would be

qualified to vote in Connecticut.

 Connecticut residents temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 overseas electors (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

Overseas electors are not required to register.

If you are an unregistered citizen temporarily outside the

U.S., you may register and request an absentee ballot by

sending your completed FPCA to the local Town Clerk so

that it arrives not later than 5 p.m. on the day before the

election. You may use the same FPCA to register and apply

for an absentee ballot. 

If you are already registered, or you are an overseas elector

(not required to register) and wish to request an absentee

ballot only, send your completed FPCA to the local Town

Clerk so that it arrives anytime before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

election office before the close of polls on election day.

Local election officials mail a blank write-in absentee ballot

to registered persons temporarily residing outside the U.S.

approximately 30 days before the primary and

approximately 45 days before the general election. Local

election officials mail ballots to overseas electors 30 days

before the primary and 45 days before the general election.

If you have not received your state ballot in a timely

manner, you may also use the Federal Write-In Absentee

Ballot. See instructions below. 

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 If you are a Connecticut resident temporarily residing

outside the U.S., you may send the FPCA for absentee

ballot request by fax. If you are using the FPCA to

register, you may fax your FPCA, but you must also

mail the original FPCA separately to the local Town

Clerk so that it arrives before 5:00 p.m. on the day

before the election. 

 If you are an overseas elector (not required to register),

you may send the FPCA for absentee ballot request by

fax, but you must also mail the original FPCA to the

local Town Clerk either separately or with the voted

ballot so that it arrives before the close of polls on

election day, in order for the ballot to be counted.

 Connecticut does not allow you to receive the blank

ballot by fax.

 Connecticut does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Federal Write-In Absentee Ballot

Connecticut is not required to accept the FWAB, but in

1996 began accepting it only for federal elections.

For further instructions on the FWAB, see instructions in

Chapter 2, page 12.

G. Application for Ballot by Proxy

If you are a Connecticut citizen residing temporarily outside

the U.S., anyone may ask the Town Clerk to send you

registration materials and/or a ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony and confined or paroled who

have not had their voting rights restored and persons

declared mentally incompetent to vote may not register or

vote.

B. Cancellation of Registration

For Armed Forces members and their spouses and

dependents, a registration cancellation procedure is initiated

for failure to vote at least once during a four-year period.
Connecticut 2004–05 Voting Assistance Guide

70

C. Action on Registration Requests

Notice of acceptance or denial is sent.

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Connecticut shall provide you with

the reason(s) for the rejection. 

E. Action If Registration Is Denied

If you receive notice that your registration is denied,

resubmit and provide the information requested in the

notice. If you receive a second denial, consult a legal

assistance officer or civilian counsel.

F. Late Registration

Any military member currently in the military or who has

been discharged within the calendar year who returns to

Connecticut too late to register during the regular

registration period may still register to vote not later than

5:00 p.m. on the last weekday before the election.

G. Where To Send It

Mail the FPCA to the Town Clerk in the town or city of

voting residence. 

City or Town Address Zip Code

Andover PO Box 328 06232-0328

Ansonia 253 Main Street 06401-1410

Ashford 25 Pompey Hollow Road 06278

Avon 60 West Main Street 06001-3719

Barkhamsted 67 Ripley Hill Road 06063-3340

Beacon Falls 10 Maple Avenue 06403-1198

Berlin PO Box 1 06037-0001

Bethany 40 Peck Road 06524-3338

Bethel 1 School Street 06801-0003

Bethlehem PO Box 160 06751-0053

Bloomfield PO Box 337 06002-0337

Bolton 222 Bolton Center Road 06043-7698

Bozrah Town Hall 06334-0158

Branford PO Box 150 06405-0150

Bridgeport 45 Lyon Terrace 06604-4062

Bridgewater PO Box 216 06752-0216

Bristol 111 North Main Street 06010-8184

Brookfield PO Box 5106 06804-5106

Brooklyn PO Box 356 06234-0356

Burlington 200 Spielman Highway 06013-1710

Canaan PO Box 42 06031-0155

Cnaterbury PO Box 27 06331-0027

Canton PO Box 168 06022-0168

Chaplin PO Box 286 06235

Cheshire 84 Shouth Maint Street 06410

Chester 65 Main Street, PO Box 328 06412

Clinton 54 East Main Street 06413-0174

Colchester 127 Norwich Avenue 06415-0146

Colebrook Box 5 06021-0005

Columbia PO Box 165 06237-0165

Cornwall PO Box 97 06753-0097

Conventry 1712 Main Street 06238

Cromwell 41 West Street 06416

Danbury 155 Deer Hill Road 06810

Darien 2 Renshaw Road 06820

Deep River 174 Main Street 06417

Derby 35 Fifth Street 06418-1897

Durham PO Box 428 06422-0428

East Granby 9 Center Street 06026-0459

East Haddam Town Office Building, PO Box K 06423-0295

East Hampton 20 East High Street 06424-1091

East Hartford 740 Main Street 06108-3114

East Haven 250 Main Street 06512-3004

East Lyme 108 Pennsylvania Ave., PO Box 519 06357-0519

East Windsor Box 213 06016-0213

Eastford Westford Road, PO Box 273 06242-0296

Easton 225 Center Road 06612-1398

Ellington PO Box 187 06029-0187

Enfield 820 Enfield Street 06082-2997

Essex PO Box 98 06426-1140

Fairfield 611 Old Post Road 06430-6690

Farmington 1 Monteith Drive Road 06032-1053

Franklin 7 Meeting House Hill Road 06254-9775

Glastonbury 2155 Main Street 06033-2208

Goshen 42 North Street, Box 54 06756-0054

Granby 15 North Granby Road 06035-9442

Greenwich Town Hall, PO Box 2540 06836-2540

Griswold PO Box 369 06351-2398

Groton 45 Fort Hill Road 06340

Guilford 31 Park Street 06437-2629

Haddam PO Box 87 06438-0087

Hamden 2372 Whitney Avenue 06518-3207

Hampton PO Box 143 06247-0143

Hartford 550 Main Street 06103-2992

Hartland 22 South Road, PO Box 297 06027-9999

Harwinton 100 Bentley Drive 06791-0065

Hebron PO Box 156 06248-0156

Kent PO Box 678 06757-0678

Killingly PO Box 6000 06239-1832

Killingworth 323 Route 81 06417-1298

Lebanon PO Box 28 06249-0028

Ledyard 741 Colonel Ledyard Highway 06339-1541

Lisbon 1 Newent Road 06351-2926

Litchfield 74 West Street 06759-9602

Lyme Route 156, RR 2 06371-9614

Madison 8 Campus Drive 06443-2563

Manchester PO Box 191 06045-0191

Mansfield 4 South Eagleville Road, RT 275 06268-2503

Marlborough North Main Street, PO Box 29 06447-0029

Meriden 142 East Main Street 06450-5605

Middlebury 1212 Whittemore Road 06762-2425

Middlefield 383 Jackson Hill Road 06455-1208

Middletown Box 1300, DeKoven Drive & Court St. 06457-1300

Milford 70 West River Street 06460-3364

Monroe 7 Fan Hill Road 06468-1823

Montville 310 Norwich-New London Road 06382-2599

Morris PO Box 66 06763-0066

Naugatuck 229 Church Street 06770-4199

New Britain 27 West Main Street 06051-2298

New Canaan 77 Main Street 06840-4790

New Fairfield Town Hall, 4 Brush Hill Road 06812

New Hartford 530 Main Street, Box 426 06057-0316

New Haven 200 Orange Street 06510-2067

New London 181 State Street 06320-6302

New Milford PO Box 360 06776-0360

Newington 131 Cedar Street 06111

Newtown 45 Main Street 06470-2185

Norfolk PO Box 552 06058-0552

North Branford PO Box 287 06471-1501

North Canaan PO Box 338 06018-0338

North Haven 18 Church Street 06473-0336

North Stonington 40 Main Street 06359

Norwalk PO Box 5125 06856-5125

Norwich 100 Broadway 06360-4431

Old Lyme 52 Lyme Street 06371

Old Saybrook 302 Main Street 06475-0618

Orange 617 Orange Center Road 06477-2423

Oxford 486 Oxford Road 06483-1298

Plainfield 8 Community Avenue 06374

City or Town Address Zip Code
2004–05 Voting Assistance Guide Connecticut

71

Plainville PO Box 250 06062-0250

Plymouth 80 Main Street 06786-1295

Pomfret 5 Haven Road 06259-0180

Portland PO Box 71 06480-0071

Preston 389 Route 2 06365

Prospect 36 Center Street 06712-2101

Putnam 126 Church Street 06260-1831

Redding 100 Hill Road, PO Box 28 06875-0028

Ridgefield 400 Main Street 06877-4699

Rocky Hill 699 Old Main Street 06067-0657

Roxbury PO Box 203, 29 North Street 06783-0365

Salem 270 Hartford Road 06420

Salisbury PO Box 548 06068-0548

Scotland PO Box 122 06264-0122

Seymour 1 First Street 06483-2817

Sharon PO Box 224 06069-0224

Shelton PO Box 364 06484-0364

Sherman Mallory Town Hall, Route 39, Box 39 06784-0039

Simsbury 933 Hopemeadow Street, 06070-0495

Somers PO Box 308 06071-0203

South Windsor 1540 Sullivan Avenue 06074-2786

Southbury 501 Main Street, South 06488-2295

Southington 75 Main Street 06489-2504

Sprague PO Box 162 06330-0162

Stafford PO Box 11 06076-0011

Stamford PO Box 891 06904-0891

Sterling PO Box 157 06373-0157

Stonington PO Box 352 06378-0352

Stratford 2725 Main Street 06615-5892

Suffield 83 Mountain Road 06078

Thomaston 158 Main Street 06787-1720

Thompson PO Box 160 06255-0160

Tolland 21 Tolland Green 06084-9445

Torrington 140 Main Street 06790-5201

Trumbull 5866 Main Street 06611-3193

Union 1043 Buckley Highway 06076-9520

Vernon 14 Park Place 06066

Voluntown PO Box 96 06384-0096

Wallingford PO Box 427 06492-0427

Warren 7 Sackett Hill Road 06754

Washington PO Box 383 06794-0383

Waterbury 235 Grand Street 06702-1983

Waterford 15 Rope Ferry Road 06385-2806

Watertown 37 DeForest Street 06795-2195

West Hartford 50 South Main Street 06107-2431

West Haven 355 Main Street 06516-4310

Westbrook 1163 Boston Post Road, PO Box G 06498-0676

Weston PO Box 1007 06883-1007

Westport 110 Myrtle Avenue 06880

Wethersfield 505 Silas Deane Highway 06109-2219

Willington 40 Old Farms Road 06279

Wilton 238 Danbury Road 06897-4008

Winchester 338 Main Street 06098-1697

Windham PO Box 94 06226-0094

Windsor PO Box 472 06095-0472

Windsor Locks 50 Church Street 06096

Wolcott 10 Kenea Avenue 06716-2114

Woodbridge 11 Meetinghouse Lane 06525-1597

Woodbury PO Box 369 06798-0369

Woodstock 415 Route 169 06281-3039

City or Town Address Zip Code

Freedom Only Cost You Your Vote...

by Msg Gregory Harden, McConnell AFB, Kansas
Connecticut 2004–05 Voting Assistance Guide

72
CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”

H. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

CONNECTICUT

“Due to military contingencies, I am unable to follow the regular absentee

ballot application process. I request a special write-in ballot.”
Connecticut 2004–05 Voting Assistance Guide

74
75

DELAWARE

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Delaware Driver’s License number is required. If

you do not have a Delaware Driver’s License then the last four

digits of your Social Security number is required for voter

registration. If you do not possess either of these

identifications, the State shall assign a number that will serve

to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Delaware

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item 7.

For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4 and

must in be the county where you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address you provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the FPCA.

Political party affiliation is not required if only requesting

absentee ballots for general elections. If you are currently

registered and want to change your political party affiliation or

if you declined to indicate a party affiliation upon registering

and now wish to vote in a primary election, you must submit a

completed FPCA which includes your new political party

affiliation to the local election official not later than March 1st

before the primary election. The period for changing political

party affiliation ends beginning the 4th Friday in September in

the year before a Presidential Election and ends the Sunday

following the Presidential Primary. The period then reopens

until March 1 or 30 days following the Monday following the

Presidential Primary whichever is later. The FPCA must be

signed and dated for it to be processed by the local election

official.

F Provide an e-mail address that you can access and/or a

phone number at which you can be reached for use in

contacting you in a timely manner in the event that there is a

question regarding your application

G Check ONE box.

H You must sign and date the FPCA. When signing, you are

swearing or affirming that the information is true and correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

C

E

G

D

F

H

B
Delaware 2004–05 Voting Assistance Guide

76

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Delaware and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, submit a

completed FPCA to the Department of Elections so that it

arrives not later than 21 days prior to a Primary Election or

20 days prior to a General Election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA requesting an

absentee ballot to the Department of Elections so that it

arrives during the year of the election and not later than 3

days before the election. In years when a Presidential

primary election is held, the Departments of Elections for

the counties will accept request for the Presidential Primary

ballot beginning August 15 of the year prior to the year of

the Presidential election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be returned to the

Department of Elections in the county of your voting

residence so that it arrives not later than 12:00 noon on the

day before the election. Voted ballots for Federal offices

received after 12:00 noon on the day before the election but

prior to the close of polls on election day will be counted.

The Departments of Elections for the counties will mail

ballots as soon as they are available. Ballots for primary

elections will be mailed approximately 30 days prior to the

election. Ballots for general elections will be mailed

approximately 45 days prior to the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Delaware allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Delaware does not allow you to receive the blank

ballot by fax.

 Delaware does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. State Special Write-In Ballot

Delaware provides a state special write-in absentee ballot

available 90 days before the election if you will be unable

to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated

or extremely remote areas of the world.

The FPCA may be used to request the state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.E. If no labels are available,

write in Item 7: “I am unable to vote by regular absentee

ballot or in person due to requirements of military service. I

request a special write-in ballot.”

The special write-in ballot may be requested at any time

before the election.

The special write-in ballot only includes the offices of

President and Vice President, U.S. Senator and

Representative in Congress.

The regular ballot that you are eligible to vote will be sent if

the request for the special write-in ballot is received after

the standard ballots are available.

Vote the special write-in ballot by writing in the name of

person for whom you wish to vote or by writing in the party

preference for each office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
2004–05 Voting Assistance Guide Delaware

77

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Delaware and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S and (but for such residence) would be qualified to

vote in Delaware.

 Delaware residents temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, submit a

completed FPCA to the Departments of Elections not later

than 21 days prior to a Primary Election or 20 days prior to

a General Election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA requesting an

absentee ballot to the Department of Elections so that it

arrives during the year of the election and not later than 3

days before the election. In years when a Presidential

primary election is held, the Department of Elections for the

counties will accept requests for the Presidential Primary

ballot beginning August 15 of the year prior to the year of

the Presidential election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be returned to the

Department of Elections in the county of your voting

residence so that it arrives not later than 12:00 noon on the

day before the election. Voted ballots for Federal offices

received after 12:00 noon on the day before the election but

prior to the close of polls on election day will be counted.

The Departments of Elections for the counties will mail

ballots as soon as they are available. Ballots for primary

elections will be mailed approximately 30 days prior to the

election. Ballots for general elections will be mailed

approximately 45 days prior to the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Delaware allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Delaware does not allow you to receive the blank

ballot by fax.

 Delaware does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. State Special Write-In Ballot

Delaware provides a state special write-in absentee ballot

available 90 days before the election if you will be unable

to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated

or extremely remote areas of the world.

The FPCA may be used to request the state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.E. If no labels are available,

write in Item 7: “I am unable to vote by regular absentee

ballot or in person due to living in isolated or extremely

remote areas of the world. I request a special write-in

ballot.”

The special write-in ballot may be requested at any time

before the election.

The special write-in ballot only includes the offices of

President and Vice President, U.S. Senator and

Representative in Congress.

The regular ballot that you are eligible to vote will be sent if

the request for the special write-in ballot is received after

the standard ballots are available.

Vote the special write-in ballot by writing in the name of

person for whom you wish to vote or by writing in the party

preference for each office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
Delaware 2004–05 Voting Assistance Guide

78

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons who have been convicted of a felony (unless

pardoned or whose voting rights have been restored) or

found mentally incompetent may not register to vote or

vote. Persons convicted of a felony have their voting rights

restored 5 years after completion of their sentence to

include payment of all fines and court ordered restitution.

This applies to all felons except those convicted of murder

or manslaughter; offenses against public administration

including bribery, improper influence or abuse or office; or

sexual offenses. See Delaware’s Constitution, Article V, s

2, and Delaware Code, Title 15, Chapter 61 for complete

information.

B. Action on Registration Requests

You are notified when your application is accepted. If your

application is rejected, you are so notified with the

reason(s) for rejection.

C. Action If Registration Is Denied

Denial of registration may be appealed to the county board

of elections and/or superior court. Consult a legal assistance

officer or civilian counsel. Upon denial of your voter

registration application or absentee ballot request, Delaware

shall provide you with the reason(s) for the rejection.

D. Late Registration

Military and overseas citizens who return to the United

States within 60 days of an election and establish residence

in Delaware can register to vote after the normal deadline.

E. Voting By Citizens Who Have Never 

Lived in the U.S.

A U.S. citizen who was born abroad and wo is eligible to

vote and who has never lived in the U.S. may register and

vote in the county where a parent would be eligible to

register and vote (for Federal offices only).

F. Where To Send It

Mail the FPCA to the Department of Elections, county of

voting residence, as listed below:

County Address City & Zip Code

New Castle 820 North French St.

4th Floor

Wilmington 19801-3531

Kent 455 Court St. Dover 19901-3729

Sussex 119 N Race St. Georgetown 19947-9985

Make The Right Choice By Choosing To Vote

by MSgt James H. Conrad, USAF, Felton, Delaware
DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

G. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in item 7 of the FPCA:

DELAWARE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”
Delaware 2004–05 Voting Assistance Guide

80
81

DISTRICT OF COLUMBIA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your District of Columbia Driver's License number is

required for voter registration. If you do not possess either

of these identifications, the District of Columbia shall

assign a number that will serve to identify you for voter

registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your District of

Columbia voting residence. A post office box is not

sufficient.

D Print the complete address where you want your ballot

to be sent — usually your current mailing address. It must

be different from the address you provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections. If you are

currently registered and want to change your political party

affiliation or you have previously declined to indicate a

political party and you now want to vote in a primary

election, you must submit a completed FPCA to the Board

of Elections and Ethics which includes your new political

party affiliation. 

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
District of Columbia 2004–05 Voting Assistance Guide

82

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of the District of Columbia and members of the

Uniformed Services and their family members. Uniformed

Services are defined as the U.S. Armed Forces, merchant

marine, commissioned corps of the Public Health Service

and the National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to the Board of Elections and

Ethics as early as 12 months preceding any election and

whenever you change your mailing address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the Board of Elections and Ethics postmarked not

later than 30 days before the election. If your FPCA is not

postmarked, your FPCA must arrive at the Board of

Elections and Ethics not later than 23 days before the

election.

If you are already registered and only wish to apply for an

absentee ballot, send a completed FPCA to the Board of

Elections and Ethics so that it arrives not later than 7 days

before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be postmarked

not later than midnight on the day of the election and must

arrive not later than 10 days after the election.

District of Columbia election officials mail absentee ballots

not later than 35 days before the election.

If you are outside the U.S. and have not received your ballot

in a timely manner, use the Federal Write-In Absentee

Ballot. See instructions in Chapter 2, page 12.

Due to its Federal status, the District of Columbia does not

send representatives to the U.S. Senate, however, it does

participate in the election of the President and Vice

President of the U.S. Additionally, a Delegate to the House

of Representatives is elected.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 The District of Columbia allows you to send the FPCA

application for registration and absentee ballot by fax.

After faxing, submit the FPCA by mail.

 The District of Columbia permits faxing of the

absentee ballot only when military service prevents the

applicant from receiving the absentee ballot and

returning the voted ballot within 45 days. An

application shall contain the reason that the applicant’s

military service prevents the applicant from receiving

and returning the voted ballot through the mail

process. Upon approval of an application, the voter is

assigned a fax authorization number and required to

sign an affidavit to waive his/her right to a secret

ballot.

 Except in the special circumstances outlined above,

the District of Columbia does not allow you to receive

and return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of the District of Columbia and overseas citizens.

The term “overseas citizen” means a U.S. citizen who

resides outside the U.S. and (but for such residence) would

be qualified to vote in the District of Columbia.

 District of Columbia residents temporarily outside the

U.S. (for local and Federal office ballots)

 overseas citizens (for Federal office ballots only)
2004–05 Voting Assistance Guide District of Columbia

83

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to the Board of Elections and

Ethics as early as 12 months preceding any election and

whenever you change your mailing address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the Board of Elections and Ethics postmarked not

later than 30 days before the election. If your FPCA is not

postmarked, your FPCA must arrive at the Board of

Elections and Ethics not later than 23 days before the

election.

If you are already registered and only wish to apply for an

absentee ballot, send a completed FPCA to the Board of

Elections and Ethics so that it arrives not later than 7 days

before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be postmarked

not later than midnight on the day of the election and must

arrive not later than 10 days after the election.

District of Columbia election officials mail absentee ballots

not later than 35 days before the election.

If you have not received your ballot in a timely manner, use

the Federal Write-In Absentee Ballot. See instructions in

Chapter 2, page 12.

Due to its Federal status, the District of Columbia does not

send representatives to the U.S. Senate, however, it does

participate in the election of the President and Vice

President of the U.S. Additionally, a Delegate to the House

of Representatives is elected.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 The District of Columbia allows you to send the FPCA

application for registration and absentee ballot by fax.

After faxing, submit the FPCA by mail.

 The District of Columbia does not allow you to

receive the blank ballot by fax.

 The District of Columbia does not allow you to return

the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons currently imprisoned for a felony or found mentally

incompetent by a court may not register or vote.

B. Action on Registration Requests

A voter registration card is sent.

C. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, the District of Columbia shall

provide you with the reason(s) for the rejection. Persons

denied registration may appeal to the Board. Consult a legal

assistance officer or civilian counsel.

D. Where To Send It

Mail the FPCA to:

The District of Columbia Board of Elections and Ethics

441 4th Street, N.W. Suite 250

Washington, DC 20001-2745

Your Country, Your Future, Your Vote

by Sirena Castillo, Civilian, Dept. of Commerce, Washington, D.C.
District of Columbia 2004–05 Voting Assistance Guide

84
85

FLORIDA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A You are requested to fill out this box. The Department of Justice

requests this data in their enforcement of the Voting Rights Act and

the National Voter Registration Act. Enter the choice that best

describes you from the following list. AI=American Indian or Alaskan

native; AP=Asian or Pacific Islander not Native Hawaiian; B=Black,

not of Hispanic Origin; H=Hispanic; M=Multi-racial; NH=Native

Hawaiian; W=White, not of Hispanic Origin; O=Other.

B Your Florida Driver’s License number, your Florida

identification card number, or the last four digits of your Social

Security number are required for voter registration. 

C If you are using the FPCA to register and you have never voted,

write “I have never voted” in the open spaces along the line of Item 2.

If you are using the FPCA to register and you have previously voted,

provide complete information on where you last registered and voted.

D Provide the complete street address of your Florida voting

residence. A post office box is not sufficient. If your address includes

a rural route, describe its location in Item 7. For example: “on

Highway _____, 2 miles past Highway _____, across the street from

the _____ gas station.” This address must be different from the one

provided in Item 4 and must be within the county where you claim

legal voting residence.

E Print the complete address where you want your absentee ballot

sent - usually your current mailing address. It must be different from

the address you provided in Item 3.

F If you wish to register to vote in a partisan primary election, you

must be a registered voter in the party for which the primary is being

held. You must indicate your political party affiliation when applying

for a primary ballot (Example: Democrat, Republican) or “none” in

Item 6 of the FPCA. However, if all candidates for an office have the

same party affiliation and the winner will have no opposition in the

general election, all qualified electors, regardless of party affiliation,

may vote in the primary elections for that office. If you are currently

registered and want to change your political party affiliation or you

have previously declined to indicate a political party and you now

want to vote in a primary election, you must submit a completed

FPCA which includes your new political party affiliation to the local

election official no later than 29 days before the election. All

registered voters, regardless of party affiliation can vote on issues and

non-partisan candidates. Political party affiliation is not required if

only requesting absentee ballots for general elections.

G Check ONE box.

H You must sign and date the FPCA. If you are using the FPCA to

register, read the following oath before signing, “I do solemnly swear

(or affirm) that I will protect and defend the Constitution of the U.S.

and the Constitution of the State of Florida, and that I am qualified to

register as an elector under the Constitution and laws of the State of

Florida and that I am a citizen of the U.S. and a legal resident of

Florida.”. Art. VI, s. 3, Fla. Const., s. 97.051 and 104.011 Fla. Stat. 

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

D

F

H

C

E

G

B
Florida 2004–05 Voting Assistance Guide

86

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Florida and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

 If you are or were a registered voter and maintain a

Florida residence, you may use it for local, state and

Federal offices. 

 If you are or were a registered voter and no longer

maintain a Florida residence but intend to return, you

may use it for everything except local offices. 

 If you have never registered in any Florida county and

maintain a Florida residence, you will receive a full

ballot. 

 If you have never registered and no longer maintain a

Florida residence but this was the last place you lived,

you will receive a ballot for Federal offices only.

To register and request an absentee ballot, send a completed

FPCA to the local Supervisor of Elections so that it arrives

not later than 29 days before the election. If you maintain a

Florida residence, you will receive a full ballot. If not and

this is the last place you lived, you will receive a ballot for

Federal offices only.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA or other written

correspondence to the Supervisor of Elections so that it

arrives not later than the Friday before the election.

Alternatively, you may request ballots for the primary and

general elections from the county supervisor by telephone,

facsimile, or e-mail.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day. If you are voting from outside

the U.S., the Federal portion of your general election or

presidential preference primary ballot will be counted if

voted by the day of the election and received within 10 days

following the election. There is a presumption that the

ballot was mailed on the date stated and witnessed on the

outside of the return envelope, regardless of the absence of

a postmark or the existence of a postmark date that is later

than election day. 

If you reside in the U.S., local election officials will mail

you your ballot as soon as the ballots are available.

Local election officials will mail your absentee ballot to you

approximately 35 days before a primary election. They also

will mail out an advance ballot 45 days before the general

election. Regular absentee ballots for the general election

are sent out as soon as they are available. Always vote and

return each ballot regardless of when you receive it.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: If you have never registered to vote in the Florida

county where you wish to register or if you had been

registered but failed to re-register, you must read the oath

under Application Instructions, Item H. before signing.

Ballot Return Envelope: When returning a voted ballot,

the certificate on the return envelope must be witnessed by

one person over the age of 18. The name and address of the

witness are required on the certificate. 

E. Electronic Transmission of FPCAs 

and Ballots

 Florida allows overseas Uniformed Services members

to send the FPCA for ballot request by fax. After

faxing, submit the FPCA by mail.

Please refer to Appendix C for specific instructions

when transmitting election materials electronically.

Use the following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

 Florida allows overseas Uniformed Services members

to receive the blank ballot by fax or e-mail.

 Florida allows overseas Uniformed Services members

to return the voted ballot to the fax number provided

by the local Supervisor of Elections.
2004–05 Voting Assistance Guide Florida

87

F. State Write-In Absentee Ballot

An overseas voter may request a state write-in ballot not

earlier than 180 days before a general election from the

Supervisor of Elections in the county of registration. The

voter will need to state that due to military or other

contingencies that preclude normal mail delivery, the voter

cannot vote an absentee ballot during the normal absentee

voting period. State write-in absentee ballots shall be

available 90 to 180 days prior to a general election.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Florida and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Florida.

 Florida residents temporarily absent from their county

(for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

 If you are or were a registered voter and maintain a

Florida residence, you may use it for local, state and

Federal offices. 

 If you are or were a registered voter and no longer

maintain a Florida residence but intend to return, you

may use it for everything except local offices. 

 If you have never registered in any Florida county and

maintain a Florida residence, you will receive a full

ballot. 

 If you have never registered and no longer maintain a

Florida residence but this was the last place you lived,

you will receive a ballot for Federal offices only.

To register and request an absentee ballot, send a completed

FPCA to the local Supervisor of Elections so that it arrives

not later than 29 days before the election. If you maintain a

Florida residence, you will receive a full ballot. If not and

this is the last place you lived, you will receive a ballot for

Federal offices only.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA or other written

correspondence to the Supervisor of Elections so that it

arrives not later than the Friday before the election.

Alternatively, you may request ballots for the primary and

general elections from the county supervisor by telephone,

facsimile, or e-mail.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day. If you are voting from outside

the U.S., the Federal portion of your general election or

presidential preference primary ballot will be counted if

voted by the day of the election and received within 10 days

following the election. There is a presumption that the

ballot was mailed on the date stated and witnessed on the

outside of the return envelope, regardless of the absence of

a postmark or the existence of a postmark date that is later

than election day. 

Local election officials will mail your absentee ballot to you

approximately 35 days before a primary election. They also

will mail out an advance ballot 45 days before the general

election. Regular absentee ballots for the general election

are sent out as soon as they are available. Always vote and

return each ballot regardless of when you receive it.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: If you have never registered to vote in the Florida

county where you wish to register or if you had been

registered but failed to re-register, you must read the oath

under Application Instructions, Item H. before signing. 

Ballot Return Envelope: When returning a voted ballot,

the certificate on the return envelope must be witnessed by

one person over the age of 18. The name and address of the

witness are required on the certificate. 

E. Electronic Transmission of FPCAs 

and Ballots

 Florida allows overseas citizens to send the FPCA for

ballot request by fax. After faxing, submit the FPCA

by mail.

Please refer to Appendix C for specific instructions

when transmitting election materials electronically.

Use the following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

 Florida allows overseas citizens to receive the blank

ballot by fax or e-mail.
Florida 2004–05 Voting Assistance Guide

88

 Florida allows overseas Uniformed Services members

to return the voted ballot to the fax number provided

by the local Supervisor of Elections.

F. State Write-In Absentee Ballot

An overseas voter may request a state write-in absentee

ballot not earlier than 180 days before a general election

from the Supervisor of Elections in the county of

registration. The voter will need to state that due to

contingencies that preclude normal mail delivery, the voter

cannot vote an absentee ballot during the normal absentee

voting period. State write-in absentee ballots shall be

available 90 to 180 days prior to a general election.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. In-Person Voting

You may vote in-person even after requesting an absentee

ballot. You must hand in the unvoted absentee ballot or

swear that it was not voted.

B. Bars to Registration and Voting

Persons convicted of a felony and whose civil rights have

not been restored or persons adjudicated as mentally

incapacitated with respect to voting and who have not had

their right to vote restored may not register or vote.

C. Cancellation of Registration

Periodically, supervisors of elections will send address

confirmation final notices to voters where the post office

has indicated that these voters have moved outside the

supervisor’s county or left no forwarding address. All

voters who have been mailed an address confirmation final

notice and who do not return the form within 30 days will

be placed on the inactive voter registration list. Voters on

the inactive list can be reinstated by updating their voter

registration, appearing to vote, or requesting an absentee

ballot. However, after two general elections for Federal

office from the date the final notice was sent, all inactive

voters who show no activity will be removed from the

registration records and must register to regain their voting

privilege.

D. Action on Registration Requests

Registered voters are sent an identification card.

E. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Florida shall provide you with the

reason(s) for the rejection. Persons denied registration

should consult a legal assistance officer or civilian counsel.

F. Late Registration

An individual or accompanying family member who has

been discharged or separated from the Uniformed Services,

merchant marine, or from employment outside the

territorial limits of the United States may register in the

office of the Supervisor of Elections, after the books close

for an election, until 5 p.m. on the Friday before that

election.

G. Where To Send It

Mail the FPCA to the Supervisor of Elections at the county

of voting residence, as listed below:

County County Seat Zip Code

Alachua PO Box 1496, Gainesville 32602-1496

Baker PO Box 505, MacClenny 32063-0505

Bay 205 Mosley Drive, Lynn Haven 32444-5603

Bradford PO Box 58, Starke 32091-0058

Brevard PO Box 1119, Titusville 32781-1119

Broward PO Box 029001, Fort Lauderdale 33302-9001

Calhoun 20859 Central Avenue E, Room G-10 

County Courthouse, Blountstown 32424-2264

Charlotte PO Box 511229, Punta Gorda 33951-1229

Citrus 120 North Apopka Avenue, Inverness 34450-4238

Clay PO Box 337, Green Cove Springs 32043-0337

Collier 3301 Tamiami Trail East, Naples 34112-4902

Columbia 971 W. Duval Street, Ste.102, Lake 

City 32055-3737

Dade (See Miami-Dade)

De Soto PO Box 89, Arcadia 34265-0089

Dixie PO Box 2057, Cross City 32628-2057

Duval 105 East Monroe Street, Jacksonville 32202-3213

Escambia PO Box 12601, Pensacola 32591-2601

Flagler PO Box 901, Bunnell 32110-0901

Franklin 33 Market St., Ste. 100, Apalachicola 32320-2311

Gadsden PO Box 186, Quincy 32353-0186

Gilchrist 112 S. Main Street, Rm. 128, Trenton 32693-3249

Glades PO Box 668, Moore Haven 33471-0668

Gulf 1000 Cecil G. Costin, Sr. Blvd.

Port St. Joe 32456-1647

Hamilton 313 Hatley St., NE, Ste. 1, Jasper 32052-6697

Hardee 315 N. 6th Ave., Ste. 110, Wauchula 33873-2361

Hendry PO Box 174, LaBelle 33975-0174

Hernando 20 N. Main St., Room 165, Brooksville 34601-2850

Highlands PO Box 3448, Sebring 33871-3448

Hillsborough 601 E. Kennedy Blvd., 16th Flr, Tampa 33602-4932

Holmes 201 N. Oklahoma Street, Bonifay 32425-2243

Indian River 1750 25th Street, Vero Beach 32960-3363

Jackson PO Box 6046, Marianna 32447-6046

Jefferson 380 West Dogwood Street, Monticello 32344-1470

Lafayette PO Box 76, Mayo 32066-0076

Lake PO Box 457, Tavares 32778-0457

Lee PO Box 2545, Fort Myers 33902-2545

Leon 301 S. Monroe St, Ste 301 

Tallahassee 32301-1825

Levy PO Box 880, Bronson 32621-0880

Liberty PO Box 597, Bristol 32321-0597

Madison 112 E Pinckney St., Rm 113 Madison 32340-2464

Manatee PO Box 1000, Bradenton 34206-1000

Marion PO Box 289, Ocala 34478-0289

Martin PO Box 1257, Stuart 34995-1257

Miami-Dade PO Box 012241, Miami 33101-2241

Monroe 530 Whitehead Street #101, Key West 33040-6547

Nassau 11 N. 14th St., Suite 11

Fernandina Beach 32034-3106
2004–05 Voting Assistance Guide Florida

89

Okaloosa 1804 Lewis Turner Blvd., Ste. 404

Fort Walton Beach 32547-1285

Okeechobee 307 Northwest 2nd St., Okeechobee 34972-4120

Orange PO Box 562001, Orlando 32856-2001

Osceola PO Box 420759, Kissimmee 34742-0759

Palm Beach PO Box 22309, West Palm Beach 33416-2309

Pasco PO Box 300, Dade City 33526-0300

Pinellas 315 Court St., Rm. 117, Clearwater 33756-5165

Polk PO Box 1460, Bartow 33831-1460

Putnam 107 N. 6th Street, Bldg. 1-7, Palatka 32177-3603

St. Johns 4455 Ave. A, Suite 101, St. Augustine 32095-5200

St. Lucie 2300 Virginia Avenue, Fort Pierce 34982-5632

Santa Rosa 6495 Caroline Street, Suite F, Milton 32570-4592

Sarasota PO Box 4194, Sarasota 34230-4194

Seminole PO Box 1479, Sanford 32772-1479

Sumter 220 East McCollum Avenue, Bushnell 33513-6124

Suwannee 200 South Ohio Avenue, Ste. 103 Live 

Oak 32064-3239

Taylor PO Box 1060, Perry 32348-1060

Union 55 West Main Street, Lake Butler 32054-1654

Volusia 136 N. Florida Avenue, Deland 32720-4208

Wakulla PO Box 305, Crawfordville 32326-0305

Walton 312 College Ave., Unit E

Defuniak Springs 32435-2852

Washington 1331 S. Boulevard, Suite 900, Chipley 32428-2233

County County Seat Zip Code

Have A Say...Vote Today!

by MSgt Charles A. Futrell, USAF, Shalimar, Florida
Florida 2004–05 Voting Assistance Guide

90
FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.

H. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following labels in Item 7 of the FPCA:

FLORIDA

Due to military or other contingencies that preclude normal mail delivery, I

cannot vote an absentee ballot during the normal voting period. I request a

special write-in absentee ballot.
Florida 2004–05 Voting Assistance Guide

92
93

GEORGIA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A You are requested to fill out this box.

B You are requested to fill out this box. The Department of

Justice requests this data in their enforcement of the Voting Rights

Act and the National Voter Registration Act. Enter the choice that

best describes you from the following list. AI=American Indian or

Alaskan Native; AP=Asian or Pacific Islander not Native

Hawaiian; B=Black, not of Hispanic Origin; H=Hispanic;

M=Multi-racial; NH=Native Hawaiian; W=White, not of

Hispanic Origin; O=Other.

C Your Social Security number is required.

D Do not leave blank. Enter “N/A” if not applicable or if you

are a first time voter.

E Provide the complete street address of your Georgia voting

residence. A post office box is not sufficient. If your address

includes a rural route, describe its location in Item 7. For example:

“on Highway _____, 2 miles past Highway _____, across the

street from the _____ gas station.” This address must be different

from the one provided in Item 4 and must be within the county or

township where you claim legal voting residence.

F Print the complete address where you want your ballot sent

— usually your current mailing address. Your current mailing

address must be different from the address you provided in Item 3. 

G If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party affiliation

when applying for a primary ballot (Example: Democrat,

Republican) or write “nonpartisan only” in Item 6 of the FPCA.

Political party affiliation is not required if only requesting absentee

ballots for general elections. If you are currently registered and

want to vote in a primary election, you must submit a completed

FPCA which includes your political party selection or

“nonpartisan” selection to the local election official. A separate

request is required for an absentee ballot for special elections.

Unregistered persons must submit the FPCA not later than the

fifth Monday before the election. No absentee ballot shall be

mailed on the day prior to an election or primary election.

Timeliness in submitting the FPCA is critical to receipt and return

of an absentee ballot.

H Check ONE box.

I You must sign and date the FPCA. When signing, you are

swearing or affirming that the information is true and correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A B

D

F

H

I

E

G

C
Georgia 2004–05 Voting Assistance Guide

94

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Georgia and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered citizen, the Board of Registrars

must receive your FPCA registration request not later than

the fifth Monday before the election. 

If you are a registered citizen, the Board of Registrars must

receive your FPCA absentee ballot request at least two

business days prior to the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

board of registrar’s office by 7 p.m. on election day.

Local election officials mail ballots approximately 45 days

before the election.

You must sign the self-administered oath on the voted ballot

return envelope. In addition if you receive assistance, this

person must complete and sign the necessary oath of

assistance.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

If you received assistance in voting, the person providing

assistance must complete and sign the necessary oath of

assistance.

E. Electronic Transmission of FPCAs 

and Ballots

 Georgia allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail. You may not submit the FPCA for registration

by fax.

 Georgia does not allow you to receive the blank ballot

by fax.

 Georgia does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Your mother, father, grandparent, aunt, uncle, sister,

brother, spouse, son, daughter, niece, nephew, mother-inlaw, father-in-law, brother-in-law, sister-in-law, son-in-law,

daughter-in-law, or grandchild (18 years of age or older)

may request (in writing to the local registrar) that an

absentee ballot be mailed to you if you are temporarily

residing outside the county.

G. Special Write-In Absentee Ballot

Georgia can provide a state special write-in absentee ballot

available 180 days before the general election if you are

unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated

or extremely remote areas of the world. 

The FPCA may be used to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.F. If no labels are available,

write in Item 7: “I am unable to vote by regular absentee

ballot or in person due to requirements of military service

or due to living in isolated or extremely remote areas of the

world. I request a special write-in absentee ballot.” 

The special write-in ballot must be requested not earlier

than 180 days before the general election. You may vote it

by writing in a party preference or the names of specific

candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
2004–05 Voting Assistance Guide Georgia

95

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Georgia and overseas citizens. The term

“overseas citizen(s) means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in Georgia.

 Georgia residents temporarily residing outside the

state (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

 U.S. citizens who have never resided in the U.S. but

have a parent who is eligible to vote in Georgia. These

citizens are eligible to vote at the same voting

residence claimed by their parent (for Federal office

ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered citizen, the Board of Registrars

must receive your FPCA registration request not later than

the fifth Monday before the election. 

If you are a registered citizen, the Board of Registrars must

receive your FPCA absentee ballot request at least two

business days prior to the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

board of registrar’s office by 7 p.m. on election day.

Local election officials mail ballots approximately 45 days

before the election.

You must sign the self-administered oath on the voted ballot

return envelope. In addition if you receive assistance, this

person must complete and sign the necessary oath of

assistance.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

If you received assistance in voting, the person providing

assistance must complete and sign the necessary oath of

assistance.

E. Electronic Transmission of FPCAs 

and Ballots

 Georgia allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail. You may not submit the FPCA for registration

by fax.

 Georgia does not allow you to receive the blank ballot

by fax.

 Georgia does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Your mother, father, grandparent, aunt, uncle, sister,

brother, spouse, son, daughter, niece, nephew, mother-inlaw, father-in-law, brother-in-law, sister-in-law, son-in-law,

daughter-in-law, or grandchild (18 years of age or older)

may request (in writing to the local registrar) that an

absentee ballot be mailed to you if you are temporarily

residing outside the county.

G. Special Write-In Absentee Ballot

Georgia can provide a state special write-in absentee ballot

available 180 days before the general election if you are

unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated

or extremely remote areas of the world. 

The FPCA may be used to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.F. If no labels are available,

write in Item 7: “I am unable to vote by regular absentee

ballot or in person due to requirements of military service

or due to living in isolated or extremely remote areas of the

world. I request a special write-in absentee ballot.” 

The special write-in ballot must be requested not earlier

than 180 days before the general election. You may vote it

by writing in a party preference or the names of specific

candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
Georgia 2004–05 Voting Assistance Guide

96

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony involving moral turpitude

may not register or vote until the sentence is completed.

Persons adjudicated mentally incompetent may not register

or vote unless the disability has been removed.

B. Action on Registration Requests

If eligible, precinct card is sent. If ineligible, notice of

denial is sent. 

C. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Georgia shall provide you with the

reason(s) for the rejection. 

D. Action If Registration Is Denied

Persons whose registration is cancelled due to a challenge

and hearing may appeal in writing the removal of their

name from the voters list within ten days from the date of

the hearing to the Clerk of the Superior Court. Said hearing

will be heard by the Judge of the Superior Court in that

jurisdiction. Consult a legal assistance officer or civilian

counsel. 

E. Voting By Citizens Who Have Never 

Resided In The U.S.

If a U.S. citizen outside the U.S. has never lived in the U.S.

and either parent is a qualified Georgia voter, then he or she

is eligible to register and vote where his or her parent is a

qualified voter.

F. Where To Send It

Mail the FPCA to the Board of Registrars at the county of

voting residence, as listed below:

County County Seat Zip Code

Appling Baxley 31513-1908

Atkinson Pearson 31642-0855

Bacon Alma 31510-0356

Baker Newton 31770-0450

Baldwin Milledgeville 31061-3399

Banks Homer 30547-0172

Barrow Winder 30680-1973

Bartow Cartersville 30120-3182

Ben Hill Fitzgerald 31750-2136

Berrien Nashville 31639-2250

Bibb Macon 31201-2678

Bleckley Cochran 31014-1633

Brantley Nahunta 31553-0326

Brooks Quitman 31643-0349

Bryan Pembroke 31321-9999

Bulloch Statesboro 30459-5355

Burke Waynesboro 30830-0089

Butts Jackson 30233-1965

Calhoun Morgan 31766-0111

Camden Woodbine 31569-6008

Candler Metter 30439-1429

Carroll Carrollton 30117-0338

Catoosa Ringgold 30736-2301

Charlton Folkston 31537-3745

Chatham Savannah 31401-3230

Chattahoochee Cusseta 31805-0125

Chattooga Summerville 30747-0165

Cherokee Canton 30114-2756

Clarke Athens 30601-4514

Clay Fort Gaines 31751-0218

Clayton Jonesboro 30236-3694

Clinch Homerville 31634-1415

Cobb Marietta 30090-3905

Coffee Douglas 31533-3854

Colquitt Moultrie 31776-0099

Columbia Appling 30809-0919

Cook Adel 31620-2400

Coweta Newnan 30263-1973

Crawford Knoxville 31078-0634

Crisp Cordele 31015-4295

Dade Trenton 30752-0152

Dawson Dawsonville 30534-0436

Decatur Bainbridge 31718-0246

DeKalb Decatur 30030-3221

Dodge Eastman 31023-1505

Dooly Vienna 31092-0322

Dougherty Albany 31702-1827

Douglas Douglasville 30134-2264

Early Blakely 31723-1811

Echols Statenville 31648-0337

Effingham Springfield 31329-0387

Elbert Elberton 30635-1840

Emanuel Swainsboro 30401-0267

Evans Claxton 30417-0634

Fannin Blue Ridge 30513-4581

Fayette Fayetteville 30214-1520

Floyd Rome 30161-2832

Forsyth Cumming 30040-2468

Franklin Carnesville 30521-4080

Fulton Atlanta 30303-3444

Gilmer Ellijay 30540-1149

Glascock Gibson 30810-0221

Glynn Brunswick 31521-0879

Gordon Calhoun 30703-0715

Grady Cairo 31728-4101

Greene Greensboro 30642-1443

Gwinnett Lawrenceville 30045-6935

Habersham Clarkesville 30523-5105

Hall Gainesville 30503-1435

Hancock Sparta 31087-0118

Haralson Buchanan 30113-0620

Harris Hamilton 31811-0123

Hart Hartwell 30643-0426

Heard Franklin 30217-0427

Henry McDonough 30253-3220

Houston Perry 31069-3825

Irwin Ocilla 31774-0514

Jackson Jefferson 30549-1013

Jasper Monticello 31064-9999

Jeff Davis Hazlehurst 31539-0602

Jefferson Louisville 30434-1657

Jenkins Millen 30442-1833

Johnson Wrightsville 31096-0264

Jones Gray 31032-1359

Lamar Barnesville 30204-1609

Lanier Lakeland 31635-1189

Laurens Dublin 31040-2102

Lee Leesburg 31763-0326

Liberty Hinesville 31313-0652

Lincoln Lincolnton 30817-0340

County County Seat Zip Code
2004–05 Voting Assistance Guide Georgia

97

Long Ludowici 31316-0669

Lowndes Valdosta 31603-1349

Lumpkin Dahlonega 30533-1167

McDuffie Thomson 30824-0600

McIntosh Darien 31305-1987

Macon Oglethorpe 31068-0415

Madison Danielsville 30633-0328

Marion Buena Vista 31803-0444

Meriwether Greenville 30222-9999

Miller Colquitt 31737-1284

Mitchell Camilla 31730-0229

Monroe Forsyth 31029-0374

Montgomery Mount Vernon 30445-0317

Morgan Madison 30650-1345

Murray Chatsworth 30705-1015

Muscogee Columbus 31902-1340

Newton Covington 30014-2435

Oconee Watkinsville 30677-2718

Oglethorpe Lexington 30648-0232

Paulding Dallas 30132-1205

Peach Fort Valley 31030-0468

Pickens Jasper 30143-1598

Pierce Blackshear 31516-1236

Pike Zebulon 30295-0377

Polk Cedartown 30125-2944

Pulaski Hawkinsville 31036-1350

Putnam Eatonton 31024-1095

Quitman Georgetown 31754-0447

Rabun Clayton 30525-0806

Randolph Cuthbert 31740-0323

Richmond Augusta 30911-4406

Rockdale Conyers 30094-6619

Schley Ellaville 31806-0385

Screven Sylvania 30467-2026

Seminole Donalsonville 31745-1602

Spalding Griffin 30223-3341

Stephens Toccoa 30577-1557

Stewart Lumpkin 31815-0713

Sumter Americus 31709-0246

Talbot Talbotton 31827-0056

Taliaferro Crawfordville 30631-0009

Tattnall Reidsville 30453-0387

Taylor Butler 31006-2044

Telfair McRae 31055-1604

Terrell Dawson 31742-0525

Thomas Thomasville 31799-0110

Tift Tifton 31793-0826

Toombs Lyons 30436-0667

Towns Hiawassee 30546-3219

Treutlen Soperton 30457-1438

Troup LaGrange 30240-4441

Turner Ashburn 31714-5313

Twiggs Jeffersonville 31044-0130

Union Blairsville 30512-4302

Upson Thomaston 30286-0547

Walker LaFayette 30728-0628

Walton Monroe 30655-1842

Ware Waycross 31501-3596

Warren Warrenton 30828-0186

Washington Sandersville 31082-9999

Wayne Jesup 31546-4320

Webster Preston 31824-0029

Wheeler Alamo 30411-0431

White Cleveland 30528-1376

Whitfield Dalton 30720-3147

Wilcox Abbeville 31001-1000

County County Seat Zip Code

Wilkes Washington 30673-1595

Wilkinson Irwinton 31042-0186

Worth Sylvester 31791-2182

County County Seat Zip Code

“The Power of One - Every Vote Counts.”

by Captain Dustin R. Thorn, USMC, Albany, Georgia
Georgia 2004–05 Voting Assistance Guide

98
GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

G. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

GEORGIA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”
Georgia 2004–05 Voting Assistance Guide

100
101

GUAM

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Social Security number is required. If you do not

have a Social Security number, your Guam Driver’s

License number is required for voter registration. If you do

not possess either of these identifications, Guam shall

assign a number that will serve to identify you for voter

registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Guam

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be within Guam and different from the one

provided in Item 4.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E Check ONE box. You may use a single FPCA to

request ballots for all elections in a calendar year.

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

D

F

A
Guam 2004–05 Voting Assistance Guide

102

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Guam and members of the Uniformed Services

and their family members. Uniformed Services are defined

as the U.S. Armed Forces, merchant marine, commissioned

corps of the Public Health Service and the National Oceanic

and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered member of the Uniformed

Services or merchant marine or a spouse or dependent of

one of these, the Election Commission must receive your

FPCA ballot request not later than 10 days before the

election. 

If you are a registered member of the Uniformed Services

or merchant marine or a spouse or dependent of one of

these, the Election Commission must receive your FPCA

ballot request not less than 3 days before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

Election Commission not later than 8 p.m. on election day.

Local election officials mail ballots approximately 45 days

before the election.

Due to its territorial status, Guam does not send

representatives to the U.S. Senate or directly participate in

the election of the President and Vice President of the U.S.

At the Federal level, only a Delegate to the House of

Representatives is elected.

If you are outside the U.S. and have not received your

Guam ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: Must be sworn to before a

commissioned officer, warrant officer, non-commissioned

officer, or any other officer authorized to administer oaths.

E. Electronic Transmission of FPCAs 

and Ballots

Guam does not allow electronic transmission of the FPCA,

the blank absentee ballot or the voted absentee ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Guam and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Guam.

 Guam residents outside of Guam 

 overseas electors 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered citizen in one of the above

categories, the Election Commission must receive your

FPCA ballot request not later than 10 days before the

election. 

If you are a registered citizen in one of the above categories,

the Election Commission must receive your FPCA ballot

request not less than 3 days before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

Election Commission not later than 8 p.m. on election day.

Local election officials mail ballots approximately 45 days

before the election.

Due to its territorial status, Guam does not send

representatives to the U.S. Senate or directly participate in

the election of the President and Vice President of the U.S.

At the Federal level, only a Delegate to the House of

Representatives is elected.

If you have not received your Guam ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.
2004–05 Voting Assistance Guide Guam

103

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: Must be sworn to before a

commissioned officer, warrant officer, non-commissioned

officer, or any other officer authorized to administer oaths.

E. Electronic Transmission of FPCAs 

and Ballots

Guam does not allow electronic transmission of the FPCA,

the blank absentee ballot or the voted absentee ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons imprisoned, confined to a mental institution, or

found insane may not register or vote.

B. Cancellation of Registration

Registration is cancelled for failure to vote in two (2)

consecutive general elections.

C. Action on Registration Requests

Notice of denial of registration is sent.

D. Action If Registration Is Denied

Persons denied registration may appeal to the Election

Commission. Consult a legal assistance officer or civilian

counsel.Upon denial of your voter registration application

or absentee ballot request, Guam shall provide you with the

reason(s) for the rejection.

E. Where To Send It

Mail the FPCA to: 

Guam Election Commission

P.O. Box BG 

Hagatna, Guam 96932-8958

Vote!...It’s Your Loudest Voice

by MSgt Steven V. Crowell, USAF, PSAB AB, Kansas
Guam 2004–05 Voting Assistance Guide

104
105

HAWAII

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Social Security number is required.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Hawaii

voting residence. A post office box is not acceptable. If

there is no street address of your residence, describe its

location in Item 7. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be different from the one

provided in Item 4 and must be within the county where

you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. This address

must be different than the address provided in Item 3. 

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct. 

G If you are unable to sign, your mark must be witnessed

by another individual 18 years of age or older.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

E

C

G
Hawaii 2004–05 Voting Assistance Guide

106

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed ServicesA.Who Can Do It

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Hawaii and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA or any other form of written

communication to your local election official early every

year and whenever you change your mailing address (see

Chapter 2). In Hawaii, all Federal, state and county

elections are held concurrently in even numbered years.

If you are unregistered, the County Clerk must receive your

FPCA not later than 30 days before the election. 

If you are registered, your FPCA must be received not later

than 7 days before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office by the close of polls on election day.

Local election officials mail ballots approximately 35 days

before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: A self-subscribing oath is required to affirm the

information entered on the voter registration application is

true and correct. If you are unable to sign, your mark must

be witnessed by another individual 18 years of age or older.

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

 Hawaii allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Hawaii allows you to request that the blank ballot be

sent to you by fax if you do not receive your requested

ballot within five (5) days of the election. 

 Hawaii allows you to return the voted ballot by fax if

you requested that the blank ballot be sent to you by

fax. You must submit a waiver of secrecy of vote with

the transmitted ballot. The waiver and ballot must be

received by the issuing clerk no later than 6 p.m.

(Hawaiian Standard Time) on election day.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers: 

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Hawaii and overseas citizens. The term

“overseas citizen(s)” means a U.S. citizen who resides

outside the U.S., was last domiciled (but no longer resides)

in Hawaii, and (but for such residence) would be qualified

to vote in Hawaii for Federal offices.

 Hawaii residents temporarily residing outside the U.S.

(for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA or any other form of written

communication to your local election official early every

year and whenever you change your mailing address (see

Chapter 2). In Hawaii, all Federal, state and county

elections are held concurrently in even numbered years.

If you are unregistered, the County Clerk must receive your

FPCA not later than 30 days before the election. 

If you are registered, your FPCA must be received not later

than 7 days before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office by the close of polls on election day. 
2004–05 Voting Assistance Guide Hawaii

107

Local election officials mail ballots approximately 35 days

before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: A self-subscribing oath is required to affirm the

information entered on the voter registration application is

true and correct. If you are unable to sign, your mark must

be witnessed by another individual 18 years of age or older.

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

 Hawaii allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Hawaii allows you to request that the blank ballot be

sent to you by fax if you do not receive your requested

ballot within five (5) days of the election. 

 Hawaii allows you to return the voted ballot by fax if

you requested that the blank ballot be sent to you by

fax. You must submit a waiver of secrecy of vote with

the transmitted ballot. The waiver and ballot must be

received by the issuing clerk no later than 6 p.m.

(Hawaiian Standard Time) on election day.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony may not register or vote while

confined. Persons judged mentally incompetent may not

register or vote.

B. Cancellation of Registration

Re-registration is required when a voter changes his/her

voting residence or name or his/her name is removed from

the voter register. Overseas citizens must submit an FPCA

for registration each election year (for Federal offices only). 

C. Action on Registration Requests

The County Clerk is not required to notify absentee voters

of their registration. 

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Hawaii shall provide you with the

reason(s) for the rejection. 

E. Action If Registration Is Denied

Persons denied registration by the clerk may appeal to the

Board of Registration. Consult a legal assistance officer or

civilian counsel. 

F. Voting By Citizens Who Have Never 

Lived in the U.S.

U.S. citizens who have never resided in the U.S. but have a

parent who is eligible to vote in Hawaii are eligible to vote

at the same voting residence claimed by their parent (for

local, state and Federal office ballots).

G. Where To Send It

Mail the FPCA to the County Clerk in your county of

voting residence as listed below: 

County Address Zip Code

Hawaii 25 Aupuni Street, Room 105, Hilo 96720-4245

Honolulu 530 S. King Street, Room 100, Honolulu 96813-3077

Kauai 4396 Rice Street, Suite 106, Lihue 96766-1371

Maui 200 S High Street, 7th Floor, Wailuku 96793-2155

Have A Voice, Be Heard, VOTE!

by TSgt. Jimmy S. Clark, Jr., Langley AFB, Virginia
Hawaii 2004–05 Voting Assistance Guide

108
109

IDAHO

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your Idaho Driver's License number is required for

voter registration. If you do not possess either of these

identifications, Idaho shall assign a number that will serve

to identify you for voter registration purposes.

B List any place where you have been previously

registered to vote or have voted. If none, write “none.”

C Provide the complete street address of your Idaho

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be within the county or township where you

claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. 

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMD D Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

C

E

F
Idaho 2004–05 Voting Assistance Guide

110

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Idaho and members of the Uniformed Services

and their family members. Uniformed Services are defined

as the U.S. Armed Forces, merchant marine, commissioned

corps of the Public Health Service and the National Oceanic

and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, your FPCA must

be postmarked by the 25th day before the election.

If you are already registered and only wish to request an

absentee ballot, the County Clerk must receive your FPCA

or a written application requesting a ballot by 5:00 p.m. on

the 6th day before the election.

If you send a written application, you must provide your

name as registered, your voting residence address, county,

and the address to which the absentee ballot should be sent.

The written application must be signed.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

election office by 8:00 p.m. on election day.

Local election officials mail ballots approximately 35-40

days before the primary election and 45 days before the

general election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Idaho allows you to send the FPCA or a written

application for absentee ballot requests by fax. You

may not submit the FPCA for registration by fax.

 In certain emergency situations, Idaho may allow you

to receive the blank ballot by fax. 

 Idaho does not allow you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Idaho and overseas electors. The term

“overseas elector(s)” means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in Idaho.

 Idaho residents temporarily residing outside the U.S. 

 overseas electors 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an Idaho resident temporarily residing outside the

U.S., to register and request an absentee ballot, your FPCA

must be postmarked by the 25th day before the election.

If you are an Idaho resident temporarily residing outside the

U.S. and are already registered and only wish to request an

absentee ballot, the County Clerk must receive your FPCA

or a written application requesting a ballot by 5:00 p.m. on

the 6th day before the election.

If you send a written application, you must provide your

name as registered, your voting residence address, county,

and the address to which the absentee ballot should be sent.

The written application must be signed.
2004–05 Voting Assistance Guide Idaho

111

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

election office by 8:00 p.m. on election day.

Local election officials mail ballots approximately 35-40

days before the primary election and 45 days before the

general election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Idaho allows you to send the FPCA or a written

application for absentee ballot requests by fax. You

may not submit the FPCA for registration by fax.

 In certain emergency situations, Idaho may allow you

to receive the blank ballot by fax. 

 Idaho does not allow you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony who have not had their voting

rights restored, or imprisoned on any criminal offense may

not vote.

B. Cancellation of Registration

Registration is canceled for failure to vote in at least one

primary or general election in the past four years.

C. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Idaho shall provide you with the

reason(s) for the rejection. 

D. Action on Registration Requests

County Clerks send a verification by First Class mail to all

electors who register by mail. 

E. Action If Registration Is Denied

Persons denied registration may appeal to the County Clerk.

Consult a legal assistance officer or civilian counsel. 

F. Where To Send It

Mail the FPCA to the County Clerk at the county of voting

residence, as listed below:

County County Seat Zip Code

Ada 200 W. Front, Boise 83702-7300

Adams PO Box 48, Council 83612-0048

Bannock PO Box 6094, Pocatello 83205-6094

Bear Lake PO Box 190, Paris 83261-0190

Benewah 701 College Ave., Saint Maries 83861-1852

Bingham 501 N. Maple St,. #205, Blackfoot 83221-1776

Blaine 206 1st Ave. South #200, Hailey 83333-8429

Boise PO Box 1300, Idaho City 83631-1300

Bonner 215 S. First Avenue, Sandpoint 83864-1392

Bonneville 605 N. Capital Avenue, Idaho Falls 83402-3582

Boundary PO Box 419, Bonners Ferry 83805-0419

Butte PO Box 737, Arco 83213-0737

Camas PO Box 430, Fairfield 83327-0430

Canyon 1102 E. Chicago, Caldwell 83605-3407

Caribou PO Box 775, Soda Springs 83276-0775

Cassia 1459 Overland Avenue, Burley 83318-1862

Clark PO Box 205, Dubois 83423-0205

Clearwater PO Box 586, Orofino 83544-0586

Custer PO Box 385, Challis 83226-0385

Elmore 150 S 4th E. #3, Mountain Home 83647-3000

Franklin 39 W. Oneida, Preston 83260-1232

Freemont 151 W. 1st N. #12, Saint Anthony 83445-1409

Gem 415 E. Main, Emmett 83617-3059

Gooding PO Box 417, Gooding 83330-0417

Idaho 320 W. Main #5, Grangeville 83530-1948

Jefferson PO Box 275, Rigby 83442-0275

Jerome 300 N. Lincoln, Room 301, Jerome 83338-2344

Kootenai PO Box 9000, Coeur d'Alene 83816-9000

Latah PO Box 8068, Moscow 83843-0568

Lemhi 206 Courthouse Drive, Salmon 83467-3900

Lewis PO Box 39, Nezperce 83543-0039

Lincoln Drawer A, Shoshone 83352-1501

Madison PO Box 389, Rexburg 83440-0389

Minidoka PO Box 368, Rupert 83350-0368

Nez Perce PO Box 896, Lewiston 83501-0896

Oneida 10 Court Street, Malad City 83252-1245

VOTE - The Best Four Letter Word In A Democracy

by MSgt Kelly W. P. Taylor, UASAF, Post Falls, Idaho
Idaho 2004–05 Voting Assistance Guide

112

Owyhee PO Box 128, Murphy 83650-0128

Payette 1130 3rd Ave., N. Room 104, Payette 83661-0277

Power 543 Bannock Avenue, American Falls 83211-1200

Shoshone 700 Bank Street #120, Wallace 83873-2348

Teton 89 N. Main #1, Driggs 83422-5164

Twin Falls PO Box 126, Twin Falls 83303-0126

Valley PO Box 1350, Cascade 83611-1350

Washington PO Box 670, Weiser 83672-0670

County County Seat Zip Code
113

ILLINOIS

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Illinois Driver's License number OR the last four

digits of your Social Security number is required for voter

registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Illinois

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence. 

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party choice is not required if only

requesting absentee ballots for general elections.

F Check ONE box. U.S. Government employees must

check “a” as defined in Section I.A of the following page.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Illinois 2004–05 Voting Assistance Guide

114

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed ServicesYou must sign and date the FPCA. When signing, you are swearing or affirming that the information is true and correct.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Illinois and members of the U.S. Service.

Defined as:

 Members of the Uniformed Services and their family

members when residing with them or accompanying

them. Uniformed Services are defined as the U.S.

Armed Forces, merchant marine, commissioned corps

of the Public Health Service and the National Oceanic

and Atmospheric Administration.

 U.S. Government employees serving outside the U.S.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Illinois waives your registration.

To apply for an absentee ballot, the local election official

must receive your FPCA ballot request not later than 10

days before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

election office in sufficient time for delivery to polling

place by 7 p.m. on election day.

Local election officials send regular absentee ballots 45

days before a primary or special election and 60 days before

the general election. 

If regular absentee ballots are not available 60 days before

the general election, local election officials mail a Special

Write-In Absentee Voter’s Blank ballot with a list of

candidates who have qualified to be on the ballot and all

referenda for which the voter is qualified to vote.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Illinois allows you to send your FPCA applications for

an absentee ballot by fax if you are a member of the

Armed Forces. After faxing, submit the FPCA by mail.

 Illinois does not allow you to receive the blank ballot

by fax.

 Illinois does not allow you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

If you are a member of the U.S. Service, and your spouse,

dependent, mother, father, sister, or brother is registered to

vote in your election precinct of voting residence, he or she

may use a special application provided by the election

official to request that an absentee ballot be mailed to you. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Illinois and overseas citizens. The term

“overseas citizen(s)” means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in Illinois.

 Illinois residents temporarily residing outside the U.S.

(Consult Section B below for ballot type eligibility)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).
2004–05 Voting Assistance Guide Illinois

115

If you are an unregistered Illinois resident temporarily

residing outside the U.S., the local election official must

receive your FPCA not later than 30 days before the

election. You will receive a ballot for local, state and

Federal offices. However, if your FPCA arrives less than 30

days, but not later than 10 days before the election,

registration is waived and the local election official will

send you a ballot for Federal offices only.

If you are a registered Illinois resident temporarily residing

outside the U.S., the local election official must receive

your FPCA not later than 10 days before the election. You

will receive a ballot for local, state and Federal offices.

If you are an overseas citizen, the local election official

must receive your FPCA not less than 10 days before the

election. Your registration is waived and you will be sent a

ballot for Federal offices only.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

election office in sufficient time for delivery to polling

place by 7 p.m. on election day.

Local election officials send regular absentee ballots 45

days before a primary or special election and 60 days before

the general election. 

If regular absentee ballots are not available 60 days before

the general election, local election officials mail a Special

Write-In Absentee Voter’s Blank ballot with a list of

candidates who have qualified to be on the ballot and all

referenda for which the voter is qualified to vote.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: The FPCA and state ballot application forms are

not notarized or witnessed. 

However, If you are an unregistered Illinois resident

temporarily residing outside the U.S. and wish to vote a

ballot for local, state and Federal offices, you may be

required to have the state registration form sworn to before

a person or officer authorized to administer oaths. 

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

Illinois does not allow electronic transmission of the FPCA,

the blank absentee ballot or the voted absentee ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons imprisoned for any crime may not register or vote.

However, persons on parole are not prohibited from voting.

B. Cancellation of Registration

Registration is suspended unless a confirmation notice

mailed to the registrant is returned prior to the next election.

An application for ballot will reactivate the full registration

during the period of two years if the registrant has not

changed Illinois residence.

C. Action on Registration Requests

Notice of registration is sent by mail after an affidavit of

registration is completed in duplicate and returned to the

local election official.

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Illinois shall provide you with the

reason(s) for the rejection.

E. Action If Registration Is Denied

Persons denied registration may appeal to the circuit court.

Persons seeking to appeal should consult a legal assistance

officer or civilian counsel. 

F. Late Registration

Members of the U.S. Armed Forces or merchant marine or

those discharged within 60 days of an election, who return

to Illinois too late to register for the upcoming election are

still entitled to vote in person in that election only by

affidavit. Registration is not required. 

G. Where To Send It

Mail the FPCA to the County Clerk, City Board of Election

Commissioners, or County Board of Election

Commissioners in your county or city of voting residence

as listed below:

County Clerks

County County Seat Zip Code

Adams 507 Vermont, PO Box 1169, Quincy 62306-1169

Alexander 2000 Washington, Cairo 62914-1717

Bond 200 W. College, Greenville 62246-1088

Boone 601 N. Main, Suite 202, Belvidere 61008-2644

Brown #1 Court Street, Mount Sterling 62353-1285

Bureau 700 S. Main, Princeton 61356-2078

Calhoun PO Box 187, Hardin 62047-0187

Carroll PO Box 152, Mount Caroll 61053-1044

Cass Courthouse, Virginia 62691-1322

Champaign 1776 E. Washington, Urbana 61802-4578

Christian PO Box 647, Taylorville 62568-0647

Clark Courthouse, Marshall 62441-1275
Illinois 2004–05 Voting Assistance Guide

116

County Board of Election Commissioners

City Board of Election Commissioners:

Clay PO Box 160, Louisville 62858-0160

Clinton PO Box 308, Carlyle 62231-0308

Coles 651 Jackson Ave., Rm. 122, Charleston 61920-2053

Cook 69 W. Washington, 5th Floor, Chicago 60602-1304

Crawford PO Box 602, Robinson 62454-0602

Cumberland PO Box 146, Toledo 62468-0146

De Kalb 110 E. Sycamore, Sycamore 60178-1497

De Witt 201 W. Washington St., PO Box 43, Clinton 61727-1628

Douglas PO Box 467, Tuscola 61953-0467

Edgar 115 W. Court St., Room “J”, Paris 61944-1785

Edwards 50 E. Main Street, Albion 62806-1262

Effingham 101 N. 4th, Box 628, Effingham 62401-0628

Fayette PO Box 401, Vandalia 62471-0401

Ford 200 W. State St., Rm 101, PO Box 568, Paxton 60957-1199

Franklin 202 W. Main, PO Box 607, Benton 62812-0607

Fulton PO Box 226, Lewistown 61542-0226

Gallatin PO Box 550, Shawneetown 62984-0550

Greene 519 N. Main, Carrollton 62016-1033

Grundy 111 E. Washington, PO Box 675, Morris 60450-0675

Hamilton Courthouse, McLeansboro 62859-1489

Hancock Courthouse, PO Box 39, Carthage 62321-0039

Hardin Courthouse, PO Box 187, Elizabethtown 62931-0187

Henderson Courthouse, PO Box 308, Oquawka 61469-0308

Henry 100 South Main, Cambridge 61238-1232

Iroquois 1001 E. Grant, Watseka 60970-1882

Jackson Courthouse, Murphysboro 62966-2177

Jasper 100 W. Jourdan, Newton 62448-1973

Jefferson Courthouse, Room 105, Mount Vernon 62864-4012

Jersey 201 W. Pearl, Jerseyville 62052-1662

Jo Daviess 330 N. Bench, Galena 61036-1323

Johnson PO Box 96, Vienna 62995-0096

Kane 719 S. Batavia, PO Box 70, Geneva 60134-0070

Kankakee 189 E. Court Street, Kankakee 60901-3892

Kendall 111 W. Fox, Yorkville 60560-1621

Knox Courthouse, Galesburg 61401-4991

Lake 18 N. County Road, Waukegan 60085-4364

La Salle 707 Etna Road, PO Box 430, Ottawa 61350-0430

Lawrence Courthouse, Lawrenceville 62439-2341

Lee PO Box 385, Dixon 61021-0385

Livingston 112 W. Madison, Pontiac 61764-1629

Logan PO Box 278, Lincoln 62656-0278

Macon 141 S. Main, Room 104, Decatur 62523-1235

Macoupin PO Box 107, Carlinville 62626-0107

Madison 157 N. Main St., Suite. 109, PO Box 218

Edwardsville 62025-0218

Marion PO Box 637, Salem 62881-0637

Marshall 122 N. Prairie, PO Box 328, Lacon 61540-0328

Mason PO Box 77, Havana 62644-0077

Massac PO Box 429, Metropolis 62960-0429

McDonough Elections #10 McDonough Co Courthouse, 

Macomb 61455-2200

McHenry 2200 N. Seminary Avenue, Woodstock 60098-2693

McLean 104 W. Front St., Box 2400, Bloomington 61702-2400

Menard PO Box 465, Petersburg 62675-0465

Mercer PO Box 66, Aledo 61231-0066

Monroe 100 S. Main, Waterloo 62298-1399

County County Seat Zip Code

Montgomery PO Box 465, Hillsboro 62049-0465

Morgan PO Box 1387, Jacksonville 62651-1387

Moultrie Courthouse, Sullivan 61951-1969

Ogle Courthouse, PO Box 357, Oregon 61061-0357

Peoria Courthouse, 324 Main Street, Peoria 61602-1319

Perry PO Box 438, Pinckneyville 62274-0438

Piatt 101 W. Washington, PO Box 558 Monticello 61856-0558

Pike Courthouse, Pittsfield 62363-1496

Pope Courthouse, PO Box 216, Golconda 62938-0216

Pulaski Courthouse, PO Box 109, Mound City 62963-0109

Putnam Courthouse, PO Box 236, Hennepin 61327-0236

Randolph Courthouse, Chester 62233-0309

Richland Courthouse, Olney 62450-2170

Rock Island 1504 3rd Avenue, County Building, Rock Island 61201-8646

Saline Courthouse, 10 E. Poplar, Harrisburg 62946-1703

Sangamon 200 S. 9th Street, Springfield 62701-1632

Schuyler Courthouse, PO Box 200, Rushville 62681-0200

Scott Courthouse, Winchester 62694-1238

Shelby Courthouse, PO Box 230, Shelbyville 62565-0230

Stark 130 W. Main, PO Box 97, Toulon 61483-0097

St. Clair 10 Public Square, Belleville 62220-1639

Stephenson 15 N. Galena Ave., Suite 1, Freeport 61032-4399

Tazewell McKenzie Bldg., 4th & Court Sts., Pekin 61554-4298

Union Courthouse, PO Box H, Jonesboro 62952-0478

Vermilion Courthouse, 6 N. Vermilion, Danville 61832-5879

Wabash Courthouse, PO Box 277, Mt. Carmel 62863-0277

Warren Courthouse, 100 W. Broadway, Monmouth 61462-1797

Washington 100 East St Louis Street, Nashville 62263-1100

Wayne Courthouse, PO Box 187, Fairfield 62837-0187

White Courthouse, PO Box 339, Carmi 62821-0339

Whiteside Couthouse, 200 E. Knox, Morrison 61270-2819

Will Courthouse, 302 N. Chicago, Joliet 60432-4060

Williamson 200 W. Jefferson, PO Box 1108, Marion 62959-2494

Winnebago 404 Elm Street, Rockford 61101-1276

Woodford 115 N. Main, Room 202, Eureka 61530-1274

County Address Zip Code

Dupage 421 N. County Farm Rd., PO Box 1087, 

Wheaton 60189-1087

City Address Zip Code

Aurora 77 S. Stolp Avenue 60506

Bloomington 200 W. Front St-Suite 400D, 61701-5048

Chicago 69 W. Washington, Suite 600-800 60602-3012

Danville 6 N. Vermillion 61832-5842

E. St. Louis 8740 State Street, Suite 200 62203-2099

Galesburg 55 W. Tompkins, PO Box 1387 61402-1387

Peoria BEC 542 SW Adams 61602-1553

Rockford 301 S. 6th St. 61104-2195

County County Seat Zip Code

Give Back To Your Country, VOTE!

by Sgt. Erich Max Klein, USMC, San Diego, California
117

INDIANA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Provide your Indiana driver’s license number as issued

by the Indiana Bureau of Motor Vehicles. If you do not

have an Indiana driver’s license, provide the last four digits

of your social security number. If you do not possess either

of these identifications, the State shall assign a number that

will serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Indiana

voting residence. A post office box is not sufficient. If your

address includes a rural route or star route or if you were a

homeless or mobile voter, describe the location of this

address in Item 7. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be different from the one

provided in Item 4 and must be within the county where

you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address you provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot. (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if you

request absentee ballots only for general elections, school

board elections or public questions voted the same day as

the primary election. If you are currently registered and

want to change your political party choice or you have

previously declined to indicate a political party and you

now want to vote in a primary election, you must submit a

completed FPCA which includes your new political party

choice to the local election official not later than 29 days

before the election. Under some circumstances, your

completed FPCA including a new political party choice

may be processed if it arrives not later than 10 days before

the primary election.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Indiana 2004–05 Voting Assistance Guide

118

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Indiana and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration. The

provisions also apply to members of the Indiana National

Guard deployed or on assignment outside Indiana and their

family members.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the clerk of the local circuit court so that it arrives

not later than 29 days before the election. Under some

circumstances, your registration may be processed if it

arrives not later than 10 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the clerk of the

local circuit court so that it arrives not later than 8 days

before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

circuit court clerk in time for the clerk to deliver the ballot

to the appropriate precinct election board (for counting)

before the close of polls on election day. It is recommended

that you return your voted ballot so that it arrives by the

Saturday before the election.

Local election officials mail ballots beginning 45 days

before primary and general elections, 38 days before

presidential elections, and 32 days before special elections.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12, and

Section I. E.

D. Notary/Witness Requirements

No registration or voting materials are sworn to or

witnessed. By signing a registration form, you are swearing

that “to the best of my belief and knowledge, I am a U.S.

citizen, at least 18 years of age, and have resided in the

precinct for 30 days.”

E. Electronic Transmission of FPCAs 

and Ballots

 Indiana allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Indiana allows you to receive the blank ballot by fax. 

 Indiana allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Indiana provides a state special write-in absentee ballot

available not earlier than the first Monday in June and not

later than 45 days before a general election if you are

outside the U.S. on general election day. This ballot is

available if you cannot vote and return a regular absentee

ballot by normal mail delivery.

This ballot includes statewide offices and state public

questions. Vote this ballot by writing in the name of a

political party or the name of a candidate for each office

and by checking “yes” or “no” on the public questions.

Use the FPCA to request this state special write-in absentee

ballot. All normal deadlines apply. The regular absentee

ballot will be mailed to you as soon as it is available. Vote

and return all ballots you receive. The state special write-in

absentee ballot will be voided if local election officials

timely receive your regular absentee ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Indiana and overseas citizens. The term

“overseas citizens” means a U.S. citizen who resides
2004–05 Voting Assistance Guide Indiana

119

outside the U.S. and (but for such residence) would be

qualified to vote in Indiana.

 Indiana residents temporarily residing outside the U.S.

(for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the clerk of the local circuit court so that it arrives

not later than 29 days before the election. Under some

circumstances, your registration may be processed if it

arrives not later than 10 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the clerk of the

local circuit court so that it arrives not later than 8 days

before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

circuit court clerk in time for the clerk to deliver the ballot

to the appropriate precinct election board (for counting)

before the close of polls on election day. It is recommended

that you return your voted ballot so that it arrives by the

Saturday before the election.

Local election officials mail ballots beginning 45 days

before primary and general elections, 38 days before

presidential elections, and 32 days before special elections.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12, and Section II. E.

D. Notary/Witness Requirements

No registration or voting materials are sworn to or

witnessed. By signing a registration form, you are swearing

that “to the best of my belief and knowledge, I am a U.S.

citizen, at least 18 years of age, and have resided in the

precinct for 30 days.”

E. Electronic Transmission of FPCAs 

and Ballots

 Indiana allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Indiana allows you to receive the blank ballot by fax.

 Indiana allows you to return the voted ballot by fax. 

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Indiana provides a state special write-in absentee ballot

available not earlier than the first Monday in June and not

later than 45 days before a general election if you are

outside the U.S. on general election day. This ballot is

available if you cannot vote and return a regular absentee

ballot by normal mail delivery.

This ballot includes statewide offices and state public

questions. Vote this ballot by writing in the name of a

political party or the name of a candidate for each office

and by checking “yes” or “no” on the public questions. 

Use the FPCA to request this state special write-in absentee

ballot. All normal deadlines apply. The regular absentee

ballot will be mailed to you as soon as it is available. Vote

and return all ballots you receive. The state special write-in

absentee ballot will be voided if local election officials

timely receive your regular absentee ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons currently imprisoned following conviction for a

crime are prohibited from voting.

B. Cancellation of Registration

Registration is canceled upon receipt of written request for

cancellation by the voter.

C. Action on Registration Requests

Separate notice of registration is sent following processing

of your application.

D. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, the county voter registration office

shall provide you with the reason(s) for the rejection.

Specific appeal procedures exist for denial of registration.

Consult a legal assistance officer or civilian counsel.
Indiana 2004–05 Voting Assistance Guide

120

E. Late Registration

An absent uniform services voter (or the voter's spouse or

dependent) may apply to register to vote after registration

closes and the poll list is printed until noon election day if

the voter:

 is otherwise entitled to vote in Indiana;

 was absent from Indiana during the previous

registration period;

 shows the county registration office a discharge dated

on or after the beginning of the preceding registration

period or a government movement order with a

reporting date on or after the beginning of the

preceding registration period;

 completes a registration application;

 signs an affidavit that the voter has not voted at any

other precinct in the election.

This voter is then entitled to vote in the upcoming election

at the office of the circuit court clerk any time after the

voter registers but before noon election day.

F. Where To Send It

Mail the FPCA to the County Voter Registration Officer at

the county of voting residence as listed below:

County Address Zip Code

Adams Circuit Court Clerk, 112 S. Second

PO Box 189, Decatur 46733-0189

Allen Board of Voter Registration, 602 South 

Calhoun St., Rm. 105 Fort Wayne 46802-1713

Bartholomew Circuit Court Clerk

PO Box 924 Columbus 47202-0924

Benton Circuit Court Clerk

706 E. 5th Street, Suite 37, Fowler 47944-1556

Blackford Circuit Court Clerk, Courthouse, 110 W. 

Washington Street, Hartford City 47348-2298

Boone Circuit Court Clerk, Room 212, Courthouse 

Square, Lebanon 46052-2100

Brown Circuit Court Clerk

PO Box 85, Nashville 47448-0085

Carroll Circuit Court Clerk

101 W. Main Street, Delphi 46923-1566

Cass Circuit Court Clerk

200 Court Park, Room 103, Logansport 46947-3192

Clark Circuit Court Clerk 

500 E. Court Avenue, Jeffersonville 47130-4090

Clay Circuit Court Clerk

609 E. National Avenue, Brazil 47834-0033

Clinton Circuit Court Clerk

265 Courthouse Square, Frankfort 46041-1993

Crawford Circuit Court Clerk

PO Box 375, Court Street, English 47118-0375

Daviess Circuit Court Clerk, 200 E. Walnut Street, PO 

Box 739, Washington 47501-0739

Dearborn Circuit Court Clerk

215 W. High Street, Lawrenceburg 47025-1909

Decatur Circuit Court Clerk, 150 Courthouse Square, 

Suite 244, Greensburg 47240-2080

De Kalb Circuit Court Clerk, PO Box 230

100 S. Main Street, Auburn 46706-0230

Delaware Board of Voter Registration, 100 West Main 

Street, Room 200, Muncie 47305-2836

Dubois Circuit Court Clerk, One Courthouse Square, 

Room 104, Jasper 47546-3058

Elkhart Board of Voter Registration, County Office 

Building, Rm L4, 117 North 2nd St., Goshen 46526-3243

Fayette Circuit Court Clerk

PO Box 607, Connersville 47331-0607

Floyd Circuit Court Clerk, 311 W. First Street, Room 

235, PO Box 1056, New Albany 47150-1056

Fountain Circuit Court Clerk

PO Box 183 Covington 46932-0183

Franklin Circuit Court Clerk 

459 Main Street, Brookville 47012-1486

Fulton Circuit Court Clerk

PO Box 524 Rochester 46975-0524

Gibson Circuit Court Clerk

PO Box 630 Princeton 47670-0630

Grant Board of Voter Registration, Courthouse, 

Suite B-9, 101 E. 4th Street, Marion 46952-4055

Greene Circuit Court Clerk

PO Box 229, Bloomfield 47424-0229

Hamilton Board of Voter Registration, 1 Hamilton 

County Square, Ste. 106, Noblesville 46060-2230

Hancock Board of Voter Registration, 9 East Main 

Street, Room 202, Greenfield 46140-2320

Harrison Circuit Court Clerk, Courthouse, Room 203

300 North Capitol Avenue, Corydon 47112-1155

Hendricks Circuit Court Clerk

PO Box 599, Danville 46122-0599

Henry Board of Voter Registration

PO Box B, New Castle 47362-1044

Howard Board of Voter Registration, Courthouse

Rm 106, 104 North Buckeye Street, Kokomo 46901-9004

Huntington Circuit Court Clerk, PO Box 228

201 North Jefferson Street, Huntington 46750-2896

Jackson Circuit Court Clerk, 111 South Main Street, 

PO Box 318, Brownstown 47220-0122

Jasper Circuit Court Clerk

115 West Washington, Rensselaer 47978-2829

Jay Circuit Court Clerk, Courthouse

120 North Court, Portland 47371-2195

Jefferson Circuit Court Clerk, Courthouse, Room 20, 

300 East Main Street, Madison 47250-3594

Jennings Circuit Court Clerk

PO Box 385, Vernon 47282-0385

Johnson Board of Voter Registration, PO Box 451, 5 

East Jefferston St., Franklin 46131-0451

Knox Circuit Court Clerk

101 North 7th Street, Vincennes 47591-2022

Kosciusko Circuit Court Clerk

121 North Lake Street, Warsaw 46580-2788

LaGrange Circuit Court Clerk

105 North Detroit Street, LaGrange 46761-1801

Lake Board of Voter Registration, 2293 North Main 

St., Suite 16, Crown Point 46307-1854

La Porte Board of Voter Registration, LaPorte Circuit 

Courthouse, Ste. 108, 813 Lincolnway

La Porte 46350-3401

Lawrence Circuit Court Clerk, Courthouse

Room 31, 1916 15th Street, Bedford 47421-3800

Madison Board of Voter Registration

16 East 9th Street, Suite 208, Anderson 46016-1588

Marion Board of Voter Registration, 200 East 

Washington, W131, Indianapolis 46204-3355

Marshall Circuit Court Clerk

211 West Madison Street, Plymouth 46563-1762

Martin Circuit Court Clerk

PO Box 120, 111 Main Street, Shoals 47581-0120

Miami Circuit Court Clerk

PO Box 184, Peru 46970-0184

Monroe Board of Voter Registration, 301 North 

College Ave., Room 202, Bloomington 47404-3865

Montgomery Circuit Court Clerk, 100 East Main Street 

Room 203, PO Box 768, Crawfordsville 47933-0768

Morgan Circuit Court Clerk

PO Box 1556, Martinsville 46151-1556

Newton Circuit Court Clerk

PO Box 49, Kentland 47951-0049

Noble Circuit Court Clerk

101 North Orange Street, Albion 46701-1092

Ohio Circuit Court Clerk

PO Box 185, Rising Sun 47040-0185

County Address Zip Code
2004–05 Voting Assistance Guide Indiana

121

Orange Circuit Court Clerk

Court Street, Paoli 47454-9632

Owen Circuit Court Clerk

PO Box 146, Spencer 47460-0146

Parke Circuit Court Clerk, 116 West High Street 

Room 204, Rockville 47872-1781

Perry Circuit Court Clerk

2219 Payne Street, Tell City 47586-2832

Pike Circuit Court Clerk

801 Main Street, 2nd Floor, Petersburg 47567-1298

Porter Board of Voter Registration, Administration 

Center, Suite 105, 155 Indiana Avenue 

Valparaiso 46383-5555

Posey Circuit Court Clerk

PO Box 606, Mount Vernon 47620-0606

Pulaski Circuit Court Clerk

112 East Main, Room 230, Winamac 46966-1394

Putnam Circuit Court Clerk

PO Box 546, Greencastle 46135-0546

Randolph Circuit Court Clerk

PO Box 230, Winchester 47394-0230

Ripley Circuit Court Clerk, PO Box 177

115 N. Main Street, Versailles 47042-0177

Rush Circuit Court Clerk, 101 East 2nd Street PO 

Box 429, Rushville 46173-0429

St Joseph Board of Voter Registration

City-County Building, 4th Floor, 227 West 

Jefferson Boulevard, South Bend 46601-1871

Scott Circuit Court Clerk

1 East McClain Avenue, Scottsburg 47170-1885

Shelby Circuit Court Clerk

PO Box 198, Shelbyville 46176-0198

Spencer Circuit Court Clerk

PO Box 12, 200 Main, Rockport 47635-0012

Starke Circuit Court Clerk, Courthouse, Room E, 53 

East Washington Street, Knox 46534-1197

Steuben Circuit Court Clerk

55 South Public Square, Angola 46703-1945

Sullivan Circuit Court Clerk, PO Box 370

100 Courthouse Sq., Sullivan 47882-0370

Switzerland Circuit Court Clerk, Courthouse

212 West Main, Vevay 47043-1180

Tippecanoe Board of Voters

301 Main Street, Lafayette 47901-1360

Tipton Circuit Court Clerk, Courthouse

101 East Jefferson, Tipton 46072-1901

Union Circuit Court Clerk

26 West Union Street, Liberty 47353-1396

Vanderburgh Board of Voter Registration, Civic Center 

Complex, Room 106, 1 NW Martin Luther 

King Jr., Blvd. Evansville 47708-1828

Vermillion Circuit Court Clerk 

PO Box 10, Newport 47966-0008

Vigo Board of Voter Registration , Courthouse 

Room 3, 33 South 3rd Street, Terre Haute 47808-3472

Wabash Circuit Court Clerk

One West Hill Street, Suite 6, Wabash 46992-3175

Warren Circuit Court Clerk, 125 North Monroe St.

Ste. 11, Williamsport 47993-1198

Warrick Circuit Court Clerk

1 County Squiare, Suite 220, Boonville 47601-1594

Washington Circuit Court Clerk, Courthouse

99 Public Square North, Salem 47167-2098

Wayne Circuit Court Clerk, 301 E. Main Street PO 

Box 1172, Richmond 47375-1172

Wells Circuit Court Clerk, 102 West Market Street, 

Suite 201, Bluffton 46714-2091

White Circuit Court Clerk

PO Box 350, Monticello 47960-0350

Whitley Circuit Court Clerk, 101 West Van Buren 

Street, Columbia City 46725-2087

County Address Zip Code

 Show The World The Power of One! Vote!

by SSgt Julie M. Edmonds, USAF, Langley, Virginia
Indiana 2004–05 Voting Assistance Guide

122
123

IOWA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

or your Iowa Driver’s License number is required for

voter registration, the full Social Security number is

requested. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Iowa

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or township where you claim

legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation in Item 6 when applying for a primary ballot

(Example: Democrat or Republican). Political party

affiliation is not required if only requesting absentee ballots

for other elections. If you are currently registered and want

to change your political party affiliation or you have

previously declined to indicate a political party and you

now want to vote in a primary election, you must submit a

completed FPCA to the local election official. Your voter

registration record will be changed to reflect the party

named on your application.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct. 

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Iowa 2004–05 Voting Assistance Guide

124

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Iowa and members of the Uniformed Services

and their family members. Uniformed Services are defined

as the U.S. Armed Forces, merchant marine, commissioned

corps of the Public Health Service and the National Oceanic

and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To request registration and/or an absentee ballot, the local

County Auditor must receive your FPCA at any time before

the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be postmarked

not later than the day before the election. Mail your voted

ballot to the local election official so that it arrives not later

than noon on the Monday after the election.

Local election officials mail ballots approximately 40 days

before primary and general elections. For other elections,

ballots are mailed later but will be sent as soon as they are

ready.

The affidavit on the ballot return envelope is the registration

form. You will be permanently registered when you return

the voted ballot, if you are not already registered. 

You may also use the Federal Write-In Absentee Ballot. See

instructions below. 

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Iowa allows you to send the FPCA for registration and

absentee ballot request by fax. You must submit the

original FPCA by mail.

 Iowa does not allow you to receive the blank ballot by

fax. 

 Iowa does not allow you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Registration and 

Ballot by Proxy

Within 70 days of the general election, your spouse, parent,

parent-in-law, adult brother, adult sister, or adult child who

resides in your county of voting residence may request

registration and an absentee ballot for you. Forms are

available from the County Auditors and the Secretary of

State.

A handwritten request may be sent including the name and

signature of the person requesting a ballot, Iowa address,

name or date of election for which the ballot is requested

(or for all ballots in a calendar year) and other information

required to determine the correct ballot for the voter.

G. Special Write-In Absentee Ballot

Iowa provides a state special write-in absentee ballot

available 90 days before the general election if you are

overseas and unable to vote and return a regular absentee

ballot by normal mail delivery within the period provided

for regular absentee ballots. This special ballot is not

available for the primary election.

The FPCA may be used to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.H. If no labels are available,

write in Item 7: “To the best of my belief I will be outside

the continental United States and unable to vote and return

a regular absentee ballot by normal mail delivery within the

period provided for regular absentee ballots. I request a

special write-in absentee ballot.” 

The state special write-in ballot must be requested not

earlier than 90 days before the general election. Vote the

ballot by writing in the names of specific candidates. 

H. Federal Write-In Absentee Ballot

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot (FWAB). 
2004–05 Voting Assistance Guide Iowa

125

Iowa has expanded the use of the FWAB. The instructions

described in Chapter 2 of this Guide remain the same,

except that Iowa also allows the FWAB to be used to vote

in state and Federal primaries and in general and special

elections to fill vacancies in the U.S. House of

Representatives and Iowa Legislature. 

Iowa also allows the FWAB return envelope to be used as

an application for registration if the person is otherwise

eligible to vote in Iowa. 

For further instructions on the FWAB see Chapter 2,

page 12.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Iowa and overseas citizens. The term “overseas

citizen” means a U.S. citizen who resides outside the U.S.

and (but for such residence) would be qualified to vote in

Iowa.

 Iowa residents temporarily residing outside the U.S. 

 overseas citizens 

 U.S. citizens who have never resided in the U.S. but

have a parent who is eligible to vote in Iowa. These

citizens are eligible to vote at the same voting

residence claimed by their parent. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To request registration and/or an absentee ballot, the local

County Auditor must receive your FPCA at any time before

the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be postmarked

not later than the day before the election. Mail your voted

ballot to the local election official so that it arrives not later

than noon on the Monday after the election. 

Local election officials mail ballots approximately 40 days

before primary and general elections. For other elections,

ballots are mailed later but will be sent as soon as they are

ready.

The affidavit on the ballot return envelope is the registration

form. You will be permanently registered when you return

the voted ballot, if you are not already registered. 

You may also use the Federal Write-In Absentee Ballot. See

instructions below. 

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Iowa allows you to send the FPCA for registration and

absentee ballot request by fax. You must submit the

original FPCA by mail. 

 Iowa does not allow you to receive the blank ballot by

fax. 

 Iowa does not allow you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Registration and 

Ballot by Proxy

Within 70 days of the general election, your spouse, parent,

parent-in-law, adult brother, adult sister, or adult child who

resides in your county of voting residence may request

registration and an absentee ballot for you. Forms are

available from the County Auditors and the Secretary of

State.

A handwritten request may be sent including the name and

signature of the person requesting a ballot, Iowa address,

name or date of election for which the ballot is requested

(or for all ballots in a calendar year) and other information

required to determine the correct ballot for the voter.

G. Special Write-In Absentee Ballot

Iowa provides a state special write-in absentee ballot

available 90 days before the general election if you are

overseas and unable to vote and return a regular absentee

ballot by normal mail delivery within the period provided

for regular absentee ballots. This special ballot is not

available for the primary election.

The FPCA may be used to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special
Iowa 2004–05 Voting Assistance Guide

126

write-in labels from Section III.H. If no labels are available,

write in Item 7: “To the best of my belief I will be outside

the continental United States and unable to vote and return

a regular absentee ballot by normal mail delivery within the

period provided for regular absentee ballots. I request a

special write-in absentee ballot.” 

The state special write-in ballot must be requested not

earlier than 90 days before the general election. Vote the

ballot by writing in the names of specific candidates. 

H. Federal Write-In Absentee Ballot

If you did not receive your state ballot in a timely manner,

use the Federal Write-In Absentee Ballot (FWAB). 

Iowa has expanded the use of the FWAB. The instructions

described in Chapter 2 of this Guide remain the same,

except that Iowa also allows the FWAB to be used to vote

in state and Federal primaries and in general and special

elections to fill vacancies in the U.S. House of

Representatives and Iowa Legislature. 

Iowa also allows the FWAB return envelope to be used as

an application for registration if the person is otherwise

eligible to vote in Iowa.

For further instructions on the FWAB see Chapter 2,

page 12.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony or declared mentally

incompetent to vote may not register or vote, unless the

voting rights are restored.

B. Cancellation of Registration

Registration is canceled after name is on the inactive list for

two successive general elections. A registration becomes

inactive if the U.S. Postal Service indicates the voter has

moved.

C. Action on Registration Requests

The local election official will send an acknowledgment to

the applicant at the mailing address provided on the FPCA.

D. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Iowa shall provide you with the

reason(s) for the rejection. Persons denied registration or

ballot should contact the Iowa Secretary of State for

additional information. 

E. Voting by Citizens Who Have Never 

Lived in the U.S.

If a U.S. citizen outside the U.S. has never lived in the U.S.

and either parent is a qualified Iowa voter, then that person

is eligible to register and vote where his or her parent is a

qualified voter.

F. Late Registration

Members of the Armed Forces or merchant marine who

have been discharged within thirty days of an election may

register and vote in that election by presenting the precinct

election official with his or her discharge papers.

G. Where To Send It

Mail the FPCA to the County Auditor at the county of

voting residence as listed below:

County County Seat Zip Code

Adair Greenfield 50849-1291

Adams Corning 50841-0028

Allamakee Waukon 52172-1700

Appanoose Centerville 52544-1794

Audubon Audubon 50025-1255

Benton Vinton 52349-0549

Black Hawk Waterloo 50703-4774

Boone Boone 50036-3992

Bremer Waverly 50677-3536

Buchanan Independence 50644-0317

Buena Vista Storm Lake 50588-2371

Butler Allison 50602-0325

Calhoun Rockwell City 50579-1487

Carroll Carroll 51401-2413

Cass Atlantic 50022-1497

Cedar Tipton 52772-1752

Cerro Gordo Mason City 50401-3254

Cherokee Cherokee 51012-1700

Chickasaw New Hampton 50659-0311

Clarke Osceola 50213-1291

Clay Spencer 51301-3860

Clayton Elkader 52043-0416

Clinton Clinton 52733-2957

Crawford Denison 51442-0423

Dallas Adel 50003-1482

Davis Bloomfield 52537-1600

Decatur Leon 50144-1647

Delaware Manchester 52057-1796

Des Moines Burlington 52601-0784

Dickinson Spirit Lake 51360-1259

Dubuque Dubuque 52001-7056

Emmet Estherville 51334-2254

Fayette West Union 52175-0267

Floyd Charles City 50616-2790

Franklin Hampton 50441-0026

Fremont Sidney 51652-0610

Greene Jefferson 50129-2144

Grundy Grundy Center 50638-1496

Guthrie Guthrie Center 50115-1331

Hamilton Webster City 50595-3195

Hancock Garner 50438-0070

Hardin Eldora 50627-1700

Harrison Logan 51546-1398

Henry Mount Pleasant 52641-0149

Howard Cresco 52136-1526

Humboldt Dakota City 50529-0100

Ida Ida Grove 51445-1497

Iowa Marengo 52301-0126

Jackson Maquoketa 52060-2295
2004–05 Voting Assistance Guide Iowa

127

Jasper Newton 50208-0944

Jefferson Fairfield 52556-2820

Johnson Iowa City 52240-4207

Jones Anamosa 52205-0109

Keokuk Sigourney 52591-1499

Kossuth Algona 50511-2643

Lee Fort Madison 52627-0190

Linn Cedar Rapids 52404-2178

Louisa Wapello 52653-0186

Lucas Chariton 50049-1764

Lyon Rock Rapids 51246-1597

Madison Winterset 50273-0152

Mahaska Oskaloosa 52577-3189

Marion Knoxville 50138-2598

Marshall Marshalltown 50158-4978

Mills Glenwood 51534-1756

Mitchell Osage 50461-1229

Monona Onawa 51041-1699

Monroe Albia 52531-2075

Montgomery Red Oak 51566-0469

Muscatine Muscatine 52761-4168

O'Brien Primghar 51245-0803

Osceola Sibley 51249-1698

Page Clarinda 51632-2197

Palo Alto Emmetsburg 50536-0095

Plymouth Le Mars 51031-2190

Pocahontas Pocahontas 50574-1694

Polk Des Moines 50309-4757

Pottawattamie Council Bluffs 51501-0649

Poweshiek Montezuma 50171-0057

Ringgold Mount Ayr 50854-1642

Sac Sac City 50583-1750

Scott Davenport 52801-1187

Shelby Harlan 51537-1441

Sioux Orange City 51041-0018

Story Nevada 50201-2084

Tama Toledo 52342-1300

Taylor Bedford 50833-1394

Union Creston 50801-2430

Van Buren Keosauqua 52565-0475

Wapello Ottumwa 52501-2518

Warren Indianola 50125-0237

Washington Washington 52353-0889

Wayne Corydon 50060-0435

Webster Fort Dodge 50501-3892

Winnebago Forest City 50436-1793

Winneshiek Decorah 52101-1775

Woodbury Sioux City 51101-1246

Worth Northwood 50459-1599

Wright Clarion 50525-0147

County County Seat Zip Code

Your Vote, His Vote, Her Vote, Our Vote, Are Votes

by Jacqueline E. Clark, USMC, Albany, Georgia
Iowa 2004–05 Voting Assistance Guide

128
IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”

H. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

IOWA

“To the best of my belief I will be outside the continental United States and

unable to vote and return a regular absentee ballot by normal mail delivery

within the period provided for regular absentee ballots. I request a special

write-in absentee ballot.”
Iowa 2004–05 Voting Assistance Guide

130
131

KANSAS

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

B Provide the complete street address of your Kansas

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or township where you claim

legal voting residence. If you have changed your name

since the last time you registered or voted, write your

previous name in Item 7.

C Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

D If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. NOTE: Kansas primary elections are currently open

only to members affiliated with the Democratic and

Republican political parties. Political party affiliation is not

required if only requesting absentee ballots for general

elections.

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E
Kansas 2004–05 Voting Assistance Guide

132

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U. S. citizens,

residents of Kansas and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Your registration is waived.

To request an absentee ballot for the August primary

election, the county election official must receive your

FPCA on or before the last business day of the week before

the August primary election.

To request an absentee ballot for the November general

election, the county election official must receive your

FPCA on or before the last business day of the week before

the November general election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

election official not later than the close of polls on election

day.

Local election officials mail ballots no later than 45 days

before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Kansas allows you to send the FPCA for registration

and ballot request by fax. After faxing, submit the

FPCA by mail.

 Kansas allows you to receive the blank ballot by fax.

 Kansas allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Kansas and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Kansas.

 Kansas residents temporarily residing outside the U.S.

(for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Your registration is waived.

To request an absentee ballot for the August primary

election, the county election official must receive your

FPCA on or before the last business day of the week before

the August primary election. 

To request an absentee ballot for the November general

election, the county election official must receive your

FPCA on or before the last business day of the week before

the November general election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

election official not later than the close of polls on election

day.

Local election officials mail ballots no later than 45 days

before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.
2004–05 Voting Assistance Guide Kansas

133

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Kansas allows you to send the FPCA for registration

and ballot request by fax. After faxing, submit the

FPCA by mail.

 Kansas allows you to receive the blank ballot by fax.

 Kansas allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony who have not been restored to

their civil rights may not vote.

B. Action on Registration Requests

The local election official sends a certificate of registration

to the applicant to the address provided on the FPCA.

C. Action If Registration Is Denied

The local election official notifies the applicant of the

reason(s) for the rejection of his or her application.

D. Late Registration

Discharged military personnel, separated merchant marine

members, and citizens terminated from overseas

employment who return to Kansas following the close of

the regular registration period for the upcoming election are

still entitled to register to vote not later than 12:00 noon on

the day before the election for that election only. 

E. Where To Send It

Mail the FPCA to the County Clerk, county of voting

residence, as listed below: (In Johnson, Sedgwick,

Shawnee, and Wyandotte Counties, mail to County Election

Commissioner)

County County Seat Zip Code

Allen Iola 66749-2895

Anderson Garnett 66032-1596

Atchison Atchison 66002-1821

Barber Medicine Lodge 67104-1499

Barton Great Bend 67530-1089

Bourbon Fort Scott 66701-1328

Brown Hiawatha 66434-2283

Butler El Dorado 67042-2193

Chase Cottonwood Falls 66845-0547

Chautauqua Sedan 67361-1395

Cherokee Columbus 66725-0014

Cheyenne Saint Francis 67756-0985

Clark Ashland 67831-0886

Clay Clay Center 67432-0098

Cloud Concordia 66901-3415

Coffey Burlington 66839-1796

Comanche Coldwater 67029-0397

Cowley Winfield 67156-2864

Crawford Girard 66743-0249

Decatur Oberlin 67749-0028

Dickinson Abilene 67410-0248

Doniphan Troy 66087-0278

Douglas Lawrence 66044-3096

Edwards Kinsley 67547-1099

Elk Howard 67349-0606

Ellis Hays 67601-3899

Ellsworth Ellsworth 67439-3118

Finney Garden City 67846-0450

Ford Dodge City 67801-1575

Franklin Ottawa 66067-2331

Geary Junction City 66441-2589

Gove Gove 67736-0128

Graham Hill City 67642-1697

Grant Ulysses 67880-2599

Gray Cimarron 67835-0487

Greeley Tribune 67879-0277

Greenwood Eureka 67045-0268

Hamilton Syracuse 67878-8025

Harper Anthony 67003-2748

Harvey Newton 67114-0687

Haskell Sublette 67877-0518

Hodgeman Jetmore 67854-0247

Jackson Holton 66436-1787

Jefferson Oskaloosa 66066-0321

Jewell Mankato 66956-2095

Johnson* Olathe 66061-6002

Kearny Lakin 67860-0086

Kingman Kingman 67068-1697

Kiowa Greensburg 67054-2294

Labette Oswego 67356-0387

Lane Dighton 67839-0788

Leavenworth Leavenworth 66048-2748

Lincoln Lincoln 67455-2098

Linn Mound City 66056-0350

Logan Oakley 67748-1233

Lyon Emporia 66801-7212

McPherson McPherson 67460-0676

Marion Marion 66861-0219

Marshall Marysville 66508-1844

Meade Meade 67864-0278

Miami Paola 66071-1795

Mitchell Beloit 67420-0190

Montgomery Independence 67301-0446

Morris Council Grove 66846-1791

Morton Elkhart 67950-1116

Nemaha Seneca 66538-1795

Neosho Erie 66733-0138

Ness Ness City 67560-1558

Norton Norton 67654-0070
Kansas 2004–05 Voting Assistance Guide

134

*Send to County Election Commissioner

Osage Lyndon 66451-0226

Osborne Osborne 67473-2302

Ottawa Minneapolis 67467-2140

Pawnee Larned 67550-3098

Phillips Phillipsburg 67661-1929

Pottawatomie Westmoreland 66549-9998

Pratt Pratt 67124-0885

Rawlins Atwood 67730-1896

Reno Hutchinson 67501-5245

Republic Belleville 66935-0429

Rice Lyons 67554-2799

Riley Manhatten 66502-0109

Rooks Stockton 67669-1666

Rush La Crosse 67548-0220

Russell Russell 67665-0113

Saline Salina 67401-2396

Scott Scott City 67871-1197

Sedgwick* Wichita 67203-3798

Seward Liberal 67901-3473

Shawnee* Topeka 66611-2378

Sheridan Hoxie 67740-0899

Sherman Goodland 67735-0011

Smith Smith Center 66967-2798

Stafford Saint John 67576-2042

Stanton Johnson 67855-0190

Stevens Hugoton 67951-2698

Summer Wellington 67152-4096

Thomas Colby 67701-2494

Trego Wakeeney 67672-2187

Wabaunsee Alma 66401-9797

Wallace Sharon Springs 67758-0070

Washington Washington 66968-1985

Wichita Leoti 67861-0279

Wilson Fredonia 66736-1382

Woodson Yates Center 66783-1497

Wyandotte* Kansas City 66112-1588

County County Seat Zip Code

You Don’t Have To Shout To Be Heard...Vote!

by MSgt Gregory Harden, McConnell AFB, Kansas
135

KENTUCKY

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Social Security number is required. If you do not

possess a Social Security number, the State shall assign a

number that will serve to identify you for voter registration

purposes.

B Do not leave blank. Enter “NA” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Kentucky

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address you provided in Item 3.

E Kentucky has closed party primary elections. You

must register DEMOCRAT or REPUBLICAN to vote in

that party’s May primary election. If you register as

OTHER, you cannot vote in Democratic or Republican

Party primaries but can vote in nonpartisan primaries. All

eligible voters can vote in the November general election.

In order to change party affiliation, you must submit a

completed FPCA (which includes your new political party

affiliation) to the local election official by December 31 in

order to be eligible to vote in your new party’s May

primary.

For example, if you voted in the Democratic primary in

2004 and want to vote in the Republican primary in 2005,

the change in political party must occur by December 31,

2004. If you vote in the 2005 Republican primary and want

to vote in the 2006 Democratic primary, you must change

political party affiliation by December 31, 2005.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
Kentucky 2004–05 Voting Assistance Guide

136

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Kentucky and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the County Clerk so that it is postmarked not later

than 29 days before the election. 

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the County

Clerk so that it arrives not later than the close of business 7

days before the election. The FPCA can be faxed to you.

If you are already registered, you may request via

telephone, fax, mail or in person that an “absentee ballot

application” be sent to you.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

County Clerk by close of polls on election day.

Local county election officials mail ballots 50 days before

primary and general elections.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Kentucky allows you to send the FPCA for registration

and absentee ballot request by fax. 

 Kentucky allows you to receive the blank ballot by

fax.

 Kentucky does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Kentucky and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Kentucky.

 Kentucky residents residing outside the U.S. (for local,

state and Federal office ballots).

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, mail or fax the

completed FPCA to the County Clerk. A mailed FPCA

must be postmarked not later than 29 days before the

election. A faxed FPCA must arrive at the County Clerk’s

office not later than 29 days before the election. To register

only, mail a completed FPCA to the County Clerk.

If you are already registered and wish to request an

absentee ballot, mail or fax a completed FPCA to the

County Clerk so that it arrives not later than the close of

business 7 days before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

County Clerk by close of polls on election day.

Local county election officials mail ballots 50 days before

primary and general elections.
2004–05 Voting Assistance Guide Kentucky

137

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Kentucky allows you to send the FPCA for registration

and absentee ballot request by fax.

 Kentucky allows you to receive the blank ballot by

fax.

 Kentucky does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony (unless his/her civil rights

have been restored by the Governor) or those declared

mentally incompetent may not register or vote.

B. Cancellation of Registration

Registration is not canceled for failure to vote.

C. Action on Registration Requests

A postcard is sent to the mailing address listed on the

application to notify the registrant of his/her normal

precinct assignment or whether more information is needed

before the application can be processed.

D. Action If Registration Is Denied

Persons denied registration should consult a legal assistance

officer or civilian counsel.Upon denial of your voter

registration application or absentee ballot request, Kentucky

shall provide you with the reason(s) for the rejection.

E. Where To Send It

Mail the FPCA to the County Clerk, county of voting

residence, as listed below (In Jefferson County, mail to the

County Board of Elections):

County County Seat Zip Code

Adair 424 Public Square, Suite 2, Columbia 42728-1493

Allen 201 W Main Street Room 6, Scottsville 42164-1161

Anderson 151 South Main Street, Lawrenceburg 40342-1192

Ballard PO Box 145, Wickliffe 42087-0145

Barren 117 N Public Square, Suite 1A, Glasgow 42141-2869

Bath PO Box 609, Owingsville 40360-0609

Bell PO Box 157, Pineville 40977-0157

Boone PO Box 874, Burlington 41005-0874

Bourbon PO Box 312, Paris 40362-0312

Boyd PO Box 523, Catlettsburg 41129-0523

Boyle 321 West Main Street, Suite 123, Danville 40422-1848

Bracken PO Box 147, Brooksville 41004-0147

Breathitt 1137 Main Street, Jackson 41339-1194

Breckinridge PO Box 538, Hardinsburg 40143-0538

Bullitt PO Box 6, Shepherdsville 40165-0006

Butler PO Box 449, Morgantown 42261-0449

Caldwell 100 E Market Street, Room 23, Princeton 42445-1696

Calloway 101 S 5th Street Suite 5, Murray 42071-2569

Campbell 340 York Street, Suite 2A, Newport 41071-1682

Carlisle PO Box 176, Bardwell 42023-0176 

Carroll 440 Main Street, Carrollton 41008-1064

Carter 300 W Main Street, Room 232, Grayson 41143-1298

Casey PO Box 310, Liberty 42539-0310

Christian 511 South Main Street, Suite 15, Hopkinsville 42240-2300

Clark PO Box 4060, Winchester 40392-4060

Clay 123 Town Square, Suite 3, Manchester 40962-1265

Clinton 100 S. Cross Street, Albany 42602-1263

Crittenden 107 S. Main Street, Suite 203, Marion 42064-1563

Cumberland PO Box 275, Burkesville 42717-0275

Daviess PO Box 609, Owensboro 42302-0609

Edmonson PO Box 830, Brownsville 42210-0830

Elliott PO Box 225, Sandy Hook 41171-0225

Estill PO Box 59, Irvine 40336-0059

Fayette 162 East Main Street, Room 131, Lexington 40507-1363

Fleming PO Box 324, Flemingsburg 41041-0324

Floyd PO Box 1089, Prestonsburg 41653-5089

Franklin PO Box 338, Frankfort 40602-0338

Fulton PO Box 126, Hickman 42050-0126

Gallatin PO Box 1309, Warsaw 41095-1309

Garrard 15 Public Square, Suite 5, Lancaster 40444-8151

Grant 101 N. Main Street, Room 15, Williamstown 41097-1188

Graves 101 E South Street, Suite 2, Mayfield 42066-2324

Grayson 10 Public Square Suite 2, Leitchfield 42754-1199

Green 203 West Court Street, Greensburg 42743-1552

Greenup PO Box 686, Greenup 41144-0686

Hancock PO Box 146, Hawesville 42348-0146

Hardin PO Box 1030, Elizabethtown 42702-1030

Harlan PO Box 670, Harlan 40831-0670

Harrison 313 Oddville Avenue, Cynthiana 41031-1242

Hart PO Box 277, Munfordville 42765-0277

Henderson PO Box 374, Henderson 42419-0374

Henry PO Box 615, New Castle 40050-0615

Hickman 110 E Clay Street Suite E, Clinton 42031-1296

Hopkins 10 S. Main Street, Room 23, Madisonville 42431-2588

Jackson PO Box 339, McKee 40447-0339

Jefferson 810 Barret Avenue Suite 103, Louisville 40204-1766

Jessamine 101 N. Main Street, Nicholasville 40356-1270

Johnson 230 Court Street, Suite 126, Paintsville 41240-1607

Kenton PO Box 1109, Covington 41012-1109

Knott PO Box 446, Hindman 41822-0446

Knox 401 Court Square, Suite 102, Barbourville 40906-1463

Larue 209 W High Street, Hodgenville 42748-1543

Laurel 101 S Main Street Room 203, London 40741-2308

Lawrence 122 South Main Cross Street, Louisa 41230-1393

Lee PO Box 551, Beattyville 41311-0551

Leslie PO Box 916, Hyden 41749-0916
Kentucky 2004–05 Voting Assistance Guide

138

Letcher 156 Main Street, Suite 102, Whitesburg 41858-7286

Lewis PO Box 129, Vanceburg 41179-0129

Lincoln 102 E Main Street, Suite 3, Stanford 40484-1298

Livingston PO Box 400, Smithland 42081-0400

Logan PO Box 358, Russellville 42276-0358

Lyon PO Box 310, Eddyville 42038-0310

McCracken PO Box 609, Paducah 42002-0609

McCreary PO Box 699, Whitley City 42653-0699

McLean PO Box 57, Calhoun 42327-0057

Madison 101 W Main Street, Suite 7, Richmond 40475-1415

Magoffin PO Box 530, Salyersville 41465-0530

Marion 120 W Main Street, Suite 3, Lebanon 40033-1245

Marshall 1101 Main St., Benton 42025-1498

Martin PO Box 460, Inez 41224-0460

Mason PO Box 234, Maysville 41056-0234

Meade PO Box 614, Brandenburg 40108-0614

Menifee PO Box 123, Frenchburg 40322-0123

Mercer PO Box 426, Harrodsburg 40330-0426

Metcalfe PO Box 25, Edmonton 42129-0025

Monroe PO Box 188, Tompkinsville 42167-0188

Montgomery PO Box 414, Mount Sterling 40353-0414

Morgan PO Box 26, West Liberty 41472-0026

Muhlenberg PO 525, Greenville 42345-0525

Nelson PO Box 312, Bardstown 40004-0312

Nicholas PO Box 227, Carlisle 40311-0227

Ohio PO Box 85, Hartford 42347-0085

Oldham 100 W Jefferson Street, LaGrange 40031-1189

Owen 135 West Bryan Street, Owenton 40359-1440

Owsley PO Box 500, Booneville 41314-0500

Pendleton PO Box 112, Falmouth 41040-0112

Perry PO Box 150, Hazard 41702-0150

Pike PO Box 631, Pikeville 41502-0631

Powell PO Box 548, Stanton 40380-0548

Pulaski PO Box 724, Somerset 42502-0724

Robertson PO Box 75, Mount Olivet 41064-0075

Rockcastle 205 East Main Street #6, Mount Vernon 40456-2211

Rowan 627 E Main, Morehead 40351-1390

Russell PO Box 579, Jamestown 42629-0579

Scott 101 E Main Street, Georgetown 40324-1794

Shelby PO Box 819, Shelbyville 40066-0819

Simpson PO Box 268, Franklin 42135-0268

Spencer PO Box 544, Taylorsville 40071-0544

Taylor 203 N Court Street Suite 5, Campbellsville 42718-2298

Todd PO Box 307, Elkton 42220-0307

Trigg PO Box 1310, Cadiz 42211-1310

Trimble PO Box 262, Bedford 40006-0262

Union PO Box 119, Morganfield 42437-0199

Warren PO Box 478, Bowling Green 42102-0478

Washington PO Box 446, Springfield 40069-0446

Wayne PO Box 565, Monticello 42633-0565

Webster PO Box 19, Dixon 42409-0019

Whitley PO Box 8, Williamsburg 40769-0008

Wolfe PO Box 400, Campton 41301-0400

Woodford 103 S Main Street Suite 120, Versailles 40383-1298

County County Seat Zip Code

Power Is Given Through Your Vote

by A1C Jerry D. Rose, USAF, Mountain Home AFB, Idaho
139

LOUISIANA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

or your Louisiana Driver’s License number is required for

voter registration, the full Social Security number may be

provided on a voluntary basis. If you do not possess either

of these identifications, you may use; a current and valid

photo identification or a current utility bill, bank

statement, government check, paycheck, or other

government document showing the name and address of

the applicant.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Louisiana

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the parish where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E If you do not list a party affiliation, you cannot vote in

the Presidential preference primary and party committee

elections. Political party affiliation is not required for any

other election. If you are currently registered and want to

change your political party affiliation or you have

previously declined to indicate a political party affiliation

and you now want to vote in a Presidential preference

primary and party committee elections, you must submit a

completed FPCA which includes your new political party

affiliation to the local election official not later than 30 days

before an election. Indicate on Item 7 if your FPCA is being

submitted only to change your party choice.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct. 

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Louisiana 2004–05 Voting Assistance Guide

140

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Louisiana and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You may use a single FPCA to request ballots for all

elections held during a period which extends from the date

the request is received in the office of the registrar of voters

through two subsequent Federal general elections (local,

state and Federal offices).

To register and request an absentee ballot, the local registrar

of voters must receive your FPCA not later than 30 days

before the election.

To request an absentee ballot if you are currently registered,

the local registrar of voters must receive your FPCA not

later than 96 hours before the close of the polls for the

election for which it is requested. The request shall remain

valid through two subsequent Federal general elections

from the date of receipt of the application in the registrar’s

office.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office no later than the day of the election.

Louisiana elections, except the Presidential preference

primary and party committee elections, are entirely open.

All parties appear on the same ballot and you may vote for

any candidate on the ballot. If any candidate receives more

than 50% of the votes cast in the primary election that

candidate is declared the winner and that office is not voted

upon in the general election. 

Local election officials mail ballots not later than 20 days

before the state primary election and 13 days before the

general election. However, special ballots for the office of

the President are available for mailing 45 days before the

general election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required

Ballot Return Envelope: Sign the ballot return envelope

certificate in the presence of two witnesses. These

witnesses must also sign the envelope.

E. Electronic Transmission of FPCAs 

and Ballots

 Louisiana allows you to send the FPCA for

registration and absentee ballot request by fax. After

faxing, submit the FPCA by mail.

 Louisiana allows you to receive the blank ballot by

fax. 

 Louisiana allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Absentee Ballot for General 

Election

If you request a primary ballot you will receive a special

ballot for the general election along with the primary ballot.

The special ballot permits you to vote in the following

general election by writing in numbers according to your

choice of preference for each candidate. You put the

number one next to the name of the candidate who is your

first choice, the number two for your second choice, and so

forth so that, in consecutive numerical order, you write a

number indicating your preference next to each candidate’s

name on the ballot.

You shall not be required to number all of the candidates on

the ballot if you so choose, but doing so will assure your

having cast a ballot in the general election.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
2004–05 Voting Assistance Guide Louisiana

141

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Louisiana and overseas citizens. The term

“overseas citizen(s)” means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in Louisiana.

 civilian employees of the U.S. Government serving

outside the U.S. and their spouses and dependents.

 members of religious or welfare groups attached to

and serving with the Armed Forces and their spouses

and dependents. 

 other residents of Louisiana temporarily residing

outside the U.S.

 overseas citizens 

B. Registering and Requesting an 

Absentee Ballot

You may use a single FPCA to request ballots for all

elections held during a period which extends from the date

the request is received in the office of the registrar of voters

through two subsequent Federal general elections (local,

state and Federal offices).

To register and request an absentee ballot, the local registrar

of voters must receive your FPCA not later than 30 days

before the election.

To request an absentee ballot if you are currently registered,

the local registrar of voters must receive your FPCA not

later than 96 hours before the close of the polls for the

election for which it is requested. The request shall remain

valid through two subsequent Federal general elections

from the date of receipt of the application in the registrar’s

office.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office no later than the day of the election.

Louisiana elections, except the Presidential preference

primary and party committee elections, are entirely open.

All parties appear on the same ballot and you may vote for

any candidate on the ballot. If any candidate receives more

than 50% of the votes cast in the primary election that

candidate is declared the winner and that office is not voted

upon in the general election. 

Local election officials mail ballots not later than 20 days

before the state primary election and 13 days before the

general election. However, special ballots for the office of

the President are available for mailing 45 days before the

general election.

If you have not receive your state ballot in a timely manner,

use the Federal Write-In Absentee Ballot. See instructions

in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: Sign the ballot return envelope

certificate in the presence of two witnesses. These

witnesses must also sign the envelope.

E. Electronic Transmission of FPCAs 

and Ballots

 Louisiana allows you to send the FPCA for

registration and absentee ballot request by fax. After

faxing, submit the FPCA by mail.

 Louisiana allows you to receive the blank ballot by

fax. 

 Louisiana allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Absentee Ballot for General 

Election

If you request a primary ballot you will receive a special

ballot for the general election along with the primary ballot.

The special ballot permits you to vote in the following

general election by writing in numbers according to your

choice of preference for each candidate. You put the

number one next to the name of the candidate who is your

first choice, the number two for your second choice, and so

forth so that, in consecutive numerical order, you write a

number indicating your preference next to each candidate’s

name on the ballot.

You shall not be required to number all of the candidates on

the ballot if you so choose, but doing so will assure your

having cast a ballot in the general election.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
Louisiana 2004–05 Voting Assistance Guide

142

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons under order of imprisonment for conviction of a

felony or indicted after being judicially declared to be

mentally incompetent may not register to vote. 

B. Cancellation of Registration

Registration of a voter whose canvassing postcard is

returned by the postmaster as being undeliverable is

canceled after due process and failure to vote for a period of

two (2) consecutive federal general elections.

C. Action on Registration Requests

Notice of registration is sent.

D. Action If Registration Is Denied 

Upon denial of your voter registration application or

absentee ballot request, Louisiana shall provide you with

the reason(s) for the rejection. If registration is denied,

provide the information called for in the notice of denial

and resubmit the application. If a second denial is received,

consult a legal assistance officer or civilian counsel.

E. Where To Send It

Submit the FPCA to the Registrar of Voters at the parish of

voting residence as listed below:

Parish Parish Seat Zip Code

Acadia Courthouse, #115, Crowley 70526-4363

Allen PO Box 150, Oberlin 70655-0150

Ascension 828 S. Irma Blvd. #103, Gonzales 70737-3631

Assumption PO Box 578, Napoleonville 70390-0578

Avoyelles 312 N. Main St. #E, Marksville 71351-2409

Beauregard PO Box 952, DeRidder 70634-0952

Bienville PO Box 697, Arcadia 71001-0697

Bossier PO Box 635, Benton 71006-0635

Caddo PO Box 1253, Shreveport 71163-1253

Calcasieu 1000 Ryan St. #7, Lake Charles 70601-5250

Caldwell PO Box 1107, Columbia 71418-1107

Cameron PO Box 1, Cameron 70631-0001

Catahoula PO Box 215, Harrisonburg 71340-0215

Claiborne 507 W. Main St. #1, Homer 71040-3929

Concordia 4001 Carter St., #4, Vidalia 71373-3021

DeSoto 105 Franklin Street, Mansfield 71052-2046

E. Baton Rouge 222 St. Louis #201, Baton Rouge 70802-5860

East Carroll PO Box 708, Lake Providence 71254-0708

East Feliciana PO Box 488, Clinton 70722-0488

Evangeline 200 Court St., Suite 102, Ville Platte 70586-4463

Franklin Courthouse, 6560 Main St., Winnsboro 71295-2750

Grant Courthouse, 200 Main St., Colfax 71417-1828

Iberia 300 Iberia St., #110, New Iberia 70560-4543

Iberville PO Box 554, Plaquemine 70765-0554

Jackson 500 E. Court St. #102, Jonesboro 71251-3400

Jefferson PO Box 10494, Jefferson 70181-0494

Jefferson Davis Courthouse Rm. 107, 300 State St., 

Jennings 70546-5361

Lafayette 1010 Lafayette #313, Lafayette 70501-6885

Lafourche 307 West 4th Street, Thibodaux 70301-3105

LaSalle PO Box 2439, Jena 71342-2439

Lincoln 100 W. Texas Ave. #10, Ruston 71270-4463

Livingston PO Box 968, Livingston 70754-0968

Madison 100 N. Cedar St, Tallulah 71282-3892

Morehouse 129 N. Franklin, Bastrop 71220-3815

Natchitoches PO Box 677, Natchitoches 71458-0677

Orleans 1300 Perdido #1W23, New Orleans 70112-2127

Ouachita 400 St. John St., #106, Monroe 71201-7342

Plaquemines PO Box 989, Port Sulphur 70083-0989

Pointe Coupee 211 E. Main St. #103, New Roads 70760-3661

Rapides 701 Murray St., Alexandria 71301-8099

Red River PO Box 432, Coushatta 71019-0432

Richland PO Box 368, Rayville 71269-0368

Sabine 400 Capitol St. #107, Many 71449-3099

St Bernard 8201 W. Judge Perez, Chalmette 70043-1696

St Charles PO Box 315, Hahnville 70057-0315

St Helena PO Box 543, Greensburg 70441-0543

St James PO Box 179, Convent 70723-0179

St John 1801 W. Airline Hwy., LaPlace 70068-3344

St Landry PO Box 818, Opelousas 70571-0818

St Martin Courthouse, 415 S. Main, St Martinville 70582-4549

St Mary Courthouse, 500 Main St. #301, Franklin 70538-6144

St Tammany 701 N. Columbia St., Covington 70433-2709

Tangipahoa PO Box 895, Amite 70422-0895

Tensas PO Box 183, St. Joseph 71366-0183

Terrebonne PO Box 9189, Houma 70361-9189

Union PO Box 235, Farmerville 71241-0235

Vermilion Courthouse Building, 100 N. State St., 

Suite 120, Abbeville 70510-5167

Vernon PO Box 626, Leesville 71496-0626

Washington 900 Washington St. #105, Franklinton 70438-1719

Webster PO Box 674, Minden 71058-0674

W. Baton Rouge PO Box 31, Port Allen 70767-0031

W. Carroll PO Box 71, Oak Grove 71263-0071

W. Feliciana PO Box 2490, St. Francisville 70775-2490

Winn PO Box 951, Winnfield 71483-0951

Parish Parish Seat Zip Code

Exercise Keeps Us Strong. Exercise Your Right To Vote!

by Brittney M. Bost, USA, Fort Polk, Louisiana
143

MAINE

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Provide your Maine Driver’s License number; or if

you do not have a Maine Driver’s License, the last four

digits of your Social Security Number; or write “NONE”

if you don’t have either identification. If you do not

possess either of these identifications, the State shall

assign a number that will serve to identify you for voter

registration purposes.

B Provide the name of the municipality and state where

you were registered to vote before you registered at your

current Maine voting residence. This address must be

different from the one in Item 3. If you have not registered

to vote before, write “none”. 

C Provide the complete street address (street name and

number) of your Maine voting residence. A post office box

is not sufficient. This address must be within the city or

township where you claim legal voting residence and (in

most cases) will be different from the address you provide

in Item 4. 

D Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections. If you are

currently registered and want to change your political party

affiliation, the FPCA card must be received by your local

election official no later than 15 days before the election. If

you are currently registered and have previously declined to

indicate a political party and you now want to vote in a

primary election, you must submit a completed FPCA to

the local election official any time before the election.

F Check ONE box.

G Sign and date the FPCA. When signing, you are

swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
Maine 2004–05 Voting Assistance Guide

144

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Maine and members of the Uniformed Services

and their family members. Uniformed Services are defined

as the U.S. Armed Forces, merchant marine, commissioned

corps of the Public Health Service and the National Oceanic

and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and/or request an absentee ballot, send a

completed FPCA to the local registration official any time

before the election.

If you are already registered and only wish to request an

absentee ballot, the municipal clerk must receive your

FPCA or a written application requesting a ballot any time

before the election. 

If you send a written application, you must provide your

name as registered, your voting residence address, and the

address to which the absentee ballot should be sent. The

written application must be signed. Registration

applications by mail or by 3rd person must be received in

the registrar’s office by the close of business on the 10th

business day before election day.

An absentee voter who is not registered may submit a

registration application after the 10th business day, but if

the municipal registrar is not satisfied as to the voter’s

qualifications, the registrar shall place the person’s name on

the voting list and challenge the absentee ballot. A

challenged ballot is counted, unless there is a recount where

the number of challenged ballots is sufficient to affect the

election. In that event, each challenge is investigated and

the corresponding ballot may not be counted.

Although the municipal registrar will accept a completed

FPCA or written request at any time before the election,

you should submit it to the registrar in time for you to

receive, vote and return the absentee ballot by mail to the

municipality. 

C. Casting Your Vote

Ballot Return Deadline: The municipality must receive your

absentee ballot by 8 PM on election day in order for your

ballot to be counted.

Local municipal clerks are provided with absentee ballots

approximately 45 days before an election for Federal office,

and approximately 30 days before a State election. Once the

municipal clerks receive their supply of absentee ballots for

an election, they must mail out the ballots immediately

upon receipt of a ballot request.

Members of the Armed Forces must seal his or her

completed ballot in its return envelope and sign a

certification as to its authenticity on the envelope

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required. 

Ballot Return Envelope: If the voter receives assistance in

reading and/or marking the ballot, the voter must have the

ballot return envelope signed by the aide and witnessed by

one other individual. If no assistance is received, the ballot

return envelope does not need to be notarized or witnessed. 

If your ballot is received through a designated 3rd party, see

I.F. for additional notary/witness requirements. 

E. Electronic Transmission of FPCAs 

and Ballots

 Maine allows you to send the FPCA for registration

and/or absentee ballot request by fax. You may also

send a written application requesting an absentee

ballot by fax. You must also submit the original FPCA

or written application by mail when requesting

registration and a ballot. 

 In certain emergency situations, such as combat

situations, Maine may allow you to receive the blank

ballot by fax. 

 In certain emergency situations, such as combat

situations, Maine may allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.
2004–05 Voting Assistance Guide Maine

145

F. Application for Ballot by Proxy

Your immediate family member (spouse, parent, child,

sister, brother, stepparent, stepchild, stepsister, stepbrother,

mother-in-law, father-in-law, brother-in-law, sister-in-law,

son-in-law, daughter-in-law, grandparent, grandchild, stepgrandparent, step-grandchild, guardian or former guardian)

may make a written request for an absentee ballot on your

behalf. The request may be made to the municipal clerk

either in person or by fax, but must be signed by the

immediate family member and must indicate the family

relationship. The clerk may either mail the ballot directly to

you, or may issue the ballot to the immediate family

member, who must either mail or deliver the ballot to you. 

You may designate a third person (someone other than the

municipal clerk or an immediate family member) to receive

the ballot on your behalf by submitting a signed application

or written request, by mail or by fax, to the municipal clerk.

The clerk must issue the ballot only to the third person you

have designated in your request, who must then deliver the

ballot to you. The voter must have the ballot return

envelope signed by a notary public, a municipal clerk, a

clerk of courts, or two other individuals (one of whom may

be the ballot carrier).

G. Request for Ballot by Telephone

Maine allows registered voters to request an absentee ballot

by telephone. The clerk shall ask the voter for information

required on the application and fill in the application with

that information. The clerk will then verify that it is the

voter who is requesting the ballot by making the voter

confirm the voter’s residence and date of birth. (Only the

voter may request an absentee ballot by telephone.) The

clerk shall mail the ballot directly to the voter at the mailing

address stated in the application. The voter returns the

ballot by mail or in person directly to the clerk.

H. Blank Absentee Ballot

Maine provides a state “blank absentee ballot,” listing all

offices to be selected with a space after each office to write

in the voter’s preference. The blank absentee ballot is

available 3 months before a candidate election and can be

used by Uniformed Services voters who believe that 30

days will not be sufficient time to receive and return the

regular absentee ballot. A blank absentee ballot is not

available for referendum elections.

You may use the FPCA to request this state blank absentee

ballot. In Item 7 of the FPCA, place one of the state blank

absentee ballot labels from Section III.F. If no labels are

available, write in Item 7: “I will be unable to vote by

regular absentee ballot. I request a blank absentee ballot.”

The Federal Write-In Absentee Ballot (FWAB) may be used

in all elections for Federal office where 3 months is not

sufficient time to request and vote a state blank write-in

absentee ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Maine and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Maine.

 residents of Maine temporarily residing outside the

U.S. 

 overseas citizens whose last residence immediately

before leaving the U.S. was in Maine. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and/or request an absentee ballot, send a

completed FPCA to the local registration official any time

before the election.

If you are already registered and only wish to request an

absentee ballot, the municipal clerk must receive your

FPCA or a written application requesting a ballot any time

before the election. 

If you send a written application, you must provide your

name as registered, your voting residence address, county,

and the address to which the absentee ballot should be sent.

The written application must be signed. Registration

applications by mail or by 3rd person must be received in

the registrar’s office by the close of business on the 10th

business day before election day.

An absentee voter who is not registered may submit a

registration application after the 10th business day, but if

the municipal registrar is not satisfied as to the voter’s

qualifications, the registrar shall place the person’s name on

the voting list and challenge the absentee ballot. A

challenged ballot is counted, unless there is a recount where

the number of challenged ballots is sufficient to affect the

election. In that event, each challenge is investigated and

the corresponding ballot may not be counted.

Although the municipal registrar will accept a completed

FPCA or written request at any time before the election,

you should submit it to the registrar in time for you to

receive, vote and return the absentee ballot by mail to the

municipality. 
Maine 2004–05 Voting Assistance Guide

146

C. Casting Your Vote

Ballot Return Deadline: The municipality must receive

your absentee ballot by 8 PM on election day in order for

your ballot to be counted.

Local municipal clerks are provided with absentee ballots

approximately 45 days before an election for Federal office,

and approximately 30 days before a State election. Once the

municipal clerks receive their supply of absentee ballots for

an election, they must mail out the ballots immediately

upon receipt of a ballot request.

Individuals voting as a civilian outside the U.S. must seal

his or her completed ballot in its return envelope and sign a

certification as to its authenticity on the envelope.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required. 

Ballot Return Envelope: If the voter receives assistance in

reading and/or marking the ballot, the voter must have the

ballot return envelope signed by the aide and witnessed by

one other individual. If no assistance is received, the ballot

return envelope does not need to be notarized or witnessed. 

If your ballot is received through a designated 3rd party, see

I.F. for notary/witness requirements. 

E. Electronic Transmission of FPCAs 

and Ballots

 Maine allows you to send the FPCA for registration

and/or absentee ballot request by fax. You may also

send a written application requesting an absentee

ballot by fax. You must also submit the original FPCA

or written application by mail when requesting

registration and a ballot. 

 Maine does not allow you to receive the blank ballot

by fax. 

 Maine does not allow you to return the voted ballot by

fax. 

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Your immediate family member (spouse, parent, child,

sister, brother, stepparent, stepchild, stepsister, stepbrother,

mother-in-law, father-in-law, brother-in-law, sister-in-law,

son-in-law, daughter-in-law, grandparent, grandchild, stepgrandparent, step-grandchild, guardian or former guardian)

may make a written request for an absentee ballot on your

behalf. The request may be made to the municipal clerk

either in person or by fax, but must be signed by the

immediate family member and must indicate the family

relationship. The clerk may either mail the ballot directly to

you, or may issue the ballot to the immediate family

member, who must either mail or deliver the ballot to you. 

You may designate a third person (someone other than the

municipal clerk or an immediate family member) to receive

the ballot on your behalf by submitting a signed application

or written request, by mail or by fax, to the municipal clerk.

The clerk must issue the ballot only to the third person you

have designated in your request, who must then deliver the

ballot to you. When a third person delivers the ballot to you

and /or delivers the voted ballot from you to the clerk, the

ballot return envelope must be witnessed and signed by a

notary public, a municipal clerk, a clerk of courts or two

other individuals (one of whom may be the ballot carrier).

G. Request for Ballot by Telephone

Maine allows registered voters to request an absentee ballot

by telephone. The clerk shall ask the voter for information

required on the application and fill in the application with

that information. The clerk will then verify that it is the

voter who is requesting the ballot by making the voter

confirm the voter’s residence and date of birth. (Only the

voter may request an absentee ballot by telephone.) The

clerk shall mail the ballot directly to the voter at the mailing

address stated in the application. The voter returns the

ballot by mail or in person directly to the clerk.

H. Blank Absentee Ballot

Maine provides a state “blank absentee ballot,” listing all

offices to be selected with a space after each office to write

in the voter’s preference. The blank absentee ballot is

available 3 months before a candidate election and can be

used by civilians outside the U.S. who believe that 30 days

will not be sufficient time to receive and return the regular

absentee ballot. A blank absentee ballot is not available for

referendum elections.

You may use the FPCA to request this state blank absentee

ballot. In Item 7 of the FPCA, place one of the state blank

absentee ballot labels from Section III.F. If no labels are

available, write in Item 7: “I will be unable to vote by

regular absentee ballot. I request a blank absentee ballot.”

The Federal Write-In Absentee Ballot (FWAB) may be used

in all elections for Federal office where 3 months is not

sufficient time to request and vote a state blank write-in

absentee ballot.
2004–05 Voting Assistance Guide Maine

147

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Cancellation of Registration

Registration is permanent. However, you may have your

name removed from the voter list by making a written

request to the registrar. In addition, moving from the

municipality is grounds for removal from the list upon

written confirmation of such a move by the registrant or by

the registrar of voters in the registrant’s new voting

jurisdiction.

B. Action on Registration Requests

All applicants are notified whether or not their registration

applications were accepted, rejected, or incomplete.

C. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Maine shall provide you with the

reason(s) for the rejection. Denial of registration can be

appealed to the registration appeals board or the municipal

officers (whichever is applicable for that municipality). The

registration appeals board or municipal officers shall

immediately fix a time and date for a prompt hearing. After

such hearing, the registration appeals board or municipal

officers may affirm, modify or reverse the decision of the

registrar of voters. The aggrieved person may appeal this

decision to the Superior Court in accordance with Rule 80B

of the Rules of Civil Procedure. Consult a legal assistance

officer or civilian counsel.

D. Where To Send It

Maine conducts elections for Municipal, State and Federal

offices at the municipal level (not at the county or state

level as in many other states). To register and

simultaneously request an absentee ballot, submit your

FPCA to the Registrar of Voters in your municipality of

voting residence. 

If you are already registered and only wish to request an

absentee ballot, submit your FPCA to the Municipal Clerk

in your municipality of voting residence. 

Maine has 526 municipal jurisdictions. A partial list of

major municipalities follows. A complete list of Municipal

Clerks and Registrars, along with addresses and telephone

numbers, may be found on the Maine Secretary of State’s

site on the World Wide Web. The Web site address for the

Elections Division is “http://www.state.me.us/sos/cec/elec/

elec.htm”. Or, you may contact the Federal Voting

Assistance Program at (703) 588-1584, 1-800-438-8683

(VOTE), DSN 425-1584 (military) or by e-mail at

vote@fvap.ncr.gov.

City or Town Zip Code

Auburn 04210-5946

Augusta 04330-5298

Bangor 04401-1808

Bath 04530-2588

Belfast 04915-1705

Biddeford 04005-2400

Boothbay Harbor 04538-0117

Brewer 04412-2010

Brunswick 04011-1583

Calais 04619-0435

Cape Elizabeth 04107-6260

Caribou 04736-2710

Dover-Foxcroft 04426-1397

Ellsworth 04605-0586

Falmouth 04105-2090

Farmington 04938-1733

Gorham 04038-1382

Houlton 04730-2104

Jackman 04945-0269

Jay 04239-1599

Lewiston 04240-7297

Limestone 04750-1116

Lubec 04652-1199

Machias 04654-0418

Millinocket 04462-1445

Old Orchard Beach 04064-0234

Old Town 04468-1497

Portland 04101-3593

Presque Isle 04769-1148

Rockland 04841-2739

Rumford 04276-2002

Saco 04072-1583

Sanford 04073-3589

Scarborough 04070-0360

Skowhegan 04976-1799

South Portland 04116-9422

Waterville 04901-6699

Westbrook 04092-0648

York 03909-0009

Do It Now--Right Now. Vote!

by MSgt Stephen F. Corker, USAF, Mildenhall Air Base, England
Maine 2004–05 Voting Assistance Guide

148
MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”

E. BLANK WRITE-IN ABSENTEE BALLOT LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

MAINE

“I will be unable to vote by regular absentee ballot. I request a blank

absentee ballot.”
Maine 2004–05 Voting Assistance Guide

150
151

MARYLAND

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A If you have a current, valid Maryland Driver’s License

or MVA identification card, enter the identification number

in Item 1.f. Only if you do not have a current, valid

Maryland Driver’s License or MVA identification card,

enter at least the last four digits of your Social Security

number in Item 1.e. If you do not possess either of these

identifications, Maryland will assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Maryland

voting residence. A post office box is insufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county to which this application is

being mailed.

D Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address you provided in Item 3.

E Generally, you must be affiliated with a political party

to vote in that party’s primary elections. If you do not list a

party affiliation, you will be registered as “unaffiliated.”

Political party affiliation is not required if you are only

requesting an absentee ballot for a general election. If you

are currently registered and want to change your political

party affiliation, you must submit a completed FPCA,

including your new political party choice or “unaffiliated,”

to the local election board not less than 84 days before the

primary. 

F Check ONE box.

G You must sign and date the FPCA. By signing, you are

swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

C

E

G

D

F

B
Maryland 2004–05 Voting Assistance Guide

152

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Maryland and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local Board of Elections

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the local Board of Elections so that it is

postmarked not later than the 21st day before the next

election (the date on which registration closes).

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA or other written

correspondence to the local Board of Elections so that it

arrives not later than the Tuesday before the election. Any

written correspondence must contain your signature, your

name and mailing address, any Maryland residential

address and your date of birth, and must state that you may

be absent from your Maryland county of residence on

election day.

C. Casting Your Vote

Ballot Return Deadline: Make sure your voted ballot is

postmarked not later than the day before the election. Your

voted ballot must arrive at the local Board of Elections by

U.S. Postal Service according to the following timetable:

 If mailed from within the U.S. - on or before 4 p.m. on

the Wednesday after election day.

 If mailed from outside the U.S. for a gubernatorial

primary - on or before 10 a.m. on the second

Wednesday after election day.

 If mailed from outside the U.S. for a general or special

election or for a Presidential primary - on or before 10

a.m. on the second Friday after election day.

Local election officials mail absentee ballots approximately

30 to 40 days before the election.

You must sign an oath stating your eligibility to vote by

absentee ballot when you return a voted absentee ballot. 

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions below in F. and in

Chapter 2, page 12.

D. Notary/Witness Requirements

Registration and voting materials need not be notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Maryland allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail. You may not submit the FPCA for registration

by fax.

 Maryland allows you to receive the blank ballot by

fax.

 Maryland does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Federal Write-In Absentee Ballot

Maryland has expanded the use of the Federal Write-In

Absentee Ballot (FWAB), SF 186, for overseas voters. The

instructions described in Chapter 2 of this Guide remain the

same, except that Maryland allows eligible overseas voters

to use the FWAB to vote in any election for any Federal,

state or local office.

G. Application for Ballot by Proxy

Until the closing of the polls on election day, a registered

voter or the voter’s duly authorized agent may apply in

person for an absentee ballot at the office of the local Board

of Elections if the voter may be absent from the voter’s

Maryland county of residence on election day.

The application must be made under penalty of perjury and

must specify the reason for absentee voting. A qualified

applicant may designate an agent to pick up and deliver the

absentee ballot. The agent:

 must be at least 18 years old
2004–05 Voting Assistance Guide Maryland

153

 may not be a candidate on the ballot

 must be designated by the voter in writing and signed

under penalty of perjury

 must sign an affidavit under penalty of perjury

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Maryland and overseas citizens as defined in

the following sentence. The term “overseas citizen,” for

purposes of the UOCAVA, means a U.S. citizen who

resides outside the U.S. and (but for such residence) would

be qualified to vote in Maryland. The term includes:

 civilian employees of the U.S. Government serving

outside the U.S. and their spouses and dependents (for

local, state and Federal office ballots)

 members of the American Red Cross, Society of

Friends, or USO serving with the Armed Forces

outside the U.S. and their spouses and dependents (for

local, state and Federal office ballots)

 other overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local Board of Elections

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the local Board of Elections so that it is

postmarked not later than the 21st day before the next

election (the date on which registration closes).

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA or other written

correspondence to the local Board of Elections so that it

arrives not later than the Tuesday before the election. Any

written correspondence must contain your signature, your

name and mailing address, any Maryland residential

address and your date of birth, and must state that you may

be absent from your Maryland county of residence on

election day.

C. Casting Your Vote

Ballot Return Deadline: Make sure your voted ballot is

postmarked not later than the day before the election. Your

voted ballot must arrive at the local Board of Elections by

U.S. Postal Service according to the following timetable:

 For a gubernatorial primary - on or before 10 a.m. on

the second Wednesday after election day.

 For a general or special election or for a Presidential

primary - on or before 10 a.m. on the second Friday

after election day.

Local election officials mail absentee ballots out

approximately 30 to 40 days before the election.

You must sign an oath stating your eligibility to vote by

absentee ballot when you return a voted absentee ballot. 

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions below in F. and in Chapter 2, page 12.

D. Notary/Witness Requirements

Registration and voting materials need not be notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Maryland allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail. You may not submit the FPCA for registration

by fax.

 Maryland allows you to receive the blank ballot by

fax.

 Maryland does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Federal Write-In Absentee Ballot

Maryland has expanded the use of the Federal Write-In

Absentee Ballot (FWAB), SF 186, for overseas voters. The

instructions described in Chapter 2 of this Guide remain the

same, except that Maryland also allows eligible overseas

voters to use the FWAB to vote in any election for any

Federal, state or local office.

G. Application for Ballot by Proxy

Until the closing of the polls on election day, a registered

voter or the voter’s duly authorized agent may apply in

person for an absentee ballot at the office of the local Board

of Elections if the voter may be absent from the voter’s

Maryland county of residence on election day.
Maryland 2004–05 Voting Assistance Guide

154

The application must be made under penalty of perjury and

must specify the reason for absentee voting. A qualified

applicant may designate an agent to pick up and deliver the

absentee ballot. The agent:

 must be at least 18 years old

 may not be a candidate on the ballot

 must be designated by the voter, in writing and signed

under penalty of perjury

 must sign an affidavit under penalty of perjury

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

The following persons may not register or vote:

 An individual who has been convicted of an infamous

crime (any felony, treason, perjury, or any crime

involving an element of deceit, fraud, or corruption)

unless:

— the individual has been pardoned, or

— for a first conviction, the individual has

completed the sentence imposed, or 

— for a second or later conviction, at least three

years have passed since the individual completed

the sentence imposed.

 An individual convicted more than once of a crime of

violence (unless the individual has been pardoned)

 An individual under guardianship for mental disability

 An individual convicted of buying or selling votes

B. Statewide Voter Registration; 

Removal From Voter Rolls

Maryland voter registration applies statewide. It is not

necessary for a voter who is registered in one Maryland

county to re-register when the voter moves to a different

Maryland county. However, it is the responsibility of the

voter to notify Maryland of any change of address by the

deadline to register to vote before an election. If it is

apparent that a person has moved out of Maryland entirely,

that person can be removed from the voter rolls for failing

to provide a current address and then failing to vote in two

general elections.

C. Action on FPCA Requests

Local boards of elections perform voter registration and

absentee ballot processing. To register or request an

absentee ballot, you should contact the board in your

Maryland county of residence.

D. Action Upon Denial of Registration or 

Absentee Ballot Request

If a local Board of Elections denies your voter registration

application or absentee ballot request, the local board will

provide you with the reason(s) for the rejection. A person

denied registration may appeal to the county circuit court.

Consult a legal assistance officer or civilian counsel.

E. Where To Send It

Mail the FPCA to the Board of Elections in your Maryland

county of residence at the appropriate address listed below:

County County Seat Zip Code

Allegany 701 Kelly Road, Suite 213

Cumberland 21502-3401

Anne Arundel PO Box 490

Glen Burnie 21060-0490

Baltimore City Benton Office Bldg., Room 129

417 E. Fayette Street, Baltimore 21202-3432 

Baltimore County 106 Bloomsbury Avenue 

Baltimore 21228-5220 

Calvert PO Box 798

Prince Frederick 20678-0798

Caroline Health & Public Services Building

403 S. 7th Street, Suite 247, Denton 21629-1335

Carroll 225 N. Center Street 

Westminster 21157-5194

Cecil 129 E. Main Street, Court House

Room 332, Elkton 21921-5970

Charles PO Box 908 

La Plata 20646-0908

Dorchester PO Box 414 

Cambridge 21613-0414

Frederick Winchester Hall, 12 E. Church Street 

Frederick 21701-5447

Garrett 2008 Maryland Hwy., Suite 1 

Mountain Lake Park 21550-6349

Harford 18 Office Street

Bel Air 21014-3778

Howard 8900 Columbia 100 Parkway 

Columbia 21045-2339

Kent 135 Dixon Drive

Chestertown 21620-1141

Montgomery PO Box 4333

Rockville 20849-4333

Prince George's 14741 Governor Oden Bowie Drive

Suite L205, Upper Marlboro 20772-3070

Queen Anne's County Annex Building, Box 274

Centreville 21617-0274

St Mary's PO Box 197

Leonardtown 20650-0197

Somerset PO Box 96

Princess Anne 21853-0096

Talbot PO Box 353

Easton 21601-0353

Don’t Be A Spectator...Get In The Game! Vote!

by Maj Douglas S. Smellie, USAF, Vandenberg Air Force Base, California
2004–05 Voting Assistance Guide Maryland

155

Washington 35 W. Washington Street, Room 101

Hagerstown 21740-4834

Wicomico PO Box 4091

Salisbury 21803-4091

Worcester 100 Belt Street

Snow Hill 21863-1310

County County Seat Zip Code
Maryland 2004–05 Voting Assistance Guide

156
157

MASSACHUSETTS

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

B Provide the complete street address of your

Massachusetts voting residence. A post office box is not

sufficient. If your address includes a rural route, describe its

location in Item 7. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be different from the one

provided in Item 4 and must be within the city or town

where you claim legal voting residence.

C Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address

provided in Item 3. 

D If you are applying for an absentee ballot for a party

primary, please indicate the party ballot you wish to receive.

In Massachusetts, there are currently four political parties:

Democratic, Republican, Libertarian and Massachusetts

Green Party.

E Check ONE box.

F You must sign the FPCA. By signing, you are

swearing or affirming the information is true and correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E
Massachusetts 2004–05 Voting Assistance Guide

158

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Massachusetts and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA, or any other form of written

communication, to your local election official early every

year and whenever you change your mailing address (see

Chapter 2).

Registration is waived.

To request an absentee ballot, the local registrar of voters

must receive your FPCA or any other form of written

communication with your name, date of birth, former

residence and present residence not later than noon the day

before the election. 

C. Casting Your Vote

Ballot Return Deadline: If you reside within the U.S., return

your voted ballot to the local election official so that it

arrives by the close of polls (8:00 p.m.) on election day. 

If you reside outside the U.S., your voted ballot must be

returned to your local election official so that it arrives by

the close of polls (8:00 p.m.) on election day to be counted

for local and primary elections. Your voted ballot must be

postmarked by election day and returned to the local

election official so that it arrives not later than 10 days after

the election to be counted for Federal elections.

Local election officials mail ballots approximately 35 days

before the primary and 21 days before a general election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Massachusetts allows you to send the FPCA for

absentee ballot requests by fax. After faxing, you must

submit the FPCA by mail in order to have your ballot

counted.

 Massachusetts does not allow you to receive the blank

ballot by fax.

 Massachusetts does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Your spouse, or person residing in the same household,

parent, in-laws, brother, sister, son, daughter, stepparent,

stepchild, half-sister, half-brother, uncle, aunt, niece,

nephew, grandparent or grandchild may request that a ballot

be sent to you. Necessary forms may be obtained at the

clerk’s office in the city or town of voting residence. Any

form of written communication containing the required

information may also be sent to the clerk’s office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Massachusetts, and “specially qualified voters.”

The term “specially qualified voter” means a U.S. citizen

who resides outside the U.S. and (but for such residence)

would be qualified to vote in Massachusetts (for local, state

and Federal office ballots).

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA, or any other form of written

communication, to your local election official early every

year and whenever you change your mailing address (see

Chapter 2).
2004–05 Voting Assistance Guide Massachusetts

159

Registration is waived.

To request an absentee ballot, the local registrar of voters

must receive your FPCA or any other form of written

communication with your name, date of birth, former

residence and present residence not later than noon the day

before the election. 

C. Casting Your Vote

Ballot Return Deadline: If you reside outside the U.S., your

voted ballot must be returned to your local election official

so that it arrives by the close of polls (8:00 p.m.) on election

day to be counted for local and primary elections. Your

voted ballot must be postmarked by election day and

returned to the local election official so that it arrives not

later than 10 days after the election to be counted for

Federal elections.

Local election officials mail ballots approximately 35 days

before the primary and 21 days before a general election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Massachusetts allows you to send the FPCA for

absentee ballot requests by fax. After faxing, you must

submit the FPCA by mail in order to have your ballot

counted.

 Massachusetts does not allow you to receive the blank

ballot by fax.

 Massachusetts does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Your spouse, or person residing in the same household,

parent, in-laws, brother, sister, son, daughter, stepparent,

stepchild, half-sister, half-brother, uncle, aunt, niece,

nephew, grandparent or grandchild may request that a ballot

be sent to you. Necessary forms may be obtained at the

clerk’s office in the city or town of voting residence. Any

form of written communication containing the required

information may also be sent to the clerk’s office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons under a legal guardianship which specifically

prohibits voting, persons temporarily or permanently

disqualified by law from voting because of corrupt

practices in respect to election, and persons currently

incarcerated for a felony conviction may not register or

vote. 

B. Late Registration

Any of the above persons not in their city or town of

residence during the 7 days before the last day to register

(the last day to register is 20 days before the election) may

register in person until 4 p.m. on the day before the election.

C. Action If Registration Is Denied

Written notice of denial is sent. You have the option to be

heard and/or appeal.

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Massachusetts shall provide you

with the reason(s) for the rejection. 

E. Voting By Citizens Who Have Never 

Lived in the U.S.

U.S. citizens who have never resided in the U.S. but have a

parent who is eligible to vote in Massachusetts are eligible

to vote at the same voting residence claimed by their parent

(for local, state and Federal office ballots).

F. Where To Send It

Mail the FPCA to the City or Town Clerk in your city or

town of voting residence. If “EC” appears on list, mail

FPCA to the Local Election Commission, not the City or

Town Clerk.

City or Town Mailing Address Zip Code

Abington Town Hall, 500 Gliniewicz Way 02351

Acton Town Hall, 472 Main Street 01720

Acushnet Town Hall, 122 Main St. 02743

Adams Town Hall, 8 Park St. 01220

Agawam Town Hall, 36 Main St. 01001

Alford Town Hall, 5 Alford Center Rd. 01230

Amesbury Town Hall, 62 Friend St. 01913

Amherst Town Hall, 4 Boltwood Ave. 01002
Massachusetts 2004–05 Voting Assistance Guide

160

Andover Town Hall, 36 Bartlet St. 01810

Aquinnah Town Hall, 65 State Road 02535

Arlington Town Hall, 730 Massachusetts Ave 02476

Ashburnham Town Hall, 32 Main St. 01430

Ashby 895 Main Street 01431

Ashfield PO Box 560 01330

Ashland Town Hall, 101 Main St. 01721

Athol Town Hall, 584 Main St. 01331

Attleboro City Hall, 77 Park St. 02703

Auburn Town Hall, 104 Central St. 01501

Avon Town Hall, 65 East Main St. 02322

Ayer Town Hall, One Main St., PO Box 308 01432

Barnstable Town Hall, 367 Main St., Hyannis, MA 02601

Barre Town Hall, 2 Exchange St., PO Box 418 01005-0418

Becket Town Hall, 557 Main St. 01223

Bedford Town Hall, 10 Mudge Way 01730

Belchertown Town Hall, 2 Jabish St., PO Box 607 01007

Bellingham Town Hall, 2 Mechanic St., PO Box 367 02019

Belmont Town Hall, 455 Concord Ave. 02478

Berkley Town Hall, One North Main St. 02779

Berlin 23 Linden Street, Box 8 01503

Bernardston PO Box 504 01337

Beverly City Hall, 191 Cabot St. 01915

Billerica Town Hall, 365 Boston Rd. 01821

Blackstone Town Hall,15 St. Paul Center 01504

Blandford Town Hall, 102 Main St., PO Box 101 01008

Bolton Town Hall 663, Main St., PO Box 278 01740

Boston (EC) Boston City Hall, One City Hall Square 02201

Bourne Town Hall, 24 Perry Ave, Buzzards Bay 02532

Boxborough Town Hall, 29 Middle Road 01719

Boxford Town Hall, 28 Middleton Rd. 01921

Boylston Town Hall, 321 Main St. 01505

Braintree Town Hall, 1 JFK Memorial Dr. 02184

Brewster Town Hall, 2198 Main St. 02631-1898

Bridgewater Town Hall, 64 Central Square 02324

Brimfield PO Box 508 01010

Brockton City Hall, 45 School St. 02301

Brookfield Town Hall, 6 Central St. 01506

Brookline Town Hall, 333 Washington St. 02445

Buckland PO Box 159 01338

Burlington Town Hall, 29 Center St. 01803

Cambridge (EC) 51 Inman St., 1st Floor 02139

Canton Town Hall, Memorial Hall

801 Washington St. 02021

Carlisle Town Hall, 66 Westford St., PO Box 827 01741

Carver Town Hall, 108 Main St. 02330

Charlemont Town Hall, 157 Main St., PO Box 605 01339

Charlton 37 Main Street 01507

Chatham Town hall, 549 Main Street 02633

Chelmsford Town Hall, 50 Billerica Rd. 01824

Chelsea City Hall, 500 Boradway, Rm. 209 02150

Cheshire Town Hall, 80 Church St., Box S 01225

Chester Town Hall, 15 Middlefield Rd. 01011

Chesterfield Town Hall, 422 Main Road, PO Box 33 01012

Chicopee City Hall, 17 Springfield St. 01013

Chilmark Town Hall, 401 Middle Rd, P O Box 119 02535

Clarksburg Town Hall, 111 River Rd. 01247

Clinton Town Hall, 242 Church St. 01510

Cohasset Town Hall, 41 Highland Ave. 02025

Colrain PO Box 31 01340

Concord Town Hall, 22 Monument Square

PO Box 535 01742

Conway Town Hall, 32 Main St., PO Box 240 01341

Cummington Town Hall, 33 Main St. 01026

Dalton Town Hall, 462 Main St. 01226

Danvers Town Hall, One Sylvan St. 01923

Dartmouth Town Hall, 400 Slocum Rd. 02747

Dedham PO Box 306 02027

Deerfield 8 Conway Street, South Deerfield, MA 01373

Dennis Town Hall, 485 Main St., Box 1419

South Dennis, MA 02660

Dighton Town Hall, 979 Somerset Ave. 02715

Douglas Town Hall, 29 Depot St. 01516

City or Town Mailing Address Zip Code

Dover Town Hall, 5 Springdale Ave.

PO Box 250 02030

Dracut Town Hall, 62 Arlington St., Room 4 01826

Dudley Town Hall, 42 Schofield Ave. Suite 17 01571

Dunstable Town Hall, 511 Main St. 01827

Duxbury Town Hall, 878 Tremont St. 02332

East Bridgewater Town Hall, 175 Central St., PO Box 568 02333

East Brookfield PO Box 568 01515

East Longmeadow Town Hall, 60 Center Sq. 01028

Eastham Town Hall, 2500 State Hwy. 02642

Easthampton Town Hall, 43 Main St. 01027

Easton Town Hall, 136 Elm St, North Easton, MA 02356

Edgartown PO Box 568 02539

Egremont PO Box 56 01258

Erving Town Hall, 12 East Main St. 01344

Essex Town Hall, 30 Martin St. 01929

Everett City Hall, 484 Broadway 02149

Fairhaven Town Hall, 40 Center St. 02719

Fall River (EC) City Hall, One Government Ctr. 02722

Falmouth Town Hall, 59 Town Hall Square 02540

Fitchburg City Hall, 718 Main St. 01420

Florida Town Hall, 20 South St. 01343

Foxborough Town Hall, 40 South St. 02035

Framingham Town Hall, 150 Concord St. 01702

Franklin Town Hall, 150 Emmons St. 02038

Freetown Town Office Bldg.,P.O. Box 438

3 No. Main St., Assonet, MA 02702

Gardner City Hall, 95 Pleasant St. 01440

Georgetown Town Hall, One Library St. 01833

Gill Town Hall, 325 Main St. 01376

Gloucester City Hall, 9 Dale Ave. 01930

Goshen Town Hall, 42 Main St., PO Box 124 01032

Gosnold PO Box 28 02713

Grafton Town Hall, 30 Providence Rd. 01519

Granby Town Hall, 250 State St. 01033

Granville Town Hall, 707 Main Rd, PO Box 247 01034

Great Barrington Town Hall, 334 Main St. 01230

Greenfield Town Hall, 14 Court Sq. 01301

Groton Town Hall, 173 Main St. 01450

Groveland Town Hall, 183 Main St. 01834

Hadley Town Hall, 100 Middle St. 01035

Halifax Town Hall, 499 Plymouth St. 02338

Hamilton Town Hall, 577 Bay Rd., PO Box 429 01936

Hampden Town Hall, 625 Main Street 01036

Hancock PO Box 1098 01237

Hanover Town Hall, 550 Hanover St. 02339

Hanson Town Hall, 542 Liberty St. 02341

Hardwick Town Hall, 307 Main St.

PO Box 575, Gilbertville, MA 01031

Harvard Town Hall, 13 Ayer Rd. 01451

Harwich Town Hall, 732 Main St. 02645

Hatfield Memorial Town Hall, 59 Main St. 01038

Haverhill City Hall, 4 Summer St., Room 118 01830

Hawley Town Hall, 8 Pudding Hollow Rd. 01339

Heath Town Hall, One East Main St. 01346

Hingham Town Hall, 210 Central St. 02043

Hinsdale PO Box 803 01235

Holbrook Town Hall, 50 North Franklin St. 02343

Holden Town Hall, 1196 Main St. 01520

Holland Town Hall, 27 Sturbridge Road 01521

Holliston Town Hall, 100 Linden St. 01746

Holyoke City Hall, 536 Dwight St. 01040

Hopedale Town Hall, 78 Hopedale St., PO Box 7 01747

Hopkinton Town Hall, 18 Main St. 01748

Hubbardston Town Hall, 7 Main St., P.O. Box H 01452

Hudson Town Hall, 78 Main St. 01749

Hull Town Hall, 253 Atlantic Ave. 02045

Huntington PO Box 523 01050

Ipswich Town Hall, 25 Green St. 01938

Kingston Town Hall, 23 Green St., PO Drawer E 02364

Lakeville Town Hall, 346 Bedford St. 02347

Lancaster Town Hall, 695 Main St., PO Box 97 01523

Lanesborough PO Box 1492 01237

City or Town Mailing Address Zip Code
2004–05 Voting Assistance Guide Massachusetts

161

Lawrence City Hall, 200 Common St. 01840

Lee Town Hall, 32 Main St. 01238

Leicester Town Hall, Three Washburn Square 01524

Lenox Town Hall, 6 Walker St. 01240

Leominister City Hall, 25 West St. 01453

Leverett PO Box 178 01054

Lexington Town Hall, 1625 Massachusetts Ave. 02420

Leyden Town Hall, 16 West Leyden Rd. 01337

Lincoln PO Box 6353 01773

Littleton Town Hall, 37 Shattuck St. 01460

Longmeadow Town Hall, 20 Williams St. 01106

Lowell (EC) City Hall, 375 Merrimack St. 01852

Ludlow Town Hall, 488 Chapin St. 01056

Lunenburg Town Hall, 17 Main St., PO Box 135 01462

Lynn City Hall Square, Room 201 01901

Lynnfield Town Hall, 55 Summer St. 01940

Malden City Hall, 200 Pleasant St. 02148

Manchester-bythe-Sea Town Hall, 10 Central St. 01944

Mansfield Town Hall, 6 Park Row 02048

Marblehead Town Hall, 188 Washington St. 01945

Marion Town Hall, 2 Spring St. 02738

Marlborough City Hall, 140 Main St. 01752

Marshfield Town Hall, 870 Moraine St. 02050

Mashpee Town Hall, 16 Great Neck Road North 02649

Mattapoisett Town Hall, 16 Main St., PO Box 89 02739

Maynard Town Hall, 195 Main St. 01754

Medfield Town Hall, 459 Main Street 02052

Medford City Hall, 85 George P. Hassett Drive 

Room 103 02155

Medway Town Hall, 155 Village St. 02053

Melrose City Hall, 562 Main St., Election Office 02176

Mendon Town Hall, 20 Main St., P.O. Box 54 01756

Merrimac Town Hall, 2 School St. 02860

Methuen Town Hall, 41 Pleasant St. 01844

Middleborough Town Hall, 20 Centre Street, 1st Floor 02346

Middlefield PO Box 265 01243

Middleton Town Hall, 48 South Main St. 01949

Milford Town Hall, 52 Main St 01757

Millbury Town Hall, 127 Elm St. 01527

Millis Town Hall, 900 Main Street 02054

Millville Town Hall, 8 Central St., PO Box 703 01529

Milton Town Hall, 525 Canton Ave. 02186

Monroe Town Hall, 3C, School Street 01350

Monson Town Hall, 110 Main St., Suite 4 01057

Montague Town Hall, One Avenue A 01376

Monterey PO Box 277 01254

Montgomery Town Hall, 161 Main Rd. 01085

Mount Washington Town Hall, 118 East Street 01258

Nahant Town Hall, 334 Nahant Rd. 01908-0075

Nantucket Town Hall, 16 Broad St. 02554

Natick Town Hall, 13 East Central St. 01760

Needham Town Hall, 1471 Highland Ave 02492

New Ashford Town Hall, 188 Mallery Road 01237

New Bedford(EC) City Hall, 133 William St., Room 114 02740

New Braintree Town Hall, 20 Memorial Drive 01531-1548

New Marlborough Town Hall, Mill River South Field Rd.

PO Box 99, Mill River, MA 01244

New Salem Town Hall, 15 South Main St. 01355-9750

Newbury Town Hall, 25 High Rd. 01951-1298

Newburyport City Hall, 60 Pleasant St., PO Box 550 01950

Newton (EC) City Hall, 1000 Commonwealth Ave. 02459

Norfolk Town Hall, One Liberty Lane 02056

North Adams City Hall, 10 Main St., Room 109 01247

North Andover Town Hall, 120 Main St. 01845

North Attleborough Town Hall, 43 South Washington St. 02760

North Brookfield Town Hall, 185 North Main St. 01535

North Reading Town Hall, 235 North St. 01864

Northampton City Hall, 212 Main St., Room 302 01060

Northborough Town Hall, 63 Main St. 01532

Northbridge Town Hall, 7 Main St. 01588

Northfield Town Hall, 69 Main St. 01360

Norton Town Hall, 70 East Main St. 02766

City or Town Mailing Address Zip Code

Norwell Town Hall, 345 Main St., PO Box 295 02061

Norwood Town Hall, 566 Washington St.

PO Box 40 02062

Oak Bluffs P.O. Box 2490 02557

Oakham Town Hall, Two Coldbrook Rd.

PO Box 222 01068

Orange Town Hall, 6 Prospect St. 01364

Orleans Town Hall, 19 School Rd. 02653

Otis PO Box 237 01253

Oxford Town Hall, 325 Main St. 01540

Palmer Town Hall, 4417 Main Street, Suite 4 01069

Paxton Town Hall, 697 Pleasant St. 01612

Peabody City Hall, 24 Lowell St. 01960

Pelham Town Hall, 351 Amherst Rd. 01002

Pembroke Town Hall, 100 Center St. 02359

Pepperell Town Hall, One Main Street 01463

Peru Town Hall, 3 West Main Rd. 01235

Petersham Town Hall, 3 South Main St., PO Box 486 01366

Phillipston Town Hall, 50 The Common 01331

Pittsfield City Hall, 70 Allen St. 01201

Plainfield Town Hall, 344 Main St. 01070

Plainville PO Box 1717 02762

Plymouth Town Hall, 11 Lincoln St. 02360-

Plympton Town Hall, 5 Palmer Rd., Box 153 02367-0153

Princeton Town Hall, 6 Town Hall Dr. 01541

Provincetown Town Hall, 260 Commercial St. 02657

Quincy City Hall, 1305 Hancock St. 02169

Randolph Town Hall, 41 South Main St. 02368

Raynham Town Hall, 53 Orchard St. 02767

Reading Town Hall, 16 Lowell St. 01867

Rehoboth Town Hall, 148R Peck St. 02769

Revere City Hall, 281 Broadway 02151

Richmond Town Hall, 1529 State Rd., PO Box 81 01254

Rochester Town Hall, 1 Constitution Way 02770

Rockland Town Hall, 242 Union St. 02370-1897

Rockport PO Box 429 01966

Rowe PO Box 308 01367

Rowley PO Box 351 01969

Royalston Town Hall, The Common, PO Box 118 01368

Russell PO Box 407 01071

Rutland Town Hall, 250 Main St. 01543

Salem City Hall, 93 Washington St. 01970

Salisbury Town Hall, 5 Beach Rd. 01952

Sandisfield Town Hall, Silverbrook Rd.

PO Box 163 01255

Sandwich Town Hall, 145 Main St. 02563

Saugus Town Hall, 298 Central St. 01906

Savoy Town Hall, 720 Main Rd. 01256

Scituate Town Hall

600 Chief Justice Cushing Way 02066

Seekonk Town Hall, 100 Peck St. 02771

Sharon Town Hall, 90 South Main St. 02067

Sheffield PO Box 175 01257

Shelburne Town Hall, 51 Bridge St.

Shelburne Falls, MA 01370

Sherborn Town Hall, 19 Washington St.

PO Box 186 01770

Shirley PO Box 782 01464

Shrewsbury Town Hall, 100 Maple Ave. 01545

Shutesbury PO Box 264 01072

Somerset Town Hall, 140 Wood St. 02726

Somerville (EC) City Hall, 93 Highland Ave. 02143

South Hadley Town Hall, 116 Main St. 01075

Southampton Town Hall, 8 East St., P.O. Box 276 01073

Southborough Town Hall, 17 Common St. 01772

Southbridge Town Hall, 41 Elm St. 01550

Southwick Town Hall, 454 College Hwy. 01077

Spencer Town Hall, 157 Main St. 01562

Springfield (EC) City Hall, 36 Court St. 01103

Sterling Town Hall, 1 Park St. 01564

Stockbridge PO Box 417 01262

Stoneham Town Hall, 35 Central St. 02180

Stoughton Town Hall, 10 Pearl St. 02072-2396

City or Town Mailing Address Zip Code
Massachusetts 2004–05 Voting Assistance Guide

162

Stow Town Hall, 380 Great Rd. 01775

Sturbridge Town Hall, 308 Main St. 01566

Sudbury Town Hall, 322 Concord Rd. 01776

Sunderland Town Offices, 12 School St. 01375

Sutton Town Hall, 4 Uxbridge Rd. 01590

Swampscott Town Hall, 22 Monument Ave. 01907

Swansea Town Hall, 81 Main St. 02777

Taunton CIty Hall, 15 Summer St. 02780

Templeton Town Hall, 9 Main St. 01436

Tewksbury Town Hall, 1009 Main St. 01876

Tisbury Town Hall, 51 Spring St.

Box 606, Vineyard Haven, MA 02568

Tolland Town Hall, 241 West Granville Rd. 01034

Topsfield Town Hall, 8 West Common St. 01983

Townsend Memorial Hall, 272 Main St. 01469

Truro PO Box 2012 02666

Tyngsborough Town Hall, 25 Bryants Lane 01879

Tyringham Town Hall, 116 Main Rd., PO Box 271 01264

Upton PO Box 969 01568

Uxbridge Town Hall, 21 South Main St. 01569

Wakefield William J. Lee Memorial Town Hall

One Lafayette St. 01880-2383

Wales Town Hall, Hollow Rd, PO Box 834 01081-0834

Walpole Town Hall, 135 School St. 02081

Waltham City Hall, 610 Main St. 02452

Ware Town Hall, 126 Main St. 01082

Wareham Town Hall, 54 Marion Rd. 02571

Warren PO Box 603 01083

Warwick Town Hall, 12 Athol Rd. 01378

Washington Town Hall, 8 Summit Hill Rd. 01223

Watertown Town Hall, 149 Main St. 02472

Wayland Town Hall, 41 Cochituate Rd. 01778

Webster PO Box 193 01570

Wellesley 525 Washington St. 02482

Wellfleet Town Hall, 300 Main St. 02667

Wendell Town Hall, 270 Wendell Depot Rd. 01380

Wenham Town Hall, 138 Main St. 01984

West Boylston Mixter Municipal Office Building

120 Prescott St. 01583

West Bridgewater Town Hall, 65 North Main St. 02379

West Brookfield PO Box 766 01585

West Newbury Town Hall, 381 Main St. 01985

West Springfield Town Hall, 26 Central St. 01089

West Stockbridge Town Hall, 9 Main St., PO Box 163 01266

West Tisbury PO Box 278 02575

Westborough Town Hall, 34 West Main St. 01581

Westfield City Hall, 59 Court Street 01085-3574

Westford Town Hall, 55 Main St. 01886

Westhampton Town Hall, One South Road 01027

Westminister Town Hall, 3 Bacon St., PO Box 456 01473

Weston Town Hall, Town House Rd., PO Box 378 02493

Westport Town Hall, 816 Main Road 02790

Westwood Town Hall, 580 High St. 02090

Weymouth Town Hall, 75 Middle St. 02189

Whately PO Box 89 01093

Whitman Town Hall, 54 South Ave., PO Box 426 02382

Wilbraham Town Hall, 240 Springfield St. 01095

Williamsburg Town Hall, 141 Main St., PO Box 447 

Haydenville, MA 01039-0447

Williamstown Town Hall, 31 North St. 01267

Wilmington Town Hall, 121 Glen Rd. 01887-3597

Winchendon Town Hall, 109 Front St. 01475

Winchester Town Hall, 71 Mt. Vernon St. 01890

Windsor Town Hall, 3 Hindsdale Rd., PO Box 225 01270-0225

Winthrop Town Hall, One Metcalf Sq. 02152

Woburn City Hall, 10 Common St. 01801

Worcester (EC) City Hall, 455 Main St., Room 208 01608

City or Town Mailing Address Zip Code

Worthington PO Box 247 01098

Wrentham Town Hall, 100 Stonewall Blvd. 02093

Yarmouth Town Hall, 1146 Route 28

South Yarmouth, MA 02664

City or Town Mailing Address Zip Code

The Power of One....Vote!

by 1LT Shaalim Hasan David, USA, Boston, Massachusetts
163

MICHIGAN

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your Michigan Driver's License number is required for

voter registration. If you do not possess either of these

identifications, Michigan shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable.

C Provide the complete street address of your Michigan

voting residence. A post office box is not sufficient. If your

address includes a rural route number, describe its location.

For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the city or township where you claim

legal voting residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

E Check ONE box.

F You must sign the FPCA. When signing, you are

swearing or affirming the information is true and correct.

G If you are a civilian outside the U.S. and you want to

obtain an absentee ballot, a notary public, commissioned

officer, consular officer, or other authorized person must

complete this section.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

M M D D Y Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

F

D

E

G

A
Michigan 2004–05 Voting Assistance Guide

164

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Michigan and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2). 

Note that under Michigan law, if there is a special state or

local election prior to the Federal office primary and

general elections, the FPCA ballot request is applied to the

special state or local election and the voter must request a

ballot for the Federal office primary and general elections

with a new FPCA.

To register and/or request an absentee ballot, send a

completed FPCA or handwritten letter to the City or

Township Clerk so that it arrives not later than the Saturday

before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the City

or Township Clerk before the close of polls on election day.

Local election officials mail absentee ballots 45 days before

the primary and general elections.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Michigan allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Michigan does not allow you to receive the blank

ballot by fax.

 Michigan does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to U.S. citizens who are

temporarily residing outside of the territorial limits of the

U.S. and who but for such residence would be qualified to

vote in Michigan.

 civilian employees of the U.S. Armed Forces or

merchant marine and their spouses and dependents 

 Michigan residents temporarily residing outside the

U.S., and their spouses and dependents 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Note that under Michigan law, if there is a special state or

local election prior to the Federal office primary and

general elections, the FPCA ballot request is applied to the

special state or local election and the voter must request a

ballot for the Federal office primary and general elections

with a new FPCA.

To register and/or request an absentee ballot, send a

completed FPCA or handwritten letter with affidavit (form

provided by clerk of city or township of residence) to the

City or Township Clerk so that it arrives not later than the

Saturday before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the City

or Township Clerk before the close of polls on election day.
2004–05 Voting Assistance Guide Michigan

165

Local election officials mail absentee ballots 45 days before

the primary and general elections.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: For all Michigan residents covered under Section

II.A., the FPCA you use to request an absentee ballot must

be sworn to before an official authorized to administer

oaths. If requesting a ballot with a handwritten letter, a

sworn affidavit must be included (form provided by clerk of

city or township of residence).

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

 Michigan allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Michigan does not allow you to receive the blank

ballot by fax.

 Michigan does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

A person may not register or vote while serving a prison

sentence.

B. Cancellation of Registration

Registration is permanent unless you move to a different

city or township in Michigan. After moving to a different

city or township, a new registration must be submitted.

C. Action on Registration Requests

A voter identification card is sent.

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Michigan shall provide you with

the reason(s) for the rejection. Denial of registration may be

appealed. Consult a legal assistance officer or civilian

counsel.

E. Where To Send It

Mail the FPCA to the City or Township Clerk in the city or

township of your voting residence. Addresses not listed

below can be found in Michigan’s Voter Information Center

at www.michigan.gov/sos, “Elections in Michigan.” For a

village election, submit a separate FPCA to the Village

Clerk. For a school election, submit a separate FPCA to the

Secretary of the School Board. A partial list of major cities

follows:

If you are unable to determine the address of your City or

Township Clerk, you can send the FPCA to the County

Clerk (see listing below). NOTE: If you send the FPCA to

the County Clerk, it will take longer for you to receive your

absentee ballot.

City or Town Mailing Address Zip Code

Ann Arbor PO Box 8647, Ann Arbor 48107-8647

Battle Creek 10 N. Division, Battle Creek 49014-1717

Bay City 301 Washington Avenue, Bay City 48708-5866

Dearborn Heights 6045 Fenton, Dearborn Heights 48127-3294

Dearborn 13615 Michigan Avenue, Dearborn 48126-3586

Detroit 2978 W. Grand Blvd, Detroit 48202-3069

East Lansing 410 Abbott Road, East Lansing 48823-3388

Farmington Hills 31555 W. Eleven Mile Rd, 

Farmington Hills 48336-1165

Flint 1101 S. Saginaw, Flint 48502-1416

Grand Rapids 300 Monroe Avenue NW, 

Grand Rapids 49503-2281

Kalamazoo 241 W. South Street, Kalamazoo 49007-4796

Lansing 124 W. Michigan, Lansing 48933-1694

Lincoln Park 1355 Southfield Road, Lincoln Park 48146-2380

Livonia 33000 Civic Center Drive, Livornia 48154-3097

Pontiac 450 Wide Track Drive, East, Pontiac 48342-2271 

Roseville 29777 Gratiot, Roseville 48066-0290

Royal Oak PO Box 64, Royal Oak 48068-0064

Saginaw 1315 S. Washington, Saginaw 48601-2599

St. Clair Shores 27600 Jefferson Circle Drive, 

St. Clair Shores 48081-9971

Southfield PO Box 2055, Southfield 48037-2055

Sterling Heights PO Box 8009, Sterling Heights 48311-8009

Taylor 23555 Goddard, Taylor 48180-4117

Troy 500 W. Big Beaver, Troy 48084-5285

Warren 29500 Van Dyke Avenue, Warren 48093-6726

Westland 36601 Ford Road, Westland 48185-2298

Wyoming PO Box 905, Wyoming 49509-0905

County Mailing Address Zip Code

Alcona PO Box 308, Harrisville 48740-0308

Alger 101 Court Street, Munising 49862-1196

Allegan 113 Chestnut, Allegan 49010-1350

Alpena 720 Chisholm, Alpena 49707-2488

Antrim 205 E. Cayuga, Bellaire 49615-0520

Arenac PO Box 747, Standish 48658-0747

Baraga 16 N. 3rd Street, L'Anse 49946-1085

Barry 220 W. State Street, Hastings 49058-0220

Bay 515 Center Street, Bay City 48708-5994

Benzie PO Box 398, Beulah 49617-0398

Berrien 811 Port Street, St. Joseph 49085-1198
Michigan 2004–05 Voting Assistance Guide

166

Branch 31 Division, Coldwater 49036-1990

Calhoun 315 W. Green, Marshall 49068-1585

Cass 120 N. Broadway, Cassopolis 49031-1398

Charlevoix 203 Antrim Street, Charlevoix 49720-1397

Cheboygan PO Box 70, Cheboygan 49721-0070

Chippewa 319 Court Street, Sault Ste. Marie 49783-2194

Clare PO Box 438, Harrison 48625-0438

Clinton PO Box 69, St. Johns 48879-0069

Crawford 200 W. Michigan, Grayling 49738-1798

Delta 310 Ludington, Escanaba 49829-4057

Dickinson PO Box 609, Iron Mountain 49801-0609

Eaton 1045 Independence Blvd, Charlotte 48813-1095

Emmet 200 Division, Petoskey 49770-2444

Genesee 900 S. Saginaw, Flint 48502-1571

Gladwin 401 W. Cedar, Gladwin 49624-2088

Gogebic 200 N. Moore, Bessemer 49911-1052

Grand Traverse 400 Boardman, Traverse City 49684-2577

Gratiot PO Drawer 437, Ithaca 48847-0437

Hillsdale 29 N. Howell, Hillsdale 49242-1698

Houghton 401 E. Houghton Ave., Houghton 49931-2099

Huron 250 E. Huron, Bad Axe 48413-1386

Ingham PO Box 179, Mason 48854-0179

Ionia Main Street, Ionia 48846-1697

Iosco PO Box 838, Tawas City 48764-0838

Iron 2 S. 6th Street, Crystal Falls 49920-1495

Isabella 200 N. Main Street, Mt. Pleasant 48858-2393

Jackson 312 S. Jackson Street, Jackson 49201-1315

Kalamazoo 201 W. Kalamazoo, Kalamazoo 49007-3777

Kalkaska PO Box 10, Kalkaska 49646-0010

Kent 300 Monroe, NW, Grand Rapids 49503-2288

Keweenaw 4th Street, Eagle River 49924-0007

Lake Drawer B, Baldwin 49304-0902

Lapeer 255 Clay Street, Lapeer 48446-2298

Leelanau PO Box 467, Leland 49654-0467

Lenawee 425 N. Main, Adrian 49221-2198

Livingston 200 E. Grand River, Howell 48843-2399

Luce 407 W. Harrie Street, Newberry 49868-1299

Mackinac 100 N. Marley, St. Ignace 49781-1491

Macomb 40 N. Main, Mt. Clemens 48043-5661

Manistee 415 3rd Street, Manistee 49660-1606

Marquette 232 Baraga, Marquette 49855-4782

Mason 304 E. Lundington, Ludington 49431-2121

Mecosta 400 Elm, Big Rapids 49307-1849

Menominee 839 10th, Menominee 49858-3000

Midland 220 W. Ellsworth Street, Midland 48640-5194

Missaukee PO Box 800, Lake City 49651-0800

Monroe 106 E. 1st Street, Monroe 48161-2185

Montcalm PO Box 368, Stanton 48888-0368

Montmorency PO Box 789, Atlanta 49709-0415

Muskegon 990 Terrace, Muskegon 49442-3378

Newaygo PO Box 885, White Cloud 49349-0885

Oakland 1200 N. Telegraph, Pontiac 48341-0413

Oceana PO Drawer 653, Hart 49420-0653

Ogemaw 806 W. Houghton Avenue, West Branch 48661-1215

Ontonagon 725 Greenland Road, Ontonagon 49953-1492

Osceola 301 W. Upton, Reed City 49677-1149

Oscoda PO Box 399, Mio 48647-0399

Otsego 225 W. Main Street, Gaylord 49735-1393

Ottawa 414 Washington, Grand Haven 49417-1494

Presque Isle PO Box 110, Rogers City 49779-0110

Roscommon PO Box 98, Roscommon 48653-0098

Saginaw 111 S. Michigan, Saginaw 48602-2086

Sanilac 60 W. Sanilac, Sandusky 48471-1094

Schoolcraft 300 Walnut, Manistique 49854-1487

Shiawassee 208 N. Shiawassee, Corunna 48817-1491

St. Clair 201 McMorran Blvd, Port Huron 48060-4082

County Mailing Address Zip Code

St. Joseph PO Box 189, Centreville 49032-0189

Tuscola 440 N. State Street, Caro 48723-1592

Van Buren 212 E. Paw Paw, Paw Paw 49079-1496

Washtenaw PO Box 8645, Ann Arbor 48107-8645

Wayne 211 City County Bldg., Detroit 48226-3463

Wexford 437 E. Division, Cadillac 49601-1905

County Mailing Address Zip Code

Show The World Why Democracy Works...Vote!!!

by MSgt Christopher S. Smith, USAF, San Antonio, Texas
167

MINNESOTA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A You must provide your military ID number or passport

number. If you cannot provide one of these numbers, then

Item 8 must be signed before an authorized official and

Item 9 must be completed by that official. The authorized

official may be a notary, another individual authorized to

administer oaths, or a commissioned or noncommissioned

officer (not below the rank of sergeant or its equivalent) of

the military.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Minnesota

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or township where you claim

legal voting residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address.

E Check ONE box.

F You must sign the FPCA. When signing, you are

swearing or affirming that the information is true and

correct. Only your parent, spouse, sister, brother, or child

over 18 years of age may sign on your behalf and that

person must state how they are related to you.

G Item 9 needs to be completed only if you are unable to

provide a military ID or a passport number in item 1f. The

authorized official may be a notary, another individual

authorized to administer oaths, or a commissioned or

noncommissioned officer (not below the rank of sergeant or

its equivalent) of the military. The official is certifying that

the voter (or other authorized family member) has attested

to the truthfulness of the content of the application under

oath.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

M M D D Y Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Minnesota 2004–05 Voting Assistance Guide

168

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Minnesota and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

You are not required to register.

To request an absentee ballot, send a completed FPCA to

the county auditor any time before the election. An absentee

ballot application may be submitted by the voter or by the

voter’s parent, spouse, sister, brother, or child over the age

of 18 years.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day.

Local election officials mail absentee ballots approximately

30 days before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA and Ballot Return Envelope: If you do not provide

a military identification card number or passport number,

your FPCA and the certificate on the ballot return envelope

must be sworn to before a notary, another individual

authorized to administer oaths, or a commissioned or

noncommissioned officer (not below the rank of sergeant or

its equivalent) of the military. 

E. Electronic Transmission of FPCAs 

and Ballots

 Minnesota allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail.

 Minnesota does not allow you to receive the blank

ballot by fax.

 Minnesota does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Minnesota and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Minnesota.

 Minnesota residents temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

You are not required to register.

To request an absentee ballot, send a completed FPCA to

the county auditor any time before the election. An absentee

ballot application may be submitted by the voter or by the

voter’s parent, spouse, sister, brother, or child over the age

of 18 years.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day.

Local election officials mail absentee ballots approximately

30 days before the election.
2004–05 Voting Assistance Guide Minnesota

169

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA and Ballot Return Envelope: If you do not provide

a passport number, your FPCA and the certificate on the

ballot return envelope must be sworn to before a notary,

another individual authorized to administer oaths, or a

commissioned or noncommissioned officer (not below the

rank of sergeant or its equivalent) of the military.

E. Electronic Transmission of FPCAs 

and Ballots

 Minnesota allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail.

 Minnesota does not allow you to receive the blank

ballot by fax.

 Minnesota does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Convicted felons whose civil rights have not been restored,

persons under court-ordered guardianship of the person

without voting rights, or those declared legally incompetent

may not vote.

B. Action Upon Denial of Registration or 

Absentee Ballot Request 

Upon denial of your voter registration application or

absentee ballot request, Minnesota shall provide you with

the reason(s) for the rejection.

C. Where To Send It

Mail the FPCA to the County Auditor at the county of

voting residence as listed below:

County County Seat Zip Code

Aitkin Aitkin 56431-1292

Anoka Anoka 55303-2465

Becker Detroit Lakes 56501-3403

Beltrami Bemidji 56601-3054

Benton Foley 56329-0129

Big Stone Ortonville 56278-1544

Blue Earth Mankato 56002-3524

Brown New Ulm 56073-0248

Carlton Carlton 55718-0010

Carver Chaska 55318-2184

Cass Walker 56484-3000

Chippewa Montevideo 56265-1652

Chisago Center City 55012-9663

Clay Moorhead 56560-0280

Clearwater Bagley 56621-8310

Cook Grand Marais 55604-1150

Cottonwood Windom 56101-1645

Crow Wing Brainerd 56401-3590

Dakota Hastings 55033-2380

Dodge Mantorville 55955-2200

Douglas Alexandria 56308-1793

Faribault Blue Earth 56013-0130

Fillmore Preston 55965-1105

Freeborn Albert Lea 56007-1147

Goodhue Red Wing 55066-0408

Grant Elbow Lake 56531-4300

Hennepin Minneapolis 55487-0068

Houston Caledonia 55921-1330

Hubbard Park Rapids 56470-1483

Isanti Cambridge 55008-9386

Itasca Grand Rapids 55744-2600

Jackson Jackson 56143-1529

Kanabec Mora 55051-1386

Kandiyohi Willmar 56201-0936

Kittson Hallock 56728-0848

Koochiching International Falls 56649-2486

Lac Qui Parle Madison 56256-1296

Lake Two Harbors 55616-1565

Lake of the Woods Baudette 56623-0808

Le Sueur Le Center 56057-1644

Lincoln Ivanhoe 56142-1600

Lyon Marshall 56258-3099

McLeod Glencoe 55336-2200

Mahnomen Mahnomen 56557-0379

Marshall Warren 56762-1697

Martin Fairmont 56031-1852

Meeker Litchfield 55355-2189

Mille Lacs Milaca 56353-1396

Morrison Little Falls 56345-3199

Mower Austin 55912-3475

Murray Slayton 56172-0057

Nicollet Saint Peter 56082-0089

Nobles Worthington 56187-0757

Norman Ada 56510-0266

Olmsted Rochester 55904-3709

Otter Tail Fergus Falls 56537-2587

Pennington Thief River Falls 56701-0616

Pine Pine City 55063-1694

Pipestone Pipestone 56164-0455

Polk Crookston 56716-1452

Pope Glenwood 56334-1628

Ramsey Saint Paul 55102-1697

Red Lake Red Lake Falls 56750-0367

Redwood Redwood Falls 56283-0130

Renville Olivia 56277-1396

Rice Fairbault 55021-5146

Rock Luverne 56156-0100
Minnesota 2004–05 Voting Assistance Guide

170

Roseau Roseau 56751-1477

St. Louis Duluth 55802-1379

Scott Shakopee 55379-1379

Sherburne Elk River 55330-4601

Sibley Gaylord 55334-0171

Stearns Saint Cloud 56303-4781

Steele Owatonna 55060-0890

Stevens Morris 56267-0530

Swift Benson 56215-0288

Todd Long Prairie 56347-1390

Traverse Wheaton 56296-0428

Wabasha Wabasha 55981-1594

Wadena Wadena 56482-1595

Waseca Waseca 56093-2993

Washington Stillwater 55082-0006

Watonwan Saint James 56081-0518

Wilkin Breckenridge 56520-0409

Winona Winona 55987-3102

Wright Buffalo 55313-1195

Yellow Medicine Granite Falls 56241-1367

County County Seat Zip Code

 Put Down Your Remote And Pick Up A Ballot!

by TSgt Jimmy S. Clark, Jr., USAF, Langley AFB, Virginia
171

MISSISSIPPI

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your current and valid Mississippi Driver’s License is

required for voter registration or the last four digits of your

Social Security number. If you do not possess either of

these identifications, the State shall assign a number that

will serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your

Mississippi voting residence. A post office box is not

sufficient. If your address includes a rural route, describe its

location in Item 7. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be different from the one

provided in Item 4 and must be within the county or

township where you claim legal voting residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming the information provided is true

and correct. Sign only in the presence of an oath taking

official.

G A notary public, commissioned officer, noncommissioned officer, petty officer, consular officer, or

other authorized person must complete this section.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

M M D D Y Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

F

D

E

G

A
Mississippi 2004–05 Voting Assistance Guide

172

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Mississippi and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register to vote and request an absentee ballot, you must

complete the FPCA and return it to the County Registrar so

that it arrives not later than 30 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the County

Registrar any time before the election. However, if you wait

until later than 20 days before the election to send your

FPCA, you may not receive your ballot in time to vote it

and return it on time.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive not later

than 5 p.m. the day before the election.

Local election officials mail out absentee ballots

approximately 45 days before an election, or as soon as

they are printed.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: Must be sworn to before a commissioned officer,

non-commissioned officer, petty officer or other person

authorized to administer oaths.

Ballot Return Envelope: The affidavit on the absentee

ballot return envelope must be sworn to before a

commissioned officer, non-commissioned officer, petty

officer or other person authorized to administer oaths.

E. Electronic Transmission of FPCAs 

and Ballots

 Mississippi allows you to send the FPCA by fax for

voter registration and absentee ballot requests. After

faxing, submit the FPCA by mail.

 Mississippi allows you to receive the blank ballot by

fax.

 Mississippi allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Another person may request that the County Registrar send

a state registration affidavit and/or an absentee ballot

application to you. Your oral authorization (by telephone) or

written authorization may be required.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Mississippi and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Mississippi.

 members of the American Red Cross 

 civilians attached to and serving outside the U.S. with

the U.S. Armed Forces, merchant marine or American

Red Cross 

 other residents of Mississippi temporarily residing

outside the U.S. 

 spouses and dependents of the above 

 overseas citizens 
2004–05 Voting Assistance Guide Mississippi

173

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register to vote and request an absentee ballot, you must

complete the FPCA and return it to the County Registrar so

that it arrives not later than 30 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the County

Registrar any time before the election. However, if you wait

until later than 20 days before the election to send your

FPCA, you may not receive your ballot in time to vote it

and return it on time.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive not later

than 5 p.m. the day before the election.

Local election officials mail out absentee ballots

approximately 45 days before an election, or as soon as

they are printed.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: Must be sworn to before a commissioned officer,

non-commissioned officer, petty officer or other person

authorized to administer oaths.

Ballot Return Envelope: The affidavit on the absentee

ballot return envelope must be sworn to before a

commissioned officer, non-commissioned officer, petty

officer or other person authorized to administer oaths.

E. Electronic Transmission of FPCAs 

and Ballots

 Mississippi allows you to send the FPCA by fax for

voter registration and absentee ballot requests.

 Mississippi allows you to receive the blank ballot by

fax.

 Mississippi allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of certain felonies or declared mentally

incompetent by a court may not vote.

B. Action on Registration Requests

Notice of registration or denial is sent.

C. Action If Registration Is Denied

Persons denied registration should correct the problems

noted in the denial. If a second denial is received, consult a

legal assistance officer or civilian counsel.Upon denial of

your voter registration application or absentee ballot

request, Mississippi shall provide you with the reason(s) for

the rejection.

D. Where To Send It

Mail the FPCA to the County Registrar at the county of

voting residence as listed below:

County County Seat Zip Code 

Adams PO Box 1224, Natchez 39121

Alcorn PO Box 430, Corinth 38835

Amite PO Box 312, Liberty 39645

Attala 118 W Washington, Kosciusko 39090

Benton PO Box 262, Ashland 38603

Bolivar PO Box 670, Cleveland 38732

Calhoun PO Box 25, Pittsboro 38951

Carroll PO Box 6, Vaiden 39176

Chickasaw 1 Pinson Sq. Rd., Room 2, Houston 38851

Choctaw PO Box 34, Ackerman 39735

Claiborne PO Box 549, Port Gibson 39150

Clarke PO Box 216, Quitman 39355

Clay PO Box 364, West Point 39773

Coahoma PO Box 849, Clarksdale 38614

Copiah PO Box 467, Hazelhurst 39083

Covington PO Box 667, Collins 39428

DeSoto 2535 Hwy. 51 S, Hernando 38632

Forrest PO Drawer 992, Hattiesburg 39403

Franklin PO Box 267, Meadville 39653

George 355 Cox Street, #C, Lucedale 39452

Greene PO Box 310, Leakesville 39451

Grenada PO Box 1517, Grenada 38902

Hancock PO Box 249, Bay Saint Louis 39520

Harrison PO Box 998, Gulfport 39502

Hinds PO Box 327, Jackson 39205

Holmes PO Box 718, Lexington 39095

Humphreys PO Box 696, Belzoni 39038

Issaquena PO Box 27, Mayersville 39113

Itawamba 201 W. Main Street, Fulton 38843

Jackson PO Box 998, Pascagoula 39568

Jasper PO Box 447, Bay Springs 39422

Jefferson PO Box 305, Fayette 39069

Jefferson Davis PO Box 1082, Prentiss 39474

Jones PO Box 1336, Laurel 39441
Mississippi 2004–05 Voting Assistance Guide

174

Kemper PO Box 130, De Kalb 39328

Lafayette 1 County Courthouse, Suite 201, Oxford 38655

Lamar PO Box 369, Purvis 39475

Lauderdale PO Box 1005, Meridian 39302

Lawrence PO Box 1249, Monticello 39654

Leake PO Box 67, Carthage 39051

Lee PO Box 762, Tupelo 38802

Leflore PO Box 1953, Greenwood 38935

Lincoln PO Box 357, Brookhaven 39602

Lowndes PO Box 31, Columbus 39703

Madison PO Box 1626, Canton 39046

Marion 250 Broad Street, #1, Columbia 39429

Marshall PO Box 459, Holly Springs 38635

Monroe PO Box 843, Aberdeen 39730

Montgomery PO Box 765, Winona 38967

Neshoba 401 E. Beacon, Philadelphia 39350

Newton PO Box 447, Decatur 39327

Noxubee PO Box 431, Macon 39341

Oktibbeha 101 E Main Street, Starkville 39759

Panola PO Box 346, Batesville 38606

Pearl River 200 S. Main, Poplarville 39470

Perry PO Box 198, New Augusta 39462

Pike PO Drawer 31, Magnolia 39652

Pontotoc PO Box 428, Pontotoc 38863

Prentiss PO Box 727, Booneville 38829

Quitman 230 Chesnut Street, Marks 38646

Rankin PO Box 1599, Brandon 39043

Scott PO Box 371, Forest 39074

Sharkey PO Box 218, Rolling Fork 39159

Simpson PO Box 307, Mendenhall 39114

Smith PO Box 517, Raleigh 39153

Stone 323 Cavers Avenue, Wiggins 39577

Sunflower PO Box 576, Indianola 38751

Tallahatchie PO Box 86, Charleston 38921

Tate 201 Ward Street, Senatobia 38668

Tippah Courthouse, Ripley 38663

Tishomingo 1008 Battleground Drive, Iuka 38852

Tunica PO Box 184, Tunica 38676

Union PO Box 298, New Albany 38652

Walthall 200 Ball Avenue, Tylertown 39667

Warren PO Box 351, Vicksburg 39181

Washington PO Box 1276, Greenville 38702

Wayne PO Box 428, Waynesboro 39367

Webster PO Box 308, Walthall 39771

Wilkinson PO Box 327, Woodville 39669

Winston PO Box 785, Louisville 39339

Yalobusha PO Box 1431, Water Valley 38965

Yazoo PO Box 108, Yazoo City 39194

County County Seat Zip Code 

Vote: You’re Never Too Far To Be Heard

by SrA Debra L. Jones, USAF, Wichita Falls, Texas
175

MISSOURI

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number are

required. If you do not have a Social Security number, your

Missouri Driver’s License number is required. If you do not

possess either of these identifications, the State shall assign

a number that will serve to identify you for voter

registration purposes. 

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Missouri

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location. For

example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or city where you claim legal

voting residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

E You must request a particular party’s ballot to apply

for a primary election ballot (Example: Democrat,

Republican) or write “none” in Item 6 of the FPCA. If you

do not respond to the request for a political party

designation, the election authority is authorized to provide

that part of the ballot for which no political party

designation is required. Political party affiliation is not

required if only requesting absentee ballots for general

elections.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are sharing or affirming the information is true and correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

D

F

C

E

G

A
Missouri 2004–05 Voting Assistance Guide

176

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Missouri and members of the Uniformed

Services and their family members. Uniformed Services are

defined as members of the U.S. Armed Forces, merchant

marine, commissioned corps of the Public Health Service

and the National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

You are not required to register, but you may register

permanently and request an absentee ballot, by sending a

completed FPCA to the local election official so that it

arrives not later than the fourth Wednesday (27 days) before

the election. 

To request an absentee ballot only, send a completed FPCA

to the local election official so that it arrives not later than

the Wednesday before the election. All applications for

absentee ballots received prior to the sixth Tuesday before

an election will be stored by the local election official until

such time as the applications are processed.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office before 7:00 p.m. on election day.

Absentee ballots are available beginning 42 days prior to

the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2.

D. Notary/Witness Requirements

FPCA: No notary or witness required. 

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

 Some Missouri counties may allow you to send the

FPCA application for an absentee ballot by fax. After

faxing, submit the FPCA by mail.

 Missouri does not allow you to receive the blank ballot

by fax. 

 Missouri does not allow you to return the voted ballot

by fax. 

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Your spouse, grandparent, parent, brother, sister, child or

grandchild may request (in person to the local election

official) that an absentee ballot be mailed to you.

G. Special Write-In Absentee Ballot

Missouri provides a state special write-in absentee ballot

available 80 days before a general election if you will be

unable to vote by any other means due to requirements of

military service or due to living in an isolated or extremely

remote area of the world.

You may use the FPCA to request this state special write-in

absentee ballot. In Item 7 of the FPCA, place one of the

state special write-in labels from Section III.F. If no labels

are available, write in Item 7: “I am unable to vote by any

other means due to requirements of military service or due

to living in isolated or extremely remote areas of the world.

I request a special write-in absentee ballot.”

You must request the state special write-in ballot within 80

days of a general election. Vote this ballot by writing in a

party preference or the names of specific candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Missouri and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Missouri.
2004–05 Voting Assistance Guide Missouri

177

 civilian employees of the U.S. Government residing

overseas and their spouses and dependents (for local,

state and Federal office ballots)

 members of religious or welfare groups attached to the

military overseas and their spouses and dependents

(for local, state and Federal office ballots)

 other Missouri residents temporarily residing outside

the U.S. (for local, state and Federal office ballots)

 overseas electors (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

You are not required to register, but you may register

permanently and request an absentee ballot, by sending a

completed FPCA to the local election official so that it

arrives not later than the fourth Wednesday (27 days) before

the election. 

If you are a Missouri resident temporarily residing outside

the U.S., are not affiliated with the U.S. Federal

Government and wish to receive a ballot for local, state and

Federal offices (instead of a ballot for Federal offices only),

you must permanently register to receive such ballot.

Otherwise, you will be treated as an overseas elector and

will be sent a ballot for Federal offices only.

To request an absentee ballot only, send a completed FPCA

to the local election official so that it arrives not later than

the Wednesday before the election. All applications for

absentee ballots received prior to the sixth Tuesday before

an election will be stored by the local election official until

such time as the applications are processed. 

If you are an overseas elector, you are eligible to vote for

Federal offices only and your application for an absentee

ballot must be received not later than 5 p.m. on the

Wednesday prior to election day.

C. Casting Your Vote

Ballot Return Deadline: Return the voted ballot to the local

election official so that it arrives before 7:00 p.m. on

election day.

Local election officials mail ballots beginning 42 days prior

to the election. Local election officials will send ballots for

Federal offices only to overseas electors, and to those

temporarily overseas persons who did not timely complete

the permanent registration procedure.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required. 

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

 Some Missouri counties allow you to send the FPCA

application for an absentee ballot by fax. After faxing,

submit the FPCA by mail.

 Missouri does not allow you to receive the blank ballot

by fax. 

 Missouri does not allow you to return the voted ballot

by fax. 

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Your spouse, grandparent, parent, brother, sister, child or

grandchild may request (in person to the local election

official) that an absentee ballot be mailed to you.

G. Special Write-In Absentee Ballot

Missouri provides a state special write-in absentee ballot

available 80 days before a general election if you will be

unable to vote by any other means due to living in an

isolated or extremely remote area of the world.

You may use the FPCA to request this state special write-in

absentee ballot. In Item 7 of the FPCA, place one of the

state special write-in labels from Section III.F. If no labels

are available, write in Item 7: “I am unable to vote by any

other means due to requirements of military service or due

to living in isolated or extremely remote areas of the world.

I request a special write-in absentee ballot.”

You must request the special write-in ballot within 80 days

of a general election. Vote this ballot by writing in a party

preference or the names of specific candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
Missouri 2004–05 Voting Assistance Guide

178

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons imprisoned, on probation or parole for a felony,

convicted of an election law violation, or found

incapacitated (with loss of voting rights) may not register or

vote.

B. Cancellation of Registration

Registration is canceled if a voter fails to respond to a

confirmation notice and then fails to vote by the second

general election occurring after the notice.

C. Late Registration

Members of the Armed Forces and merchant marine,

civilian employees of the U.S. Government working

outside the U.S. and members of religious or welfare

organizations assisting Service members who have been

honorably discharged or terminated from their service

within sixty days of an election, are eligible to vote in that

election.

D. Action on Registration Requests

Verification notices are sent within seven (7) working days

of receipt of application. Upon denial of your voter

registration application or absentee ballot request, Missouri

shall provide you with the reason(s) for the rejection.

Rejection notices are sent within seven (7) working days of

receipt of application.

E. Where To Send It

Mail your FPCA to the County Clerk in the city or county

of your legal voting residence, listed as follows (unless

otherwise noted):

City Mailing Address Zip Code

Adair 106 W. Washington, 

Kirksville 63501

Andrew Andrew Co. Courthouse, PO Box 206, 

Savannah 64485

Atchison 400 S. Washington Street,

Rock Port 64482

Audrain 101 N. Jefferson, Room 101, 

Mexico 65265

Barry 700 Main, Suite 2, 

Cassville 65625

Barton 1004 Gulf, 

Lamar 64759

Bates 1 N. Delaware, 

Butler 64730

Benton PO Box 1238, 

Warsaw 65355

Bollinger 204 E. High Street, 

Marble Hill 63764

Boone 801 E. Walnut St., Room. 236, 

Columbia 65201

Buchanan 411 Jules, 

Saint Joseph 64501

Butler Butler County Courthouse, 

Poplar Bluff 63901

Caldwell Caldwell County Courthouse, PO Box 

67, Kingston 64650

Callaway 10 E. Fifth Street, 

Fulton 65251

Camden #1 Court Circle, PO Box 960, 

Camdenton 65020

Cape Girardeau 1 Barton Square, 

Jackson 63755

Carroll Carroll County Courthouse, 

Carrollton 64633

Carter Carter County courthouse, PO Box 517, 

Van Buren 63965

Cass 102 E. Wall, 

Harrisonville 64701

Cedar Cedar County Courthouse, 

Stockton 65785

Chariton 306 S. Cherry, 

Keytesville 65261

Christian 100 W. Church, Room 206, 

Ozark 65721

Clark 111 E. Clark, 

Kahoka 63445

Clay Director, 100 W. Mississippi, 

Liberty 64068

Clinton Clinton County Courthouse, PO Box 

245, Plattsburg 64477

Cole 311 E. High Street, 

Jefferson City 65101

Copper 200 Main Street, Room 23, 

Boonville 65233

Crawford Crawford County Courthouse, PO Box 

AS, Steelville 65565

Dade Dade County Courthouse, 

Greenfield 65661

Dallas Dallas County Courthouse, 

102 S. Cedar,

Buffalo 65622

Daviess 102 N. Main, 

Gallatin 64640

De Kalb 109 W. Main Street, 

Maysville 64469

Dent 400 N. Main Street, 

Salem 65560

Douglas 203 S.E. Second, PO Box 398, 

Ava 65608

Dunklin Dunklin County Courthouse, PO Box 

188, Kennett 63857

Franklin 300 East Main, Room 201, 

Union 63084

Gasconade 119 E. First Street, Suite 2, 

Hermann 65041

Gentry Gentry County Courthouse, 

Albany 64402

Greene 940 Boonville, Room 113, 

Springfield 65802

Grundy 700 Main Street, 

Trenton 64683

Harrison 1500 Main Street, PO Box 525, 

Bethany 64424

Henry 100 W. Franklin, 

Clinton 64735

Hickory Hickory County Courthouse, PO Box 3, 

Hermitage 65668

Holt 102 W. Nodaway, PO Box 437, 

Oregon 64473

Howard #1 Courthouse Square, 

Fayette 65248

Howell 1 Courthouse Square, 

West Plains 65775

Iron Iron County Courthouse, PO Box 42, 

Ironton 63650

Jackson Director, 215 N. Liberty, PO Box 296, 

Independence 64051

Jasper Jasper County Courthouse, 302 S. Main 

Street, Room 102, Carthage 64836

Jefferson 300 Second Street, PO Box 100, 

Hillsboro 63050

City Mailing Address Zip Code
2004–05 Voting Assistance Guide Missouri

179

Johnson Johnson County Courthouse, 

Warrensburg 64093

Kansas City Director, 1828 Walnut, Suite, 300., 

Kanasa City 64108

Knox 107 N. 4th Street, 

Edina 63537

Laclede 200 N. Adams, 

Lebanon 65536

Lafayette 1001 Main, 

Lexington 64067

Lawrence 1 E. Courthouse Square, Ste. 101, 

Mount Vernon 65712

Lewis 100 E. Lafayette, PO Box 67, 

Monticello 63457

Lincoln 201 Main Street, 

Troy 63379

Linn High Street, PO Box 92, 

Linneus 64653

Livingston 700 Webster St., Suite 10, 

Chillicothe 64601

Macon 101 E. Washington, PO Box 96, 

Macon 63552

Madison 1 Courthouse Square, 

Fredericktown 63645

Maries Fourth & Main, PO Box 205, 

Vienna 65582

Marion 100 S. Main, 

Palmyra 63461

McDonald McDonald County Courthouse, PO Box 

665 64856

Mercer 802 Main St. Mercer Co. Courthouse, 

Princeton 64673

Miller Miller County Courthouse, PO Box 12, 

Tuscumbia 65082

Mississippi 200 N. Main, PO Box 369, 

Charleston 63834

Moniteau 200 E. Main Street, 

California 65018

Monroe 300 N. Main Street, 

Paris 65275

Montgomery 211 E. Third Street, 

Montgomery City 63361

Morgan 100 E. Newton, 

Versailles 65084

New Madrid New Madrid County Courthouse, PO 

BOx 68, New Madrid 63869

Newton Newton County Courthouse, PO Box 

488, Neosho 64850

Nodaway Nodaway County Courthouse,PO Box 

218, Maryville 64468

Oregon Oregon County Courthouse, PO Box 

324, Alton 65606

Osage Osage County Courthouse, PO Box 826, 

Linn 65051

Ozark Ozark County Courthouse, PO Box 416, 

Gainesville 65655

Pemiscot 610 Ward Avenue, 

Caruthersville 63830

Perry 321 N. Main, No. 2, 

Perryville 63775

Pettis 415 S. Ohio, 

Sedalia 65301

Phelps 200 N. Main Street, 

Rolla 65401

Pike 115 W. Main, 

Bowling Green 63334

Platte Director, 2600 NW Prairie View Road, 

PO Box 560, Platte City 64079

Polk Polk County Courthouse, 

Bolivar 65613

City Mailing Address Zip Code

Pulaski 201 Historic 66 E., Suite 101, 

Waynesville 65583

Putnam Putnam County Courthouse, 

Unionville 63565

Ralls Ralls County Courthouse, PO Box 400, 

New London 63459

Randolph 110 South Main Street, 

Huntsville 65259

Ray 100 W. Main, 

Richmond 64085

Reynolds Courthouse Square, PO Box 10, 

Centerville 63633

Ripley Ripley Couty Courthouse, 100 

Courthouse Circle, Doniphan 63935

Saline Saline County Courthouse, 

Marshall 65340

Schuyler Schuyler County Courthouse, PO Box 

187, Lancaster 63548

Scotland 117 S. Market, Suite 100, 

Memphis 63555

Scott Scott County Courthouse, PO Box 188, 

Benton 63736

Shannon Shannon County Courthouse, PO Box 

187, Eminence 65466

Shelby Shelby County Courthouse, PO Box 

186, Shelbyville 63469

St Charles 201 N. Second Street, Rm. 541, 

St Charles 63301

St Clair 655 Second Street, PO Box 525, 

Oceola 64776

St Francois St. Francois County Courthouse, 

Farmington 63640

St Louis City Director, 300 N. Tucker, 

St. Louis 63101

St Louis County 12 Sunnen Drive, 

Maplewood 63143

Ste Genevieve 55 S. Third, 

Ste. Genevieve 63670

Stoddard Stoddard County Courthouse, PO Box 

110, Bloomfield 63825

Stone Stone County Courthouse, PO Box 45, 

Galena 65656

Sullivan 109 N. Main, 

Milan 63556

Taney 266 A. Main Street, PO Box 156, 

Forsyth 65653

Texas 210 N. Grand Avenue, 

Houston 65483

Vernon 100 W. Cherry, 

Nevada 64772

Warren 104 W. Main, Suite B, 

Warrenton 63383

Washington 102 N. Missouri Street, 

Potosi 63664

Wayne Wayne County Courthouse, PO Box 

168, Greenville 63944

Webster Webster County Courthouse, 101 S. 

Crittenden, Marshfield 65706

Worth Fourth & Front Street, PO Box L, 

Grant City 64456

Wright 125 Court Square, PO Box 98, 

Hartville 65667

City Mailing Address Zip Code

Give Your Opinion On Something That Really Matters! Vote!!

by PN1 John Hawkinson, USN, Sicily, Italy
Missouri 2004–05 Voting Assistance Guide

180
MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”

F. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

MISSOURI

“I am unable to vote by any other means due to requirements of military

service or due to living in isolated or extremely remote areas of the world. I

request a special write-in absentee ballot.”
Missouri 2004–05 Voting Assistance Guide

182
183

MONTANA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Montana Driver's License number OR the last

four digits of your Social Security number is required for

voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Montana

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location. For

example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or township where you claim

legal voting residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

C

E

F
Montana 2004–05 Voting Assistance Guide

184

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Montana and members of the U.S. Armed

Forces, merchant marine, and religious groups or welfare

agencies assisting and officially attached to the Armed

Forces, their spouses and dependents. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA or Federal Write-In Absentee Ballot (FWAB) to the

local County Election Administrator so that it arrives not

later than 30 days before the election. You may only use the

FWAB if you are outside the U.S. If the registration

application is received less than 30 days before the election,

the registration application will be processed for the next

election.

If you are already registered and only wish to request an

absentee ballot, your FPCA must be received by the County

Election Administrator by noon on the day before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by 8:00

p.m. on election day.

Local election officials mail absentee ballots approximately

30 days before elections for Federal office. For other

elections, ballots are mailed approximately 20 days before

the election.

To access the Montana Voter Information Pamphlet, link to

the Montana state election website from www.fvap.gov.

You may also use the Federal Write-In Absentee Ballot. See

instructions below.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Montana allows you to send the FPCA and FWAB for

registration and absentee ballot by fax. After faxing,

submit the form by mail.

 Montana allows you to receive the blank ballot by fax.

 Montana allows you to return the voted ballot by fax if

your county of voting residence has the facility for

voting by fax.

Only the following Montana counties currently have

facilities for voting via fax: Big Horn, Cascade, Custer,

Flathead, Jefferson, Lincoln, McCone, Missoula, Prairie,

Ravalli, Rosebud, Stillwater and Toole. Residents of other

Montana counties must use the mail. Check the on-line

Guide at www.fvap.gov for updates on counties with faxing

facilities.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Federal Write-In Absentee Ballot

If you are overseas, you may vote the Federal Write-In

Absentee Ballot (FWAB). The instructions in Chapter 2 of

this guide still apply for the FWAB except that the voter

does not have to wait until he/she determines that the

regular ballot will not be received (condition 3) to use the

FWAB.

The FWAB must be received by 8 p.m. on election day. The

FWAB will be counted if your request for a regular

absentee ballot was received not later than 30 days before

the election. 

If you receive the regular ballot after returning the voted

FWAB, you may also vote and return the regular ballot. If

both ballots are received by 8 p.m. on election day, only the

regular ballot will be counted.

For further instructions on the FWAB see Chapter 2,

page 12.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
2004–05 Voting Assistance Guide Montana

185

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens

and residents of Montana, and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Montana.

 Montana residents temporarily residing outside the

U.S. 

 overseas electors 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA or Federal Write-In Absentee Ballot (FWAB) to the

local County Election Administrator so that it arrives not

later than 30 days before the election. If the registration

application is received less than 30 days before the election,

the registration application will be processed for the next

election.

If you are already registered and only wish to request an

absentee ballot, your FPCA must be received by the County

Election Administrator by noon on the day before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by 8:00

p.m. on election day.

Local election officials mail absentee ballots approximately

30 days before elections for Federal office. For other

elections, ballots are mailed approximately 20 days before

the election.

To access the Montana Voter Information Pamphlet link to

the Montana state election website from www.fvap.gov.

You may also use the Federal Write-In Absentee Ballot. See

instructions below.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Montana allows you to send the FPCA and FWAB for

registration and absentee ballot by fax. After faxing,

submit the form by mail.

 Montana allows you to receive the blank ballot by fax.

 Montana allows you to return the voted ballot by fax if

your county of voting residence has the facility for

voting by fax.

Only the following Montana counties currently have

facilities for voting via fax: Big Horn, Cascade, Custer,

Flathead, Jefferson, Lincoln, McCone, Missoula, Prairie,

Ravalli, Rosebud, Stillwater and Toole. Residents of other

Montana counties must use the mail. Check the on-line

Guide at www.fvap.gov for updates on counties with faxing

facilities.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Federal Write-In Absentee Ballot

The instructions in Chapter 2 of this Guide still apply for

the FWAB except that the voter does not have to wait until

he/she determines that the regular ballot will not be

received (condition 3) to use the FWAB.

The FWAB must be received by 8 p.m. on election day. The

FWAB will be counted if your request for a regular

absentee ballot was received not later than 30 days before

the election. 

If you receive the regular ballot after returning the voted

FWAB, you may also vote and return the regular ballot. If

both ballots are received by 8 p.m. on election day, only the

regular ballot will be counted.

For further instructions on the FWAB see Chapter 2,

page 12.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
Montana 2004–05 Voting Assistance Guide

186

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Late Registration

Honorably discharged military personnel and citizens

terminated from employment outside the territorial limits of

the U.S. following the close of the registration period for

the upcoming election are still entitled to register up to

noon on the day before the election.

B. Bars to Registration and Voting

Persons currently incarcerated for a felony or found to be of

unsound mind, as determined by a court, may not vote.

C. Cancellation of Registration

Registration is canceled if the voter fails to respond to

certain confirmation mailings and fails to vote in two

subsequent consecutive general elections for Federal office.

D. Action on Registration Requests

Notice of registration or denial is sent.

E. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Montana shall provide you with the

reason(s) for the rejection. 

F. Action If Registration Is Denied

No provision exists for appeal of a denial of registration. If

denial occurs, consult a legal assistance officer or civilian

counsel. Montana has an administrative procedure for filing

complaints about the Federal election process.

G. Where To Send It

Mail the FPCA to the County Election Administrator,

county of voting residence, as listed below:

County Address Zip Code

Beaverhead 2 South Pacific Street #3, Dillon 59725-2799

Big Horn PO Box 908, Hardin 59034-0908

Blaine Box 278, Chinook 59523-0278

Broadwater 515 Broadway street, Townsend 59644-2397

Carbon Box 887, Red Lodge 59068-0887

Carter Box 315, Ekalaka 59324-0315

Cascade Box 2305, Great Falls 59403-2305

Chouteau Box 459, Fort Benton 59442-0459

Custer 1010 Main, Miles City 59301-3496

Daniels Box 247, Scobey 59263-0247

Dawson 207 West Bell, Glendive 59330-1616

Deer Lodge 800 South Main, Anaconda 59711-2950

Fallon Box 846, Baker 59313-0846

Fergus 712 West Main, Lewistown 59457-2562

Flathead 800 South Main, Kalispell 59901-5435

Gallatin 311 W Main, Room 103, Bozeman 59715-4502

Garfield Box 7, Jordan 59337-0007

Glacier 512 East Main, Cut Bank 59427-3075

Golden Valley PO Box 10, Ryegate 59074-0010

Granite Box 925, Philipsburg 59858-0925

Hill Courthouse, Havre 59501-3923

Jefferson Box H, Boulder 59632-0249

Judith Basin Box 427, Stanford 59479-0427

Lake 106 4th Avenue East, Polson 59860-2125

Lewis and Clark Box 1721, Helena 59624-1721

Liberty Box 459, Chester 59522-0459

Lincoln 512 California, Libby 59923-1942

Madison Box 366, Virginia City 59755-0366

McCone Box 199, Circle 59215-0199

Meagher Box 309, White Sulphur Springs 59645-0309

Mineral Box 550, Superior 59872-0550

Missoula 200 W Broadway, Missoula 59802-4216

Musselshell 506 Main, Roundup 59072-2426

Park Box 1037, Livingston 59047-1037

Petroleum Box 226, Winnett 59087-0226

Phillips Box 360, Malta 59538-0360

Pondera 20 4th Avenue SW, Conrad 59425-2383

Powder River Box 270, Broadus 59317-0270

Powell 409 Missouri, Deer Lodge 59722-1078

Prairie Box 125, Terry 59349-0125

Ravalli 215 S 4th Street, Suite C, Hamilton 59840-2703

Richland 20 West Main, Sidney 59270-4087

Roosevelt 400 2nd Avenue South, Wolf Point 59201-1600

Rosebud Box 47, Forsyth 59327-0047

Sanders Box 519, Thompson Falls 59873-0519

Sheridan 100 W. Laurel Ave, Plentywood 59254-1647

Silver Bow 155 W Granite, Room 208, Butte 59701-9256

Stillwater Box 149, Columbus 59019-0149

Sweet Grass Box 888, Big Timber 59011-0888

Teton Box 610, Choteau 59422-0610

Toole 226 1st Street South, Shelby 59474-1990

Treasure Box 392, Hysham 59038-0392

Valley 501 Court Square, Box 2, Glasgow 59230-2405

Wheatland Box 1903, Harlowton 59036-1903

Wibaux PO Box 199, Wibaux 59353-0199

Yellowstone Box 35002, Billings 59107-5002

County Address Zip Code

Just Do It. Vote Today. It Truly Will Count

by CWO3 Thomas Hudson, USMC, Pensacola, Florida
187

NEBRASKA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your Nebraska Driver's License number is required for

voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Nebraska

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

E You must write the name of your political party

affiliation (Democrat, Republican, Libertarian, Nebraska, or

Green (1st Congressional District only)) or write “none” in

Item 6 of the FPCA. In Nebraska, Independents (nonpartisan registrants) may vote the non-partisan ballot and

may also vote in the partisan primary for U.S. Congress and

U.S. Senate. An Independent voter may select one

recognized party ballot for these two offices. They may not

vote in other partisan races. Political party affiliation is not

required if only requesting absentee ballots for general

elections. If you are currently registered and want to change

your political party affiliation, or you are registered as

nonpartisan and want to vote in a partisan primary election,

you must submit a completed FPCA which includes your

new party preference to the local election official not later

than the second Friday before the election.

F If you are a married woman who has assumed her

husband’s surname, write your maiden name here.

G Check ONE box.

H You must sign and date the FPCA. When signing, you

are swearing or affirming the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G

H
Nebraska 2004–05 Voting Assistance Guide

188

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Nebraska and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register, send a completed FPCA to the County Clerk or

Election Commissioner so that it arrives not later than 6:00

p.m. on the second Friday (11 days) before the election. 

To register and request an absentee ballot and you do not

have access to an FPCA, apply in writing for a state

registration form and an absentee ballot. You must include

your full name, your address in your county of legal voting

residence (not where you live currently), type of election

(primary/general), political party (Democrat, Republican,

Libertarian, Nebraska, Green (1st Congressional District

only) or Non-partisan) and you must sign the request.

Submit this request early enough to request, receive,

complete and return the state registration form to the

County Clerk or Election Commissioner so that it arrives

not later than 6:00 p.m. on the second Friday (11 days)

before the election.

If your FPCA, written request or state registration form is

received after 6:00 p.m. on the second Friday (11 days)

before the election, it will be held until after the election. At

that time, your documents will be processed, you will be

registered, and a ballot will be issued to you for the next

election.

If you are already registered and wish only to request an

absentee ballot, send a completed FPCA or written request

to the County Clerk or Election Commissioner so that it

arrives not later than the Wednesday (6 days) before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

Election Commissioner’s or County Clerk’s office before

the close of polls on election day.

Local election officials mail absentee ballots to persons

outside the U.S. approximately 45 days before an election,

and to persons within the U.S. 35 days before an election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Nebraska allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Nebraska does not allow you to receive the blank

ballot by fax.

 Nebraska does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Agent

Your spouse, parent, son, daughter or any other person

acting as an agent on your behalf may apply for an absentee

ballot for you.

G. Special Write-In Absentee Ballot

A state special write-in ballot is available if you are a

member of the U.S. Armed Forces residing outside the

territorial limits of the U.S.

Use the FPCA to request this state special write-in ballot. In

Item 7 of the FPCA, place one of the state special write-in

labels from Section III.G. If no labels are available, write in

Item 7: “I am outside the territorial limits of the U.S. I

request a special write-in absentee ballot.” The state special

write-in ballot is available 57 days before the election. Vote

it by writing in the names of specific candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
2004–05 Voting Assistance Guide Nebraska

189

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens

and residents of Nebraska, or overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Nebraska.

 residents of Nebraska temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register, send a completed FPCA to the County Clerk or

Election Commissioner so that it arrives not later than 6:00

p.m. on the second Friday (11 days) before the election. 

To register and request an absentee ballot and you do not

have access to an FPCA, apply in writing for a state

registration form and an absentee ballot. You must include

your full name, your address in your county of legal voting

residence (not where you live currently), type of election

(primary/general), political party (Democrat, Republican,

Libertarian, Nebraska, Green (1st Congressional District

only) or Non-partisan) and you must sign the request.

Submit this request early enough to request, receive,

complete and return the state registration form to the

County Clerk or Election Commissioner so that it arrives

not later than 6:00 p.m. on the second Friday (11 days)

before the election.

If your FPCA, written request or state registration form is

received after 6:00 p.m. on the second Friday (11 days)

before the election, it will be held until after the election. At

that time, your documents will be processed, you will be

registered, and a ballot will be issued to you for the next

election.

If you are already registered and wish only to request an

absentee ballot, send a completed FPCA or written request

to the County Clerk or Election Commissioner so that it

arrives not later than the Wednesday (6 days) before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

Election Commissioner’s or County Clerk’s office before

the close of polls on election day.

Local election officials mail absentee ballots to persons

outside the U.S. approximately 45 days before an election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Nebraska allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Nebraska does not allow you to receive the blank

ballot by fax.

 Nebraska does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers.

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Agent

Your spouse, parent, son, daughter or any other person

acting as an agent on your behalf may apply for an absentee

ballot for you.

G. Special Write-In Absentee Ballot

A state special write-in ballot is available if you are a

Nebraska resident residing outside the territorial limits of

the U.S.

Use the FPCA to request this state special write-in ballot. In

Item 7 of the FPCA, place one of the state special write-in

labels from Section III.G. If no labels are available, write in

Item 7: “I am outside the territorial limits of the U.S. I

request a special write-in absentee ballot.”

The state special write-in ballot is available 57 days before

the election. Vote it by writing in the names of specific

candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
Nebraska 2004–05 Voting Assistance Guide

190

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony (unless civil rights restored),

and persons declared mentally incompetent, may not

register or vote.

B. Cancellation of Registration

Change of residence outside the county or state cancels

registration. Re-registration is required. Change of name

requires an update of information prior to voting but does

not cancel registration.

C. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Nebraska shall provide you with the

reason(s) for the rejection.

D. Action on Registration Requests

An acknowledgment of registration application status

(whether accepted or rejected, and if rejected, reasons for

rejection) is sent to the applicant.

E. Action If Registration Is Denied

If registration is denied, consult a legal assistance officer or

civilian counsel.

F. Late Registration

Any member of the Armed Forces, merchant marine or any

civilian citizen who was discharged from overseas Federal

service or employment too late to meet the regular state

registration deadline, may register to vote by completing

the necessary voter registration forms in the office of the

Election Commissioner or County Clerk of his or her

county of voting residence by noon on the day before the

election.

G. Where To Send It

Mail the FPCA to the County Clerk, (or where noted by an

asterisk, to the Election Commissioner) in your county of

voting residence as listed below:

County County Seat Zip Code

Adams PO Box 2067, Hastings 68902-2067

Antelope Neligh 68756-1424

Arthur Arthur 69121-0126

Banner Harrisburg 69345-0067

Blaine Brewster 68821-0136

Boone Albion 68620-1247

Box Butte Alliance 69301-0678

Boyd Butte 68722-0028

Brown Ainsworth 69210-1647

Buffalo* PO Box 1270, Kearney 68848-1270

Burt Tekamah 68061-1096

Butler David City 68632-0289

Cass* Plattsmouth 68048-1957

Cedar Hartington 68739-0047

Chase Imperial 69033-1299

Cherry Valentine 69201-0120

Cheyenne Sidney 69162-0217

Clay Clay Center 68933-1499

Colfax Schuyler 68661-1987

Cuming West Point 68788-0290

Custer Broken Bow 68822-2099

Dakota Dakota City 68731-0038

Dawes Chadron 69337-2698

Dawson Lexington 68850-0370

Deuel Chappell 69129-0327

Dixon Ponca 68770-0546

Dodge Fremont 68025-4967

Douglas* 225 North 115th Street, Omaha 68154

Dundy Benkelman 69021-0506

Fillmore Geneva 69361-0307

Franklin Franklin 68939-0146

Frontier Stockville 69042-0040

Furnas Beaver City 68926-0387

Gage Beatrice 68310-0429

Garden Oshkosh 69154-0486

Garfield Burwell 68823-0218

Gosper Elwood 68937-0136

Grant Hyannis 69350-0139

Greeley Greeley 68842-0287

Hall* 121 South Pine Street, Grand Island 68801-6099

Hamilton Aurora 68818-2017

Harlan Alma 68920-0379

Hayes Hayes Center 69032-0370

Hitchcock Trenton 69044-0248

Holt O'Neil 68763-0329

Hooker Mullen 69152-0184

Howard Saint Paul 68873-0025

Jefferson Fairbury 68352-2536

Johnson Tecumseh 68450-0416

Kearney Minden 68959-0339

Keith Ogallala 69153-0149

Keya Paha Springview 68778-0349

Kimball Kimball 69145-1296

Knox Center 68724-0166

Lancaster* 601 North 46th Steet, Lincoln 68503-3720

Lincoln North Platte 69101-3997

Logan Stapleton 69163-0008

Loup Taylor 68879-0187

McPherson Tryon 69167-0122

Madison Madison 68748-0290

Merrick Central City 68826-0027

Morrill Bridgeport 69336-0610

Nance Fullerton 68638-0338

Nemaha Auburn 68305-2399

Nuckolls Nelson 68961-0366

Otoe Nebraska City 68410-0249

Pawnee Pawnee City 68420-0431

Perkins Grant 69140-0156

Phelps Holdrege 68949-0404

Pierce Pierce 68767-0218

Platte* Columbus 68602

Polk Osceola 68651-0276

Red Willow McCook 69001-3159

Richardson Falls City 68355-2091

Rock Bassett 68714-0367

Saline Wilber 68465-0865

Sarpy* 1261 Golden Gate Drive, Suite 6E, Papillion 68046-2845

County County Seat Zip Code

“Speak Your Mind, VOTE!!”

by John Russell, Registrar of Voters, Tangipahoa Parish, Louisiana
2004–05 Voting Assistance Guide Nebraska

191

Saunders Wahoo 68066-0061

Scotts Bluff Gering 69341-2487

Seward Seward 68434-0190

Sheridan Rushville 69360-0039

Sherman Loup City 68853-0456

Sioux Harrison 69346-0158

Stanton Stanton 68779-0347

Thayer Hebron 68370-0208

Thomas Thedford 69166-0226

Thurston Pender 68047-0138

Valley Ord 68862-1499

Washington Blair 68008-0466

Wayne Wayne 68787-0248

Webster Red Cloud 68970-2399 

Wheeler Bartlett 68622-0127

York York 68467-2997

*Mail to the Election Commissioner.

County County Seat Zip Code
Nebraska 2004–05 Voting Assistance Guide

192
NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”

H. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

NEBRASKA

“I am outside the territorial limits of the United States. I request a special

write-in absentee ballot.”
Nebraska 2004–05 Voting Assistance Guide

194
195

NEVADA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Provide your Driver’s License number, the last four

digits of your Social Security number, or your identification

number issued by the Nevada Department of Motor

Vehicles. If you do not possess any of the above

identification, the County Clerk will issue a unique

identification number to you.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Nevada

voting residence. A post office box or rural route is not

sufficient. If your address includes a rural route, describe its

location in Item 7. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be different from the one

provided in Item 4 and must be within the county where

you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E If you do not list a party affiliation or if you affiliate

with a minor party or as nonpartisan, you will receive a

nonpartisan ballot. If you have left this block blank, you

will be registered as nonpartisan. You must indicate your

political party affiliation when applying for a primary ballot

(Example: Democrat, Republican) or write “none” in Item

6 of the FPCA. Political party affiliation is not required if

only requesting absentee ballots for general elections. If

you are currently registered and want to change your

political party affiliation or you have previously declined to

indicate a political party and you now want to vote in a

primary election, you must submit a completed FPCA

which includes your new political party affiliation so that

the local election official receives it no later than 21 days

before the election.

F Check ONE box

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Nevada 2004–05 Voting Assistance Guide

196

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Nevada and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2). If you wish to receive an absentee

ballot for municipal elections, please specify this on your

FPCA. 

If you are an unregistered citizen, the local election official

must receive your FPCA not later than 21 days before the

election. 

If you are a registered citizen, the local election official

must receive your FPCA not later than seven days before

the election.

To receive a sample ballot in large font, specify this request

in your FPCA.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office by 7 p.m. on election day.

Local election officials prepare absentee ballots for

distribution not later than 20 days before the election for

voters who reside within the state and not later than 40 days

before the election for voters who reside outside the state.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 If you are already registered and you live outside the

continental U.S., Nevada allows you to send the FPCA

application for absentee ballot request by fax. Your

request must be received by the seventh day before the

election. After faxing, submit the FPCA by mail.

 Nevada allows you to receive the absentee ballot by

fax if you live outside the continental U.S.

 Nevada does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers.

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Nevada and overseas citizens. The term

“overseas citizen(s)” means a U.S. citizen who resides

outside the U.S., and (but for such residence) would be

qualified to vote in Nevada.

 civilian employees of the U.S. Government outside

Nevada and their spouses and dependents 

 members of religious or welfare groups officially

attached to and serving with the Armed Forces 

 Nevada residents temporarily residing abroad

 overseas electors 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2). If you wish to receive an absentee

ballot for municipal elections, please specify this on your

FPCA.

If you are an unregistered citizen, the local election official

must receive your FPCA not later than 21 days before the

election. 
2004–05 Voting Assistance Guide Nevada

197

If you are a registered citizen, the local election official

must receive your FPCA not later than seven days before

the election.

To receive a sample ballot in large font, specify this request in

your FPCA.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office by 7 p.m. on election day. 

Local election officials prepare absentee ballots for distribution

not later than 20 days before the election for voters who reside

within the state and not later than 40 days before the election

for voters who reside outside the state.

If you have not received your state ballot in a timely manner,

use the Federal Write-In Absentee Ballot. See instructions in

Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or witnessed.

E. Electronic Transmission of FPCAs and 

Ballots

 If you are already registered and you live outside the

continental U.S., Nevada allows you to send the FPCA

application for absentee ballot request by fax. Your request

must be received by the seventh day before the election.

After faxing, submit the FPCA by mail.

 Nevada allows you to receive the absentee ballot by fax if

you live outside the continental U.S.

 Nevada does not allow you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony who have not had their voting

rights restored and persons declared mentally incompetent

may not register or vote. 

B. Action on Receipt of Application

A voter registration card, request for information, or notice

of denial will be sent.

C. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Nevada shall provide you with the

reason(s) for the rejection. If registration is denied, consult

a legal assistance officer or civilian counsel. 

D. Late Registration

Members of the Armed Forces discharged within 60 days of

an election may register in person in their county of voting

residence upon return to that county.

E. Where To Send It

Mail the FPCA to the County Clerk at the county of voting

residence as listed below: (In Washoe County, mail to

Registrar of Voters):

County County Seat Zip Code

Carson City 885 E. Musser Street, Ste. 1025

Carson City 89701-4475

Churchill 155 N. Taylor Street, 

Suite 110, Fallon 89406-2748

Clark Clark County Elections Department, 

Mail Requests, PO Box 3910, 

Las Vegas 89127-3910

Douglas 1594 Esmeralda Street, PO Box 218, 

Minden 89423-0218

Elko 571 Idaho Street, 3rd Floor, County 

Courthouse, Elko 89801-3700

Esmeralda Corner of Crook & Euclid, PO Box 547, 

Goldfield 89013-0547

Eureka County Courthouse Main Street, POS 

Box 677, Eureka 89316-0677

Humboldt 50 W. 5th Street #207, 

Winnemucca 89445-3199

Lander 315 S. Humboldt St., 

Battle Mountain 89820-9998

Lincoln 1 North Main Street, PO Box 90, 

Pioche 89043-0090

Lyon 27 S. Main Street, 

Yerington 89447-2571

Mineral 105 S, “A” Street, Suite 1, PO Box 

1450, Hawthorne 89415-1450

Nye 101 Radar Rd., PO Box 1031, 

Tonopah 89049-1031

Pershing 398 Main Street, PO Box 820, 

Lovelock 89419-0820

“Don’t Miss The Boat By Not Casting Your Vote!”

by WG05 Barry J. Cason, USMC, Albany, Georgia
Nevada 2004–05 Voting Assistance Guide

198

Storey County Courthouse “B” Street, Drawer 

“D”, Virginia City 89440-0139

Washoe 1001 E. Ninth St., PO Box 11130, 

Reno 89520-0027

White Pine 801 Clark Street, Suite 4, 

Ely 89301-1994

County County Seat Zip Code
199

NEW HAMPSHIRE

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your New Hampshire Driver's License number is

required for voter registration. If you do not possess either

of these identifications, the State shall assign a number that

will serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your New

Hampshire voting residence. A post office box is not

sufficient. If your address includes a rural route, describe its

location in Item 7. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be different from the one

provided in Item 4 and must be within the county or

township where you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections. If you are

currently registered and want to change your political party

affiliation or you have previously declined to indicate a

political party and you now want to vote in a primary

election, you must submit a completed FPCA which

includes your new political party choice to be received by

the local election official not later than 10 days before the

election. 

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
New Hampshire 2004–05 Voting Assistance Guide

200

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of New Hampshire and members of the

Uniformed Services and their family members. Uniformed

Services are defined as the U.S. Armed Forces, merchant

marine, commissioned corps of the Public Health Service

and the National Oceanic and Atmospheric

Administrations.

 members of the U.S. Armed Forces or merchant

marine and their accompanying spouses and

dependents

 civilian employees of the U.S. Government outside the

U.S. and their accompanying spouses and dependents

 members of religious or welfare groups attached to

and serving with the Armed Forces outside the U.S.

and their accompanying spouses and dependents

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

New Hampshire waives your registration.

To request an absentee ballot, the local city or town clerk

must receive your FPCA at any time before the election.

Remember to allow for sufficient mail transit time. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office by 5 p.m. on election day. 

Local election officials mail ballots approximately 30 days

before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

New Hampshire does not allow electronic transmission of

the FPCA, the blank absentee ballot or the voted absentee

ballot.

F. Special Write-In Absentee Ballot

New Hampshire provides a state special write-in absentee

ballot if you are unable to vote by regular absentee ballot or

in person due to requirements of military service or due to

living in isolated areas outside the U.S. and Canada. 

Use an FPCA to request this state special write-in ballot. In

Item 7 of the FPCA, place one of the state special write-in

labels from Section III.G. If no labels are available, write in

Item 7: “I am unable to vote by regular absentee ballot or in

person due to requirements of military service or due to

living in isolated areas outside the United States and

Canada. I request a special write-in absentee ballot.” 

The special write-in ballot is available for the state primary

no later than July 15. The special write-in ballot is available

for the general election not later than the date of the state

primary. Vote this ballot by writing in a party preference or

the names of specific candidates.

Instructions continue in Section III. Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of New Hampshire or Federal overseas voters.

The term “Federal overseas voter” means a U.S. citizen

who resides outside the U.S. and (but for such residence)

would be qualified to vote in New Hampshire.

 New Hampshire residents temporarily residing outside

the U.S. (for local, state and Federal office ballots)

 Federal overseas voters (for Federal office ballots

only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are an unregistered federal overseas voter, the local

registrar of voters must receive your FPCA request for
2004–05 Voting Assistance Guide New Hampshire

201

registration and an absentee ballot at anytime prior to

election day. Remember to allow for sufficient mail transit

time. Your name will be added to the registered voter

checklist when the registrar of voters receives the affidavit

accompanying the absentee ballot.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office by 5 p.m. on election day.

Local election officials mail ballots approximately 30 days

before the election. 

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: If you are an unregistered New Hampshire resident

temporarily residing outside the U.S., the FPCA is used to

request a state registration form. The FPCA must be

witnessed.

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

New Hampshire does not allow electronic transmission of

the FPCA, the blank absentee ballot or the voted absentee

ballot.

F. Special Write-In Absentee Ballot

New Hampshire provides a state special write-in absentee

ballot for federal overseas voters who are unable to vote by

regular absentee ballot or in person due to requirements of

military service or due to living in isolated areas outside the

U.S. and Canada. 

Use an FPCA to request this state special write-in ballot. In

Item 7 of the FPCA, place one of the state special write-in

labels from Section III.G. If no labels are available, write in

Item 7: “I am unable to vote by regular absentee ballot or in

person due to requirements of military service or due to

living in isolated areas outside the United States and

Canada. I request a special write-in absentee ballot.” 

The special write-in ballot is available for the state primary

no later than July 15. The special write-in ballot is available

for the general election not later than the date of the state

primary. Vote this ballot by writing in a party preference or

the names of specific candidates.

Instruction continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony may not register or vote until

they have completed their sentences. 

B. Cancellation of Registration

If you have not voted since 1999, or if you have a question

about the validity of your registration, request an

application for addition to the checklist as provided in

Section II.B. (1) above.

C. Action on Registration Requests

Notice is sent only if a request is denied. 

D. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, New Hampshire shall provide you

with the reason(s) for the rejection. Persons denied

registration may file a complaint in superior court. Consult

a legal assistance officer or civilian counsel.

E. Same Day Registration

New Hampshire citizens who are in the state on the day of

the election may register to vote at the polling place. They

will be required to produce proof of qualifications and must

sign an affidavit. They will then be allowed to vote at that

election and be registered to vote at subsequent elections.

F. Where To Send It

Mail the FPCA to the City Clerk or Town Clerk of the town

or city of voting residence as listed below:

City Mailing Address Zip Code

Berlin City Hall-Main Street 03570

Claremont 58 Tremont Square 03743

Concord 41 Green Street 03301

Dover 288 Central Avenue 03820

Franklin 316 Central Street 03235

Keene 3 Washington Street 03431

Laconia P.O. Box 489 03246

Lebanon 51 N. Park Street 03766

Manchester 904 Elm Street 03101

Nashua City Hall 03061

Portsmouth P.O. Box 628 03802

Rochester 31 Wakefield Street 03867

Somersworth 157 Main Street 03878

Town Mailing Address Zip Code

Acworth Box 193 03061

Albany 1972 Rte 16 Ste B 03818

Alexandria 44 Perkins Hill Road 03222

Allenstown 16 School Street 03275

Alstead P.O. Box 65 03602

Alton P.O. Box 637 03809

Amherst P.O. Box 960 03031

Andover P.O. Box 61 03216
New Hampshire 2004–05 Voting Assistance Guide

202

Antrim P.O. Box 517 03440

Ashland P.O. Box 517 03217

Atkinson 21 Academy Avenue 03811

Auburn P.O. Box 309 03032

Barnstead P.O. Box 11 03225

Barrington 41 Province Lane 03825

Bartlett RFD #1, Box 50, Intervale 03845

Bath P.O. Box 165 03740

Bedford 24 N. Amherst Road 03110

Belmont P.O. Box 310 03220

Bennington 7 School Street, Unit 101 03442

Benton 30 Ingersoll Road 03785

Bethlehem P.O. Box 189 03574

Boscawen 17 High Street 03303

Bow 10 Grandview Road 03304

Bradford P.O. Box 607 03221

Brentwood 1 Dalton Road 03833

Bridgewater PO Box 419 03264

Bristol 230 Lake Street 03222

Brookfield P.O. Box 756 03872

Brookline P.O. Box 336 03033

Campton 1307 NH Rte 175 03223

Canaan P.O. Box 38 03741

Candia 74 High Street 03034

Canterbury P.O. Box 500 03224

Carroll P.O. Box 88, Twin Mountain, NH 03595

Center Harbor P.O. Box 140 03226

Charlestown P.O. Box 834 03603

Chatham 1681 Main Road 03813

Chester P.O. Box 275 03036

Chesterfield P.O. Box 64 03443

Chichester 54 Main Street 03234

Clarksville 408 NH Rt. 145 03592

Colebrook 10 Bridge Street 03576

Columbia PO Box 157, Colebrook 03576

Conway P.O. Box 70, Ctr. Conway, NH 03813

Cornish P.O. Box 183, Cornish Flat, NH 03746

Croydon 879 NH Rte 10 03773

Dalton 741 Dalton Road 03598

Danbury 23 High Street 03230

Danville P.O. Box 11 03819

Deerfield P.O. Box 159 03037

Deering 762 Deering Ctr Road 03244

Derry 48 East Broadway 03038

Dixville RFD 1, Dixville Notch 03576

Dorchester 368 N Dorchester Road 03266

Dublin Box 62 03444

Dummer 1420 East Side River Road 03588

Dunbarton 1011 School Street 03045

Durham 15 Newmarket Road 03824

East Kingston 24 Depot Road 03827

Easton 381 Easton Valley Road 03580

Eaton PO Box 118, Eaton Center 03832

Effingham P.O. Box 48, S Effingham 03882

Ellsworth RR 1 Box 1846, Campton 03223

Enfield P.O. Box 373 03748

Epping 157 Main Street 03042

Epsom P.O. Box 10 03234

Errol P.O. Box 100 03579

Exeter 10 Front Street 03833

Farmington 39 Main Street 03835

Fitzwilliam P.O. Box 504 03447

Francestown P.O. Box 67 03043

Franconia P.O. Box 900 03580

Franklin 316 Central Street 03235

Freedom P.O. Box 457 03836

Fremont P.O. Box 120 03044

Gilford 47 Cherry Valley Road 03249

Gilmanton P.O. Box 550 03237

Gilsum P.O. Box 36 03448

Goffstown 16 Main Street 03045

Gorham 20 Park Street 03581

Town Mailing Address Zip Code

Goshen P.O. Box 58 03752

Grafton P.O. Box 297 03240

Grantham P.O. Box 135 03753

Greenfield P.O. Box 100 03047

Greenland P.O. Box 100 03840

Greenville P.O. Box 354 03048

Groton 63-1 N. Groton Road 03241

Hampstead P.O. Box 298 03841

Hampton 100 Winnachunnet Road 03842

Hampton Falls 1 Drinkwater Road, Town Hall 03844

Hancock P.O. Box 6 03449

Hanover P.O. Box 483 03755

Harrisville P.O. Box 284 03450

Harts Location 5 Forest Road 03812

Haverhill 2975 Dartmouth College Highway, No. 

Haverhill 03774

Hebron HC 58, Box 286, E. Hebron, NH 03232

Henniker 2 Depot Hill Road 03242

Hill P.O. Box 251 03242

Hillsborough P.O. Box 1699 03244

Hinsdale 27 Spring Street 03451

Holderness P.O. Box 203 03245

Hollis 7 Moument Square 03049

Hooksett 16 Main Street 03106

Hopkinton P.O. Box446 03229

Hudson 12 School Street 03051

Jackson P.O. Box 336 03846

Jaffrey 10 Goodnow Street 03452

Jefferson 84 Stag Hollow Road 03583

Keene 3 Washington Street 03431

Kensington 95 Amesbury Road 03833

Kingston P.O. Box 657 03848

Lanconia PO Box 489 03246

Lancaster 25 Main Street 03584

Landaff PO Box 125 03585

Langdon RR 1, Box 122, Alstead 03602

Lebanon 51 North Park Street 03766

Lee 7 Mast Road 03824

Lempster P.O. Box 33 03605

Lincoln P.O. Box 39 03251

Lisbon 45 School Street 03585

Litchfield 2 Liberty Way Suite 3 03051

Littleton 125 Main Street, Suite 202 03561

Londonderry 50 Nashua Road, Suite 100 03053

Loudon P.O. Box 7837 03301

Lyman 65 Parker Hill 03585

Lyme P.O. Box 342 03768

Lyndeborough P.O. Box 164 03082

Madbury 13 Town Hall Road 03820

Madison P.O. Box 248 03849

Manchester 904 Elm Street 03101

Marlborough P.O. Box 425 03455

Marlow P.O. Box 184 03456

Mason 16 Darling Road 03048

Meredith 41 Main Street 03253

Merrimack P.O. Box 27 03054

Middleton 182 Kings Highway 03887

Milan P.O. Box 158 03588

Milford 1 Union Square 03055

Millsfield P.O. Box 48, Errol 03579

Milton P.O. Box 180 03851

Monroe P.O. Box 63 03771

Mont Vernon P.O. Box 444 03057

Moultonborough P.O. Box 15 03254

Nashua 229 Main Street 03061

Nelson HCR 33, Box 660 03457

New Boston P.O. Box 250 03070

New Castle P.O. Box 367 03854

New Durham P.O. Box 207 03855

New Hampton P.O. Box 538 03256

New Ipswich 661 Turnpike Road 03071

New London P.O. Box 314 03257

Newbury P.O. Box 253 03255

Town Mailing Address Zip Code
2004–05 Voting Assistance Guide New Hampshire

203

Newfields P.O. Box 300 03856

Newington 205 Nimble Hill Road 03801

Newmarket 186 Main Street 03857

Newport 15 Sunapee Street 03773

Newton P.O. Box 375 03858

North Hampton P.O. Box 141 03862

Northfield 21 Summer Street 03276

Northumberland 2 State Street, Groveton, NH 03582

Northwood P.O. Box 314 03261

Nottingham P.O. Box 114 03290

Orange RR 2, Box 113, Eastman Road 03741

Orford RR 1Box 176 03777

Ossipee P.O. Box 67, Ctr. Ossipee 03814

Pelham 6 Main Street, 03076

Pembroke 311 Pembroke Street 03275

Peterborough 1 Grove Street 03458

Piermont P.O. Box 27 03779

Pittsburg Main Street 03592

Pittsfield P.O. Box 98 03263

Plainfield Box 380, Meriden, NH 03770

Plaistow 145 Main Street 03865

Plymouth 6 Post Office Square 03264

Portsmouth 1 Junkins Avenue 03801

Randolph RD 1, Box 1429 03570

Raymond 4 Epping Street 03077

Richmond 105 Old Homestead Highway 03470

Rindge P.O. Box 11 03461

Rochester 31 Wakefield Street 03867

Rollinsford P.O. Box 309 03869

Roxbury 404 Branch Road 03431

Rumney PO Box 275 03266

Rye 10 Central Road 03870

Salem 33 Geremonty Dr. 03079

Salisbury PO Box 180 03268

Sanbornton P.O. Box 124 03269

Sandown P.O. Box 583 03873

Sandwich P.O. Box 194, Ctr. Sandwich 03227

Seabrook P.O. Box 476 03874

Sharon 432 RT 123 03458

Shelburne 881 North Road 03581

Somersworth 157 Main Street 03878

South Hampton 3 Hilldale Avenue 03827

Springfield P.O. Box 22 03284

Stark 337 Percy Road 03582

Stewartstown PO Box 119 03597

Stoddard 2175 RT 9 03464

Stafford P.O. Box 169 03884

Stratford P.O. Box 386, N Stratford 03590

Stratham 10 Bunker Hill Avenue 03885

Sugar Hill P.O. Box 574 03585

Sullivan 522 South Road 03431

Sunapee P.O. Box 303 03782

Surry 358 Pond Road 03431

Sutton P.O. Box 554, South Sutton, NH 03273

Swanzey P.O. Box 10009 03446

Tamworth P.O. Box 279 03886

Temple P.O. Box 69 03084

Thornton 16 Merrill Access Road 03223

Tilton 257 Main Street 03276

Troy P.O. Box 249 03465

Tuftonboro P.O. Box 98, 03816

Unity HCR 66, Box 176A 03773

Wakefield 2 High Street, Sanbornville, NH 03872

Walpole P.O. Box 756 03608

Warner P.O. Box 265 03278

Warren RR 1 Box 200B 03279

Town Mailing Address Zip Code

Washington P.O. Box 109 03280

Waterville Valley P.O. Box 500 03215

Weare P.O. Box 190 03281

Webster 945 Battle Street 03303

Wentworth P.O. Box 2 03282

Westmoreland 108 Pierce Lane 03467

Whitefield 7 Jefferson Road 03598

Wilmot P.O. Box 94 03287

Wilton P.O. Box 83 03086

Winchester 1 Richmond Road 03470

Windham P.O. Box 120 03087

Windsor 14 White Pond Road 03244

Wolfeboro P.O. Box 1207 03894

Woodstock Box 156, N. Woodstock, NH 03262

Town Mailing Address Zip Code

One Vote Is The Difference....Make Yours Count!

by Captain Joel M. Hoffman, USMC, Camp Lejeune, North Carolina
New Hampshire 2004–05 Voting Assistance Guide

204
NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”

G. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

NEW HAMPSHIRE

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated areas outside the

United States and Canada. I request a special write-in absentee ballot.”
New Hampshire 2004–05 Voting Assistance Guide

206
207

NEW JERSEY

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your New Jersey Driver's License number is required

for voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your New

Jersey voting residence. A post office box is not sufficient.

If your address includes a rural route, describe its location

in Item 7. For example: “on Highway _____, 2 miles past

Highway _____, across the street from the _____ gas

station.” This address must be different from the one

provided in Item 4 and must be within the county where

you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct. 

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) MMDDY Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

D

F

A
New Jersey 2004–05 Voting Assistance Guide

208

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of New Jersey and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you want an absentee ballot sent to you by airmail, the

County Clerk must receive your FPCA request not later

than 30 days before the election. (See Section D. below for

a later deadline if using electronic transmission.)

If you are stationed overseas and want a Federal office

ballot sent to you by fax, the County Clerk must receive

your FPCA request not later than 4 days before the election.

(See Section D. below for more details.)

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

county board of elections office by the close of polls on

election day. 

County Clerks mail absentee ballots as far as practicable, 40

days before the election.

If you are outside the U.S. and have not received your ballot

from the state in a timely manner, for a general election for

Federal office, you may use the Federal Write-In Absentee

Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or witness.

E. Electronic Transmission of FPCAs 

and Ballots

 If you are overseas, New Jersey allows you to send the

FPCA request for an absentee ballot for Federal

offices by fax. You must also submit the original

FPCA by airmail to the appropriate County Clerk. 

 If you are overseas, New Jersey allows you to receive

the blank Federal office ballot by fax. If you wish to

receive the blank Federal office ballot by fax, the

County Clerk must receive your FPCA not later than 4

days before the election.

 If you are overseas, New Jersey allows you to return

the voted ballot by fax, not later than 8 p.m. (EST) on

election day. You must also submit the original ballot

by airmail together with certification.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

Your friends or relatives may apply for an absentee ballot

on your behalf by requesting an “Application by Relative or

Friend of a Military Service Voter” form from your County

Clerk.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

The following procedures apply to persons who are U.S.

citizens, residents of New Jersey and overseas Federal

election voters. The term “overseas Federal election

voter(s)” means a U.S. citizen who resides outside the U.S.,

and (but for such residence) would be qualified to vote in

New Jersey.

 civilians attached to the Armed Forces outside the U.S.

and their spouses and dependents when residing with

or accompanying them. 

 overseas Federal election voters. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you want an absentee ballot sent to you by airmail, the

County Clerk must receive your FPCA request not later

than 30 days before the election.
2004–05 Voting Assistance Guide New Jersey

209

If you are residing overseas and want an absentee ballot

sent to you by fax, the County Clerk must receive your

FPCA request not later than 4 days before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

county board of elections office by the close of polls on

election day. 

County Clerks mail absentee ballots, as far as practicable,

40 days before the election.

If you have not received your ballot from the state in a

timely manner, for general election for Federal office, you

may use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 If you are overseas, New Jersey allows you to send the

FPCA request for an absentee ballot for Federal

offices by fax. You must also submit the original

FPCA by airmail to the appropriate County Clerk.

 If you are overseas, New Jersey allows you to receive

the blank Federal office ballot by fax. If you wish to

receive the blank Federal office ballot by fax, the

County Clerk must receive your FPCA not later than 4

days before the election.

 If you are overseas, New Jersey allows you to return

the voted ballot by fax, no later than 8 p.m. (EST) on

election day. You must also submit the original ballot

by airmail together with certification.

Please refer to Appendix D for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Any person who has been declared to be mentally

disqualified from voting, by a court of competent

jurisdiction; or a person who is serving a sentence, is on

probation or parole, as a result of a conviction for an

indictable offense under the laws of this or another state or

of the U.S., may not register to vote.

B. Late Registration

Discharged military personnel (including their spouses and

dependents) and released civilians attached to or serving

with the Armed Forces (including their spouses and

dependents) who return to New Jersey too late to register on

the last registration day before any election may still

register and obtain an emergency voting form at the office

of the county commissioner of registration, if individual

was previously registered to vote in New Jersey. If

individual was not previously registered to vote, he or she

may obtain an emergency voting form upon presentation of

his/her discharge or certification of service.

C. Where To Send It

If you are not currently registered to vote and are using the

FPCA to register to vote and to request an absentee Ballot,

or if you do not know the county of your former voting

residence, mail your application to the New Jersey State

Division of Elections at PO Box 304, Trenton, New Jersey

08625.

If you are requesting an absentee ballot, mail the FPCA to

the County Clerk of the county in which you were formally

registered.

County County Seat Zip Code

Atlantic 5901 Main Street

Mays Landing 08330-1797

Bergen One Bergen Plaza, Room 122, 

Hackensack 07601

Burlington Court Complex, PO Box 6000,

49 Rancocas Road, Mount Holly 08060-1397

Camden Election Div., 6th St. Entrance, 

Suite 316, PO Box 150, Camden 08101-0150

Cape May 7 N. Main Street, PO Box 5000, 

Cape May Courthouse 08210-5000

Cumberland PO Box 716, 60 W. Broad St.

Bridgeton 08302-2665

Essex 465 King Blvd, Room 247

Newark 07102-1795

Gloucester Ct.House, 1st Floor, PO Box 129

1 North Board St., Woodbury 08096-3327

Hudson 583 Newark Avenue

Jersey City 07306-2018

Hunterdon 71 Main Street, Hall of Records, 

Flemington 08822-1495

Mercer Court House, PO Box 8068, 

209 S. Broad Street, Trenton 08650-8068

Middlesex PO Box 1110, 75 Bayard St., 4th Fl. 

New Brunswick 08901-1110

Monmouth 300 Halls Mill Road

Freehold 07728-1254
New Jersey 2004–05 Voting Assistance Guide

210

Morris PO Box 315, Court Street

Morristown 07963-0315

Ocean PO Box 2191, Court House, Rm. 105 

118 Washington St., Toms River 08754-2191

Passaic 401 Grand Street

Paterson 07505

Salem 92 Market St., PO Box 18

Salem 08079-1913

Somerset PO Box 3000, 20 Grove St., 

Administration Building, Somerville 08876-1262

Sussex 4 Park Place

Newton 07860-1795

Union Court House, 1st Fl., Rom 115, 

2 Broad Street, Elizabeth 07207-6099

Warren 413 Second Street, Court House, 

Belvidere 07823-1500

County County Seat Zip Code

Vote- It’s The Only Way To Make A Difference

by Florence Rubinacci, Directorate of Information Management, Fort Monmouth, New Jersey
211

NEW MEXICO

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

B Provide the complete street address of your New

Mexico voting residence. A post office box is not sufficient.

If your address includes a rural route, describe its location

in Item 7. For example: “on Highway _____, 2 miles past

Highway _____, across the street from the _____ gas

station.” This address must be different from the one

provided in Item 4 and must be within the county or

township where you claim legal voting residence.

C Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

D If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican, Green, or other qualified party) or

write “none” in Item 6 of the FPCA. Political party

affiliation is not required if only requesting absentee ballots

for general elections. If you are currently registered and

want to change your political party affiliation, you must

submit a completed FPCA which indicates your new

political party affiliation so that the local election official

receives it no later than 28 days before the election in which

you wish to vote.

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E
New Mexico 2004–05 Voting Assistance Guide

212

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of New Mexico and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

New Mexico waives your registration.

To request an absentee ballot, the local County Clerk must

receive your FPCA not later than 5:00 PM the Friday

before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office before the close of polls on election day. 

Local election officials mail ballots approximately 40 days

before the primary election, 49 days before the general

election, and 35 days before a special election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 New Mexico allows you to send the FPCA for

absentee ballot request by fax. After faxing, submit the

FPCA by mail. 

 New Mexico allows you to receive the blank ballot by

fax.

 New Mexico allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of New Mexico and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in New Mexico.

 New Mexico residents temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

New Mexico waives your registration.

To request an absentee ballot the local County Clerk must

receive your FPCA not later than 5:00 PM the Friday

before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office before the close of polls on election day. 

Local election officials mail ballots approximately 40 days

before the primary election, 49 days before the general

election, and 35 days before a special election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.
2004–05 Voting Assistance Guide New Mexico

213

E. Electronic Transmission of FPCAs 

and Ballots

 New Mexico allows you to send the FPCA for

absentee ballot request by fax. After faxing, submit the

FPCA by mail. 

 New Mexico allows you to receive the blank ballot by

fax.

 New Mexico allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons who have been convicted of a felony who have not

been granted a pardon by the governor or have not served

the entirety of their sentence, including a term of probation

or parole, and those persons who have been judged

mentally incompetent by a court of law may not register to

vote.

B. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, New Mexico shall provide you with

the reason(s) for the rejection. 

C. Where To Send It

Mail the FPCA to the County Clerk of the county of voting

residence as listed below:

County County Seat Zip Code

Bernalillo 1 Civic Plaza, NW, Albuquerque, NM 87102-2169

Catron Box 197, Reserve, NM 87830-0197

Chaves Box 580, Roswell, NM 88202-0580

Cibola 515 W. High, Grants, NM 87020-2526

Colfax Box 159, Raton, NM 87740-0159

Curry P.O. Box 1168, Clovis, NM 88102-1168

De Baca Box 347, Fort Sumner, NM 88119-0347

Dona Ana 251 W. Amador Ave., Las Cruces, NM 88005-2893

Eddy Box 850, Carlsbad, NM 88221-0850

Grant Box 898, Silver City, NM 88062-0898

Guadalupe 420 Parker Avenue, Santa Rosa, NM 88435-2361

Harding Box 1002, Mosquero, NM 87733-1002

Hidalgo 300 S. Shakespeare St., Lordsburg, NM 88045-1939

Lea Box 1507, Lovington, NM 88260-1507

Lincoln Box 338, Carrizozo, NM 88301-0338

Los Alamos P.O. Box 30, Los Alamos, NM 87544-0030

Luna P.O. Box 1838, Deming, NM 88031-1838

McKinley Box 1268, Gallup, NM 87301-1268

Mora Box 360, Mora, NM 87732-0360

Otero 1000 New York Avenue, Room 108 

Alamogordo, NM 88310-6932

Quay Box 1225, Tucumcari, NM 88401-1225

Rio Arriba Box 158, Tierra Amarilla, NM 87575-0158

Roosevelt 101 West First Street, Portales, NM 88130-5901

Sandoval Box 40, Bernalillo, NM 87004-0040

San Juan Box 550, Aztec, NM 87410-0550

San Miguel 500 West National Ave., Las Vegas, NM 87701-3703

Santa Fe Box 1985, Santa Fe, NM 87504-1985

Sierra 311 Date Street, Tor C, NM 87901-2398

Socorro Box 1, Socorro, NM 87801-0001

Taos Box 676, Taos, NM 87571-0676

Torrance Box 48, Estancia, NM 87016-0048

Union Box 430, Clayton, NM 88415-0430

Valencia Box 969, Los Lunas, NM 87031-0969

Take The Time To Protect Your Freedoms - Vote

by Jennifer Keys, USN, Europe
New Mexico 2004–05 Voting Assistance Guide

214
215

NEW YORK

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Provide your New York Driver's License number. If

you do not have a driver’s license number, you may provide

the last 4 digits of your Social Security number.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your New York

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections. If you are

currently registered and want to change your political party

affiliation or you have previously declined to indicate a

political party and you now want to vote in a primary

election, you must timely submit a completed FPCA, which

includes your new political party affiliation, to the local

election official. Please note that when changing parties,

your new political party affiliation will not become

effective until after the general election preceding the

primary election of interest to you. For example, if a person

voted in the 2002 Republican primary and wants to vote in

the 2004 Democratic primary, the voter must return a

change of political party choice postmarked not later than

25 days before the 2003 general election and received by

the local board of elections not later than 20 days before the

2003 general election. Following the election, the change

will be officially recorded.

F Check ONE box.

G You sign and date the FPCA. When signing, you are

swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
New York 2004–05 Voting Assistance Guide

216

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of New York and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the local board of elections so that it arrives not

later than 25 days before the primary election and not later

than 10 days before a general or special election. 

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the local board

of elections so that it arrives not later than 7 days before the

election. 

C. Casting Your Vote

Ballot Return Deadline: Return your voted ballot to the

local board of elections. It must be postmarked by the day

before the election and must arrive by the seventh day after

the primary or special election and not later than thirteen

days following the day of a general election. Ask the mail

clerk to hand stamp the ballot envelope to ensure a date

appears on the envelope. The mailing envelope may be

witnessed, in the space provided, indicating that the ballot

was mailed not later than the day before the election. This

action may help ensure that ballots arriving at boards of

election with no postmarks or other date/time markings or

indicia, can be counted

Local election officials mail out absentee ballots

approximately 32 days before an election, with the

following exceptions: ballots are sent out 12 days before

special elections and 25 days before school board elections

in New York City and Buffalo.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration materials must be notarized or

witnessed.Mailing envelopes containing voted ballots may

be witnessed, to help ensure that they can be counted, in

cases where they lack required postmarks or other date/time

markings or indicia. See paragraph I. C., above.

E. Electronic Transmission of FPCAs 

and Ballots

New York does not allow electronic transmission of the

FPCA, the blank absentee ballot or the voted absentee

ballot. 

F. Application for Ballot by Proxy

If you are outside the U.S., your spouse, parent, adult child,

brother, sister or duly authorized agent may apply to the

local board of elections for an absentee ballot on your

behalf.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of New York and special Federal voters. The term

“special Federal voter” means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in New York.

 New York residents temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 special Federal voters (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

If you are a New York resident temporarily residing outside

the U.S., register by sending a completed FPCA to the local

board of elections early enough to request, receive, fill in

and return the state mail registration form so that it is

postmarked not later than 25 days before the election, and

received by the local board of elections not later than 20

days before the election. Local election officials will send

you an absentee ballot upon the timely return of the state

mail registration form.
2004–05 Voting Assistance Guide New York

217

If you are a registered New York resident temporarily

residing outside the U.S., and only wish to request an

absentee ballot, send a completed FPCA to the local board

of elections so that it arrives not later than 7 days before the

election. 

If you are an unregistered special Federal voter, register by

submitting a completed FPCA to the local board of

elections so that it arrives not later than 25 days before any

election. 

If you are a registered special Federal voter, request an

absentee ballot by sending a completed FPCA to the local

board of elections so that it arrives not later than 7 days

before the election.

C. Casting Your Vote

Ballot Return Deadline: Return your voted ballot to the

local board of elections. It must be postmarked by the day

before the election and must arrive by the seventh day after

the primary or special election and not later than thirteen

days following the day of a general election. Ask the mail

clerk to hand stamp the ballot envelope to ensure a date

appears on the envelope. The mailing envelope may be

witnessed, in the space provided, indicating that the ballot

was mailed not later than the day before the election. This

action may help ensure that ballots arriving at boards of

election with no postmarks or other date/time markings or

indicia, can be counted.

Local election officials mail absentee ballots approximately

32 days before an election, with the following exceptions:

ballots are sent out 12 days before special elections and 25

days before school board elections in New York City and

Buffalo.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration materials must be notarized or

witnessed.Mailing envelopes containing voted ballots may

be witnessed, to help ensure that they can be counted, in

cases where they lack required postmarks or other date/time

markings or indicia. See paragraph II. C., above.

E. Electronic Transmission of FPCAs 

and Ballots

New York does not allow electronic transmission of the

FPCA, the blank absentee ballot or the voted absentee

ballot. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Convicted felons serving a term of imprisonment (including

parole) and those found mentally incompetent may not

register or vote.

B. Cancellation of Registration

Registration is canceled after four (4) years of inactive

status.

C. Action on Registration Requests

Notification of approval or denial is sent to resident voters.

Military voters and special Federal voters receive either a

ballot or notification of denial.

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, New York shall provide you with

the reason(s) for the rejection. Consult a legal assistance

officer or civilian counsel.

E. Voting By Citizens Who Have Never 

Lived in the U.S.

A U.S. citizen who was born abroad and who is eligible to

vote and who has never lived in the U.S. may register and

vote in the county where a parent would be eligible to

register and vote (for Federal offices only).

F. Where To Send It

Mail the FPCA to the County or Borough Board of

Elections, county or borough of voting residence, as listed

below:

County County Seat Zip Code

Albany 16 Eagle Street, Albany 12207-1019

Allegany 6 Schuyler Street, Belmont 14813

Broome 44 Hawley St., PO Box 1766 Binghamton 13902-3722

Cattaraugus 302 Court Street, Little Valley 14755-1091

Cayuga 10 Court Street, Auburn 13021-3470

Chautauqua Gerace Office Bldg., 3 N. Erie St. Mayville 14757-1007

Chemung 425 Pennsylvania Ave., PO Box 588 Elmira 14902-0588

Chenango 5 Court St. Norwich 13815-1676

Clinton 137 Margaret Street, Plattsburg 12901-2933

Columbia 401 State Street, Hudson 12534-1996

Cortland County Court House, 46 Greenbush St., 

Ste. 102, Cortland 13045-3703

Delaware 3 Gallant Avenue, Delhi 13753-1095

Dutchess 47 Cannon Street, Poughkeepsie 12601-3270

Erie 134 W. Eagle Street, Buffalo 14202-3896

Essex County Court House, PO Box 217 

Elizabethtown 12932-9801

Franklin 355 West Main Street, Malone 12953-1821

Fulton 2714 STHWY 29, Suite 1, Johnstown 12095-9946

Genesee 15 Main Street, PO Box 284, Batavia 14020

Greene 441 Main St., 2nd Floor, Catskill 12414-1445
New York 2004–05 Voting Assistance Guide

218

Hamilton County Complex, Route 8, PO Box 175 

Lake Pleasant 12108-9801

Herkimer 109 Mary St., Suite 1306, Herkimer 13350-0527

Jefferson 175 Arsenal Street, Watertown 13601-2543

Lewis 7660 North State Street, Lowville 13367-9801

Livingston 6 Court Street, Room 104, Geneseo 14454-1043

Madison N. Court St., PO Box 666, Wampsville 13163-9998

Monroe 39 Main St. West, Rochester 14614

Montgomery Old Court House, PO Box 1500, Fonda 12068-1500

Nassau New Admin Building, 400 County Seat 

Drive, Mineola 11501-4800

Niagara 111 Main Street, Suite 100, Lockport 14094

Oneida Union Station, 321 Main Street., 3rd Floor, 

Utica 13501

Onondaga Civic Center, 421 Montgomery St Syracuse 13202-2999

Ontario 20 Ontario Street, Canandaigua 14424-1801

Orange 25 Court Lane, PO Box 30, Goshen 10924-1508

Orleans County Office Bldg., 14016 Rte. 31, Albion 14411-9382

Oswego 46 E. Bridge Street, Oswego 13126-2118

Otsego County Office Bldg., 197 Main Street, 

Cooperstown 13326-1193

Putnam 1 Geneva Road, Brewster 10509

Rensselaer 1600 7th Avenue, Troy 12180-4098

Rockland 11 New Hempstead Road, New City 10956-3600

St. Lawrence Courthouse, 48 Court Street, Canton 13617-9987

Saratoga 50 W. High Street, Ballston Spa 12020-1979

Schenectady 388 Broadway, Suite E, Schenectady 12305-2520

Schoharie 300 Main St., PO Box 99, Schoharie 12157-9998

Schuyler County Office Building,105 9th Street 

Unit 13, Watkins Glen 14891-9972

Seneca 1 DiPronio Drive, Waterloo 13165-1681

Steuben 3 E. Pulteney Square, Bath 14810-1510

Suffolk Yaphank Avenue, PO Box 700, Yaphank 11980-9733

Sullivan 100 North St., PO Box 5012, Monticello 12701-5192

Tioga County Office Building, 56 Main St., Owego 13827-1595

Tompkins Court House Annex 

128 E. Buffalo Street, Ithaca 14850

Ulster 284 Wall Street, Kingston 12401-3641

Warren 1340 St. Route 9, Lake George 12845-9803

Washington 383 Broadway, Fort Edward 12828-1021

Wayne 157 Montezuma St Ext, PO Box 636 Lyons 14489-0636

Westchester 25 Quarropas Street, White Plains 10601-4824

Wyoming 76 North Main Street, Warsaw 14569-1329

Yates 417 Liberty Street, Suite 1124, Penn Yan 14527

New York City (Send to Borough Board of 

Elections)

Borough Address Zip Code

NY (Manhattan) 200 Varick Street

New York 10014

Bronx 1780 Grand Concourse

Bronx 10457

Kings (Brooklyn) 345 Adams Street

Brooklyn 11201

Queens 42-16 West Street, Queens Plaza

Long Island City 11101

Richmond (Staten Island) 1 Edgewater Plaza

Staten Island 10305

County County Seat Zip Code

Voice Your Choice--VOTE

by Carol Cooper, USA, Ft. Monmouth, New Jersey
219

NORTH CAROLINA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A You are requested to fill out this box. This data is requested

from some states by the Department of Justice in their

enforcement of the Voting Rights Act and the National Voter

Registration Act. Enter the choice that best describes you from the

following list for both ethnicity and race. Choices for ethnicity are

Hispanic or Latino-of any race (write HL) or Not Hispanic or

Latino (write NH). Choices for race: White (W), Black or African

American (B), American Indian or Alaska Native (I), Asian (A),

Multi-racial (M), Other (O), or Undesignated (U). For example, a

person with Hispanic ethnicity who is white would write “HLW”

in the space provided.

B The last four digits of your Social Security number OR

your North Carolina Driver's License number is required for

voter registration. If you do not possess either of these

identifications, North Carolina shall assign a number that will

serve to identify you for voter registration purposes.

C Though optional when applying for an absentee ballot only,

providing your Driver’s License number in this blank would be

helpful in processing your application.

D Do not leave blank. Enter “N/A” if not applicable or if you

are a first time voter.

E Provide the complete street address of your North Carolina

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item 7. For

example: “on Highway _____, 2 miles past Highway _____,

across the street from the _____ gas station.” This address must be

different from the one provided in Item 4 and must be within the

county where you claim legal voting residence. Please note that

the local Board of Elections may make a reasonable investigation

concerning your residence. Written verification of residency may

be required.

F Print the complete address where you want your ballot sent -

usually your current mailing address. It must be different from the

address you provided in Item 3.

G You must register with a party to vote in that party’s primary

unless that party allows unaffiliated voters to vote in its primary. If

you indicate a political party that is not a qualified party, or

indicate no party, you will be listed as “Unaffiliated”. You must

write the name of your political party affiliation (Example:

Democratic, Republican, Libertarian or other qualified party),

“Unaffiliated”, or “None” in Item 6 of the FPCA. Political party

choice is not required if only requesting absentee ballots for

general elections. To change or declare your political party choice,

you must complete this section and return the FPCA at least 25

days before the election.

H Check ONE box. Please note: Mental competence is not a

requirement to register and vote in North Carolina.

I You must sign and date the FPCA. When signing, you are

swearing or affirming that the information is true and correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

C

E

G

D

F

I

B

H
North Carolina 2004–05 Voting Assistance Guide

220

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of North Carolina and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your County Board of

Elections early every year and whenever you change your

mailing address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA or written request to the County Board of Elections

anytime before the election.

To request an absentee ballot, send a completed FPCA to

the County Board of Elections anytime before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive not later

than 5:00 p.m. on the day before the election.

Absentee ballots are available 50 days before an election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: The certificate on the ballot

return envelope must be witnessed by two persons 18 years

of age or older. Witnesses must provide their signatures and

addresses.

E. Electronic Transmission of FPCAs 

and Ballots

 North Carolina allows you to send the FPCA for

registration and absentee ballot request by fax. After

faxing, submit the FPCA by mail.

 North Carolina allows you to receive the blank ballot

by fax. 

 North Carolina allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of North Carolina and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in North Carolina.

 civilians attached to and serving with the U.S. Armed

Forces outside the U.S. (for local, state and Federal

office ballots)

 members of the Peace Corps (for local, state and

Federal office ballots)

 North Carolina residents temporarily outside the U.S.

who are unaffiliated with the U.S. government (for

Federal office ballots only)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your County Board of

Elections early every year and whenever you change your

mailing address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA or written request to the County Board of Elections.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the County

Board of Elections anytime before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive not later

than 5:00 p.m. on the day before the election.
2004–05 Voting Assistance Guide North Carolina

221

Absentee ballots are available 50 days before an election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA/Affidavit-Application: No notary or witness

required.

Ballot Return Envelope: The certificate on the ballot

return envelope must be witnessed by two persons 18 years

of age or older. Witnesses must provide their signatures and

addresses.

E. Electronic Transmission of FPCAs 

and Ballots

 North Carolina allows you to send the FPCA for

registration and absentee ballot request by fax. After

faxing, submit the FPCA by mail.

 North Carolina allows you to receive the blank ballot

by fax. 

 North Carolina allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

Late Registration

A. Late Registration

Any member of the Uniformed Services who is qualified to

vote absentee and returns to North Carolina after the

registration records have closed, may still register and vote

in person up to and including election day.

B. Bars to Registration and Voting

A person convicted of a felony may not register to vote,

unless that person is restored to the rights of citizenship. A

person is automatically restored to the rights of citizenship

upon unconditional discharge from prison, probation, or

parole.

C. Cancellation of Registration

Any person who fails to respond to confirmation mailings

and who fails to contact the County Board of Elections

office through the next two consecutive general elections

for Federal office following the date of the mailing may be

removed from the registration rolls.

D. Action on Registration Requests

North Carolina sends a notice of registration. 

E. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, North Carolina shall provide you

with the reason(s) for the rejection. Provide the information

requested in the notice of denial. If a second denial is

received, consult a legal assistance officer or civilian

counsel.

F. Where To Send It

Mail the FPCA to the County Board of Elections in the

county of voting residence as listed below:

County County Seat Zip Code

Alamance 206 W. Elm Street, Graham 27253-2804

Alexander PO Box 326, Taylorsville 28681-0321

Alleghany PO Box 65, Sparta 28675-0065

Anson PO Box 768, Wadesboro 28170-0768

Ashe 150 Gov. Circle, Ste. 2100, Jefferson 28640-9378

Avery PO Box 145, Newland 28657-0145

Beaufort PO Box 1016, Washington 27889-1016

Bertie PO Box 312, Windsor 27983-0312

Bladen PO Box 512, Elizabethtown 28337-0512

Brunswick PO Box 2, Bolivia 28422-0002

Buncombe PO Box 7468, Asheville 28802-7468

Burke PO Box 798, Morganton 28680-0798

Cabarrus PO Box 1315, Concord 28026-1315

Caldwell PO Box 564, Lenoir 28645-0564

Camden PO Box 206, Camden 27921-0206

Carteret 1724-A Life Oak Street, Beaufort 28516-1898

Caswell PO Box 698, Yanceyville 27379-0698

Catawba PO Box 132, Newton 28658-0389

Chatham PO Box 111, Pittsboro 27312-0111

Cherokee PO Box 816, Murphy 28906-0816

Chowan PO Box 133, Edenton 27932-0133

Clay PO Box 687, Hayesville 28904-0687

Cleveland PO Box 1299, Shelby 28151-1299

Columbus PO Box 37, Whiteville 28472-0037

Craven 406 Craven Street, New Bern 28560-4911

Cumberland PO Box 1829, Fayetteville 28302-1829

Currituck PO Box 177, Currituck 27929-0177

Dare PO Box 1000, Manteo 27954-1000

Davidson PO Box 1084, Lexington 27293-1084

Davie 124 S. Salisbury St., Ste. 102, Mocksville 27028-2359

Duplin PO Box 975, Kenansville 28349-0975

Durham PO Box 868, Durham 27702-0868

Edgecombe PO Box 10, Tarboro 27886-0010

Forsyth 680 W. Fourth Street, Winston Salem 27101-2730

Franklin PO Box 180, Louisburg 27549-0180

Gaston PO Box 1396, Gastonia 28053-1396

Gates PO Box 621, Gatesville 27938-0621

Graham PO Box 1239, Robbinsville 28771-1239

Granville PO Box 83, Oxford 27565-0083

Greene PO Box 583, Snow Hill 28580-0583

Guilford PO Box 3427, Greensboro 27402-3927
North Carolina 2004–05 Voting Assistance Guide

222

Halifax PO Box 101, Halifax 27839-0101

Harnett PO Box 356, Lillington 27546-0356

Haywood 1233 N. Main St., Annex II, Waynesville 28786-2599

Henderson PO Box 2090, Hendersonville 28793-2090

Hertford PO Box 416, Winton 27986-0416

Hoke PO Box 1565, Raeford 28376-1565

Hyde PO Box 152, Swanquarter 27885-0152

Iredell 117 Court St., B-1, Statesville 28677-5802

Jackson 401 Grindstaff Cove Road, Sylva 28779-2952

Johnston PO Box 1172, Smithfield 27577-1172

Jones PO Box 263, Trenton 28585-0263

Lee PO Box 1443, Sanford 27331-1443

Lenoir PO Box 3503, Kinston 28502-3503

Lincoln 115 W. Main St., Room 201, Lincolnton 28092-2601

Macon 5 West Main Street, Franklin 28734-3005

Madison PO Box 142, Marshall 28753-0142

Martin PO Box 801, Williamston 27892-0801

McDowell PO Box 1509, Marion 28752-1509

Mecklenburg PO Box 31788, Charlotte 28231-1788

Mitchell PO Box 381, Bakersville 28705-0381

Montgomery PO Box 607, Troy 27371-0607

Moore PO Box 787, Carthage 28327-0787

Nash PO Box 305, Nashville 27856-0305

New Hanover 24 N. Third St., Rm. 101, Wilmington 28401-4529

Northampton PO Box 603, Jackson 27845-0603

Onslow 521 Mill Avenue, Jacksonville 28540-4258

Orange PO Box 220, Hillsborough 27278-0220

Pamlico PO Box 464, Bayboro 28515-0464

Pasquotank PO Box 28, Elizabeth City 27907-0028

Pender PO Box 1232, Burgaw 28425-1232

Perquimans PO Box 336, Hertford 27944-0336

Person 304 S. Morgan St., Rm. 150, Roxboro 27573-5245

Pitt PO Drawer 56, Greenville 27835-0056

Polk PO Box 253, Columbus 28722-0253

Randolph Shaw Bldg., 158 Worth St., Asheboro 27203-5518

Richmond PO Box 1843, Rockingham 28380-1843

Robeson PO Box 2159, Lumberton 28359-2159

Rockingham PO Box 208, Wentworth 27375-0208

Rowan 130 W. Innes Street, Salisbury 28144-4365

Rutherford PO Box 927, Rutherfordton 28139-0927

Sampson PO Box 33, Clinton 28329-0033

Scotland 231 E. Cronly St., Ste. 305, Laurinburg 28352-3820

Stanly 201 S. Second St., Rm. 302, Albemarle 28001-5741

Stokes PO Box 34, Danbury 27016-0034

Surry PO Box 372, Dobson 27017-0372

Swain PO Box 133, Bryson City 28713-0133

Transylvania PO Drawer 868, Brevard 28712-0868

Tyrrell PO Box 449, Columbia 27925-0449

Union PO Box 1106, Monroe 28111-1106

Vance 300 S. Garnett Street, Henderson 27536-4566

Wake PO Box 695, Raleigh 27602-0695

Warren PO Box 803, Warrenton 27589-0803

Washington PO Box 1007, Plymouth 27962-1007

Watauga PO Box 528, Boone 28607-0528

Wayne PO Box 1240, Goldsboro 27533-1240

Wilkes 110 North Street, Rm. 315, Wilkesboro 28697-2428

Wilson PO Box 2121, Wilson 27894-2121

Yadkin PO Box 877, Yadkinville 27055-0877

Yancey PO Box 763, Burnsville 28714-0763

County County Seat Zip Code

“Don’t Be Invisible...Come Out And Vote!”

by Captain Joel M. Hoffman, USMC, Camp Lejeune, North Carolina
223

NORTH DAKOTA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

B Provide the complete street address of your North

Dakota voting residence. A post office box is not sufficient.

If your address includes a rural route, describe its location.

For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or township where you claim

legal voting residence.

C Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

D Check ONE box.

E You must sign the FPCA. When signing, you are

swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) MMDDY Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

C

E
North Dakota 2004–05 Voting Assistance Guide

224

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of North Dakota and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

North Dakota has no voter registration.

To request an absentee ballot, the County Auditor must

receive your FPCA at any time in an election year.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

County Auditor before the county canvassing board meets

which is usually 3 days after the election and as many as 6

days after the election. 

Postmark your voted ballot before election day. 

Local election officials mail ballots approximately 40 days

before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 North Dakota allows you to send the FPCA for ballot

request by fax. After faxing, submit the FPCA by mail. 

 North Dakota allows you to receive the blank ballot by

fax.

 North Dakota allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Agent

Any person acting as an agent on your behalf may request

an application for an absentee ballot for you. The request

can be made by telephone or in person at the County

Auditor’s office.

G. Special Write-In Absentee Ballot

North Dakota provides a state special write-in absentee

ballot available before an election if you will be unable to

vote by regular absentee ballot or in person due to

requirements of military service or due to living in

extremely remote areas of the world.

The FPCA may be used to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.C. If no labels are available,

write in Item 7: “I am unable to vote by regular absentee

ballot or in person due to requirements of military service

or due to living in extremely remote areas of the world. I

request a special write-in absentee ballot.” 

The state special write-in ballot may be requested at any

time before the election. It may be used to vote for

presidential electors, members of the U.S. Senate and

members of the U.S. House of Representatives. Vote it by

writing in a party preference for each office, the names of

specific candidates for each office or the name of the person

whom you prefer for each office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of North Dakota and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in North Dakota.
2004–05 Voting Assistance Guide North Dakota

225

 residents of North Dakota temporarily residing outside

the U.S. (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

North Dakota has no voter registration.

To request an absentee ballot, the County Auditor must

receive your FPCA at any time in a election year.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

County Auditor before the county canvassing board meets

which is usually 3 days after the election and as many as 6

days after the election. 

Postmark your voted ballot before election day.

Local election officials mail ballots approximately 40 days

before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 North Dakota allows you to send the FPCA for ballot

request by fax. After faxing, submit the FPCA by mail.

 North Dakota allows you to receive the blank ballot by

fax. 

 North Dakota allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers: 

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Agent

Any person acting as an agent on your behalf may request

an application for an absentee ballot for you. The request

can be made by telephone or in person at the County

Auditor’s office.

G. Special Write-In Absentee Ballot

North Dakota provides a state special write-in absentee

ballot available before an election if you will be unable to

vote by regular absentee ballot or in person due to

requirements of military service or due to living in

extremely remote areas of the world.

The FPCA may be used to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.C. If no labels are available,

write in Item 7: “I am unable to vote by regular absentee

ballot or in person due to requirements of military service

or due to living in extremely remote areas of the world. I

request a special write-in absentee ballot.” 

The state special write-in ballot may be requested at any

time before the election. It may be used to vote for

presidential electors, members of the U.S. Senate and

members of the U.S. House of Representatives. Vote it by

writing in a party preference for each office, the names of

specific candidates for each office or the name of the person

whom you prefer for each office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of treason or another felony (unless civil

rights are restored) or found mentally incompetent by a

court or other authority having jurisdiction (unless order is

rescinded) may not vote.

B. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, North Dakota shall provide you

with the reason(s) for the rejection.

C. Where To Send It

Mail the FPCA to the County Auditor, county of voting

residence, as listed below:

County County Seat Zip Code

Adams PO Box 589, Hettinger 58639-0589

Barnes 230 4th Street, NW, Valley City 58072-2947

Benson PO Box 206, Minnewaukan 58351-0206

Billings PO Box 168, Medora 58645-0168

Bottineau 314 W. 5th Street, Bottineau 58318-1204
North Dakota 2004–05 Voting Assistance Guide

226

Bowman PO Box 439, Bowman 58623-0439

Burke PO Box 310, Bowbells 58721-0310

Burleigh PO Box 5518, Bismarck 58506-5518

Cass PO Box 2806, Fargo 58108-2806

Cavalier 901 3rd Street, Langdon 58249-2457

Dickey PO Box 215, Ellendale 58436-0215

Divide PO Box 49, Crosby 58730-0049

Dunn PO Box 105, Manning 58642-0105

Eddy 524 Central Avenue, New Rockford 58356-1698

Emmons PO Box 129, Linton 58552-0129

Foster PO Box 104, Carrington 58421-0104

Golden Valley PO Box 67, Beach 58621-0067

Grand Forks PO Box 5726, Grand Forks 58206-5726

Grant PO Box 227, Carson 58529-0227

Griggs PO Box 511, Cooperstown 58425-0511

Hettinger PO Box 668, Mott 58646-0668

Kidder PO Box 167, Steele 58482-0167

LaMoure PO Box 128, LaMoure 58458-0128

Logan 301 Broadway, Napoleon 58561-7010

McHenry PO Box 147, Towner 58788-0147

McIntosh PO Box D, Ashley 58413-0019

McKenzie PO Box 543, Watford City 58854-0543

McLean PO Box 1108, Washburn 58577-1108

Mercer PO Box 39, Stanton 58571-0039

Morton 210 2nd Avenue, NW, Mandan 58554-3158

Mountrail PO Box 69, Stanley 58784-0069

Nelson PO Box 585, Lakota 58344-0585

Oliver PO Box 188, Center 58530-0188

Pembina 301 Dakota Street W 1, Cavalier 58220-4100

Pierce 240 SE 2nd Street, Suite 5, Rugby 58368-1897

Ramsey 524 4th Avenue, Unit 6, Devils Lake 58301-2490

Ransom PO Box 668, Lisbon 58054-0668

Renville PO Box 68, Mohall 58761-0068

Richland 418 2nd Avenue, N, Wahpeton 58075-4400

Rolette PO Box 939, Rolla 58367-0939

Sargent PO Box 177, Forman 58032-0177

Sheridan PO Box 439, McClusky 58463-0439

Sioux PO Box L, Fort Yates 58538-0529

Slope PO Box NN, Amidon 58620-0449

Stark PO Box 130, Dickinson 58602-0130

Steele PO Box 275, Finley 58230-0275

Stutsman 511 2nd Avenue, SE, Jamestown 58401-4299

Towner PO Box 603, Cando 58324-0603

Traill PO Box 429, Hillsboro 58045-0429

Walsh 600 Cooper Avenue, Grafton 58237-1535

Ward 315 3rd Street, SE, Minot 58702-5005

Wells PO Box 37, Fessenden 58438-0037

Williams PO Box 2047, Williston 58802-2047

County County Seat Zip Code

Vote - The World Is Listening

by TSgt Jill Westeyn, USAF, Alexandria, Virginia
NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”

D. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

NORTH DAKOTA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in extremely remote areas

of the world. I request a special write-in absentee ballot.”
North Dakota 2004–05 Voting Assistance Guide

228
229

OHIO

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

or your Ohio Driver’s License number is required for

voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Ohio

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

partisan primary elections. You must indicate your political

party affiliation when applying for a partisan primary ballot

(Example: Democrat, Republican) or “issues only” if you

want to vote questions and issues and not candidates in Item

6 of the FPCA. Political party affiliation is not required if

requesting absentee ballots for non-partisan primary and

general elections. If you voted in a primary election within

the last two calendar years and you now want to change

your political party choice or you have previously declined

to indicate a political party and you now want to vote in a

primary election, you must submit a completed FPCA

which includes your political party affiliation to the local

election official. If you are changing political party

affiliation, you will receive, in addition to your absentee

ballot, a state affidavit form which must be completed and

returned with your voted ballot.

F Fill in the length of time you resided in Ohio

immediately before leaving Ohio or leaving to be near a

service member. (“I was an Ohio resident for

__________.”)

G Check ONE box.

H You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

H

A
Ohio 2004–05 Voting Assistance Guide

230

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Ohio and members of the Uniformed Services

and their spouses and dependents residing outside Ohio to

be with or near such service members. Uniformed Services

are defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

If you are an absent uniformed services voter, or an

overseas voter, submitting an FPCA for both voter

registration and absentee ballot application under the

UOCAVA, you may request that your FPCA be considered

an application for an absentee ballot for each subsequent

election for Federal office held in Ohio for which you are

eligible to vote, through the next two regularly scheduled

elections for Federal office.

Registration is waived only for members of the U.S. Armed

Forces and their spouses and dependents residing outside

Ohio to be with or near such service members.

To register and request an absentee ballot, send a completed

FPCA to the county board of elections so that it arrives not

later than 30 days before the election.

If you are already registered or if you are not required to

register, and only wish to request an absentee ballot, send a

completed FPCA to the county board of elections so that it

arrives not later than noon on the third day before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive not later

than the close of polls on election day. 

Exception: If you are voting from outside the U.S., your

ballot will be counted if it arrives not later than 10 days

after the election, as long as it is signed not later than the

close of polls on election day.

Local election officials begin mailing absentee ballots not

later than 35 days before an election or 25 days before a

presidential primary election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instruction in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Ohio allows you to send the FPCA for ballot request

by fax. After faxing, submit the original FPCA by

mail. Ohio does not allow you to send the FPCA for

registration by fax. 

 Ohio allows you to receive the blank ballot by fax.

 Ohio does not allow you to return the voted ballot by

fax.

Please refer to appendix C for specific instructions when

transmitting election materials electronically. You may fax

directly to the appropriate county board of elections or use

the following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

If you are a member of the Armed Forces, or the spouse or

dependent of a member of the Armed Forces, your father,

mother, father-in-law, mother-in-law, grandfather,

grandmother, brother, sister, son, daughter, stepparent,

stepchild, uncle, aunt, nephew or niece may request an

absentee ballot for you, using either a special form provided

by the county board or an FPCA.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Ohio and overseas citizens. The term “overseas

citizen” means a U.S. citizen who resides outside the U.S.

and (but for such residence) would be qualified to vote in

Ohio.

 residents of Ohio temporarily residing outside the U.S.

(for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)
2004–05 Voting Assistance Guide Ohio

231

B. Registering and Requesting an 

Absentee Ballot

If you are an absent uniformed services voter, or an

overseas voter, submitting an FPCA for both voter

registration and absentee ballot application under the

UOCAVA, you may request that your FPCA be considered

an application for an absentee ballot for each subsequent

election for Federal office held in Ohio for which you are

eligible to vote, through the next two regularly scheduled

elections for Federal office.

To register and request an absentee ballot, send a completed

FPCA to the county board of elections so that it arrives not

later than 30 days before the election. 

To request an absentee ballot if you are already registered,

send a completed FPCA to the county board of elections so

that it arrives not later than three days before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be signed,

mailed and postmarked not later than the close of the polls

on election day. It will be counted if it is received not later

than 10 days after the election.

Local election officials begin mailing absentee ballots not

later than 35 days before an election or 25 days before a

presidential primary election.

If you have not receive your state ballot in a timely manner,

use the Federal Write-In Absentee Ballot. See instructions

in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

Ohio does not allow electronic transmission of the FPCA,

the blank absentee ballot or the voted absentee ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons adjudicated incompetent for voting purposes or

currently incarcerated for a felony may not register or vote.

B. Cancellation of Registration

Registration is canceled for failure of the registered voter,

after he/she has been mailed a confirmation notice, to do

either: 1) respond to such a notice or engage in voter

activity at least once during a period of four consecutive

years, which period shall include two general elections for

Federal office, or 2) update his/her registration or engage in

voter activity at least once during a period of four

consecutive years, which period shall include two general

elections for Federal office.

C. Action on Registration Requests

Notice of acceptance or denial is sent.

D. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Ohio shall provide you with the

reason(s) for the rejection. If registration is denied, submit a

request for reconsideration to the director of the board of

elections. If a second request is denied, consult a legal

assistance officer or civilian counsel.

E. Late Registration

Discharged military personnel and spouses who return to

Ohio after the closing date of registration are permitted to

vote prior to election day in the office of their county board

of elections.

F. Where To Send It

Mail the FPCA to the Director, County Board of Elections

of the county of voting residence as listed below:

County County Seat Zip Code

Adams 215 N. Cross Street, Room 103 

West Union 45693-1389

Allen 204 N. Main Street 

Lima 45801-4433

Ashland 110 Cottage Street 

Ashland 44805-2183

Ashtabula 8 W. Walnut Street 

Jefferson 44047-1097

Athens 15 S. Court Street, Room 130 

Athens 45701-2836

Auglaize 12 W. Main Street 

Wapakoneta 45895-0158

Belmont Bank One Building, 3rd Floor

PO Box 127 Bellaire 43906-1547

Brown 800 Mt. Orab Pike 

Georgetown 45121-1283

Butler 315 Hight Street, 10th Floor 

Hamilton 45011-6016

Carroll Court House

Carrolton 44615-1489

Champaign 1512 S. U.S. Highway 68, Suite 100 

Urbana 43078-9288

Clark 25 W. Pleasant Street, PO Box 1766 

Springfield 45501-1766

Clermont 76 S. RIverside Drive

Batavia 45103-2961

Clinton 46 S. South Street, 1st Floor 

Wilmington 45177-2214

Columbiana 41 N. Park Avenue 

Lisbon 44432-1258

Coshocton 724 S. Seventh Street, Room. 100

Coshocton 43812-2397

Crawford 130 N. Walnut Street 

Bucyrus 44820-2383

Cuyahoga 2925 Euclid Avenue 

Cleveland 44115-2497
Ohio 2004–05 Voting Assistance Guide

232

Darke 300 Garst Avenue

Greenville 45331-1409

Defiance 197-A Island Park Avenue 

Defiance 43512-2255

Delaware 91 N. Sandusky Street

Delaware 43015-1777

Erie 2900 Columbus Avenue, Room 101

Sandusky 44870-5553

Fairfield 224 E. Main Street, Room 101 

Lancaster 43130-3875

Fayette 321 S. Fayette Street 

Washington Court House 43160-2235

Franklin 410 S. High Street 

Columbus 43215-4572

Fulton 525 N. Shoop Avenue

Wauseon 43567-1235

Gallia 18 Locust St., Room 1266, 2nd Floor 

Gallipolis 45631-1292

Geauga 215 Main Street 

Chardon 44024-12143

Greene 651 Dayton-Xenia Road

Xenia 45385-2605

Guernsey 224 Dewey Avenue 

Cambridge 43725-2657

Hamilton 824 Broadway

Cincinnati 45202-1345

Hancock 351 S. West Street 

Findlay 45840-3279

Hardin 1 Court House Square, Suite 170 

Kenton 43326-2387

Harrison Court House, 100 W. Market Street 

Cadiz 43907-1197

Henry 660 N. Perry Street 

Napoleon 43545-1796

Highland 119 Governor Foraker Place

Hillsboro 45133-1089

Hocking 1 E. Main Street, PO Box 109 

Logan 43138-1207

Holmes 75 E. Clinton Street, Suite 108 

Millersburg 44654-1269

Huron 180 Milan Avenue

Norwalk 44857-1168

Jackson 226 Main Street, Suite. 2 Court House 

Jackson 45640-1769

Jefferson 177 N. 3rd Street

Steubenville 43952-4499

Knox 117 E. Hight Street, Room 210, 

Mount Vernon 43050-3306

Lake 105 Main Street, PO Box 490

Painesville 44077-0490

Lawrence 111 S. 4th Street, Veterans Square

 Ironton 45638-1521

Licking 20 S. 2nd Street

 Newark 43055-5663

Logan 101 S. Main Street, Court House Room 4 

Bellefontaine 43311-2075

Lorain 115 Cedar Street

 Elyria 44035-5681

Lucas One Government Center, Suite 300 

Toledo 43604-2250

Madison 117 W. High Street, Suite 102

London 43140-1095

Mahoning 2801 Market Street

Youngstown 44507-1695

Marion 100 Court House Square

Marion 43302-3089

Medina 144 N. Boradway Street 

Medina 44256-1902

Meigs 112 Mulberry Avenue, PO BOX 688 

Pomeroy 45769-0688

County County Seat Zip Code

Mercer Court House, Room 107

Celina 45822-1790

Miami 215 W. Main Street

Troy 45373-3263

Monroe 101 N. Main Street, Room 15

Woodsfield 43793-1001

Montgomery 14 W. 4th St., PO Box 8705 

Dayton 45481-8705

Morgan 37 E. Main Street

McConnelsville 43756-1166

Morrow 48 E. High Street 

Mount Gilead 43338-1458

Muskingum 205 N. Seventh Street

 Zanesville 43701-3709

Noble 190 Court House

Caldwell 43724-1243

Ottawa 8444 W. SR 163, Suite 101

 Port Clinton 43339-8885

Paulding 105 E. Perry Street

Paulding 45879-1412

Perry 121 W. Brown Street, PO Box 187 

New Lexington 43764-1241

Pickaway 141 W. Main Street, Suite 800

Circleville 43113-1601

Pike 105 E. 3rd Street 

Waverly 45690-1402

Portage 449 S. Meridian Street 

Ravenna 44266-2963

Preble 101 E. Main Street

Eaton 45320-1758

Putnam 245 E. Main Street, Suite 102 

Ottawa 45875-1957

Richland 77 N. Mulberry Street

Mansfield 44907-1224

Ross 475 Western Avenue, Suite D 

PO Box 1663, Chillicothe 45601-3207

Sandusky 2020 Countryside Drive 

Fremont 43420-9574

Scioto 602 Seventh Street, Room 105 

Court House, Portsmouth 45662-3927

Seneca 71 S. Washington Street, Suite A

PO Box 667, Tiffin 44883-2302

Shelby Annex Building, 129 E. Court Street 

Sidney 45365-3060

Stark 201 3rd Street, NE

 Canton 44702-1296

Summit 470 Grant Street

Akron 44311-1157

Trumbull 2947 Youngstown Road, SE,

Warren 44484-5294

Tuscarawas Courthouse, Public Square, PO Box 69 

New Philadelphia 44663-2599

Union 221 S. Plum Street 

Marysville 43040-1621

Van Wert 120 E. Main Street 

Van Wert 45891-1425

Vinton 112 N. Market Street

McArthur 45651-1298

Warren 406 Justice Drive, Room 323 

Lebanon 45036-2314

Washington 205 Putnam Street 

Marietta 45750-3014

Wayne 428 W. Liberty Street 

Wooster 44691-5000

Williams 228 S. Main Street 

Bryan 43506-1751

Wood 1 Courthouse Square, 

Bowling Green 43402-2427

Wyandot 109 South Sandusky Avenue, 

Upper Sandusky 43351-1423

County County Seat Zip Code

We’re Counting On Your VOTE!

by LT Christopher S. Lake, USN, Europe
233

OKLAHOMA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

B Provide the complete street address of your Oklahoma

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence.

C Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

D If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party choice is not required if only

requesting absentee ballots for general elections. If you

have previously submitted an FPCA and want to change

your political party affiliation or you have previously

declined to indicate a political party and you now want to

vote in a primary election, you must submit a completed

FPCA which includes your new political party choice to the

local election official not later than the Wednesday before

the election. 

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E
Oklahoma 2004–05 Voting Assistance Guide

234

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Oklahoma and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration. 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Registration is not required. 

To request an absentee ballot, send a completed FPCA to

the County Election Board so that it arrives not later than 5

p.m. on the Wednesday before an election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive not later

than 7 p.m. on election day. Special provision is made for

Runoff Primary Election Ballots, which must be returned

by 5 p.m. on the fourteenth day following the election.

Local election officials mail out ballots approximately 30

days before an election (as soon as the County Election

Board receives them from the printer).

You may also use the Federal Write-In Absentee Ballot. See

instructions below. 

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Oklahoma allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail.

 Under certain limited circumstances, Oklahoma allows

you to receive the blank ballot by fax.

 Under certain limited circumstances, Oklahoma allows

you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

A state special write-in absentee ballot is available 90 days

before an election if you will be unable to vote by regular

absentee ballot, or in person due to military contingencies

or due to living in an isolated or extremely remote area of

the world. 

You may use the FPCA or a written letter to request this

state special write-in absentee ballot. In Item 7 of the

FPCA, place one of the state special write-in labels from

Section III.D. If no labels are available, write in Item 7 or in

your letter: “Due to military contingencies or due to living

in an isolated or extremely remote area of the world, I

cannot follow the regular application procedure for an

absentee ballot. I request a special write-in absentee ballot.” 

You must request the state special write-in absentee ballot

within 90 days before an election. Vote for Federal

candidates in a primary, run-off primary or general election

by writing in the names of specific candidates or the names

of persons whom you prefer. In general elections, you may

write in party preference for each office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

G. Federal Write-In Absentee Ballot

Oklahoma has expanded the use of the Federal Write-In

Absentee Ballot (FWAB). The instructions described in

Chapter 2 of this guide remain the same except that

Oklahoma allows UOCAVA citizens to vote and submit the

FWAB for all federal elections and even if the citizen has

not requested the regular state ballot. 

For further instructions on the FWAB see Chapter 2,

page 12.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
2004–05 Voting Assistance Guide Oklahoma

235

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Oklahoma and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Oklahoma.

 Oklahoma residents temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 overseas electors (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Registration is not required.

To request an absentee ballot, send a completed FPCA to

the County Election Board so that it arrives not later than 5

p.m. on the Wednesday before an election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive not later

than 7 p.m. on election day. Special provision is made for

Runoff Primary Election Ballots, which must be returned

by 5 p.m. on the fourteenth day following the election.

Local election officials mail out ballots approximately 30

days before an election (as soon as the County Election

Board receives them from the printer).

You may also use the Federal Write-In Absentee Ballot. See

instructions below. 

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Oklahoma allows you to send the FPCA for absentee

ballot request by fax. After faxing, submit the FPCA

by mail.

 Under certain limited circumstances, Oklahoma allows

you to receive the blank ballot by fax.

 Under certain limited circumstances, Oklahoma allows

you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

A state special write-in absentee ballot is available 90 days

before an election if you will be unable to vote by regular

absentee ballot, or in-person due to military contingencies

or due to living in an isolated or extremely remote area of

the world.

You may use the FPCA or a written letter to request this

state special write-in absentee ballot. In Item 7 of the

FPCA, place one of the state special write-in labels from

Section III.D. If no labels are available, write in Item 7 or in

your letter: “Due to living in an isolated or extremely

remote area of the world, I cannot follow the regular

application procedure for an absentee ballot. I request a

special write-in absentee ballot.”

You must request the state special write-in absentee ballot

within 90 days before an election. You may use it to vote

for Federal candidates in a primary, run-off primary or

general election by writing in the names of specific

candidates or the names of persons whom you prefer. In

general elections, you may write in party preference for

each office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

G. Federal Write-In Absentee Ballot

Oklahoma has expanded the use of the Federal Write-In

Absentee Ballot (FWAB). The instructions described in

Chapter 2 of this guide remain the same except that

Oklahoma allows UOCAVA citizens to vote and submit the

FWAB for all federal elections and even if the citizen has

not requested the regular state ballot.

For further instructions on the FWAB see Chapter 2,

page 12.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.
Oklahoma 2004–05 Voting Assistance Guide

236

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony for which a period of time

equal to the original sentence has not expired and those

found to be incapacitated or partially incapacitated and

prohibited from registering to vote shall be ineligible to

register to vote.

B. Late Registration

If you are honorably discharged from the U.S. Armed

Forces or terminated in your service or employment

overseas, and you are returning home to Oklahoma too late

to register for the upcoming election, you may vote in that

election only (in the precinct where you are a qualified

voter) without being registered (provided that you have

satisfied the precinct inspector that you are entitled to vote

in the election).

C. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Oklahoma shall provide you with

the reason(s) for the rejection. 

D. Voting By Citizens Who Have Never 

Resided In The U.S.

If a U.S. citizen outside the U.S. has never lived in the U.S.

and either parent is a qualified Oklahoma voter, then he or

she is eligible to register and vote where his or her parent is

a qualified voter.

E. Where To Send It

Mail the FPCA to the Secretary, County Election Board,

county of voting residence, as listed below:

County County Seat Zip Code

Adair Stilwell 74960-0006

Alfalfa Cherokee 73728-2548

Atoka Atoka 74525-2056

Beaver Beaver 73932-0639

Beckham Sayre 73662-3046

Blaine Watonga 73772-3843

Bryan Durant 74701-3607

Caddo Anadarko 73005-0277

Canadian El Reno 73036-0307

Carter Ardmore 73401-6412

Cherokee Tahlequah 74464-4726

Choctaw Hugo 74743-0517

Cimarron Boise City 73933-0331

Cleveland Norman 73069-6046

Coal Coalgate 74538-0202

Comanche Lawton 73501-4326

Cotton Walters 73572-1271

Craig Vinita 74301-0861

Creek Sapulpa 74067-0990

Custer Clinton* 73601-1326

Delaware Jay 74346-0589

Dewey Taloga 73667-0115

Ellis Arnett 73832-0492

Garfield Enid 73702-1872

Garvin Pauls Valley 73075-3234

Grady Chickasha 73023-1226

Grant Medford 73759-0068

Greer Mangum 73554-4200

Harmon Hollis 73550-3053

Harper Buffalo 73834-0541

Haskell Stigler 74462-0300

Hughes Holdenville 74848-3402

Jackson Altus 73522-0154

Jefferson Waurika 73573-2235

Johnston Tishomingo 73460-1730

Kay Newkirk 74647-0331

Kingfisher Kingfisher 73750-3241

Kiowa Hobart 73651-4016

Latimer Wilburton 74578-2435

LeFlore Poteau 74953-0249

Lincoln Chandler 74834-0097

Logan Guthrie 73044-4834

Love Marietta 73448-2849

McClain Purcell 73080-0759

McCurtain Idabel 74745-3835

McIntosh Eufaula 74432-1022

Major Fairview 73737-2243

Marshall Madill 73446-0009

Mayes Pryor 74362-0606

Murray Sulphur 73086-0556

Muskogee Muskogee 74402-0216

Noble Perry 73077-6649

Nowata Nowata 74048-2654

Okfuskee Okemah 74859-2603

Oklahoma Oklahoma City 73105-5210

Okmulgee Okmulgee 74447-5013

Osage Pawhuska 74056-0929

Ottawa Miami 74354-7009

Pawnee Pawnee 74058-0038

Payne Stillwater 74074-4080

Pittsburg McAlester 74501-5020

Pontotoc Ada 74821-0302

Pottawatomie Shawnee 74801-6938

Pushmataha Antlers 74523-3864

Roger Mills Cheyenne 73628-0147

Rogers Claremore 74018-1029

Seminole Wewoka 74884-2653

Sequoyah Sallisaw 74955-4641

Stephens Duncan 73533-4758

Texas Guymon 73942-0607

Tillman Frederick 73542-5499

Tulsa Tulsa 74103-1008

Wagoner Wagoner 74477-0714

Washington Bartlesville 74003-6602

Washita Cordell 73632-4831

Woods Alva 73717-0184

Woodward Woodward 73802-0613

* Not county seat

County County Seat Zip Code

Influence Your Future, Vote!

by Sgt Erich Max Klein, USSMC, San Diego, California
OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”

F. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

OKLAHOMA

“Due to military contingencies or due to living in an isolated or extremely

remote area of the world, I cannot follow the regular application procedure

for an absentee ballot. I request a special write-in absentee ballot.”
Oklahoma 2004–05 Voting Assistance Guide

238
239

OREGON

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your Oregon Driver's License number is required for

voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Oregon

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address is different from the one provided in Item 4 and

must be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. It is different

from the address you provided in Item 3.

E Print the name of a political party or write, “not

affiliated with a party.” If you do not complete Item 6, you

will be registered “non-affiliated.” If you print the name of

a party that selects its candidates at the primary election,

you will be eligible to vote in that party’s primary. Political

party affiliation is not required if only requesting absentee

ballots for general elections. If you are not affiliated with a

political party and you wish to vote the primary ballot of a

party that has authorized participation of non-affiliated

electors, write in Item 7: “I want to vote in the (fill in the

name of the political party) primary. Please send me its

primary election absentee ballot.” In this case submit your

FPCA at least 45 days prior to the primary election.

Candidates nominated at a primary election run in the

general election.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct. A witness or a notary is not required.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
Oregon 2004–05 Voting Assistance Guide

240

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Oregon and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address, except if you are requesting a special write-in

ballot (See Section F and also Chapter 2).

To register to vote and request an absentee ballot, send a

completed FPCA to the county clerk by the 21st day before

the election at which you intend to vote. A postmark of the

21st day before the election is accepted.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the county clerk

so that it arrives not later than the Thursday before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by 8 p.m.

on election day.

Local election officials mail absentee ballots 45 days before

the primary and general elections.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12, and

Section I. E.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Oregon allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Oregon allows you to receive the blank absentee ballot

by fax.

 Oregon does not allow you to return the voted ballot

by fax. 

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Oregon provides a state special write-in absentee ballot if

you are residing, stationed, or working outside the U.S. and

will be unable to vote and return a regular absentee ballot

by normal mail delivery within the period provided for

regular absentee ballots. 

Use the FPCA to request this state special write-in ballot. In

Item 7 of the FPCA, place one of the state special write-in

labels from Section III.H. If no labels are available, write in

Item 7: “I am outside the territorial limits of the United

States and the District of Columbia and I am unable to vote

and return a regular absentee ballot by normal mail delivery

in the time provided for regular absentee ballots. I request a

special write-in absentee ballot.” 

You may request the state special write-in ballot any time

before the election, but any request received by the county

clerk less than 40 days before the election is treated as a

request for a regular absentee ballot. 

The FPCA you use to request a write-in ballot is valid only

for the election specified in the application.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens

and residents of Oregon.

 Oregon residents and their spouses and dependents

temporarily residing outside the U.S. (for local, state

and Federal office ballots)

 overseas citizens from Oregon (for Federal office

ballots only)
2004–05 Voting Assistance Guide Oregon

241

 U.S. citizens who have never resided in the U.S. but

have a parent who is eligible to vote in Oregon. These

citizens are eligible to vote at the same voting

residence claimed by their parent (for Federal office

ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address, except if you are requesting a special write-in

ballot (See Section E and also Chapter 2).

To register to vote and request an absentee ballot, send a

completed FPCA to the county clerk by the 21st day before

the election at which you intend to vote. A postmark of the

21st day before the election is accepted.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the county clerk

so that it arrives not later than the Thursday before the

election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by 8 p.m.

on election day.

Local election officials mail absentee ballots 45 days before

the primary and general elections.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12 and Section II. E.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Oregon allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Oregon allows you to receive the absentee ballot by

fax.

 Oregon does not allow you to return the voted ballot

by fax. 

Please refer to APpendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Oregon provides a state special write-in absentee ballot if

you are residing, stationed, or working outside the U.S. and

will be unable to vote and return a regular absentee ballot

by normal mail delivery within the period provided for

regular absentee ballots.

Use the FPCA to request this state special write-in ballot. In

Item 7 of the FPCA, place one of the state special write-in

labels from Section III. If no labels are available, write in

Item 7: “I am outside the territorial limits of the United

States and the District of Columbia and I am unable to vote

and return a regular absentee ballot by normal mail delivery

in the time provided for regular absentee ballots. I request a

special write-in absentee ballot.” 

You may request the state special write-in ballot any time

before the election, but any request received by the county

clerk less than 40 days before the election is treated as a

request for a regular absentee ballot. 

The FPCA you use to request a write-in ballot is valid only

for the election specified in the application.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Late Registration

Members of the U.S. Armed Forces or merchant marine

who have been discharged within 30 days of an election

may follow the procedures outlined in Section I to register

and vote.

B. Bars to Registration and Voting

Persons found mentally incompetent by a court may not

register or vote. Persons imprisoned by the Oregon

Department of Corrections for a felony may register but

may not vote from the date of sentencing until released,

paroled or the conviction is set aside.

C. Cancellation of Registration

Registration is valid until the registrant notifies the county

clerk of cancellation or changes to his or her voting status.

An election official also automatically updates registrations

for which they receive information from the U. S. Postal

Service of a mailing or residence address change.

Additionally, an elections official may inactivate or cancel a

registration if a person has moved, has not responded to a

notice from the election official and has not voted for at

least four years.
Oregon 2004–05 Voting Assistance Guide

242

D. Action on Registration Requests

Notice of acceptance or denial is sent.

E. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Oregon shall provide you with the

reason(s) for the rejection. Persons denied registration may

appeal to the county clerk. Consult a legal assistance officer

or civilian counsel.

F. Voting By Citizens Who Have Never 

Lived in the U.S.

A U.S. citizen who was born abroad and who is eligible to

vote and who has never lived in the U.S. may register

temporarily and vote in the county where a parent would be

eligible to temporarily register and vote pursuant to this

action.

G. Where To Send It

Mail the FPCA to the County Clerk--Elections Office,

county of voting residence, as listed below:

County County Seat Zip Code

Baker 1995 3rd Street, Suite 150, Baker City 97814-3398

Benton PO Box 888, Corvallis 97339

Clackamas 825 Portland Avenue, Gladstone 97027-2195

Clatsop PO Box 178, Astoria 97103-0178

Columbia Columbia County Courthouse, 

230 Strand St., Saint Helens 97051-2089

Coos Coos County Courthouse,

250 N. Baxter, Coquille 97423-1899

Crook 300 NE 3rd, Room 23, Prineville 97754-1919

Curry PO Box 746, Gold Beach 97444-0746

Deschutes 1340 NW Wall Street, Bend 97701-1941

Douglas PO Box 10, Roseburg 97470-0004

Gilliam Courthouse, PO Box 427, Condon 97823-0427

Grant 201 Humbolt, Suite 290, Canyon City 97820-0039

Harney Courthouse, 450 N. Buena Vista, Burns 97720-1598

Hood River Courthouse, 309 State St., Hood River 97031-2093

Jackson 1101 W. Main St., Ste. 201, Medford 97501-2369

Jefferson 66 SE “D” Street, Ste. C , Madras 97741

Josephine PO Box 69, Grants Pass 97528-0203

Klamath 305 Main Street, Klamath Falls 97601-6384

Lake 513 Center Street, Lakeview 97630-1579

Lane 135 E. 6th Avenue, Eugene 97401-2671

Lincoln 225 W. Olive Street, Room 201, Newport 97365-2908

Linn 300 SW 4th Avenue, Albany 97321-8602

Malheur Courthouse, Box 4, 251 B Street W, Vale 97918-1397

Marion 4263 Commercial St. SE, #300, Salem 97302-3987

Morrow PO Box 338, Heppner 97836-0338

Multnomah 1040 SE Morrison, Portland 97214-2495

Polk 850 Main St., Room 201, Dallas 97338-3179

Sherman PO Box 365, Moro 97039-0365

Tillamook 201 Laurel Avenue, Tillamook 97141-2394

Umatilla PO Box 1227, Pendleton 97801

Union 1001 4th Street, Suite D, La Grande 97850-2121

Wallowa 101 S. River Street, Room 100 

Enterprise 97828-1335

Wasco Courthouse, 511 Washington Street 

The Dalles 97058-2266

Washington 3700 SW Murray Blvd., Ste. 101 

Hillsboro

97005-2365

Wheeler PO Box 327, Fossil 97830-0327

Yamhill Courthouse, 535 NE 5th Street, 

Room 119, McMinnville 97128-4593

County County Seat Zip Code

It’s Never Too Late To Start Voting! Start Now!

by David Nelson, Civilian, MacDill AFB, Florida 
OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”

H. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

OREGON

“I am outside the territorial limits of the United States and the District of

Columbia, and I am unable to vote and return a regular absentee ballot by

normal mail delivery in the time provided for regular absentee ballots. I

request a special write-in absentee ballot.”
Oregon 2004–05 Voting Assistance Guide

244
245

PENNSYLVANIA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Designation of race is optional in Pennsylvania. This

data is requested from some states by the Department of

Justice in their enforcement of the Voting Rights Act and

the National Voter Registration Act. Enter the choice that

best describes you from the following list. AI = American

Indian or Alaskan Native; AP = Asian or Pacific Islander

not Native Hawaiian; B = Black, not of Hispanic Origin; H

= Hispanic; M = Multi-racial; NH = Native Hawaiian; W =

White, not of Hispanic Origin; O = Other.

B Your Pennsylvania Driver's License is required for

voter registration. If you do not have a Pennsylvania

Driver's License, you must include the last four digits of

your Social Security number. If you do not possess either of

these identifications, Pennsylvania will assign a number

that will serve to identify you for voter registration

purposes.

C Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

D Provide the complete street address of your

Pennsylvania voting residence. A post office box is not

sufficient. If your address includes a rural route, describe its

location in Item 7. For example: “2 miles past Highway

_____, across the street from the ___________ gas station.”

This address must be different from the one provided in

Item 4 and must be within the county where you claim legal

voting residence.

E Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

F If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections.

G Check ONE box. Please note under 8f: 1) Mental

competence is not a requirement to register and vote in

Pennsylvania and 2) Reinstatement — in Pennsylvania,

once a convicted felon is released from prison, he or she

may register to vote.

H You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

C

E

G

D

F

H

B
Pennsylvania 2004–05 Voting Assistance Guide

246

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Pennsylvania and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your County Board of

Elections early every year and whenever you change your

mailing address (see Chapter 2).

If you are a member of the Armed Forces, you are

exempted from registration and the County Board of

Elections must receive your FPCA for ballot request

anytime before the election. In some cases, however, the

County Board of Elections may send you a state Voter

Registration Mail Application (VRMA) or a state absentee

ballot application if they cannot determine from the

information on the FPCA whether or not you meet all the

requirements to vote in that county. Either the state VRMA

or the state absentee ballot application must be completed

and returned with the voted ballot to the County Board of

Elections so your ballot for all offices is counted. If the

local election official does not receive either application,

your ballot will be counted for Federal offices only. 

If you are a spouse or dependent of a member of the Armed

Forces, or a merchant marine member or a spouse or

dependent of a merchant marine member, the County Board

of Elections must receive your FPCA for ballot request

anytime before the election. If you are not registered you

may receive, along with your ballot, a state VRMA. You

must complete and return the state VRMA with your voted

ballot so your ballot for all offices is counted. If you do not

return the state VRMA, the ballot is counted for Federal

offices only. 

The registration declaration on the Pennsylvania VRMA is

accepted for all purposes as the equivalent of an affidavit,

and if the VRMA contains a materially false statement, the

applicant will be subject to penalties for perjury.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by 5:00

p.m. on the Friday before the election.

Local election officials mail ballots and state registration

materials approximately 45 days before the election.

If official absentee ballots are not available at that time, you

will be sent a special write-in absentee ballot.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Pennsylvania allows you to send the FPCA for

registration and absentee ballot by fax. After faxing,

submit the FPCA by mail. The original FPCA must be

received prior to the election by the county election

office in order for the ballot to count.

 Pennsylvania allows you to receive the blank ballot by

fax if you are in a designated hostile fire, imminent

danger pay, combat zone or qualified hazardous duty

area.

 Pennsylvania does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Pennsylvania provides a state special write-in absentee

ballot available 50 days before the primary election and 70

days before the general election if you will be unable to

vote during the regular absentee balloting period by reason

of military service or living in a remote or isolated area of

the world.

The FPCA may be used to request the state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.E. If no labels are available,

write in Item 7: “I am unable to vote during the regular

absentee balloting period by reason of living or performing

military service in an extremely remote or isolated area of

the world. I request a special write-in absentee ballot.”
2004–05 Voting Assistance Guide Pennsylvania

247

The special write-in ballot may be requested at any time

before the election.

Vote the special write-in ballot by writing in the names of

specific candidates from the list provided.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Pennsylvania and overseas electors. The term

“overseas electors” means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in Pennsylvania.

 U.S. Government employees overseas and their

spouses and dependents (for local, state and Federal

office ballots)

 other residents of Pennsylvania temporarily residing

outside the U.S. (for local, state and Federal office

ballots)

 overseas electors as defined above (for Federal office

ballots only).

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your County Board of

Elections early every year and whenever you change your

mailing address (see Chapter 2).

If you are a civilian employee of the U.S. Government, or a

spouse or dependent of a civilian employee of the U.S.

Government, the County Board of Elections must receive

your FPCA for ballot request anytime before the election. If

you are not registered you may receive, along with your

ballot, a state Voter Registration Mail Application (VRMA).

You must complete and return the state VRMA with your

voted ballot so your ballot for all offices is counted. If you

do not return the state VRMA, the ballot is counted for

Federal offices only. 

If you are a registered Pennsylvania elector temporarily

residing outside the U.S., the County Board of Elections

must receive your FPCA at least 7 days before the election.

If you are an unregistered resident temporarily residing

outside the U.S., the County Board of Elections must

receive your FPCA not later than 30 days before the

election. You may receive, along with your ballot, a state

VRMA if the County Board of Elections cannot determine

from the information on the FPCA whether you meet all the

requirements to vote in the county. The completed state

VRMA must arrive at least 30 days before the election for

the ballot to be counted for all offices. If the state VRMA is

not received timely, your ballot will be counted for Federal

offices only.

If you are an overseas elector who does not meet the state

residency requirement, you will receive a ballot for Federal

offices only.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by 5:00

p.m. on the Friday before the election.

Local election officials mail ballots and state registration

materials approximately 45 days before the election.

If official absentee ballots are not available at that time, you

will be sent a special write-in absentee ballot.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Pennsylvania allows you to send the FPCA for

registration and absentee ballot by fax. After faxing,

submit the FPCA by mail. The original FPCA must be

received prior to the election by the county election

office in order for the ballot to count.

 Pennsylvania does not allow you to receive the blank

ballot by fax.

 Pennsylvania does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Pennsylvania provides a state special write-in absentee

ballot available 50 days before the primary election and 70

days before the general election if you will be unable to

vote during the regular absentee balloting period by reason

of living in a remote or isolated area of the world.
Pennsylvania 2004–05 Voting Assistance Guide

248

The FPCA may be used to request the state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.E. If no labels are available,

write in Item 7: “I am unable to vote during the regular

absentee balloting period by reason of living or performing

military service in an extremely remote or isolated area of

the world. I request a special write-in absentee ballot.”

The special write-in ballot may be requested at any time

before the election.

Vote the special write-in ballot by writing in the names of

specific candidates from the list provided.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons imprisoned for a felony conviction may not vote

absentee. 

B. Action on Registration Requests

Pennsylvania sends notification of registration.

C. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Pennsylvania will provide you with

the reason(s) for the rejection. Persons denied registration

should consult a legal assistance officer or civilian counsel. 

D. Where To Send It

Mail the FPCA to the County Board of Elections, county of

voting residence, as listed below:

County County Seat Zip Code

Adams Gettysburg 17325-2312

Allegheny Pittsburgh 15219-2953

Armstrong Kittanning 16201-1448

Beaver Beaver 15009-2145

Bedford Bedford 15522-0166

Berks Reading 19601-3540

Blair Hollidaysburg 16648-2022

Bradford Towanda 18848-1878

Bucks Doylestown 18901-4318

Butler Butler 16603-1208

Cambria Ebensburg 15931-1947

Cameron Emporium 15834-1469

Carbon Jim Thorpe 18229-0129

Centre Bellefonte 16823-1488

Chester West Chester 19382-0990

Clarion Clarion 16214-1093

Clearfield Clearfield 16830-2425

Clinton Lock Haven 17745-1385

Columbia Bloomsburg 17815-0380

Crawford Meadville 16335-2678

Cumberland Carlisle 17013-3044

Dauphin Harrisburg 17108-1295

Delaware Media 19063-2728

Elk Ridgway 15853-0448

Erie Erie 16501-1096

Fayette Uniontown 15401-3412

Forest Tionesta 16353-0126

Franklin Chambersburg 17201-2211

Fulton McConnellsburg 17233-1198

Greene Waynesburg 15370-1839

Huntingdon Huntingdon 16652-1486

Indiana Indiana 15701-3934

Jefferson Brookville 15825-1269

Juniata Mifflintown 17059-0068

Lackawanna Scranton 18503-1714

Lancaster Lancaster 17608-3480

Lawrence New Castle 16101-3593

Lebanon Lebanon 17042-6794

Lehigh Allentown 18101-2400

Luzerne Wilkes-Barre 18711-1001

Lycoming Williamsport 17701-0536

McKean Smethport 16749-0507

Mercer Mercer 16137-1227

Mifflin Lewistown 17044-1797

Monroe Stroudsburg 18360-2170

Montgomery Norristown 19404-0311

Montour Danville 17821-1999

Northampton Easton 18042-3695

Northumberland Sunbury 17801-2360

Perry New Bloomfield 17068-0037

County County Seat Zip Code

Philadelphia Philadelphia 19107-3211

Pike Milford 18337-1535

Potter Coudersport 16915-1690

Schuylkill Pottsville 17901-3602

Snyder Middleburg 17842-0217

Somerset Somerset 15501-1459

Sullivan Laporte 18626-0157

Susquehanna Montrose 18801-0218

Tioga Wellsboro 16901-0589

Union Lewisburg 17837-1996

Venango Franklin 16323-0831

Warren Warren 16365-2399

Washington Washington 15301-4480

Wayne Honesdale 18431-1996

Westmoreland Greensburg 15601-9620

Wyoming Tunkhannock 18657-1216

York York 17401-1256

County County Seat Zip Code

Be Heard. Be Counted. Vote

by SSgt Jeffery Barnes, USAF, Franklin, Pennsylvania
PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”

E. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

PENNSYLVANIA

“I am unable to vote during the regular absentee balloting period by reason

of living or performing military service in an extremely remote or isolated

area of the world. I request a special write-in ballot.”
Pennsylvania 2004–05 Voting Assistance Guide

250
251

PUERTO RICO

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Both your paternal and your maternal surnames are

required. Otherwise, provide your full name as it appears on

file at the State Elections Commission.

B Your Social Security number is required. If you do not

have a Social Security number, your Puerto Rico Driver's

License number (use Item 1.e) is required for voter

registration. If you do not possess either of these

identifications, the Commonwealth shall assign a number

that will serve to identify you for voter registration purposes.

C Provide your father’s and mother’s first names.

D Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

E Provide the complete street address of your Puerto Rico

voting residence. If your address includes a rural route,

describe its’ location. For example: “On Highway ____, 2

miles past Highway ____, across the street from the ____ gas

station.” A post office box is not sufficient. This address must

be different from the one provided in Item 4 and must be

within Puerto Rico.

F Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address you provided in Item 3. Please

note: members of the Armed Forces and merchant marine

must utilize an APO/FPO address if available. 

G Provide your e-mail, phone or fax number, whichever is

the easiest way to contact you.

H If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections.

I The certifying officer who signs Item 9 must state here:

“I certify that [voter] is a [member of the U.S. Army, student

at XX University, etc., whichever is applicable].” See

Sections I and II D below for details.

J Check ONE box.

K You are swearing or affirming that the information

provided is true and correct by signing the FPCA. Also, see

Sections I.D and II.D.

L Applicant must sign and date in the presence of an oath

taking official.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

M M D D Y Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

K

A

B

D

F

H

I

J

C

E

G L
Puerto Rico 2004–05 Voting Assistance Guide

252

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Puerto Rico and members of the Uniformed

Services and their family members. Uniformed Services are

defined as members of the U.S. Armed Forces, merchant

marine, commissioned corps of the Public Health Service

and the National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register permanently, you must register in person.

However, you may register temporarily to vote in the

primary and general elections for Resident Commissioner.

To register temporarily and request an absentee ballot, send

your completed FPCA to the Absentee Voting

Administrative Board so that it arrives not later than 30

days before the election. You will be sent a special absentee

ballot which lists only the candidates for Resident

Commissioner to the U.S. Congress.

If you are permanently registered and wish only to request

an absentee ballot, send a completed FPCA to the Absentee

Voting Administrative Board so that it arrives not later than

60 days before the election. Alternatively, you may request

a ballot by using the Petition for Absentee Ballot, which is

available by mail either from the Elections Commission or

the political parties. You will be sent a ballot for local and

Federal offices.

If your absentee ballot request arrives between 59 and 30

days before the election, you will be sent the special

absentee ballot which lists only candidates for Resident

Commissioner to the U.S. Congress. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be postmarked

not later than election day. The State Elections Commission

must receive it before 3:00 p.m. on election day.

The State Elections Commission begins mailing ballots

approximately 45 days before the election.

Due to its commonwealth status, Puerto Rico does not send

representatives to the U.S. Senate or directly participate in

the election of the President and Vice President of the U.S.

At the Federal level, a Resident Commissioner to the House

of Representatives is elected.

If you are outside the U.S. and have not received your ballot

in a timely manner, use the Federal Write-In Absentee

Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: Must be sworn to.

The person who administers the oath is verifying your

identity and your status (for example, military spouse,

merchant marine member, etc.).

Military members, their spouses and their dependents must

obtain the signature of a commissioned officer. 

Merchant marine members must obtain the signature of the

highest officer on board.

Ballot Return Envelope: Must be sworn to. 

The person who administers the oath is verifying your

identity and your status (for example, military spouse,

merchant marine member, etc.).

Military members, their spouses and their dependents must

obtain the signature of a commissioned officer. 

Merchant marine members must obtain the signature of the

highest officer on board.

E. Electronic Transmission of FPCAs 

and Ballots

 Puerto Rico allows electronic transmission of the

FPCA, including fax and e-mail. You must submit the

original FPCA by mail and it must be received by the

State Elections Commission no later than 3:00 p.m. on

election day.

 Puerto Rico does not allow electronic transmission of

the blank absentee ballot or the voted absentee ballot.

Please refer to Appendix C for Specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.
2004–05 Voting Assistance Guide Puerto Rico

253

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.Instructions continue in Section III: Uniformed Services & Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Puerto Rico and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Puerto Rico. (Consult Section B below for ballot

type eligibility)

 those studying outside of Puerto Rico in a duly

accredited educational institution

 agricultural workers under contract with the

Agricultural Employment Program of the

Commonwealth Labor Department outside Puerto

Rico

 members of the diplomatic or foreign aid service of

the U.S., or of exchange programs between Puerto

Rico and a foreign government

 spouses and children of the above

 airline crew members who are working outside Puerto

Rico on election day

 overseas electors

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register permanently, you must register in person.

However, you may register temporarily to vote in the

primary and general elections for Resident Commissioner.

If you are not permanently registered, request an absentee

ballot by sending your completed FPCA to the Absentee

Voting Administrative Board so that it arrives not later than

30 days before the election. You will be sent a special

absentee ballot which lists only the candidates for Resident

Commissioner to the U.S. Congress.

If you are permanently registered and wish only to request

an absentee ballot, send a completed FPCA to the Absentee

Voting Administrative Board so that it arrives not later than

60 days before the election. Alternatively, you may request

a ballot by using the Petition for Absentee Ballot, which is

available by mail either from the Elections Commission or

the political parties.You will be sent a ballot for local and

Federal offices.

If your absentee ballot request arrives between 59 and 30

days before the election, you will be sent the special

absentee ballot which lists only candidates for Resident

Commissioner to the U.S. Congress.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be postmarked

not later than election day. The State Elections Commission

must receive it before 3:00 p.m. on election day. 

The State Elections Commission begin mailing ballots

approximately 45 days before the election.

Due to its commonwealth status, Puerto Rico does not send

representatives to the U.S. Senate or directly participate in

the election of the President and Vice President of the U.S.

At the Federal level, a Resident Commissioner to the House

of Representatives is elected.

If you are outside the U.S. and have not received your ballot

in a timely manner, use the Federal Write-In Absentee

Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: Must be sworn to.

The person who administers the oath is verifying your

identity and your status (for example, student, agricultural

worker, etc.).

Students must obtain the signature of an official in the

school registrar’s office. 

Dependents, agricultural workers, and airline crew

members must swear an oath before a notary public or

person authorized by law to administer the oath.

Overseas electors must obtain the signature of a consular

officer.

Ballot Return Envelope: Must be sworn to.

The person who administers the oath is verifying your

identity and your status (for example, student, agricultural

worker, etc.).

Students must obtain the signature of an official in the

school registrar’s office. 

Dependents, agricultural workers, and airline crew

members must swear an oath before a notary public or

person authorized by law to administer the oath.

Overseas electors must obtain the signature of a consular

officer.
Puerto Rico 2004–05 Voting Assistance Guide

254

E. Electronic Transmission of FPCAs 

and Ballots

 Puerto Rico allows electronic transmission of the

FPCA, including fax and e-mail. You must submit the

original FPCA by mail and it must be received by the

State Elections Commission no later than 3:00 p.m. on

election day.

 Puerto Rico does not allow electronic transmission of

the blank absentee ballot or the voted absentee ballot.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Puerto Rico shall provide you with

the reason(s) for the rejection. 

B. Where To Send It

Mail the FPCA to:

Absentee Voting Administrative Board

State Elections Commission

PO Box 366220

San Juan, Puerto Rico 00936-6220

Voting - Knowing You Can Make A Difference!

by IC2 Robert Crumpler, USN, Naval Medical Center, Puerto Rico
255

RHODE ISLAND

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your current and valid Rhode Island driver’s license

number is required in 1.f. If you do not have a current and

valid Rhode Island driver’s license number, the last four

digits of your Social Security number are required in 1.e. If

you do not possess either of these identifications, Rhode

Island shall assign a number that will serve to identify you

for voting purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete address of your Rhode Island

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location. For

example: “on Highway ____, 2 miles past Highway _____,

across the street from the _____ gas station.” This address

must be different from the one provided in Item 4 and must

be within the city or town where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3.

E You must list a party affiliation to vote in primaries,

e.g., Democrat, Republican or write “none” in Item 6 of the

FPCA. Changes of party affiliation must be made on or

before the 90th day before the election. Political party

affiliation is not required to vote in general elections.

F Check ONE box. 

G You are swearing or affirming that the information provided

is true and correct by signing the FPCA.

H If you are an “other” overseas citizen (see Section II.

A.) requesting a state voter registration form only, a notary

public, commissioned officer, consular officer, or other

authorized person must complete this section.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

M M D D Y Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

H

A

F
Rhode Island 2004–05 Voting Assistance Guide

256

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Rhode Island, members of the Uniformed

Services and their family members, and members of

religious groups or welfare agencies officially attached to

the Armed Forces overseas and their spouses and

dependents accompanying them outside the state.

Uniformed Services are defined as the U.S. Armed Forces,

merchant marine, commissioned corps of the Public Health

Service and the National Oceanic and Atmospheric

Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your Board of Canvassers

early every year and whenever you change your mailing

address (see Chapter 2).

This single FPCA can be extended beyond one year to the

length of the assignment at a duty station (if over one year)

by completing an absentee ballot certificate. In Item 7 of the

FPCA write: “I request an absentee ballot certificate

(Section 17-20-9.2).” When you receive the certificate,

complete the form (including your name, Rhode Island

address, duty station address where you want your ballot

mailed, length of time assigned to that duty station) and

obtain the name and signature of the military commander.

Rhode Island waives registration. 

To request an absentee ballot, the Board of Canvassers in

your city or town of voting residence must receive your

FPCA not later than 4:00 p.m., 21 days before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the State

Board of Elections by 9:00 p.m. on election day.

State election officials begin mailing ballots approximately

21 days before the election. State elections officials will

also issue an official state blank ballot 45 days before an

election if the official ballot is not yet available and then

will issue the official mail ballot when it becomes available.

If you are outside the U.S. and have not received your

official state ballot or official blank state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions below and in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 Rhode Island allows you to send the FPCA for

absentee ballot request by fax. The FPCA must be

received not later than 4:00 p.m., 21 days before the

election. After faxing, the original FPCA must be

mailed. Include your fax number on the FPCA, Item 5.

Use fax numbers below.

 Rhode Island will transmit the appropriate ballot by

fax and by mail to the voter.

 Rhode Island allows you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Rhode Island provides an official state blank ballot 45 days

before an election if the official ballot is not yet available. 

G. Federal Write-In Absentee Ballot

Rhode Island has expanded the use of the Federal Write-In

Ballot (FWAB). The instructions described in Chapter 2

remain the same except that Rhode Island also allows the

FWAB to be used to vote for offices in state and local

elections.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Rhode Island and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Rhode Island.
2004–05 Voting Assistance Guide Rhode Island

257

 overseas citizens temporarily residing outside the U.S.

by reason of employment by any agency, department

or division of the U.S. Government, overseas citizens

employed outside the U.S. and spouses and

dependents of such persons (for local, state and

Federal office ballots)

 “other” overseas citizens residing outside the U.S. (for

Federal office ballots)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your Board of Canvassers

early every year and whenever you change your mailing

address (see Chapter 2).

To request an absentee ballot, send the FPCA to the Board

of Canvassers in your city or town of voting residence not

later than 4:00 p.m., 21 days before the election.

Rhode Island waives registration except for “other”

overseas citizens residing outside the U.S. “Other” overseas

citizens must complete a voter registration form and an

Affidavit of Absentee Voter Upon Registration; both

documents must be returned to the Board of Canvassers not

later than 30 days before the election.

These forms may be requested by using the FPCA, letter,

telephone, fax or e-mail.

“Other” overseas citizens are those persons who reside

outside the territorial limits of the U.S., for reasons other

than employment or military service.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the state

board of elections by 9:00 p.m. on election day.

State election officials begin mailing ballots approximately

21 days before the election. For overseas citizens employed

outside the U.S., state elections officials will also issue an

official state blank ballot 45 days before an election if the

official ballot is not yet available and will issue the official

mail ballot when it becomes available.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions below and in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required. However, “other”

overseas citizens, in order to register to vote, must have

their Affidavit of Absentee Voter Upon Registration

notarized by a person authorized to administer oaths.

Ballot Return Envelope: No notary or witness required.

E. Electronic Transmission of FPCAs 

and Ballots

 Except for “other” overseas citizens, Rhode Island

allows you to send the FPCA for absentee ballot

request by fax. The FPCA must be received not later

than 4:00 p.m., 21 days before the election. After

faxing, the original FPCA must be mailed. Include

your fax number on the FPCA, Item 5. Use fax

numbers below.

 Except for “other” overseas citizens, Rhode Island will

transmit the appropriate ballot by fax and by mail to

the voter.

 Except for “other” overseas citizens, Rhode Island

allows you to return the voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Rhode Island provides an official state blank ballot 45 days

before an election if the official ballot is not yet available. 

G. Federal Write-In Absentee Ballot

Rhode Island has expanded the use of the Federal Write-In

Absentee Ballot (FWAB). The instructions described in

Chapter 2 remain the same except that Rhode Island also

allows the FWAB to be used to vote for offices in state and

local elections.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

No person convicted of a felony can vote until completion

of the sentence, including parole or probation, regardless of

a no contest plea. Upon such completion, the person’s right

to vote shall be restored. No person declared mentally

incapable can vote.

B. Cancellation of Registration

Registration is canceled for failure to respond to

confirmation mailings along with the failure to vote in the

next two general (Federal office) elections.
Rhode Island 2004–05 Voting Assistance Guide

258

C. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Rhode Island shall provide you

with the reason(s) for the rejection. Denial of registration

may be appealed to the State Board of Elections. Consult a

legal assistance officer or civilian counsel. 

D. Late Registration

Any member of the Armed Forces or of the merchant

marine of the U.S. in active service, and any person absent

from the state in the performance of “services intimately

connected with military operations”; any person who is

employed by any agency, department or division of the U.S.

Government and who by reason of such employment

resides outside of the continental U.S.; and any person

employed outside the territorial limits of the U.S. shall be

exempt from registration during the period of his/her

service or employment for 2 years after their return to the

U.S. 

E. Voting By Citizens Who Have Never 

Lived in the U.S.

If the person is a U.S. citizen and has never lived in the U.S.

but has a parent who is a qualified Rhode Island elector,

then this person will be eligible to register and vote in

Federal elections.

F. Where To Send It

Mail the FPCA to the Board of Canvassers, city or town of

voting residence listed below:

City or Town Zip Code

Barrington 02806-2406

Bristol 02809-2230

Burrillville 02830-1420

Central Falls 02863-2835

Charlestown 02813-3454

Coventry 02816-8909

Cranston 02910-2738

Cumberland 02864-8351

East Greenwich 02818-3808

East Providence 02914-4530

Exeter 02822-2446

Foster 02825-1226

Glocester 02814-1959

Hopkinton 02833-1142

Jamestown 02835-1149

Johnston 02919-7191

Lincoln 02865-1332

Little Compton 02837-1543

Middletown 02842-7264

Narragansett 02882-3612

Newport 02840-2792

New Shoreham 02807-0220

North Kingstown 02852-5767

North Providence 02911-1740

North Smithfield 02876-7227

Pawtucket 02860-2163

Portsmouth 02871-1268

Providence 02903-1738

Richmond 02898-1247

Scituate 02857-1906

Smithfield 02917-3224

South Kingstown 02879-3140

Tiverton 02878-4401

Warren 02885-4369

Warwick 02886-7145

Westerly 02891-1888

West Greenwich 02817-2155

West Warwick 02893-4829

Woonsocket 02895-4330

City or Town Zip Code

“Your Vote Counts, No Matter Where You Are”

by Ben D. Roth, Civilian, Ramstein, Germany
259

SOUTH CAROLINA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A You are requested to fill out this box. This data is

requested from some states by the Department of Justice in

their enforcement of the Voting Rights Act and the National

Voter Registration Act. Enter the choice that best describes

you from the following list: W= White; B/AA= Black/

African-American; A= Asian; H= Hispanic; N= Native

American; O= Other.

B Your Social Security number is required. If you do not

have a Social Security number, your South Carolina

Driver's License number is required for voter registration. If

you do not possess either of these identifications, the State

shall assign a number that will serve to identify you for

voter registration purposes.

C Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

D Provide the complete street address of your South

Carolina voting residence. A post office box is not

sufficient. If your address includes a rural route, describe its

location in Item 7. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be different from the one

provided in Item 4 and must be within the county or

township where you claim legal voting residence.

E Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provided in Item 3.

F If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party choice is not required if only

requesting absentee ballots for general elections.

G Check ONE box.

H You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

M M D D Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

C

E

G

D

F

H

B
South Carolina 2004–05 Voting Assistance Guide

260

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of South Carolina and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the Board of Voter Registration so that it arrives

not later than 30 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the local county

Board of Voter Registration so that it arrives not later than

four days before the election. However, waiting too long

may make it impossible for you to receive your blank ballot

in time to return it by the deadline for receipt of voted

ballots. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day.

Local election officials mail out absentee ballots

approximately 45 days before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instruction in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required. 

Ballot Return Envelope: The oath on the ballot return

envelope must be witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 South Carolina allows you to send the FPCA for

absentee ballot requests and registration by fax. You

must also submit the original FPCA by mail. 

 South Carolina allows you to receive the blank ballot

by fax in declared emergency situations.

 South Carolina allows you to return the voted ballot by

fax in declared emergency situations.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

South Carolina provides a state special write-in absentee

ballot available 90 days before the election if you will be

unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in an

isolated or extremely remote area of the world. 

You may use the FPCA to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.G below. If no labels are

available, write in Item 7: “I am unable to vote by regular

absentee ballot or in person due to requirements of military

service or due to living in isolated or extremely remote

areas of the world. I request a special write-in absentee

ballot.” 

You must request the state special write-in ballot not earlier

than 90 days before an election and you may use it to vote

for Federal offices, statewide offices, and members of the

South Carolina General Assembly by writing in a political

party choice or the names of specific candidates. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of South Carolina and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in South Carolina.

 members of the American Red Cross or service

agencies serving with the Armed Forces (for local,

state and Federal office ballots)
2004–05 Voting Assistance Guide South Carolina

261

 employees of the U.S. Government serving overseas

(for local, state and Federal office ballots)

 spouses and dependents who reside with the above

persons (for local, state and Federal office ballots)

 South Carolina residents temporarily residing outside

the U.S. (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the Board of Voter Registration so that it arrives

not later than 30 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the local county

Board of Voter Registration so that it arrives not later than

four days before the election. However, waiting too long

may make it impossible for you to receive your blank ballot

in time to return it by the deadline for receipt of voted

ballots. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day.

Local election officials mail out absentee ballots

approximately 45 days before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required. 

Ballot Return Envelope: The oath on the ballot return

envelope must be witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 South Carolina allows you to send the FPCA for

absentee ballot requests and registration by fax. You

must also submit the original FPCA by mail. 

 South Carolina allows you to receive the blank ballot

by fax in declared emergency situations.

 South Carolina allows you to return the voted ballot by

fax in declared emergency situations.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

South Carolina provides a state special write-in absentee

ballot available 90 days before the election if you will be

unable to vote by regular absentee ballot or in person due to

living in an isolated or extremely remote area of the world. 

You may use the FPCA to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.F below. If no labels are

available, write in Item 7: “I am unable to vote by regular

absentee ballot or in person due to requirements of military

service or due to living in isolated or extremely remote

areas of the world. I request a special write-in absentee

ballot.” 

You must request the state special write-in ballot not earlier

than 90 days before an election and you may use it to vote

for Federal offices, statewide offices, and members of the

South Carolina General Assembly by writing in a political

party choice or the names of specific candidates. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Late Registration

Any person eligible to register who has been discharged or

separated from service in the Armed Forces of the U.S., and

returned home too late to register at the time when

registration is required, is entitled to register for the purpose

of voting in the next ensuing election after discharge or

separation from service, up to 5:00 p.m. on the day of the

election. This application for registration must be made at

the office of the Board of Voter Registration in the county in

which the person wishes to register, and if qualified, the

person must be issued a registration notification stating the

precinct in which the person is entitled to vote and a

certification to the managers of the precinct that the person

is entitled to vote and should be placed on the registration

rolls of the precinct. 
South Carolina 2004–05 Voting Assistance Guide

262

B. Bars to Registration and Voting

A person is disqualified from being registered or voting if

she/he: is mentally incompetent as adjudicated by a court of

competent jurisdiction; is serving a term of imprisonment

resulting from a conviction of a crime; or is convicted of a

felony or offenses against the election laws, unless the

disqualification has been removed by service of the

sentence, including probation and parole time unless sooner

pardoned.

C. Cancellation of Registration

Permanent registration may be canceled if voting residence

is changed to another South Carolina county or state or

committing a crime as noted in Section B above.

D. Action on Registration Requests

Notice of acceptance or denial is sent.

E. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, South Carolina shall provide you

with the reason(s) for the rejection. 

F. Action If Registration Is Denied

Persons denied registration should correct the defects noted

in the denial notice. If a second denial is received, consult a

legal assistance officer or civilian counsel.

G. Where To Send It

Mail the FPCA to the Board of Voter Registration, county

of voting residence, as listed below:

County County Seat Zip Code

Abbeville PO Box 417, Abbeville 29620-0417

Aiken PO Box 3127, Aiken 29802-3127

Allendale PO Box 552, Allendale 29810-0552

Anderson 107 S. Main Street, Rm. 101, Anderson 29624-1618

Bamberg 110 N. Main St., Courthouse, Bamberg 29003-1148

Barnwell Cnty. Courthouse, Rm. 109, Barnwell 29812

Beaufort PO Box 1228, Beaufort 29901-1228

Berkeley 223 N. Live Oak Drive, Moncks Corner 29461-3707

Calhoun 102 Courthouse Dr., Room 103, St. 

Matthews 29135

Charleston PO Box 71419, Charleston 29415-1419

Cherokee 1434 N. Limestone Street, Gaffney 29340-4734

Chester PO Drawer 580, Chester 29706-0580

Chesterfield 200 W. Main St., Courthouse, 

Chesterfield 29709-1527

Clarendon E. Keitt St., Rm. 101/Courthouse, 

PO Box 548, Manning 29102-0458

Colleton PO Box 97, Walterboro 29488-0001

Darlington 300 Russell St., Room 107, Darlington 29532-3329

Dillon PO Box 973, Dillon 29536-0973

Dorchester 201 Johnston Street, Saint George 29477-2443

Edgefield PO Box 442, Edgefield 29824-0442

Fairfield PO Drawer 60, Winnsboro 29180-0060

Florence City-County Complex, Room 406, 180 

N. Irby St., MSC-U, Florence 29501

Georgetown PO Box 421270, Georgetown 29440-4200

Greenville 301 University Ridge, Ste. 1900, 

Greenville 29601-3668

Greenwood 600 Monument Street, Ste. 113, 

Greenwood 29646-2643

Hampton 201 Lee Avenue, Room 101, Hampton 29944

Horry 801 Main Street, Conway 29526

Jasper Post Office Box 299, Ridgeland 29936-0299

Kershaw County Courthouse, Rm. 213, Camden 29020

Lancaster Post Office Box 1809, Lancaster 29721-1809

Laurens 3 Catherine St., PO Box 769, Laurens 29360-0769

Lee PO Box 309, Bishopville 29010

Lexington 605 W. Main St., Suite 105, Lexington 29072

McCormick Post Office Box 636, McCormick 29835-0636

Marion 137 Airport Ct., Suite E, Mullins 29574-6034

Marlboro Admin. Bldg., PO Box 502, 

Bennettsville 29512-0502

Newberry Couthouse, 1226 College St., Newberry 29108

Oconee 415 S. Pine St., Walhalla 29691-2145

Orangeburg Post Office Box 9000, Orangeburg 29116-9000

Pickens 222 McDaniel Avenue, B-9, Pickens 29671-2556

Richland 2020 Hampton Street, Columbia 29202-1002

Saluda County Courthouse, Saluda 29138

Spartanburg Post Office Box 1287, Spartanburg 29304-1287

Sumter 141 N. Main St., Rm. 114, Sumter 29150-4987

Union 210 W. Main St., PO Box 200, Union 29379-0200

Williamsburg 5 Courthouse Square, Kingstree 29556-3932

York 13 S. Congress Street, E.C. Black Bldg, 

York 29745-1856

County County Seat Zip Code

Yes, It Does Count! VOTE!

by MAJ Bary W. Presley, USA, Harvest, Alabama
SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”

H. STATE SPECIAL WITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

SOUTH CAROLINA

“I am unable to vote by regular absentee ballot or in person due to

requirements of military service or due to living in isolated or extremely

remote areas of the world. I request a special write-in absentee ballot.”
South Carolina 2004–05 Voting Assistance Guide

264
265

SOUTH DAKOTA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your U.S. Driver’s License number is required for

voter registration. If you do not have a driver’s license

number then you must give the last four digits of your

social security number. If you do not possess either of these

identifications, the voter may only register at the County

Auditor’s office and shall sign a statement of such fact.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your South

Dakota voting residence. A post office box is not sufficient.

If your address includes a rural route, describe its location

in Item 7. For example: “on Highway _____, 2 miles past

Highway _____, across the street from the _____ gas

station.” This address must be different from the one

provided in Item 4 and must be within the county where

you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address you provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party choice is not required if only

requesting absentee ballots for general elections. If you are

currently registered and want to change your political party

affiliation or you have previously declined to indicate a

political party and you now want to vote in a primary

election, you must submit a completed FPCA which

includes your new political party choice to the local County

Auditor.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

H Absentee ballot applications must be notarized by a

notary public or other person authorized to administer oath.

Instead of a notarized signature, you may provide a photo

copy of your valid ID. An acceptable ID is: A South Dakota

Drivers License or non-driver ID card; a passport or other

picture ID issued by the U.S. government; a tribal photo ID;

a photo ID issued by a South Dakota postsecondary

education institution.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

M M D D Y Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G

H
South Dakota 2004–05 Voting Assistance Guide

266

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of South Dakota and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2). However, a separate FPCA is

needed for school or municipal elections.

To register and request an absentee ballot, send a completed

FPCA to the local County Auditor so that it arrives not later

than 15 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the local County

Auditor anytime before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office in time to be delivered to the

Superintendent of Elections of the voter’s home precinct

prior to the close of the polls.

Local election officials mail ballots within 48 hours after

receiving your request, or as soon as ballots are available

(six weeks before any primary or general election).

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instruction in Chapter 2, page 12.

D. Notary/Witness Requirements

Absentee ballot applications must be notarized by a notary

public or other person authorized to administer an oath.

Instead of a notarized signature, you may provide a photo

copy of your valid ID. An acceptable ID is: A South Dakota

Drivers License or nondriver ID card; a passport or other

picture ID issued by the U.S. government; a tribal photo ID;

a photo ID issued by a South Dakota postsecondary

education institution.

E. Electronic Transmission of FPCAs 

and Ballots

South Dakota does not allow electronic transmission of the

FPCA, the blank absentee ballot or the voted absentee

ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of South Dakota and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in South Dakota.

 South Dakota residents temporarily residing outside

the U.S. (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2). However, a separate FPCA is

needed for school or municipal elections.

To register and request an absentee ballot, send a completed

FPCA to the local County Auditor so that it arrives not later

than 15 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the local County

Auditor anytime before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the local

elections office in time to be delivered to the

Superintendent of Elections of the voter’s home precinct

prior to the close of the polls.

Local election officials mail ballots within 48 hours after

receiving your request, or as soon as ballots are available

(six weeks before any primary or general election).

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.
2004–05 Voting Assistance Guide South Dakota

267

D. Notary/Witness Requirements

Absentee ballot applications must be notarized by a notary

public or other person authorized to administer an oath.

Instead of a notarized signature, you may provide a photo

copy of your valid ID. An acceptable ID is: a South Dakota

Drivers License or nondriver ID card; a passport or other

picture ID issued by the U.S. government; a tribal photo ID;

a photo ID issued by a South Dakota postsecondary

education institution.

E. Electronic Transmission of FPCAs 

and Ballots

South Dakota does not allow electronic transmission of the

FPCA, the blank absentee ballot or the voted absentee

ballot.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons currently serving a sentence for a felony conviction

which included imprisonment, served or suspended, in an

adult penitentiary system and persons judged mentally

incompetent may not register or vote.

B. Cancellation of Registration

Persons are removed from registration rolls for failure to

vote at all in the last eight years and failure to respond to a

confirmation notice.

C. Action on Registration Requests

Notification of completed registration is sent.

D. Action If Registration Is Denied

Persons denied registration may appeal to the circuit court.

Consult a legal assistance officer or civilian counsel.Upon

denial of your voter registration application or absentee

ballot request, South Dakota shall provide you with the

reason(s) for the rejections.

E. Where To Send It

Mail the FPCA to the County Auditor, county of voting

residence, as listed below:

County County Seat Zip Code

Aurora PO Box 397, Plankinton 57368-0397

Beadle PO Box 845, Huron 57350-0845

Bennett PO Box 460, Martin 57551-0460

Bon Homme PO Drawer E, Tyndall 57066-0605

Brookings 314 6th Avenue, Brookings 57006-2086

Brown 25 Market Street, Aberdeen 57401-4293

Brule 300 S. Courtland, Ste. 103, Chamberlain 57325-1599

Buffalo PO Box 146, Gann Valley 57341-0146

Butte 839 Fifth Avenue, Belle Fourche 57717-1719

Campbell PO Box 37, Mound City 57646-0037

Charles Mix PO Box 490, Lake Andes 57356-0490

Clark PO Box 294, Clark 57225-0294

Clay 211 West Main, Suite 200, Vermillion 57069-2039

Codington 14 First Avenue, SE, Watertown 57201-3611

Corson PO Box 255, McIntosh 57641-0255

Custer 420 Mt. Rushmore Road, Custer 57730-1934

Davison 200 East 4th Street, Mitchell 57301-2692

Day 711 West 1st Street, Webster 57274-1364

Deuel PO Box 616, Clear Lake 57226-0616

Dewey PO Box 277, Timber Lake 57656-0277

Douglas PO Box 159, Armour 57313-0159

Edmunds PO Box 97, Ipswich 57451-0097

Fall River 906 North River Street, Hot Springs 57747-1398

Faulk PO Box 309, Faulkton 57438-0309

Grant 210 East Fifth Avenue, Milbank 57252-2499

Gregory Courthouse, Box 413, Burke 57523-0413

Haakon PO Box 698, Philip 57567-0698

Hamlin PO Box 237, Hayti 57241-0237

Hand 415 West First Avenue, Miller 57362-1346

Hanson PO Box 500, Alexandria 57311-0500

Harding PO Box 26, Buffalo 57720-0026

Hughes 104 East Capitol Avenue, Pierre 57501-2591

Hutchinson 140 Euclid, Room 128, Olivet 57052-0128

Hyde PO Box 379, Highmore 57345-0379

Jackson PO Box 280, Kadoka 57543-0280

Jerauld PO Box 422, Wessington Springs 57382-0422

Jones PO Box 307, Murdo 57559-0307

Kingsbury PO Box 196, Desmet 57231-0196

Lake 200 East Center, Madison 57042-2941

Lawrence PO Box F, Deadwood 57732-0678

Lincoln 100 East Fifth, Canton 57013-1792

Lyman PO Box 38, Kennebec 57544-0038

Marshall PO Box 130, Britton 57430-0130

McCook PO Box 190, Salem 57058-0190

McPherson PO Drawer L, Leola 57456-0448

Meade 1425 Sherman Street, Sturgis 57785-1452

Mellette PO Box C, White River 57579-0403

Miner PO Box 86, Howard 57349-0086

Minnehaha 415 North Dakota Avenue, Sioux Falls 57104-2465

Moody 101 E. Pipestone Ave., ST. , Flandreau 57028-0750

Pennington 315 St. Joseph Street, Rapid City 57701-2879

Perkins PO Box 126, Bison 57620-0126

Potter 201 South Exene, Gettysburg 57442-1521

Roberts 411 2nd Avenue, E., Sisseton 57262-1495

Sanborn PO Box 7, Woonsocket 57385-0007

Shannon (send to Fall River County)

Spink 210 East 7th Avenue, Redfield 57469-1266

Stanley PO Box 595, Fort Pierre 57532-0595

Sully PO Box 265, Onida 57564-0265

Todd (send to Tripp County)

Tripp 200 East 3rd, Winner 57580-1806

 Who Say’s One Person Can’t Make A Difference? VOTE

by ITSN Sergio Lozano, USN, USS Constellation
South Dakota 2004–05 Voting Assistance Guide

268

Turner PO Box 370, Parker 57053-0370

Union PO Box 519, Elk Point 57025-0519

Walworth PO Box 199, Selby 57472-0199

Yankton PO Box 137, Yankton 57078-0137

Ziebach PO Box 68, Dupree 57623-0068

County County Seat Zip Code
269

TENNESSEE

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Optional. You are requested to fill out this box. This

data is requested from some states by the Department of

Justice in their enforcement of the Voting Rights Act and

the National Voter Registration Act. Enter the choice that

best describes you from the following list: AI=American

Indian or Alaskan Native; AP=Asian or Pacific Islander not

Native Hawaiian; B=Black, not of Hispanic Origin;

H=Hispanic; M=Multi-racial; NH=Native Hawaiian;

W=White, not of Hispanic Origin; O=Other.

B Your full Social Security number is required. Social

Security number, if any, is required for purpose of

identification and to avoid duplicate registration. If you do

not have a Social Security number, write “none” in place of

the Social Security number.

C Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

D Provide the complete street address of your Tennessee

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or township where you claim

legal voting residence.

E Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address you provided in Item 3.

F If you do not list a political party affiliation, you

cannot vote in primary elections. You must indicate your

political party affiliation when applying for a primary ballot

(Example: Democrat, Republican) or write “none” in Item

6 of the FPCA. Political party choice is not required if only

requesting absentee ballots for general elections.

G Check ONE box.

H Sign and date the FPCA. When signing, you are

swearing or affirming under penalty of perjury that the

information is true and correct.

I If an absentee applicant or voter requires assistance

one person must witness the assistance given in completing

the FPCA or ballot.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

C

E

G

I

D

F

H

B
Tennessee 2004–05 Voting Assistance Guide

270

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Tennessee and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register temporarily and request an absentee ballot, send

a completed FPCA to the county election commission

during the same calendar year as the election(s), so that it

arrives not earlier than January 1 (or 90 days before an

election if the election is held less than 90 days after

January 1) and not later than five days before the election.

Alternatively, send a written request for temporary

registration and an absentee ballot to the local county

election commission. This written request must include

your name, social security number, date of birth, the

address you claim as your legal voting residence, and your

current mailing address (where you want the ballot to be

sent), and must be signed under penalty of perjury that the

information is true, correct and that you are eligible to vote

in the election.

To register permanently, submit a completed FPCA

postmarked it at least 30 days before the election and return

it to the local county election commission.

If you are permanently registered and only wish to request

an absentee ballot, send a completed FPCA to the county

election commission so that it arrives not earlier than

January 1 (or 90 days before an election if the election is

held less than 90 days after January 1) and not later than

five days before the election. Or you may send a letter that

contains your name, residential address, social security

number, address where to mail ballot outside of the county,

the election that you plan to participate in, the reason for

voting absentee and your signature to the county election

commission office not later than 5 days before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day.

Local election officials mail absentee ballots approximately

45 days before the election.

If you are outside the U.S. and have not received your

requested state ballot in a timely manner, use the Federal

Write-In Absentee Ballot. See instructions in Chapter 2.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. However, if the applicant required assistance,

one person must witness the assistance given in completing

the FPCA or ballot.

E. Electronic Transmission of FPCAs 

and Ballots

 Tennessee allows you to send the FPCA to temporarily

register and request an absentee ballot by fax. After

faxing, submit the FPCA by mail.

 Tennessee does not allow you to receive the blank

ballot by fax.

 Tennessee does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

State law generally provides that no later than forty-five

(45) days before an election, the county election

commission shall mail a special write-in absentee ballot and

list of candidates to all Armed Forces personnel who as of

that date have made a valid application for a ballot. This

special write-in absentee ballot is sent when the regular

absentee ballot has not been printed or is not ready for

distribution. After requesting an official absentee ballot,

Armed Forces personnel who feel that due to requirements

of military service this may not be a sufficient amount of

time to receive and then return the voted ballot may also use

the Federal Write-In Absentee Ballot referred to in the last

paragraph of Section I.B. above. If both ballots are received

prior to the close of the polls on election day, the county

election commission will count the ballot it provided to the

voter.
2004–05 Voting Assistance Guide Tennessee

271

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Tennessee and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Tennessee.

 residents of Tennessee temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 overseas citizens 

 U.S. citizens who have never resided in the U.S. but

have a parent who is eligible to vote in Tennessee.

These citizens are eligible to vote at the same voting

residence claimed by their parent 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register temporarily and request an absentee ballot, send

a completed FPCA to the county election commission

during the same calendar year as the election(s), so that it

arrives not earlier than January 1 (or 90 days before an

election if the election is held less than 90 days after Jan. 1)

and not later than five days before the election.

Alternatively, send a written request for temporary

registration and an absentee ballot to the local county

election commission. This written request must include

your name, social security number, date of birth, the

address you claim as your legal voting residence, and your

current mailing address (where you want the ballot to be

sent), and must be signed under penalty of perjury that the

information is true, correct and that you are eligible to vote

in the election.

To register permanently, submit a completed FPCA

postmarked it at least 30 days before the election and return

it to the local county election commission.

If you are already permanently registered and only wish to

request an absentee ballot, send a completed FPCA to the

county election commission so that it arrives not earlier

than January 1 (or 90 days before an election if the election

is held less than 90 days after January 1) and not later than

five days before the election. Or you may send a letter that

contains your name, residential address, social security

number, address where to mail ballot outside of the county,

the election that you plan to participate in, the reason for

voting absentee and your signature to the county election

commission office no later than 5 days before the elections.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by close of

polls on election day.

Local election officials mail absentee ballots approximately

45 days before the election.

If you have not received your requested state ballot in a

timely manner, use the Federal Write-In Absentee Ballot.

See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. However, if the applicant required assistance,

one person must witness the assistance given in completing

the FPCA or ballot.

E. Electronic Transmission of FPCAs 

and Ballots

 Tennessee allows you to send the FPCA to temporarily

register and request an absentee ballot by fax. After

faxing, submit the FPCA by mail.

 Tennessee does not allow you to receive the blank

ballot by fax.

 Tennessee does not allow you to return the voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony may not register or vote

unless voting rights have been reinstated.

B. Cancellation of Registration

Temporary registration is canceled following the election(s)

for which a ballot is requested.
Tennessee 2004–05 Voting Assistance Guide

272

Permanent registration is canceled for changing voting

residence outside county of residence, changing name for

reason other than marriage, or conviction of a felony.

C. Action on Registration Requests

Upon denial of your voter registration application or

absentee ballot request, Tennessee shall provide you with

the reason(s) for the rejection. 

D. Action If Registration Is Denied

Persons denied registration may appeal to the county

election commission within ten (10) days from the date of

rejection. Consult a legal assistance officer or civilian

counsel.

E. Voting By Citizens Who Have Never 

Lived in the U.S.

A U.S. citizen who was born abroad and who is eligible to

vote and who has never lived in the U.S. may register

temporarily and vote in the county where a parent would be

eligible to temporarily register and vote pursuant to this

action.

F. Where To Send It

Mail the FPCA to the County Election Commission, county

of voting residence, as listed below:

County County Seat Zip Code

Anderson 100 North Main, Room 207, Anderson 

Courthouse, Clinton, TN 37716-3617

Bedford One Public Square, Suite 20

Shelbyville, TN 37160-3952

Benton One East Court Square, Room 211, Benton 

County Courthouse, Camden, TN 38320-2071

Bledsoe P.O. Box 253

Pikeville, TN 37367-0253

Blount 383 Court Street, 2nd Floor, Blount County 

Courthouse, Mayville, TN 37804-5906

Bradley 155 Broad Street, N.W., Courthouse Annex 

Cleveland, TN 37311-5000

Campbell P.O. Box 84

Jacksboro, TN 37757-0084

Cannon 301 West Main Street, Room 244, Adams 

Office Bldg., Woodbury, TN 37190-1100

Carroll 625 High Street, Suite 113 

Huntington, TN 38344-1703

Carter 801 Elk Avenue, Room 207, Main Carter Co. 

Courthouse, Elizabethton, TN 37643-2439

Cheatham 162 County Service Dr., Suite 120

Ashland City, TN 37015-0000

Chester P.O. Box 127

Henderson, TN 38340-0127

Claiborne P.O. Box 343

Tazewell, TN 37879-0343

Clay P.O. Box 721 

Celina, TN 38551-0721

Cocke 360 East Main Street, Room 130, Courthouse 

Annex, Newport, TN 37821-3121

Coffee Coffee County Election Commission, 1329 

McArthur St., Suite 6, Manachester, TN 37355-2456

Crockett 10 North Johnson, Suite 1, Courthouse Annex 

Alamo, TN 38001-1709

Cumberland 2 South Main Street, Suite 105, Milo Lemert 

Building, Crossville, TN 38555-4583

Davidson P.O. Box 650

Nashville, TN 37202-0650

Decatur P.O. Box 298

Decaturville, TN 38329-0298

DeKalb P.O. Box 543

Smithville, TN 37166-0543

Dickson P.O. Box 522

Charlotte, TN 37036-0522

Dyer P.O. Box 1109

Dyersburg, TN 38025-1109

Fayette 16265 Highway 64 West, Suite One 

Somerville, TN 38068-6154

Fentress P.O. Box 1027

Jamestown, TN 38556-1027

Franklin 213 N. Jefferson St.

Winchester, TN 37398-1745

Gibson One Court Square, Gibson County 

Courthouse, Trenton, TN 38382-1851

Giles P.O. Box 678

Pulaski, TN 38478-0678

Grainger P.O. Box 28

Rutledge, TN 37861-0028

Greene 218 North Main Street, Suite 1, Greene 

County Offices, Greeneville, TN 37745-3816

Grundy P. O. Box 181

Altamont, TN 37301-0181

Hamblen 511 West Second North Street, Room 101 

Courthouse, Morristown, TN 37814-3964

Hamilton 514 East 4th St., Election Commission 

Chattanooga, TN 37403-1838

Hancock P.O. Box 423

Sneedville, TN 37869-0423

Hardeman P.O. Box 12

Bolivar, TN 38008-0012

Hardin 601 Main Street, Basement Courthouse 

Savannah, TN 38372-2061

Hawkins 100 East Main Street

Rogersville, TN 37857-3360

Haywood One North Washington St, Basement 

Courthouse, Brownsville, TN 38012-2561

Henderson 12 Natchez Trace Drive

Lexington, TN 38351-1838

Henry P.O. Box 967

Paris, TN 38242-0967

Hickman Public Square, Room 8, Courthouse 

Centerville, TN 37033-1639

Houston P.O. Box 346

Erin, TN 37061-0346

Humphreys 208 West Wyly Street

Waverly, TN 37185-1547

Jackson P.O. Box 13

Gainesboro, TN 38562-0013

Jefferson P.O. Box 177

Dandridge, TN 37725-0177

Johnson P.O. Box 106

Mountain City, TN 37683-0106

Knox 300 Main Ave, Room 218, Knox Co. 

Courthouse, Knoxville, TN 37902-1850

Lake 217 South Court

Tiptonville, TN 38079-0000

Lauderdale P.O. Box 532

Ripley, TN 38063-0532

Lawrence 240 West Gaines Street, NBU #10 Lawrence 

Co. Courthouse, Lawrenceburg, TN 38464-3635

Lewis 110 North Park Ave., Room 7, Courthouse 

Hohenwald, TN 38462-1428

Lincoln 208 Davidson Street East, Room 106

Fayetteville, TN 37334-3581

Loudon P.O. Box 193

Loudon, TN 37774-0193

Macon 111 East Locust Street

Lafayete, TN 37083-1219

Madison 311 North Parkway

Jackson, TN 38305-2713

Marion 104 Academy Avenue, County Commission 

Bldg., Jasper, TN 37347-3519

Marshall PO Box 1105, Suite 120 

Lewisburg, TN 37091-0105

County County Seat Zip Code
2004–05 Voting Assistance Guide Tennessee

273

Maury 1207A Tradewinds Drive

Columbia, TN 38401-4607

McMinn 5 South Hill St., Ste B

Athens, TN 37303-5403

McNairy P.O. Box 764

Selmer, TN 38375-0764

Meigs P.O. Box 1266

Decatur, TN 37322-1266

Monroe P.O. Box 397

Madisonville, TN 37354-0397

Montgomery P.O. Box 422

Clarksville, TN 37041-0422

Moore P.O. Box 8056

Lynchburg, TN 37352-8056

Morgan P.O. Box 266

Wartburg, TN 37887-0266

Obion P.O. Box 52

Union City, TN 38281-0052

Overton P.O. Box 384

Livingston, TN 38570-0384

Perry P.O. Box 77

Linden, TN 37096-0077

Picket P.O. Box 213

Byrdstown, TN 38549-0213

Polk P.O. Box 157

Benton, TN 37307-0157

Putnam 300 East Spring Street, Room 10 Courthouse 

Cookeville, TN 38501-3350

Rhea P.O. Box 181

Dayton, TN 37321-0181

Roane P.O. Box 157

Kingston, TN 37763-0157

Robertson 513 South Brown Street, Room 137 

Robertson Co. Office Bld, Springfield, TN 37172-2941

Rutherford 1 Public Square So., Room 103 Rutherford 

Co. Bldg., Murfreesboro, TN 37130-8001

Scott P.O. Box 586

Huntsville, TN 37756-0586

Sequatchie 224 Cedar Street North

Dunlap, TN 37327-6005

Sevier 125 Court Avenue, Room 208E 

Sevier Co. Courthouse, Sevierville, TN 37862-3525

Shelby 157 Poplar Avenue, Room 109, Shelby Co. 

Office Bldg., Memphis, TN 38103-1948

Smith 122 Turner High Circle, Suite 105

Carthage, TN 37030-1555

Stewart P.O. Box 217

Dover, TN 37058-0217

Sullivan 3258 Highway 126, Suite 103, Blountville 

Courthouse, Blountville, TN 37617

Sumner 355 North Belvedere Drive, Room 106 

Sumner Co. Admin. Bldg., Gallatin, TN 37066-5410

Tipton P.O. Box 456

Covington, TN 38019-0456

Trousdale 214 Broadway

Hartsville, TN 37074-1304

Unicoi P.O. Box 76

Erwin, TN 37650-0076

Union P.O. Box 39

Maynardville, TN 37807-0039

Van Buren P.O. Box 254

Spencer, TN 38585-0254

Warren 201 Locust St., Sutie 3

McMinnville, TN 37110

Washington 110 East Main Street, Courthouse 

Jonesborough, TN 37659-1228

Wayne P.O. Box 706

Waynesboro, TN 38485-0706

Weakley 135 South Poplar Street, Suite A, 

Dresden, TN 38225-1451

County County Seat Zip Code

White 1 Bockman Way, Room 215 Courthouse 

Sparta, TN 38583-2034

Williamson 1320 West Main Street, Suite 140 

Administrative Complex, Franklin, TN 37064-3731

Wilson P.O. Box 97

Lebanon, TN 37088-0097

County County Seat Zip Code

Support Democracy Vote Absentee

by SPC Dennis Abernathy, USA, Fort Polk, Louisiana
Tennessee 2004–05 Voting Assistance Guide

274
275

TEXAS

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your Texas Driver's License is required for voter

registration. If you do not possess either of these

identifications, Texas shall assign a number that will serve

to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Texas

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county or township where you claim

legal voting residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. The mailing

address must be an address outside the county of voting

residence or an address anywhere in the U.S. (including an

address within the county of voting residence) used for

forwarding or delivery of an early voting ballot to you at a

location outside the U.S.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if you

request early voting ballots only for general elections. 

F If the address given in Item 4 is within the county of

your voting residence, you must state that the balloting

materials will be forwarded to you at an address outside the

U.S. If you want a Special State Write-In Ballot in lieu of an

officially printed ballot, indicate “Special State Write-In

Ballot” in this item (military only). To foster

communication with your local election official, you may

include a phone number or e-mail address here.

G Check ONE box.

H You must sign and date the FPCA. By signing, you are

swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

D

F

H

A

G
Texas 2004–05 Voting Assistance Guide

276

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U. S. citizens,

residents of Texas, and members of the Uniformed Services

and their family members. Uniformed Services are defined

as the U.S. Armed Forces, merchant marine, the

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration. 

The term “early voting” refers to Texas election procedures

which allow citizens to vote by mail (or in person 17 days

before the election without a reason). References to

“absentee voting” have been changed to “early voting.”

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your Early Voting Clerk at the

beginning of every year and whenever you change your

mailing address (see Chapter 2).

To register and request an early voting ballot for local, state

and Federal offices, send a completed FPCA to the Early

Voting Clerk in the county of your voting residence not

later than the 30th day before the election. If the 30th day

before the election is a Saturday, Sunday or a legal state or

national holiday, your FPCA must be submitted by the next

business day. However, if the election is held in January or

February, you may submit your FPCA so that it arrives not

earlier than 60 days before the election, even though it may

arrive in the preceding calendar year. Persons who are

registered to vote by FPCA may not use this procedure to

vote in person.

If you submit your FPCA between the 29th and the 7th day

before the election and you are not permanently registered,

you will receive a ballot for Federal offices only. However,

for elections during the remainder of the calendar year, you

will receive ballots for local, state and Federal offices.

To register permanently, use the FPCA to request the Texas

voter registration form from the County Voter Registrar.

Complete the Texas voter registration form and return it to

the County Voter Registrar postmarked not later than 30

days before the election. If the 30th day before an election

is a Saturday, Sunday, or a legal state or national holiday,

your application submitted by mail will be considered

timely if it is postmarked by the next business day. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day. If you are casting a ballot

from outside the U.S., it must be placed in delivery by 7:00

p.m. on election day so that it arrives at the Early Voting

Clerk’s office according to the following timetable: 

 Not later than five (5) days after the general election

for state and county officers (includes Federal offices).

 Not later than two (2) days after the date of any

election other than the general election for state and

county officers (e.g., primary, special, school trustee,

and city elections). 

Local election officials mail early voting ballots

approximately 45 days before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions below in G. and in

Chapter 2, page 12.

D. Notary/Witness Requirements

Registration or voting materials are not required to be

notarized or witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Texas allows you to send the FPCA by fax. After

faxing, submit the FPCA by mail.

 Texas does not allow you to receive the blank ballot by

fax.

 Texas allows you to return the voted ballot by fax if

you are a member of the U.S. Armed Forces on active

duty overseas, or the spouse or dependent of the

member, and you are casting the ballot from an area in

which members of the Armed Forces are eligible to

receive hostile fire pay or imminent danger pay, or that

has been designated by the President of the U.S. as a

combat zone.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special State Write-In Ballot

Texas provides a Special State Write-In Ballot if you are

unable to cast a ballot on election day or during the regular

period of early voting because of a military contingency.
2004–05 Voting Assistance Guide Texas

277

You may use this Special State Write-In Ballot to write in

the name of an official candidate. If you apply for a Special

State Write-In Ballot, you will not be sent the official

regular ballot from the state, unless the officially-printed

ballot is available for mailing at the time your FPCA is

received.

You may apply for this Special State Write-In Ballot not

earlier than the 180th day before the election. If you wish to

receive a Special State Write-In Ballot for any election held

outside the 180 days of submission of your initial FPCA,

you must make another request for the Special State WriteIn Ballot.

To request the Special State Write-In Ballot, indicate in

Item 7 of the FPCA “Special State Write-In Ballot.” The

ballot will be mailed as soon as your FPCA has been

approved by the Early Voting Clerk.

G. Federal Write-In Absentee Ballot

Texas has expanded the use of the Federal Write-In

Absentee Ballot (FWAB), SF 186, for overseas voters. The

instructions described in Chapter 2 of this Guide remain the

same, except that Texas allows eligible overseas voters to

use the FWAB to vote in any general, special, primary or

runoff election for Federal office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Texas, and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S., whose intent to return is uncertain, and (but for

such residence) would be qualified to vote in Texas.

The term “early voting” refers to Texas election procedures

which allow citizens to vote by mail (or in person 17 days

before the election without a reason). References to

“absentee voting” have been changed to “early voting.”

 Texas residents temporarily residing outside the U.S.

(for local, state, and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your Early Voting Clerk at the

beginning of every year and whenever you change your

mailing address (see Chapter 2).

To register and request an early voting ballot for local, state

and Federal offices, send a completed FPCA to the Early

Voting Clerk in the county of your voting residence not

later than the 30th day before the election. If the 30th day

before the election is a Saturday, Sunday or a legal state or

national holiday, your FPCA must be submitted by the next

business day. However, if the election is held in January or

February, you may submit your FPCA so that it arrives not

earlier than 60 days before the election, even though it may

arrive in the preceding calendar year. Persons who are

registered to vote by FPCA may not use this procedure to

vote in person.

If you submit your FPCA between the 29th and the 7th day

before the election and you are not permanently registered,

you will receive a ballot for Federal offices only. However,

for elections during the remainder of the calendar year, you

will receive ballots for local, state and Federal offices.

To register permanently, use the FPCA to request the Texas

voter registration form from the County Voter Registrar.

Complete the Texas voter registration form and return it to

the County Voter Registrar postmarked not later than 30

days before the election. If the 30th day before an election

is a Saturday, Sunday, or a legal state or national holiday,

your application submitted by mail will be considered

timely if it is postmarked by the next business day. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be placed in

delivery by 7:00 p.m. on election day so that it arrives at the

Early Voting Clerk’s office according to the following

timetable: 

 Not later than five (5) days after the general election

for state and county offices (includes Federal offices). 

 Not later than two (2) days after the date of any

election other than the general election for state and

county officers (e.g., primary, special, school trustee,

and city elections).

Local election officials mail early voting ballots

approximately 45 days before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in F. below and in Chapter 2, page 12.

D. Notary/Witness Requirements

Registration or voting materials are not required to be

notarized or witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Texas allows you to send the FPCA by fax. After

faxing, submit the FPCA by mail.

 Texas does not allow you to receive the blank ballot by

fax.
Texas 2004–05 Voting Assistance Guide

278

 Texas does not allow you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Federal Write-In Absentee Ballot

Texas has expanded the use of the Federal Write-In

Absentee Ballot (FWAB), SF 186, for overseas voters. The

instructions described in Chapter 2 of this Guide remain the

same, except that Texas allows eligible overseas voters to

use the FWAB to vote in any general, special, primary or

runoff election for Federal office.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Convicted felons while serving their sentence, parole or

probation and persons declared mentally incompetent by

final judgment of a court may not register or vote.

B. Cancellation of Registration

Temporary registration is canceled at the end of each

calendar year. Change of residence may trigger being

placed on the suspense list and could result in cancellation

of permanent registration. If cancellation of registration

occurs, re-registration is required.

C. Action on Registration Requests

You will receive a notice of denial if your FPCA is rejected.

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Texas shall provide you with the

reason(s) for the rejection. Provide the information

requested in the notice of denial. If registration is again

denied, consult a legal assistance officer or civilian counsel.

E. Where To Send It

Mail the FPCA to the Early Voting Clerk in the county of

your voting residence, as listed below, for primary, runoff

and general elections. For any elections other than Federal,

state and county office elections or any other election

conducted by the county, send a separate FPCA to the Early

Voting Clerk conducting that election. (Generally, the

authority ordering the election appoints the Early Voting

Clerk, e.g., city, school district, water district. Addresses for

a particular jurisdiction can be obtained by contacting the

County Clerk or Elections Administrator in that area or the

administrative officers of the political subdivision

conducting the election). Requests for a Texas voter

registration form must be mailed to the County Voter

Registrar.

County County Seat Zip Code

Anderson 500 N. Church St., Palestine 75801-2968

Andrews PO Box 727, Andrews 79714-0727

Angelina PO Box 1344, Lufkin 75902-1344

Aransas 301 N. Live Oak Street, Rockport 78382-2798

Archer PO Box 815, Ancher CIty 76351-0427

Armstrong PO Box 309, Claude 79019-0309

Atascosa 1306 Brown St., Jourdanton 78026-2816

Austin One East Main Street, Bellville 77418-1598

Bailey 300 South 1st St., Ste. 200, Muleshoe 79347-3621

Bandera PO Box 823, Bandera 78003-0823

Bastrop PO Box 577, Bastrop 78602-0577

Baylor PO Box 689, Seymour 76380-0689

Bee 105 W. Corpus Christi St., #103 Beeville 78102-5627

Bell P.O Box 480, Belton 76513-0480

Bexar 203 W. Nueva, Ste. 3.61, San Antonio 78207-4505

Blanco PO Box 65, Johnson City 78636-0117

Borden PO Box 124, Gail 79738-0124

Bosque PO Box 617, Meridian 76665-0617

Bowie PO Box 248, New Boston 75570-0248

Brazoria 111 E. Locust, Ste. 200, Angleton 77515-4654

Brazos 300 E. 26th St., Suite 120, Bryan 77803-5393

Brewster 107 West Ave. E., #3, Alpine 79830-4618

Briscoe PO Box 555, Silverton 79257-0555

Brooks PO Box 427, Falfurrias 78355-0427

Brown 200 S. Broadway, Brownwood 76801-3188

Burleson 100 W. Buck St. #203, Caldwell 77836-1762

Burnet 220 S. Pierce, Burnet 78611-3136

Caldwell 100 E. Market Street, Lockhart 78644-2747

Calhoun 211 S. Ann Street, Port Lavaca 77979-4298

Callahan 100 W. 4th Street, Suite 104, Baird 79504-5300

Cameron PO Box 832, Brownsville 78522-0832

Camp 126 Church Street, Pittsburg 75686-1344

Carson PO Box 487, Panhandle 79068-0487

Cass PO Box 449, Linden 75563-0449

Castro 100 E. Bedford, Dimmit 79027-2643

Chambers PO Box 728, Anahuac 77514-0728

Cherokee PO Box 420, Rusk 75785-0420

Childress Courthouse, Box 4, Childress 79201-0004

Clay 100 N. Bridge, Henrietta 76365-2800

Cochran Courthouse, Room 102, Morton 79346-2598

Coke PO Box 150, Robert Lee 76945-0052

Coleman PO Box 591, Coleman 76834-0591

Collin 920 E. Park Blvd., Suite 120, Plano 75074-5466

Collingsworth 800 W. Ave., Box 10, Wellington 79095-3092

Colorado PO Box 68, Columbus 78934-0068

Comal 150 N. Seguin Av, #101 New Braunfels 78130-5122

Comanche 101 W. Central, Comanche 76442-3263

Concho PO Box 98, Paint Rock 76866-0098

Cooke Courthouse, 100 S. Dixon St 

Gainesville

76240-4717

Coryell PO Box 237, Gatesville 76528-0237

Cottle PO Box 717, Paducah 79248-0717

Crane PO Box 578, Crane 79731-0578

Crockett PO Drawer C, Ozona 76943-2502

Crosby PO Box 218, Crosbyton 79322-2500

Culberson PO Box 158, Van Horn 79855-0158

Dallam PO Box 1352, Dalhart 79022-1352

Dallas 2377 North Stemmons, Ste. 820, Dallas 75207-2706
2004–05 Voting Assistance Guide Texas

279

Dawson PO 1268, Lamesa 79331-1268

Deaf Smith 235 E. 3rd, Room 203, Hereford 79045-5542

Delta PO Box 455, Cooper 75432-0455

Denton PO Box 1720, Denton 76202-1720

DeWitt 307 N. Gonzales Street, Cuero 77954-2998

Dickens PO Box 120, Dickens 79229-0120

Dimmit 303 S. 5th Street, Carrizo Springs 78834-3811

Donley Drawer U, Clarendon 79226-2020

Duval PO Box 248, San Diego 78384-0248

Eastland PO Box 110, Eastland 76448-0110

Ector PO Box 11149, Odessa 79760-8149

Edwards PO Box 184, Rocksprings 78880-0184

El Paso 500 E. San Antonio, Rm. 402, El Paso 79901-2421

Ellis PO Drawer W, Waxahachie 75168-1230

Erath 100 W. Washington, Stephenville 76401-4280

Falls PO Box 458, Marlin 76661-0458

Fannin 101 E. Sam Rayburn Dr., Bonham 75418-4346

Fayette PO Box 59, La Grange 78945-0296

Fisher PO Box 368, Roby 79543-0368

Floyd Courthouse, Room 101, Floydada 79235-0476

Foard PO Box 539, Crowell 79227-0539

Fort Bend 301 Jackson St., Ste. 624 Richmond 77469-3108

Franklin PO Box 68, Mount Vernon 75457-0008

Freestone PO Box 1010, Fairfield 75840-1017

Frio 500 E. San Antonto Street, Pearsall 78061-3100

Gaines 101 So. Main, Room 107, Seminole 79360-4397

Galveston PO Box 2450, Galveston 77550-2450

Garza PO Box 366, Post 79356-3242

Gillespie 101 W. Main, #13, Fredericksburg 78624-3700

Glasscock PO Box 190, Garden City 79739-0190

Goliad PO Box 50, Goliad 77963-0050

Gonzales PO Box 77, Gonzales 78629-0077

Gray PO Box 1902, Pampa 79066

Grayson 100 W. Houston, Suite 17, Sherman 75090-5958

Gregg PO Box 2827, Longview 75606

Grimes PO Box 209, Anderson 77830-0209

Guadalupe PO Box 1346, Seguin 78156-1346

Hale 500 Broadway #140, Plainview 79702-8050

Hall 512 W. Main, Memphis 79245-3343

Hamilton Courthouse, Hamilton 76531-1897

Hansford PO Box 397, Spearman 79081-0397

Hardeman PO Box 30, Quanah 79252-0030

Hardin PO Box 38, Kountz 77625-0038

Harris PO Box 1525, Houston 77251-1525

Harrison PO Box 8409, Marshall 75671-8409

Hartley PO Box Q, Channing 79018-0147

Haskell PO Box 725, Haskell 79521-0725

Hays 401-C Broadway St. San Marcos 78666-7751

Hemphill PO Box 867, Canadian 79014-0867

Henderson Courthouse, Athens 75751-0632

Hidalgo PO Box 659, Edinburg 78540-0659

Hill PO Box 398, Hillsboro 76645-0398

Hockley 802 Houston, Suite 213, Levelland 79336-0013

Hood PO Box 339, Granbury 76048-0339

Hopkins PO Box 288, Sulphur Springs 75483-0288

Houston PO Box 370, Crockett 75835-0370

Howard P.O. Box 1468, Big Spring 79720-1468

Hudspeth PO Box 58, Sierra Blanca 79851-0058 

Hunt PO Box 1316, Greenville 75403-1316

Hutchinson PO Box 1186, Stinnett 79083-1186

Irion PO Box 736, Mertzon 76941-0736

Jack 100 Main, Jacksboro 76458-1746

Jackson 115 W. Main, Room 101, Edna 77957-2799

Jasper PO Box 2070, Jasper 75951-8070

Jeff Davis PO Box 398, Fort Davis 79734-0398

Jefferson PO Box 1151, Beaumont 77704-1151

Jim Hogg PO Box 878, Hebbronville 78361-0878

Jim Wells PO Box 1459, Alice 78333-1459

Johnson 2 N. Main St., Cleburne 76031-5502

Jones PO Box 552, Anson 79501-0552

Karnes 101 N. Panna Maria Ave., Karnes City 78118-2909

Kaufman PO Box 339, Kaufman 75142-0339

County County Seat Zip Code

Kendall 201 E. San Antonio Street, Boerne 78006-2050

Kenedy PO Box 227, Sarita 78385-1519

Kent PO Box 9, Jayton 79528-0009

Kerr 700 Main Street, Suite 122, Kerrville 78028-5389

Kimble 501 Main St., Courthouse, Junction 76849-4743

King PO Box 135, Guthrie 79236-0135

Kinney PO Box 9, Brackettville 78832-0937

Kleberg PO Box 1327, Kingsville 78364-1327

Knox PO Box 196, Benjamin 79505-0196

La Salle Courthouse Square, #107, Cotulla 78014-2263

Lamar 119 N. Main, Paris 75460-4265

Lamb Box 3, Rm. 103, Courthouse, Littlefield 79339-0003

Lampasas PO Box 347, Lampasas 76550-0347

Lavaca PO Box 326, Hallettsville 77964-0326

Lee PO Box 419, Giddings 78942-0419

Leon PO Box 98, Centerville 75833-0098

Liberty PO Box 369, Liberty 77575-0369

Limestone PO Box 350, Groesbeck 76642-0350

Lipscomb PO Box 70, Lipscomb 79056-0070

Live Oak PO Box 280, George West 78022-0280

Llano PO Box 40, Llano 78643-0040

Loving PO Box 194, Mentone 79754-0194

Lubbock PO Box 10536, Lubbock 79408-3536

Lynn PO Box 937, Tahoka 79373-0937

Madison 101 W. Main, Rm. 102, Madisonville 77864-1981

Marion PO Box 763, Jefferson 75657

Martin PO Box 906, Stanton 79782-0906

Mason PO Box 702, Mason 76856-0702

Matagorda 1700 Seventh St. #202, Bay City 77414-5094

Maverick 500 Quarry St., Ste. 1, Eagle Pass 78853-4577

McCulloch Courthouse Square, Brady 76825-4535

McLennan PO Box 2450, Waco 76703-2450

McMullen PO Box 235, Tilden 78072-0235

Medina 1100 16th St., Rm. 109, Hondo 78861-1897

Menard PO Box 1038, Menard 76859-1038

Midland PO Box 3434, Midland 79702-3434

Milam PO Box 191, Cameron 76520-0191

Mills PO Box 646, Goldthwaite 76844-0646

Mitchell 349 Oak St., Rm. 103, Colorado City 79512-6225

Montague PO Box 77, Montague 76251-0077

Montgomery PO Box 2646, Conroe 77305-2646

Moore 715 S. Dumas Ave., #105, Dumas 79029-0396

Morris 500 Broadnax Street, Daingerfield 75638-1397

Motley PO Box 660, Matador 79244-0660

Nacogdoches 203 W. Main, Nacogdoches 75961-4810

Navarro PO Box 423, Corsicana 75151-0423

Newton PO Box 484, Newton 75966-0484

Nolan 100 E. 3rd., Suite 108, Sweetwater 79556-0098

Nueces 901 Leopard St, Rm 201, Corpus Christi 78401-3602

Ochiltree 511 S. Main, Perryton 79070-3154

Oldham PO Box 360, Vega 79092-0360

Orange PO Box 1536, Orange 77631-1536

Palo Pinto PO Box 219, Palo Pinto 76484-0219

Panola 110 S. Sycamore Street, Carthage 75633-2527

Parker PO Box 819, Weatherford 76086-0819

Parmer PO Box 356, Farwell 79325-0356

Pecos 103 W. Callaghan, Fort Stockton 79735-7101

Polk PO Drawer 2119, Livingston 77351-7119

Potter PO Box 9638, Amarillo 79105-9638

Presidio PO Box 789, Marfa 79843-0789

Rains PO Box 187, Emory 75440-0187

Randall PO Box 660, Canyon 79015-0660

Reagan PO Box 100, Big Lake 76932-0100

Real PO Box 750, Leakey 78873-0656

Red River 200 N. Walnut Street, Clarksville 75426-3041

Reeves PO Box 867, Pecos 79772-0867

Refugio PO Box 704, Refugio 78377-0704

Roberts Box 477, Miami 79059-0477

Robertson PO Box 1029, Franklin 77856-1029

Rockwall 1101 Ridge Road, S-101, Rockwall 75087-3724

Runnels PO Box 189, Ballinger 76821-0189

Rusk P.O. Box 758, Henderson 75652-0758

County County Seat Zip Code
Texas 2004–05 Voting Assistance Guide

280

Sabine PO Box 580, Hemphill 75948-0580

San Augustine 100 W. Columbia, Rm 106

San Augustine

75972-2452

San Jacinto 1 State Hwy 150, Rm 2, Coldspring 77331-0669

San Patricio PO Box 578, Sinton 78387-0578

San Saba 500 E. Wallace, Courthouse, San Saba 76877-3608

Schleicher PO Box 580, Eldorado 76936-0580

Scurry 1806 25th Street, Snyder 79549-0508

Shackelford PO Box 247, Albany 76430-0247

Shelby PO Box 1987, Center 75935-1987

Sherman PO Box 270, Stratford 79084-0270

Smith PO Box 777, Tyler 75710-0777

Somervell PO Box 1098, Glen Rose 76043-1098

Starr Courthouse, Rm. 201, Rio Grande City 78582-2620

Stephens Courthouse, Breckenridge 76424-3551

Sterling PO Box 55, Sterling City 76951-0055

Stonewall P.O. Drawer P, Aspermont 79502-0914

Sutton 300 E. Oak, Suite 3, Sonora 76950-3106

Swisher Courthouse, 119 S. Maxwell, Tulia 79088-2297

Tarrant 100 W. Weatherford St. Fort Worth 76196-0136

Taylor PO Box 3318, Abilene 79604-3318

Terrell PO Box 410, Sanderson 79848-0410

Terry 501 W. Main, Rm. 105, Brownfield 79316-4327

Throckmorton PO Box 309, Throckmorton 76483-0509

Titus 100 W. 1st St., Ste. 204, Mt. Pleasant 75455-4443

Tom Green 113 W. Beauregard Ave., San Angelo 76903-5887

Travis PO Box 1748, Austin 78767-1748

Trinity PO Box 456, Groveton 75845-0456

Tyler 100 W. Bluff, Room 110, Woodville 75979-5245

Upshur PO Box 730, Gilmer 75644-0730

Upton PO Box 465, Rankin 79778-0465

Uvalde PO Box 284, Uvalde 78802-0284

Val Verde PO Box 1267, Del Rio 78841-1267

Van Zandt 121 E. Dallas, Rm. 202, Canton 75103-1465

Victoria 111 N. Glass, Victoria 77901-6414

Walker 1021 University Ave., Huntsville 77320-3951

Waller 846 6th Street, #1, Hempstead 77445-5402

Ward 400 S. Allen St., Ste. 101, Monahans 79756-4602

Washington 100 E. Main, Ste 102, Brenham 77833-3753

Webb PO Drawer 29, Laredo 78042-0029

Wharton PO Box 69, Wharton 77488-0069

Wheeler PO Box 465, Wheeler 79096-0465

Wichita PO Box 1679, Wichita Falls 76307-1679

Wilbarger 1700 Wilbarger, Rm. 15, Vernon 76384-4748

Willacy 540 W. Hidalgo, 1st Flr, Raymondville 78580-3597

Williamson 710 Main St., 2nd Floor, Georgetown 78626-5701

Wilson PO Box 27, Floresville 78114-0027

Winkler PO Box 1007, Kermit 79745-1007

Wise PO Box 359, Decatur 76234-0359

Wood PO Box 1796, Quitman 75783-2796

Yoakum PO Box 309, Plains 79355-0309

Young 516 Fourth St., Rm 104, Graham 76450-3063

Zapata PO Box 789, Zapata 78076-0789

Zavala Courthouse, Crystal City 78839-3590

County County Seat Zip Code

Make The Choice. Use Your Voice. Vote

by Victoria Loughran, USMC, Yuma, Arizona
281

 UTAH

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number or

your Utah Driver’s License is required for voter

registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Utah

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E Provide your political party affiliation.

F Check ONE box.

G You must sign and date the FPCA. By signing, you are

swearing or affirming that the information is true and

correct. 

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Utah 2004–05 Voting Assistance Guide

282

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Utah, military voters, and members of the

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

Under Utah law, military voters are defined as:

 members of the U.S. Armed Forces or merchant

marine

 civilian employees of the U.S. Government serving

overseas

 members of religious groups or welfare agencies

officially attached to the Armed Forces overseas

 spouses and dependents of the above

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Registration is not required when using the FPCA to

request ballots. When you return the voted ballot you will

be temporarily registered.

If you are a member of the Armed Forces or merchant

marine or a spouse or dependent of one of these and live in

the U.S., the County Clerk must receive your FPCA not

later than the Friday before the election. 

If you are a voter defined in I(A) above and you live

overseas, the County Clerk must receive your FPCA not

later than 20 days before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must be postmarked

by the day before the election and received by the elections

officer before noon on the day of the official canvass

following the election (see Item D).

Local election officials mail ballots to persons residing

overseas not later than 35 days before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witnessed required. 

Ballot Return Envelope: If it is not possible to obtain the

military postmark on or before election day a

noncommissioned officer or commissioned officer may

certify that the ballot was voted on or before election day by

writing the following on the exterior of the ballot:

 “I certify that this ballot was voted on or before

election day”

 sign and date; and

 clearly print their name and service number below the

signature.

E. Electronic Transmission FPCAs and 

Ballots

 Some counties in Utah allow you to send your FPCA

for registration and ballot request by fax in emergency

situations. After faxing, submit the FPCA by mail.

 Some counties in Utah allow you to receive the blank

ballot by fax in emergency situations.

 Some counties in Utah allow you to return the voted

ballot by fax in emergency situations.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Utah provides a state special write-in absentee ballot to

military voters who will be unable to vote by regular

absentee ballot or in person because of military service.

This special write-in ballot is only available for general

elections.

The FPCA may be used to request this special write-in

ballot. In Item 7 of the FPCA, place one of the state

special write-in labels from Section III.G. If no labels are

available, write in Item 7: “I am unable to vote by regular

absentee ballot or in person because of military service. I

request a special write-in absentee ballot.”
2004–05 Voting Assistance Guide Utah

283

The special write-in ballot is available 90 days before an

election and must be requested not later than 30 days before

the election. It may be used to vote for Federal offices only.

You may vote it by writing a party choice or the names of

specific candidates.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S. 

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens

and residents of Utah, or overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Utah.

 Utah residents temporarily residing outside the U.S.

(Consult Section B below for ballot type eligibility)

 Overseas citizens (for ballots for Federal offices only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Registration is not required when using the FPCA to

request ballots. When you return the voted ballot you will

be temporarily registered.

If you are an unregistered resident temporarily residing

outside the U.S. and wish to receive a ballot for local, state

and Federal offices, send your FPCA to the County Clerk.

The County Clerk will then mail you the state by-mail

registration form which must be completed and returned so

that it arrives not later than 20 days before the election.

Request the state by-mail registration form by submitting

an FPCA to the local election official.

If you are an unregistered resident temporarily residing

outside the U.S. and wish to vote a ballot for Federal offices

only, the County Clerk must receive your FPCA request for

a ballot for Federal offices not later than 30 days before the

election. In this case, you are considered an overseas

citizen.

If you are a registered resident temporarily residing outside

the U.S., the County Clerk must receive your FPCA not

later than 20 days before the election. You will receive

ballots for local, state and Federal offices.

If you are an overseas citizen, the County Clerk must

receive your FPCA not later than 30 days before the

election. You will be temporarily registered. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

County Clerk before noon on the day of the official canvass

following the election. Postmark your voted ballot by the

day before the election.

Local election officials mail ballots to persons residing

overseas not later than 35 days before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCA and 

Ballots

 Some counties in Utah allow you to send your FPCA

for registration and ballot request by fax in emergency

situations. After faxing, submit the FPCA by mail.

 Some counties in Utah allow you to receive the blank

ballot by fax in emergency situations.

 Some counties in Utah allow you to return the voted

ballot by fax in emergency situations.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.Instructions continue in Section III: Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons incarcerated for a felony conviction or persons

found mentally incompetent may not register or vote, unless

civil rights have been restored. 

B. Cancellation of Registration

Temporary registration is canceled at the end of the

calendar year.
Utah 2004–05 Voting Assistance Guide

284

C. Action on Registration Requests

A ballot or a state by-mail registration form is sent, as

appropriate.

D. Action If Registration Is Denied

If registration is denied, consult a legal assistance officer or

civilian counsel. Upon denial of your voter registration

application or absentee ballot request, Utah shall provide

you with the reason(s) for the rejection.

E. Late Registration

Any member of the Armed Forces, merchant marine or any

civilian citizen who was discharged from overseas service

or employment too late to meet the regular state registration

deadline, may register to vote by filing an affidavit

establishing his or her eligibility to vote with the County

Clerk of his or her county of voting residence by noon on

the day before the election.

F. Where To Send It

Mail the FPCA to the County Clerk, county of voting

residence, as listed below:

County County Seat Zip Code

Beaver PO Box 392

Beaver 84713-0392

Box Elder 01 S. Main Street

Brigham City 84302-2599

Cache 170 No. Main Street 

Logan 84321-4567

Carbon 120 East Main

Price 84501-3057

Daggett PO Box 218 

Manila 84046-0218

Davis PO Box 618 

Farmington 84025-0618

Duchesne PO Box 270 

Duchesne 84021-0270

Emery PO Box 907

Castle Dale 84513-0907

Garfield PO Box 77 

Panguitch 84759-0077

Grand 125 E. Center

Moab 84532-2492

Iron PO Box 429

Parowan 84761-0429

Juab 160 N. Main

Nephi

84648-1412

Kane 76 North Main 

Kanab

84741-0050

Millard 765 S. Highway 99

Fillmore

84631-5002

Morgan PO Box 886

Morgan

84050-0886

Piute PO Box 99 

Junction

84740-0099

Rich 20 South Main, PO Box 218 

Randolph

84064-0218

Salt Lake 2001 S. State Satreet, #S1100

Salt Lake City 84190-1051

San Juan PO Box 338

Monticello 84535-0338

Sanpete 160 N. Main

Manti 84642-1268

Sevier PO Box 517 

Richfield 84701-0517

Summit PO Box 128 

Coalville 84017-0128

Tooele 47 So. Main 

Tooele 84074-2194

Uintah 147 East Main 

Vernal 84078-2643

Utah 100 East Center, Room 3100

Provo 84606-3106

Wasatch 25 No. Main 

Heber City 84032-1827

Washington 197 E. Tabernacle 

Saint George 84770-3473

Wayne PO Box 189

Loa 84747-0189

Weber 2380 Washington Boulevard, 3rd Floor 

Ogden 84401-1456

County County Seat Zip Code

Don’t Sacrifice Your Vote. Use It!!

by A1C Jerry Rose, USAF, Mountain Home, Idaho
UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”

G. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

UTAH

“I am unable to vote by regular absentee ballot or in person because of

military service. I request a special write-in absentee ballot.”
Utah 2004–05 Voting Assistance Guide

286
287

VERMONT

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Provide your Vermont Driver’s License number or if

you do not have a Vermont Driver’s License, the last four

digits of your Social Security Number. If you do not

possess either of these identifications, the State shall

assign a number that will serve to identify you for voter

registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Vermont

voting residence. A post office box is not sufficient. If you

do not have a street address, describe the physical location

of your residence. For example: “on Highway _____, 2

miles past Highway _____, across the street from the _____

gas station.” This address must be within the town where

you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address you provided in Item 3.

E If you have not been administered the oath previously,

you must place an oath label or write the oath in Item 7,

Remarks (See Section I.C. and II.C.). Also, you must

specify your desire for acceptance of your application as a

ballot request for both the primary and general elections,

otherwise, your FPCA will serve as a request for one

election only.

F Item 8f is not applicable for voting purposes in

Vermont.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

H If you are using the FPCA to register and have not

taken the Voter’s Oath previously, a notary public,

commissioned officer, or any official authorized to

administer oaths must complete this section.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

M M D D Y Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

H

A
Vermont 2004–05 Voting Assistance Guide

288

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Vermont and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the town clerk so that it is postmarked not later

than the second Monday before the election.

To request an absentee ballot if you are already registered,

send a completed FPCA to the town clerk so that it arrives

not later than 5 p.m. or the closing of the town clerk’s office

on the day preceding the election. Alternatively, you may

request a ballot by telephone. (Although Vermont law

allows absentee ballot requests as stated, you must time

your request in order for you to receive your ballot in time

to actually return it so it arrives at the Town Clerk’s office

before 7 p.m. on election day.)

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the town

clerk not later than the close of polls on election day.

Local election officials mail absentee ballots approximately

30 days before Federal and state elections. Ballots for local

elections are available 20 days before the election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: If you have never registered before in Vermont, you

must take the “Voter’s Oath” as part of the registration

process. You must take this oath before a commissioned

officer, notary, or other official authorized to administer

oaths.

Voter’s Oath:

“I solemnly swear (or affirm) that whenever I give my vote

or suffrage, touching any matter that concerns the State of

Vermont, I will do it so as in my conscience I shall judge

will most conduce to the best good of the same, as

established by the Constitution, without fear or favor of any

person.” (Vermont Constitution, Chapter II, Section 42). 

Following completion of the oath, place one of the state

oath labels from Section III.E in Item 7 of the FPCA. If no

labels are available, write the above oath in Item 7. 

Ballot Return Envelope: The ballot return envelope is not

sworn to or witnessed. However, your signature must be on

the inside envelope certificate

E. Electronic Transmission of FPCAs 

and Ballots

 Vermont allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail or express delivery service.

 Vermont allows you to receive the blank absentee

ballot by fax.

 Vermont does not allow you to return your voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application for Ballot by Proxy

A member of your immediate family may request a ballot

from the town clerk for you. This request by proxy must be

received by 5 p.m., the day before the election.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Vermont and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Vermont.
2004–05 Voting Assistance Guide Vermont

289

 residents of Vermont temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 overseas citizens (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and request an absentee ballot, send a completed

FPCA to the town clerk so that it is postmarked not later

than the second Monday before the election.

To request an absentee ballot if you are already registered,

send a completed FPCA to the town clerk so that it arrives

not later than 5 p.m. or the closing of the town clerk’s office

on the day preceding the election. Alternatively, you may

request a ballot by telephone. (Although Vermont law

allows absentee ballot requests as stated, you must time

your request in order for you to receive your ballot in time

to actually return it so it arrives at the Town Clerk’s office

before 7 p.m. on election day.)

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the town

clerk by close of polls on election day.

Local election officials mail absentee ballots approximately

30 days before Federal and state elections. Ballots for local

elections are available 20 days before the election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: If you have never registered before in Vermont, you

must take the “Voter’s Oath” as part of the registration

process. You must take this oath before a commissioned

officer, notary, or other official authorized to administer

oaths.

Voter’s Oath:

“I solemnly swear (or affirm) that whenever I give my vote

or suffrage, touching any matter that concerns the State of

Vermont, I will do it so as in my conscience I shall judge

will most conduce to the best good of the same, as

established by the Constitution, without fear or favor of any

person.” (Vermont Constitution, Chapter II, Section 42). 

Following completion of the oath, place one of the state

oath labels from Section III in Item 7 of the FPCA. If no

labels are available, write the above oath in Item 7. 

Ballot Return Envelope: The ballot return envelope is not

sworn to or witnessed. 

E. Electronic Transmission of FPCAs and 

Ballots

 Vermont allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail or express delivery service.

 Vermont allows you to receive the absentee ballot by

fax.

 Vermont does not allow you to return your voted ballot

by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Application For Ballot By Proxy

A member of your immediate family may request a ballot

from the town clerk for you. This request by proxy must be

received by 5 p.m., the day before the election. (Although

Vermont law allows absentee ballot requests as stated, you

must time your request in order for you to receive your

ballot in time to actually return it so it arrives at the Town

Clerk’s office before 7 p.m. on election day.)

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Cancellation of Registration

Persons who are no longer residents of Vermont may be

removed from the voting checklist.

B. Action on Registration Requests

Notice of acceptance or denial is sent.

C. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Vermont shall provide you with the

reason(s) for the rejection. Persons denied registration

should reapply, providing the information requested in the

first notice of denial. If a second denial is received, consult

a legal assistance officer or civilian counsel.

D. Where To Send It

Mail the FPCA to the Town Clerk, town or city of voting

residence. A list of towns and cities follows. If your town is

not listed below, please call the Federal Voting Assistance
Vermont 2004–05 Voting Assistance Guide

290

Program at 703-588-1584, 1-800-438-8683 (VOTE), DSN

425-1584 (military) or using the toll-free fax number on the

inside back cover. You may also e-mail at

vote@fvap.ncr.gov.

City or Town Mailing Address Zip Code

Addison 7099 VT RTE 22A 05491

Albany PO Box 284 05820

Alburg PO Box 346 05440

Andover 953 Weston-Andover Rd. 05143

Arlington PO Box 304 05250

Athens 25 Brookline Rd. 05143

Bakersfield PO Box 203 05441

Baltimore 49 Harris Rd. 05143

Barnard PO Box 274 05031

Barnet PO Box 15 05821

Barre City PO Box 418 05641

Barre Town PO Box 124, Websterville, VT 05678

Barton PO Box 657 05822

Belvidere 3996 VT RTE 109 05442

Bennington 205 South Street 05201

Benson PO Box 163 05731

Berkshire 4454 Watertower Rd, 

Berkshire, VT 05450

Berlin 108 Shed Road 05602

Bethel PO Box 404 05032

Bloomfield PO Box 336, N. Stratford, NH 03590

Bolton 3045 T. Roosevelt Hwy 05676

Bradford PO Box 339 05033

Braintree 932 Vt. Rt. 12A 05060

Brandon 49 Center Street 05733

Brattleboro 230 Main St., Suite 108 05301

Bridgewater PO Box 14 05034

Bridport PO Box 27 05734

Brighton PO Box 337 

Island Pond, VT 05846

Bristol PO Box 249 05443

Brookfield PO Box 463 05036

Brookline PO Box 403, Newfane, VT 05345

Brownington 509 Dutton Brook Lane 05860

Brunswick 994 VT RTE 102 05905

Burke 212 School Street., West Burke, VT 05871

Burlington 149 Church St. 05401

Cabot PO Box 36 05647

Calais 668 West County Rd. 05648

Cambridge PO Box 127, Jeffersonville, VT 05464

Canaan PO Box 159 05903

Castleton PO Box 727 05735

Cavendish PO Box 126 05142

Charleston 5063 Vt. Rte. 105, West Charleston, VT 05872

Charlotte PO Box 119 05445

Chelsea PO Box 266 05038

Chester PO Box 370 05143

Chittenden PO Box 89 05737

Clarendon PO Box 30, Clarendon, VT 05759

Colchester PO Box 55 05446

Concord PO Box 317 05824

Corinth PO Box 461 05039

Cornwall 2629 Route 30 05753

Conventry PO Box 104 05825

Craftsbury PO Box 55 05826

Danby PO Box 231 05739

Danville PO Box 183 05828

Derby PO Box 25 05829

Dorset PO Box 0024, East Dorset, VT 05253

Dover PO Box 527, West Dover, VT 05356

Dummerston 1523 Middle Rd., East Dummerston, VT 05346

Duxbury 3316 Crossett Hill, 05676

East Haven PO Box 10 05837

East Montpelier PO Box 157 05651

Eden 71 Old Schoolhouse Rd., 

Eden Mills, VT 05653

Elmore PO Box 123, Lake Elmore, VT 05657

Enosburgh PO Box 465, Enosburg Falls, VT 05450

Essex 81 Main Street, Essex Junction, VT 05452

Fair Haven 3 North Park Place 05743

Fairfax PO Box 27 05454

Fairfield PO Box 5 05455

Fairlee PO Box 95 05045

Fayston 866 N. Fayston Rd., North Fayston, VT 05660

Ferrisburgh PO Box 6 05456

Fletcher 215 Cambridge Rd., Cambridge, VT 05444

Franklin PO Box 82 05457

Georgia 47 Town Common Rd., N. 

St. Albans, VT 05478

Glover 51 Bean Hill 05839

Goshen 50 Carlisle Hill Rd. 05733

Grafton PO Box 180 05146

Granby PO Box 56 05840

Grand Isle PO Box 49 05458

Granville PO Box 66 05747

Greensboro PO Box 119 05841

Groton 314 Scott Highway 05046

Guildhall PO Box 10 05905

Guilford 236 School Road 05301

Halifax PO Box 127, West Halifax 05358

Hancock PO Box 100 05748

Hardwick PO Box 523 05843

Hartford 171 Bridge Street, 

White River Junction, VT 05001

Hartland PO Box 349 05048

Highgate PO Box 67, Highgate Center, VT 05459

Hinesburg PO Box 133 05461

Holland 120 School Rd., Holland 05830

Hubbardton 1831 Monument Hill Road,

Castleton, VT 05735

Huntington 4930 Main Road 05462

Hyde Park PO Box 98 05655

Ira 808 Route 133-IRA, W. Rutland, VT 05777

Irasburg PO Box 51 05845

Isle La Motte PO Box 250 05463

Jamaica PO Box 173 05343

Jay 1036 VT RTE 242 05859

Jericho PO Box 67 05465

Johnson PO Box 383 05656

Killington PO Box 429 05751

Kirby 346 Town Hall Rd., Lyndonville, VT 05851

Landgrove Box 508, Londonderry, VT 05148

Leicester 44 Schoolhouse Rd. 05733

Lemington 2549 River Rd., VT 102 05903

Lincoln 62 Quaker St. 05443

Londonderry PO Box 118, South Londonderry, VT 05155

Lowell 2170 VT Rt. 100 05847

Ludlow PO Box 307 05149

Lunenburg PO Box 54 05906

Lyndon PO Box 167, Lyndonville 05851

Maidstone PO Box 118, Guildhall, VT 05905

Manchester PO Box 830, Manchester Center, VT 05255

Marlboro PO Box E 05344

Marshfield 122 School St., RM 1 05658

Mendon 34 US Route 4 05701

Middlebury 94 Main Street 05753

Middlesex 5 Church St. 05602

Middletown 

Springs PO Box 1232 05757

Milton PO Box 18 05468

Monkton 280 Monkton Ridge, N. Ferrisburgh, VT 05473

Montgomery PO Box 356, Montgomery Center, VT 05471

Montpelier 39 Main St. 05602

Moretown PO Box 666 05660

Morgan PO Box 45 05853

Morristown PO Box 748, Morrisville, VT 05661

Mount Holly PO Box 248 05758

Mount Tabor PO Box 245 05739

New Haven 78 North St. 05472

Newark 1336 Newark St. 05871

City or Town Mailing Address Zip Code
2004–05 Voting Assistance Guide Vermont

291

Newbury PO Box 126 05051

Newfane PO Box 36 05345

Newport City 222 Main St., Newport, VT 05855

Newport Town PO Box 85, Newport Center 05857

North Hero PO Box 38 05474

Northfield 51 South Main Street 05663

Norton PO Box 148 05907

Norwich PO Box 376 05055

Orange PO Box 233, East Barre, VT 05649

Orwell PO Box 32 05760

Panton PO Box 174, Vergennes, VT 05491

Pawlet PO Box 128 05761

Peacham PO Box 244 05862

Peru PO Box 127 05152

Pittsfield PO Box 556 05762

Pittsford PO Box 10 05763

Plainfield PO Box 217 05667

Plymouth 68 Town Office Rd. 05056

Pomfret PO Box 286, South Pomfret, VT 05053

Poultney 9 Main St., Ste. 2 05764

Pownal PO Box 411 05261

Proctor 45 Main Street 05765

Putney PO Box 233 05346

Randolph Drawer B 05060

Reading PO Box 72 05062

Readsboro PO Box 187 05350

Richford PO Box 236 05476

Richmond PO Box 285 05477

Ripton PO Box 10 05766

Rochester PO Box 238 05767

Rockingham PO Box 339, Bellows Falls, VT 05101

Roxbury PO Box 53 05669

Royalton PO Box 680, South Royalton, VT 05068

Rupert PO Box 140, West Rupert, VT 05776

Rutland City PO Box 969, Rutland, VT 05702

Rutland Town PO Box 225, Center Rutland, VT 05736

Ryegate PO Box 332 05042

St. Albans City PO Box 867, St. Albans, VT 05478

St. Albans 

Town PO Box 37, St. Albans Bay, VT 05481

St. George 1 Barber Road 05495

St. Johnsbury 1187 Main St., Ste. 2 05819

Salisbury PO Box 66 05769

Sandgate 3266 Sandgate Rd. 05250

Searsburg PO Box 157, Wilmington, VT 05363

Shaftsbury PO Box 409 05262

Sharon PO Box 250 05065

Sheffield PO Box 165 05866

Shelburne PO Box 88 05482

Sheldon PO Box 66 05483

Shoreham 297 Main St. 05770

Shrewsbury 9823 Cold River Rd. 05738

South 

Burlington 575 Dorset Street 05403

South Hero PO Box 175 05486

Springfield 96 Main Street 05156

Stamford 986 Main Road 05352

Stannard PO Box 94, Greensboro Bend, VT 05842

Starksboro PO Box 91 05487

Stockbridge PO Box 39 05772

Stowe PO Box 248 05672

Strafford PO Box 27 05072

Stratton 9 West Jamaica Road 05360

Sudbury 36 Blacksmith Lane 05733

Sunderland PO Box 295, East Arlington, VT 05252

Sutton PO Box 106 05867

Swanton PO Box 711 05488

City or Town Mailing Address Zip Code

Thetford PO Box 126, Thetford Center, VT 05075

Tinmouth 515 North End Rd. 05773

Topsham PO Box 69 05076

Townshend PO Box 223 05353

Troy PO Box 80, North Troy, VT 05859

Tunbridge PO Box 6 05077

Underhill PO Box 32, Underhill Center, VT 05490

Vergennes PO Box 35 05491

Vernon 567 Governor Hunt Rd. 05354

Vershire 6894 VT Rte. 113 05079

Victory PO Box 609, North Concord, VT 05858

Waitsfield 9 Bridge St. 05673

Walden 12 VT RTE 215, West Danville, VT 05873

Wallingford PO Box 327 05773

Waltham PO Box 175 05491

Wardsboro PO Box 48 05355

Warren PO Box 337 05674

Washington 2895 VT RTE 110 05675

Waterbury 51 South Main Street 05676

Waterford PO Box 56, Lower Waterford, VT 05848

Waterville PO Box 31 05492

Weathersfield PO Box 550, Ascutney, VT 05030

Wells PO Box 585 05774

West Fairlee PO Box 615 05083

West Haven 2919 Main Road, West Haven 05743

West Rutland 35 Marble Street 05777

West Windsor PO Box 6, Brownsville, VT 05037

Westfield 1257 VT Rt. 100 05874

Westford 1713 Vt. Route 128 05494

Westminster PO Box 147 05158

Westmore 54 Hinton Hill Rd., Orleans, VT 05860

Weston PO Box 98 05161

Weybridge 1727 Quaker Village Rd. 05753

Wheelock PO Box 1328, Lyndonville, VT 05851

Whiting 29 South Main Street 05778

Whitingham PO Box 529, Jacksonville, VT 05342

Williamstown PO Box 646 05679

Williston 7900 Williston Road 05495

Wilmington PO Box 217 05363

Windham 5976 WIndham Hill Road 05359

Windsor PO Box 47 05089

Winhall Box 389, Bondville, VT 05340

Winooski 27 West Allen Street 05404

Wolcott PO Box 100 05680

Woodbury PO Box 10 05681

Woodford 1391 VT RTE 9 05201

Woodstock 31 The Green 05091

Worcester Drawer 161 05682

City or Town Mailing Address Zip Code

What If Your Vote Would Have Made The Difference?

by Ken Hablitzel, Civilian, Keesler AFB, Mississippi 
Vermont 2004–05 Voting Assistance Guide

292
VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”

E. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

VERMONT

“I solemnly swear (or affirm) that whenever I give my vote or suffrage,

touching any matter that concerns the State of Vermont, I will do it so as in

my conscience I shall judge will most conduce to the best good of the same,

as established by the Constitution, without fear or favor of any person.”
Vermont 2004–05 Voting Assistance Guide

294
295

VIRGINIA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Social Security number is required. If you do not have a

Social Security number, Virginia shall assign a number that will

serve to identify you for voting purposes.

B Military members, merchant marine members, and their

spouses and dependents must provide the service identification

number of the member. Overseas electors and/or their spouses and

dependents must provide an identification number or name and

address of employer. (See H. below). 

C All voters must complete. Write “None” if not applicable. If

previously registered in Virginia, your voter registration number is

your Social Security number.

D Enter last day of residency at your Virginia voting residence

address only if that home is no longer available to you. 

E Provide the complete street address of your Virginia voting

residence. A post office box is not sufficient. If your address

includes a rural route number, describe its location in Item 7. For

example: “on Highway _____, 2 miles past Highway _____, across

the street from the _____ gas station.” This address must be

different from the one provided in Item 4 and must be within the

county or city where you claim legal voting residence.

F Print the complete address where you want your ballot sent -

usually your current mailing address. It must be different from the

address you provided in Item 3.

G If you do not list a party affiliation, you cannot vote in primary

elections. You must indicate your political party affiliation when

applying for a primary ballot (Example: Democrat, Republican) or

write “none” in Item 6 of the FPCA. Primaries are held only if

requested by the political party and then only if at least two

candidates file for the office. Political party affiliation is not required

if only requesting ballots for general elections. If you are currently

registered and want to change your political party affiliation or you

have previously declined to indicate a political party affiliation and

you now want to vote in a primary election, you must submit a

completed FPCA which includes your new political party affiliation

to the General Registrar not later than 29 days before the election.

H Uniformed Service members, merchant marine members, and

their spouses and dependents must provide the branch of service,

and grade or rank of the military member. Citizens residing overseas

for reason of employment and their accompanying spouse/

dependents must provide the name and address of the employer.

Please include an e-mail address here, if available, in case there are

any questions about your application.

I Check ONE box.

J You must sign and date the FPCA. When signing, you are

swearing or affirming that the information is true and correct. No

notary or witness required except when a voter is unable to sign the

application due to a physical disability or inability to read or write.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

M M D D Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

D

F

H

J

C

E

G

I

A B
Virginia 2004–05 Voting Assistance Guide

296

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Virginia and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your General Registrar early

every year and whenever you change your mailing address

(see Chapter 2).

To register permanently and request an absentee ballot,

send a completed FPCA to the General Registrar so that it

arrives as early as possible before the election and not later

than 5 days before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the General

Registrar so that it arrives as early as possible, but not

earlier than 12 months before the election and not later than

5 days before the election.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day.

Local election officials mail absentee ballots approximately

45 days before an election.

Voted ballots may be returned by mail or by a commercial

delivery service by the voter, but may not be delivered by a

personal courier service or another individual who is not the

voter.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions below and in Chapter 2,

page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required except when a voter

is unable to sign the application due to a physical disability

or inability to read or write.

Ballot Return Envelope: The oath on the envelope must

be witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Virginia allows you to send the FPCA for registration

and absentee ballot by fax. After faxing, submit the

FPCA by mail.

 Virginia does not allow you to receive the blank ballot

by fax.

 Virginia does not allow you to return the voted ballot

by fax.

 Ballots for some elections may be available for

transmission by e-mail. To request that your ballot be

sent to you by e-mail, if available, include your e-mail

address on the FPCA. After receiving your e-mail

ballot, you must print and return the voted ballot and

oath by mail or a commercial delivery service. Refer

to http://www.sbe.state.va.us for more information.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Early Absentee Ballot

Virginia provides an early absentee ballot for the elections

for governor, lieutenant governor or attorney general only.

You are eligible to use this ballot if you are overseas and

you will not be able to vote and return a regular absentee

ballot within the time provided for regular absentee ballots.

Use the FPCA to request this early absentee ballot. In Item

7 of the FPCA, place one of the state special write-in labels

from Section III.G. If no labels are available, write in Item

7: “I am unable to vote in any other manner due to overseas

military service or due to living in an isolated or extremely

remote overseas area. I request an early voting absentee

ballot.”

The early absentee ballot must be requested not later than

90 days before the election. 

G. Federal Write-In Absentee Ballot

Virginia has expanded the use of the Federal Write-In

Absentee Ballot (FWAB), SF 186. The instructions

described in Chapter 2 of this Guide remain the same,

except that Virginia also allows the FWAB to be used by

any of the persons listed in Section A. above, whether

voting from inside or outside the U.S. Virginia also allows
2004–05 Voting Assistance Guide Virginia

297

the FWAB to be used in primary, general or special

elections for Federal offices.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens

and residents of Virginia, or overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (except for living outside the U.S.) would be

qualified to vote in Virginia.

 residents of Virginia temporarily living outside the

U.S. who still have a Virginia place of abode available

to them (for local, state and Federal office ballots) 

 residents of Virginia living outside the U.S. by virtue

of employment and their spouses and dependents

living with them who were registered to vote

immediately preceding the move overseas, who moved

after July 1, 1999 and who no longer have a Virginia

place of abode (for local, state and Federal office

ballots)

 all other citizens whose last residence before moving

overseas was Virginia (for Federal office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your General Registrar early

every year and whenever you change your mailing address

(see Chapter 2).

You may register permanently and request an absentee

ballot if you are a Virginia resident residing temporarily

outside the U.S. and you maintain your Virginia place of

abode by sending a completed FPCA to the General

Registrar as early as possible before the election and not

later than 29 days before the election. 

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the General

Registrar so that it arrives as early as possible, but not

earlier than 12 months before the election and not later than

5 days before the election.

Residents of Virginia living outside the U.S. by virtue of

employment and their spouses and dependents living with

them who were registered to vote immediately preceding

the move overseas and who moved overseas on or after July

1, 1999 and other Virginians overseas who no longer have a

Virginia place of abode may be registered temporarily. To

register temporarily and request an absentee ballot, send a

completed FPCA to the General Registrar so that it arrives

not earlier than 6 months or not later than 29 days before

the election. You must submit a separate FPCA for each

election in a calendar year.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by the

close of polls on election day.

Local election officials mail absentee ballots approximately

45 days before an election.

Voted ballots may be returned by mail or by a commercial

delivery service by the voter, but may not be delivered by a

personal courier service or another individual who is not the

voter.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions below and in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required except when a voter

is unable to sign the application due to a physical disability

or inability to read or write.

Ballot Return Envelope: The oath on the envelope must

be witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Virginia allows you to send the FPCA for registration

and absentee ballot or the Virginia application for

temporary registration by fax. After faxing, submit the

FPCA or Virginia application by mail.

 Virginia does not allow you to receive the blank ballot

by fax.

 Virginia does not allow you to return the voted ballot

by fax.

 Ballots for some elections may be available for

transmission by e-mail. To request that your ballot be

sent to you by e-mail, if available, include your e-mail

address on the FPCA. After receiving your e-mail

ballot, you must print and return the voted ballot and

oath by mail or a commercial delivery service. Refer

to http://www.sbe.state.va.us for more information.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.
Virginia 2004–05 Voting Assistance Guide

298

F. Early Absentee Ballot

Virginia provides an early absentee ballot for the elections

for governor, lieutenant governor or attorney general to any

person voting from overseas who believes that he or she

will not be able to vote and return a regular absentee ballot

by normal mail delivery within the period provided for

regular absentee ballots.

Use the FPCA to request this early absentee ballot. In Item

7 of the FPCA, place one of the state special write-in labels

from Section III.G. If no labels are available, write in Item

7: “I am unable to vote in any other manner due to overseas

military service or due to living in an isolated or extremely

remote overseas area. I request an early voting absentee

ballot.”

The early absentee ballot must be requested not later than

90 days before the election. 

G. Federal Write-In Absentee Ballot

Virginia has expanded the use of the Federal Write-In

Absentee Ballot (FWAB), SF 186. The instructions

described in Chapter 2 of this Guide remain the same,

except that Virginia also allows the FWAB to be used by

any of the persons listed in Section A above, whether voting

from inside or outside the U.S. Virginia also allows the

FWAB to be used in primary, general or special elections

for Federal offices.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Late Registration

The following persons, if otherwise qualified to register,

may register in person up to and including the date of an

election: (1) active duty military, and their spouses and

dependents, who are discharged within 60 days of election

day; (2) persons who are normally absent from their county

or city of residence or who return to reside there during the

28 days preceding the election who are (i) active duty

military, (ii) members of the merchant marine, (iii) persons

who reside temporarily outside the U.S. by virtue of their

employment, and (iv) spouses or dependents of (i), (ii), and

(iii) who reside with them. 

B. Bars to Registration and Voting

Persons convicted of a felony or declared mentally

incapacitated by a court may not register or vote unless

their rights have been restored.

C. Cancellation of Registration

Temporary registration for overseas citizens is canceled

following each election. 

D. Action on Registration Requests

Registration applications must be complete. Failure to

complete all requests may result in denial of your

application.

E. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Virginia shall provide you with the

reason(s) for the rejection. Persons denied registration may

appeal to the circuit court. A form for petitioning the court

is provided on the reverse side of the denial. Consult a legal

assistance officer or civilian counsel.

F. Where to Send It

Mail the FPCA to the General Registrar, county or city of

voting residence, as listed below:

County Address Zip Code

Accomack PO Box 97, Accomack 23301-0097

Albemarle 536 Pantops Center, Charlottesville 22911-4596

Allegheny 212 N. Monroe Ave., Covington 24426-1410

Amelia PO Box 481, Amelia 23002-0481

Amherst PO Box 550, Amherst 24521-0550

Appomattox PO Box 8, Appomattox 24522-0235

Arlington 2100 Clarendon Blvd, Ste 320, 

Arlington

22201-5400

Augusta PO Box 590, Verona 24482-0590

Bath PO Box 157, Warm Springs 24484-0157

Bedford 122 E. Main St., Bedford 24523-2000

Bland PO Box 535, Bland 24315-0535

Botetourt PO Box 62, Fincastle 24090-0062

Brunswick 100 Tobacco St., Lawrenceville 23868-1823

Buchanan PO Box 975, Grundy 24614-0975

Buckingham PO Box 222, Buckingham 23921-0222

Campbell PO Box 103, Rustburg 24588-0103

Caroline PO Box 617, Bowling Green 22427-0617

Carroll 605-3 Pine St. Rm B110, Hillsville 24343-1404

Charles City PO Box 146, Charles City 23030-0146

Charlotte PO Box 118, Charlotte Courthouse 23923-0118

Chesterfield PO Box 1690, Chesterfield 23832-1690

Clarke PO Box 555, Berryville 22611-0555

Craig PO Box 8, New Castle 24127-0008

Culpeper 131 W. Davis St., Culpeper 22701-3017

Cumberland PO Box 8, Cumberland 23040-0008

Dickenson PO Box 1306, Clintwood 24228-1306

Dinwiddie PO Box 365, Dinwiddie 23841-0365

Essex PO Box 1561, Tappahannock 22560-1561

Fairfax 12000 Govt Center Pkwy, #323, Fairfax 22035-0081

Fauquier 32 Waterloo St., #207, Warrenton 20186-3238

Floyd 100 E. Main St. Box 9, Floyd 24091-2101

Fluvanna PO Box 44, Palmyra 22963-0044

Franklin 70 E. Court St., #302, Rocky Mount 24151-1720

Frederick 107 N. Kent St. Suite 102, Winchester 22601-5000

Giles 120 N. Main St. Suite 3, Pearisburg 24134-1625

Gloucester PO Box 208, Gloucester 23061-0208

Goochland PO Box 1013, Goochland 23063-1013

Grayson PO Box 449, Independence 24348-0449

Greene PO Box 341, Stanardsville 22973-0341

Greensville PO Box 1092, Emporia 23847-1092

Halifax PO Box 400, Halifax 24558-0400

Hanover PO Box 419, Hanover 23069-0419

Henrico PO Box 27032, Richmond 23273-7032

Henry PO Box 7, Collinsville 24078-0007

Highland PO Box 386, Monterey 24465-0386

Isle of Wight PO Box 77, Isle of Wight 23397-0077

James City PO Box 3567, Williamsburg 23187-3567
2004–05 Voting Assistance Guide Virginia

299

King and Queen PO Box 56, King and Queen C.H. 23085-0056

King George PO Box 1359, King George 22485-1359

King William PO Box 173, King William 23086-0173

Lancaster PO Box 159, Lancaster 22503-0159

Lee PO Box 363, Jonesville 24263-0363

Loudoun 26-C Fairfax St. SE, Leesburg 20175-3621

Louisa PO Box 220, Louisa 23093-0220

Lunenburg 11441 Courthouse Rd., Lunenburg 23952-9999

Madison PO Box 267, Madison 22727-0267

Mathews PO Box 328, Mathews 23109-0328

Mecklenburg PO Box 436, Boydton 23917-0436

Middlesex PO Box 358, Saluda 23149-0358

Montgomery 755 Roanoke St, Ste 1F, Christiansburg 24073-3175

Nelson PO Box 292, Lovingston 22949-0292

New Kent PO Box 128, New Kent 23124-0128

Northampton PO Box 510, Eastville 23347-0510

Northumberland PO Box 84, Heathsville 22473-0084

Nottoway PO Box 24, Nottoway 23955-0024

Orange 146 Madison Rd., Suite 204, Orange 22960-1449

Page 117 S. Court St., Luray 22835-1289

Patrick PO Box 635, Stuart 24171-0635

Pittsylvania PO Box 1136, Chatham 24531-1136

Powhatan 3834-G Old Buckingham Rd., 

Powhatan

23139-7051

Prince Edward Box J, Farmville 23901-0269

Prince George PO Box 34, Prince George 23875-0034

Prince William 9252 Lee Ave., Manassas 20110-5557

Pulaski 52 W. Main St., Rm 300, Pulaski 24301-5045

Rappahannock PO Box 236, Washington 22747-0236

Richmond PO Box 1000, Warsaw 22572-1000

Roanoke PO Box 20884, Roanoke 24018-0089

Rockbridge 1 E. Washington St., Lexington 24450-2528

Rockingham PO Box 1252, Harrisonburg 22803-1252

Russell PO Box 383, Lebanon 24266-0383

Scott PO Box 1892, Gate City 24251-4892

Shenandoah 600 N. Main St., Suite 103, Woodstock 22664-1855

Smyth 121 Bagley Circle, Suite 108, Marion 24354-0067

Southampton PO Box 666, Courtland 23837-0666

Spotsylvania PO Box 133, Spotsylvania 22553-0133

Stafford PO Box 301, Stafford 22555-0301

Surry PO Box 264, Surry 23883-0264

Sussex PO Box 1302, Sussex 23884-0302

Tazewell PO Box 201, Tazewell 24651-0201

Warren 220 N Commerce Av #700, Front Royal 22630-3372

Washington 25552 Lee Hwy, Suite 1, Abingdon 24211-7466

Westmoreland PO Box 354, Montross 22520-0354

Wise PO Box 309, Wise 24293-0309

Wythe 245 S. Fourth St., Suite 101, Wytheville 24382-2598

York PO Box 451, Yorktown 23690-0451

Independent 

Cities Address Zip Code

Alexandria 132 N. Royal St., Suite 100, Alexandria 22314-3283

Bedford PO Box 807, Bedford 24523-0807

Bristol 300 Lee St., Bristol 24201-4327

Buena Vista 2039 Sycamore Ave., Buena Vista 24416-3133

Charlottesville PO Box 911, Charlottesville 22902-0911

Chesapeake PO Box 15225, Chesapeake 23328-0225

Clifton Forge**

 Colonial Heights PO Box 3401, Colonial Heights 23834-9001

Covington 1011-A N. Rockbridge Ave., Covington 24426-1534

Danville 515 Main St., Danville 24541-1317

Emporia PO Box 1092, Emporia 23847-1092

Fairfax 10455 Armstrong St., Fairfax 22030-3627

County Address Zip Code

Falls Church 300 Park Ave., Rm 101, Falls Church 22046-3332

Franklin PO Box 42, Franklin 23851-0042

Fredericksburg PO Box 7447, Fredricksburg 22404-7447

Galax PO Box 1045, Galax 24333-1045

Hampton 101 Kings Way, Hampton 23669-3500

Harrisonburg PO Box 20031, Harrisonburg 22801-3638

Hopewell 309 N. 2nd Ave., Hopewell 23860-2704

Lexington PO Box 922, Lexington 24450-0922

Lynchburg 3236 Odd Fellow Rd., Lynchburg 24501-0060

Manassas 9025 Center St., Manassas 20110-5403

Manassas Park 1 Park Center Court, Manassas Park 20111-2395 

Martinsville PO Box 1323, Martinsville 24114-1323

Newport News 2400 Washington Ave., Newport News 23607-4305

Norfolk PO Box 1531, Norfolk 23501-1531

Norton PO Box 225, Norton 24273-0225

Petersburg PO Box 1031, Petersburg 23804-1031

Poquoson 500 City Hall Ave. Rm 139, Poquoson 23662-1996

Portsmouth 801 Crawford Sr. 1st floor, Portsmouth 23704-3822

Radford 106 Arlington Ave., Suite A, Radford 24141-1540

Richmond PO Box 61037, Richmond 23261-1037

Roanoke PO Box 1095, Roanoke 24005-1095

Salem PO Box 203, Salem 24153-0203

Staunton PO Box 58, Staunton 24402-0058

Suffolk PO Box 1966, Suffolk 23439-1966

Virginia Beach PO Box 6247, Virginia Beach 23456-0247

Waynesboro PO Box 1028, Waynesboro 22980-0748

Williamsburg PO Box 3538, Williamsburg 23187-3538

Winchester 15 North Cameron St., Winchester 22601-4764

**Note: The City of Clifton Forge has reverted to town status and become 

part of Allegheny County. Voters with residency in Clifton Forge should 

send their applications to the Allegheny County registrar.

Independent 

Cities Address Zip Code

The Best Decisions Are Made When Everyone Votes!

by Judith A. Brown, Civilian, Loudoun County, Virginia
Virginia 2004–05 Voting Assistance Guide

300
VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”

G. EARLY ABSENTEE BALLOT

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

VIRGINIA

“I am unable to vote in any other manner due to overseas military service or

due to living in an isolated or extremely remote overseas area. I request an

early voting absentee ballot.”
Virginia 2004–05 Voting Assistance Guide

302
303

VIRGIN ISLANDS

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Social Security number is required. If you do not

have a Social Security number, your Virgin Islands Driver's

License number is required for voter registration. If you do

not possess either of these identifications, the Territory shall

assign a number that will serve to identify you for voter

registration purposes.

B Do not leave blank. Enter “N/A” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Virgin

Islands voting residence. A post office box is not sufficient.

If your address includes a rural route, describe its location.

For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the Virgin Islands.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address

provided in Item 3. 

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, ICM, Republican) or write “none” in Item 6 of

the FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections. If you are

currently registered and want to change your political party

affiliation, you must submit a completed FPCA which

indicates your new political party choice so that the local

election official receives it not later than 30 days before the

election in which you wish to vote.

F Check ONE box.

G You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G
Virgin Islands 2004–05 Voting Assistance Guide

304

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of the Virgin Islands and members of the

Uniformed Services and their family members. Uniformed

Services are defined as the U.S. Armed Forces, merchant

marine, commissioned corps of the Public Health Service

and the National Oceanic and Atmospheric Administration.

They also apply to members of religious, welfare or service

agencies assisting or attached to the Armed Forces.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and/or request an absentee ballot, the Supervisor

of Elections must receive your FPCA not later than 14

working days before the election. 

C. Casting Your Vote

Ballot Return Deadline: Mail your voted ballot by the day

of the election. Voted ballot must arrive not later than 10

days after the election.

Local election officials shall prepare ballots not later than

30 days before the election.

Due to its territorial status, the Virgin Islands does not send

representatives to the U.S. Senate or directly participate in

the election of the President and Vice President of the U.S.

At the Federal level, only a Delegate to the House of

Representatives is elected.

If you are outside the U.S. and have not received your

Virgin Islands ballot in a timely manner, use the Federal

Write-In Absentee Ballot. See instructions in Chapter 2,

page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 The Virgin Islands allows you to send the FPCA for

registration and ballot request by fax. After faxing,

submit the FPCA by mail.

 The Virgin Islands allows you to receive the blank

ballot by fax.

 The Virgin Islands allows you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Ballot Application By Proxy

If you are currently registered, anyone may apply for an

absentee ballot on your behalf if that person can

satisfactorily provide the required information about you. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of the Virgin Islands and overseas electors. The

term “overseas elector” means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in the Virgin Islands.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register and/or request an absentee ballot, the Supervisor

of Elections must receive your FPCA not later than 14

working days before the election. 

C. Casting Your Vote

Ballot Return Deadline: Mail your voted ballot by the day

of the election. Voted ballot must arrive not later than 10

days after the election.

Local election officials shall prepare ballots not later than

30 days before the election.
2004–05 Voting Assistance Guide Virgin Islands

305

Due to its territorial status, the Virgin Islands does not send

representatives to the U.S. Senate or directly participate in

the election of the President and Vice President of the U.S.

At the Federal level, only a Delegate to the House of

Representatives is elected.

If you have not received your Virgin Islands ballot in a

timely manner, use the Federal Write-In Absentee Ballot.

See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 The Virgin Islands allows you to send the FPCA for

registration and ballot request by fax. After faxing,

submit the FPCA by mail.

 The Virgin Islands allows you to receive the blank

ballot by fax.

 The Virgin Islands allows you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers: 

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Ballot Application By Proxy

If you are currently registered, anyone may apply for an

absentee ballot on your behalf if that person can

satisfactorily provide the required information about you. 

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony or of a crime involving moral

turpitude or declared mentally incompetent may not register

or vote.

B. Cancellation of Registration

Registration can be canceled if the elector changes

domicile, registers in another state, or does not vote in two

consecutive general elections.

C. Action If Registration is Cancelled

The elector can register after cancellation if they meet

residency requirements.

D. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, the Virgin Islands shall provide you

with the reason(s) for the rejection. 

E. Action If Registration Is Denied

Persons denied registration may appeal to the District

Court. Persons seeking to appeal should consult a legal

assistance officer or civilian counsel.

F. Late Registration

Members of the Armed Forces or merchant marine who

have been discharged within sixty days of an election may

register and vote in that election by presenting the local

election official with his or her discharge papers.

G. Where to Send it

Mail the FPCA to:

Supervisor of Elections

P.O. Box 6038, Charlotte Amalie

St. Thomas, Virgin Islands 00804-6038 

Or to:

Supervisor of Elections

P.O. Box 1499, Kingshill

St. Croix, Virgin Islands 00851-1499

Vote. Make Things Happen

by Major Sheila Marie Thornton, USAF, Schertz, Texas
Virgin Islands 2004–05 Voting Assistance Guide

306
307

WASHINGTON

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Washington driver’s license number is required

for voter registration. If you do not have a driver’s license,

the last four digits of your social security number is

required. If you do not posses either of these identifications,

the State will assign a unique identifying number to you for

voter registration purposes.

B Do not leave blank. Enter “NA” if not applicable or if

you are a first time voter.

C Provide the complete street address of your

Washington voting residence. A post office box or rural

route is not sufficient. If your address includes a rural route,

describe its location in Item 7. For example: “on Highway

_____, 2 miles past Highway _____, across the street from

the _____ gas station.” This address must be within the

county or township where you claim legal voting residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. Your current

mailing address must be different from the address you

provided in Item 3. 

E Washington is a Blanket primary state. Designation of

political party affiliation is not required.

F If you do not wish to request an absentee ballot for all

future elections, indicate in this section for which elections

you are requesting an absentee ballot. You may also use this

section to include any former name under which you may

be registered or a telephone number where you can be

reached.

G Check ONE box.

H You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

A

B

D

F

C

E

G

H
Washington 2004–05 Voting Assistance Guide

308

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Washington and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address except if you are requesting a special write-in ballot

(see Section F and also Chapter 2). 

You may also request absentee ballots by telephone, fax, email or by filling out and mailing the request form printed

from the Secretary of State web site. Notifying the County

Auditor of any mailing address changes is required for an

individual to receive absentee ballots for all future elections

(for local, state and Federal offices).

Washington will automatically use a completed FPCA as a

form for voter registration.

To register to vote only, send a completed FPCA to the

auditor in the county where your voting residence is located

at any time. It must be postmarked 30 days prior to the

election.

To register and request an absentee ballot, send your FPCA

to the auditor in the county where your voting residence is

located. The County Auditor must receive your FPCA not

later than one day before the election.

If you are already registered and only wish to request an

absentee ballot, send your FPCA to the auditor in the

county where your voting residence is located. The County

Auditor must receive your FPCA or any other written and

signed request not later than one day before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

County Auditor within 10 days after the primary election or

15 days after the general election. Postmark your voted

ballot by election day. 

Local election officials mail ballots approximately 20 days

before the election.

You must sign and date an oath validating the ballot

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Washington allows you to send your FPCA ballot

request by fax. If you are registering to vote, the

original form must also be mailed.

 Washington allows you to receive the blank ballot by

fax.

 Some Washington counties allow you to return the

voted ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers: 

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Washington provides a state special write-in absentee

ballot, available 90 days before an election, if you believe

that you will be unable to vote and return a regular absentee

ballot by normal mail delivery within the period provided

for regular absentee ballots. 

The FPCA may be used to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.E. If no labels are available,

write in Item 7: “I am unable to vote and return a regular

absentee ballot by normal mail delivery within the time

provided for regular absentee ballots. I request a special

write-in absentee ballot.” Candidate and issue information

may not be available at the time of your request.

The state special write-in ballot must be requested not

earlier than 90 days before the election. You may vote it by

writing in the names of specific candidates.

G. Ballot Application By Proxy

If you are currently registered, a member of your immediate

family may request an absentee ballot for your use on your

behalf. As a means of ensuring that the person who requests
2004–05 Voting Assistance Guide Washington

309

the absentee ballot is requesting the ballot for you, an

auditor may require the person who requests the absentee

ballot to identify your date of birth and deny a request that

is not accompanied by this information.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

The following procedures apply to persons who are U.S.

citizens, residents of Washington and overseas citizens. The

term “overseas citizen(s)” means a U.S. citizen who resides

outside the U.S. and (but for such residence) would be

qualified to vote in Washington. (for local, state and Federal

office ballots)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address except if you are requesting a special write-in ballot

(see Section F and also Chapter 2). 

You may also request absentee ballots by telephone, fax, email or by filling out and mailing the request form printed

from the Secretary of State web site. Notifying the County

Auditor of any mailing address changes is required for an

individual to receive absentee ballots for all future

elections.

Washington will automatically use a completed FPCA as a

form for voter registration.

To register to vote only, send a completed FPCA to the

auditor in the county where your voting residence is located

at any time. It must be postmarked 30 days prior to the

election.

To register and request an absentee ballot, send your FPCA

to the auditor in the county where your voting residence is

located. The County Auditor must receive your FPCA not

later than one day before the election.

If you are already registered and only wish to request an

absentee ballot, send your FPCA to the auditor in the

county where your voting residence is located. The County

Auditor must receive your FPCA or any other written and

signed request not later than one day before the election. 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive at the

County Auditor within 10 days after the primary election or

15 days after the general election. Postmark your voted

ballot by election day. 

Local election officials mail ballots approximately 20 days

before the election.

You must sign and date an oath validating the ballot.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 Washington allows you to send your FPCA ballot

request by fax. If you are registering to vote, the

original form must also be mailed.

 Washington allows you to receive the blank ballot by

fax.

 Some counties allow you to return the voted ballot by

fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Washington provides a state special write-in absentee ballot

available 90 days before an election if you believe that you

will be unable to vote and return a regular absentee ballot

by normal mail delivery within the period provided for

regular absentee ballots. 

The FPCA may be used to request this state special write-in

ballot. In Item 7 of the FPCA, place one of the state special

write-in labels from Section III.E. If no labels are available,

write in Item 7: “I am unable to vote and return a regular

absentee ballot by normal mail delivery within the time

provided for regular absentee ballots. I request a special

write-in absentee ballot.” Candidate and issue information

may not be available at the time of your request.

The state special write-in ballot must be requested not

earlier than 90 days before the election. You may vote it by

writing in the names of specific candidates.

G. Ballot Application By Proxy

If you are currently registered, a member of your immediate

family may request an absentee ballot for your use on your
Washington 2004–05 Voting Assistance Guide

310

behalf. As a means of ensuring that the person who requests

the absentee ballot is requesting the ballot for you, an

auditor may require the person who requests the absentee

ballot to identify your date of birth and deny a request that

is not accompanied by this information.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Voting

Persons convicted of a felony must have voting rights

restored prior to voting. Persons judicially declared

incompetent may not vote.

B. Action Upon Denial of Registration or 

Absentee Ballot Request

Upon denial of your voter registration application or

absentee ballot request, Washington shall provide you with

the reason(s) for the rejection. 

C. Cancellation of Registration

If you change your residence to a different county, you must

re-register. If you change your residence within the same

county, you must notify the county elections department by

phone or in writing. Both of these actions must be

completed at least 30 days before the election to be eligible

to vote.

D. Late Registration

Unregistered qualified persons may register to vote in

person at the office of the County Auditor or a voter

registration site in the county in which the applicant resides.

This may be done after the close of registration for voting at

the polls up until the 15th day before a primary, special

election, or general election. These persons will be given an

absentee ballot to vote and return by mail.

E. Where To Send It

Mail the FPCA or other signed request to the County

Auditor in your county of voting residence as listed below:

County Address City Zip

Adams 210 Broadway St., West Ritzville 99169-1897

Asotin PO Box 129 Asotin 99402-0129

Benton PO Box 470 Prosser 99350-0470

Chelan PO Box 400 Wenatchee 98807-0400

Clallam PO Box 3030 Port Angeles 98362-0338

Clark PO Box 8815 Vancouver 98666-8815

Columbia 341 East Main St. Dayton 99328-1361

Cowlitz 207 4th Ave., N. Kelso 98626-4193

Douglas PO Box 456 Waterville 98858-0456

Ferry 350 E Delaware #2 Republic 99166-9747

Franklin PO Box 1451 Pasco 99301-1451

Garfield PO Box 278 Pomeroy 99347-0278

Grant PO Box 37 Ephrata 98823-0037

Grays Harbor 100 W Broadway, Ste. 2 Montesano 98563-3614

Island PO Box 5000 Coupeville 98239-5000

Jefferson PO Box 563 Port Townsend 98368-0563

King 500 4th Ave., Rm. 553 Seattle 98104-3280

Kitsap 1026 Sidney Ave., Ste 175 Port Orchard 98366-4206

Kittitas 205 W. 5th Ave. Ellensburg 98926-3129

Klickitat 205 Columbus St., Rm.203 Goldendale 98620-9293

Lewis PO Box 29 Chehalis 98532-0029

Lincoln PO Box 28 Davenport 99122-0028

Mason PO Box 400 Shelton 98584-0400

Okanogan PO Box 1010 Okanogan 98840-1010

Pacific PO Box 97 South Bend 98586-0097

Pend Oreille PO Box 5015 Newport 99156-5015

Pierce 2401 S. 35th St., Rm 200 Tacoma 98409-7498

San Juan PO Box 638 Friday Harbor 98250-0638

Skagit PO Box 1306 Mt Vernon 98273-1306

Skamania PO Box 790 Stevenson 98648-0790

Snohomish 3000 Rockefeller Ave.(MS-505) Everett 98201-4046

Spokane W. 1116 Broadway Spokane 99260-0020

Stevens 215 South Oak, Room 106 Colville 99114-0189

Thurston 2000 Lakeridge Dr., SW Olympia 98502-6090

Wahkiakum PO Box 543 Cathlamet 98612-0543

Walla Walla PO Box 1856 Walla Walla 99362-1856

Whatcom 311 Grand Ave., Ste 103 Bellingham 98225-4038

Whitman PO Box 350 Colfax 99111-0350

Yakima 128 N.Second St., #117 Yakima 98901-2646

Voting Allows American Dreams To Become The American 

Reality

by Sara Desautel, Civilian, Seattle, Washington
WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”

F. STATE SPECIAL WRITE-IN LABELS

If needed, place one of the following stick-on labels in Item 7 of the FPCA:

WASHINGTON

“I am unable to vote and return a regular absentee ballot by normal mail

delivery within the time provided for regular absentee ballots. I request a

special write-in absentee ballot.”
Washington 2004–05 Voting Assistance Guide

312
313

WEST VIRGINIA

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your West Virginia Driver’s License or the last four

digits of your Social Security number is required for voter

registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “NA” if not applicable or if

you are a first time voter.

C Provide the complete street address of your West

Virginia voting residence. A post office box is not

sufficient. If your address includes a rural route, describe its

location. For example: “2 miles up Low Gap Creek from

Highway 11.” This address must be different from the one

provided in Item 4 and must be within the county or

township where you claim legal voting residence. 

D Print the complete address where you want your ballot

sent — usually your current mailing address. The address

used must be out of the county of your residence (Item 3).

E If you do not list a party affiliation, you will vote a

nonpartisan ballot in primary elections. You must indicate

your political party affiliation when applying for a primary

ballot (Example: Democrat, Republican) or write “none” in

Item 6 of the FPCA. (Since 1988, the Republican Party has

allowed “no party affiliation voters” to vote in its primary

election by requesting a Republican ballot. The Democratic

Party allows only registered Democrats to vote in its

primary election.) Political party affiliation is not required if

only requesting absentee ballots for general elections. If

you are currently registered and want to change your

political party affiliation or you have previously declined to

indicate a political party and you now want to vote in a

partisan primary election, you must submit a completed

FPCA which includes your new political party affiliation to

the local election official not later than 20 days before the

election.

F Check ONE box.

G Sign and date the FPCA. When signing, you are

swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
West Virginia 2004–05 Voting Assistance Guide

314

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of West Virginia and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration. Persons

who are not West Virginia residents are not eligible as a

result of their spouses’ residence.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2 of this Guide).

To register to vote, send a completed FPCA to the Clerk of

the County Commission so that it is received not later than

the 20th day before the election.

If you are already registered to vote and only wish to

request an absentee ballot, send a completed FPCA so that

it arrives not earlier than January 1st or 84 days before the

election (whichever is earlier) and not later than the sixth

day before the election.

C. Casting Your Vote

Ballot Return Deadline: Your ballot will be counted if it is

received through the mail before the start of canvassing

which occurs on the Friday following a primary and 5 days

after a general or special election.

The clerk mails out absentee ballots beginning 42 days

before an election.

You may also use the Federal Write-In Absentee Ballot. See

instructions below.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

 West Virginia allows you to send the FPCA for

absentee ballot by fax. If you are registering to vote,

the original form must also be mailed.

 West Virginia does not allow you to receive the blank

ballot by fax. 

 West Virginia does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Federal Write-In Absentee Ballot

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot (FWAB, SF 186). 

West Virginia has expanded the use of the FWAB. The

instructions described in Chapter 2 of this Guide remain the

same, except that West Virginia also allows the FWAB to be

used in all Federal, state and local elections.

Use the FWAB only in accordance with the instructions

described in Chapter 2 and only in those elections

mentioned above. Otherwise, your ballot will not be

counted.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of West Virginia and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in West Virginia. Persons who are not West Virginia

residents are not eligible as a result of their spouses’

residence.

 residents of West Virginia temporarily residing outside

the U.S. (for local, state and Federal office ballots)

 overseas electors 

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2 of this Guide).
2004–05 Voting Assistance Guide West Virginia

315

To register to vote, send a completed FPCA to the Clerk of

the County Commission so that it has a U.S. postmark date

not later than the 20th day before the election.

If you are already registered to vote and only wish to

request an absentee ballot, send a completed FPCA so that

it arrives not earlier than January 1st or 84 days before the

election (whichever is earlier) and not later than the sixth

day before the election.

C. Casting Your Vote

Ballot Return Deadline: Your ballot will be counted if it is

received through the mail before the start of canvassing

which occurs on the Friday following a primary and 5 days

after a general or special election.

The clerk mails out absentee ballots beginning 42 days

before an election.

You may also use the Federal Write-In Absentee Ballot.

See instructions below.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed. 

E. Electronic Transmission of FPCAs 

and Ballots

 West Virginia allows you to send the FPCA for

absentee ballot by fax. If you are registering to vote,

the original form must also be mailed.

 West Virginia does not allow you to receive the blank

ballot by fax.

 West Virginia does not allow you to return the voted

ballot by fax.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Federal Write-In Absentee Ballot

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot (FWAB,

SF 186).

West Virginia has expanded the use of the FWAB. The

instructions described in Chapter 2 of this Guide remain the

same, except that West Virginia also allows the FWAB to be

used in all Federal, state and local elections.

Use the FWAB only in accordance with the instructions

described in Chapter 2 of this Guide and only in those

elections mentioned above. Otherwise, your ballot will not

be counted.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony, treason or election bribery

and persons found of unsound mind may not vote.

B. Cancellation of Registration

If a voter does not respond to a confirmation notice, the

voter is identified as inactive. If a voter does not vote or

otherwise update registration after two general elections

following notice, registration is canceled.

C. Action on Registration Requests

A registration receipt is sent. Incomplete applications are

returned.

D. Action If Registration Is Denied

Persons denied registration may appeal to the county

commission. Consult a legal assistance officer or civilian

counsel. Upon denial of your voter registration application

or absentee ballot request, West Virginia shall provide you

with the reason(s) for the rejection.

E. Voting By Citizens Who Have Never 

Lived in the U.S.

A U.S. citizen who was born abroad and who is eligible to

vote and who has never lived in the U.S. may register and

vote in the county where either parent would be eligible to

register and vote.

F. Where To Send It

If you are registering and/or applying for an absentee ballot,

mail the FPCA to the Clerk of the County Commission,

county of voting residence, as listed below:

County County Seat Zip Code

Barbour Philippi 26416-1154

Berkeley Martinsburg 25401-3210

Boone Madison 25130-1189

Braxton Sutton 26601-1313

Brooke Wellsburg 26070-0474

Cabell Huntington 25701-0545

Calhoun Grantsville 26147-0266

Clay Clay 25043-0129

Doddridge West Union 26456-1297

Fayette Fayetteville 25840-1517

Gilmer Glenville 26351-1246

Grant Petersburg 26847-1795
West Virginia 2004–05 Voting Assistance Guide

316

Greenbrier Lewisburg 24901-0751

Hampshire Romney 26757-1696

Hancock New Cumberland 26047-0428

Hardy Moorefield 26836-1155

Harrison Clarksburg 26301-2967

Jackson Ripley 25271-0427

Jefferson Charles Town 25414-1072

Kanawha Charleston 25301-2500

Lewis Weston 26452-0069

Lincoln Hamlin 25523-1419

Logan Logan 25601-3939

McDowell Welch 24801-0400

Marion Fairmont 26554-1269

Marshall Moundsville 26041-2129

Mason Point Pleasant 25550-1131

Mercer Princeton 24740-2626

Mineral Keyser 26726-3597

Mingo Williamson 25661-0435

Monongalia Morgantown 26505-5427

Monroe Union 24983-0350

Morgan Berkeley Springs 25411-1501

Nicholas Summersville 26651-1489

Ohio Wheeling 26003-3592

Pendleton Franklin 26807-0089

Pleasants St. Marys 26170-1317

Pocahontas Marlinton 24954-1394

Preston Kingwood 26537-1121

Putnam Winfield 25213-0358

Raleigh Beckley 25802-4688

Randolph Elkins 26241-4099

Ritchie Harrisville 26362-1271

Roane Spencer 25276-0122

Summers Hinton 25951-1058

Taylor Grafton 26354-1387

Tucker Parsons 26287-1235

Tyler Middlebourne 26149-0008

Upshur Buckhannon 26201-2259

Wayne Wayne 25570-0038

Webster Webster Springs 26288-1095

Wetzel New Martinsville 26155-0263

Wirt Elizabeth 26143-0465

Wood Parkersburg 26101-5353

Wyoming Pineville 24874-9802

County County Seat Zip Code

Make Your Freedom Count! Vote!

by SSgt Fred G. Woodruff, USAF, Travis AFB, California
317

WISCONSIN

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A The last four digits of your Social Security number

OR your Wisconsin Driver's License number is required for

voter registration. If you do not possess either of these

identifications, the State shall assign a number that will

serve to identify you for voter registration purposes.

B Do not leave blank. Enter “NA” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Wisconsin

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “Box _____, Highway _____.” This

address must be different from the one provided in Item 4

and must be within the town, city or village where you

claim legal voting residence.

D Print the complete address where you want your ballot

sent - usually your current mailing address. It must be

different from the address you provide in Item 3.

E Check ONE box.

F You must sign and date the FPCA. When signing, you

are swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y ––

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

D

F

A
Wisconsin 2004–05 Voting Assistance Guide

318

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens

and residents of Wisconsin.

Under Wisconsin law, “military voters” are defined as:

 members of the U.S. Armed Forces or merchant

marine

 civilians officially attached to the military overseas

 civilian employees of the U.S. Government overseas

 Peace Corps volunteers, members of the

commissioned corps of the Federal Public Health

Service or the commissioned corps of the National

Oceanic and Atmospheric Administration

 spouses and dependents of the above

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

Registration is not required.

To request an absentee ballot, send a completed FPCA to

the municipal clerk so that it arrives not later than the

Friday before the election. Or, you may request an absentee

ballot by sending a written request, making sure to include

the information needed on the FPCA (such as your full

name, your legal voting address in Wisconsin, where you

wish the ballot to be sent, signature, etc.). 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by close of

polls on election day.

Local election officials mail out absentee ballots 30 days

before the fall primary election and 30 days before the

subsequent general election. Absentee ballots are mailed

out 21 days before a spring primary and 21 days before the

subsequent spring general election.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: The certificate on the ballot

return envelope must be witnessed by one (1) adult U.S.

citizen. List your date of birth.

E. Electronic Transmission of FPCAs 

and Ballots

 Wisconsin allows you to send the FPCA for absentee

ballot request by fax. However, you must then mail the

FPCA to the municipal clerk, making sure that it is

postmarked the same day that it is faxed.

 Wisconsin allows you to receive the blank ballot by

fax or e-mail.

 Wisconsin does not allow you to return the voted

ballot by fax or e-mail.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Wisconsin provides a state special write-in absentee ballot.

The ballot is sent automatically to those listed under

Section I.A. “Who Can Do It” who have previously

requested an absentee ballot for any election.

Vote it by writing in the names of the specific candidates or

the name of any recognized political party.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Wisconsin and overseas electors. The term

“overseas elector” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Wisconsin.
2004–05 Voting Assistance Guide Wisconsin

319

 Wisconsin residents temporarily residing outside the

U.S. not listed in Section I.A. (for local, state and

Federal office ballots) 

 overseas electors (for Federal office ballots only) 

B. Registering and Requesting an 

Absentee Ballot

Wisconsin residents temporarily residing outside the U.S.

may use a single FPCA or written correspondence to

request ballots for any local, state and federal elections in a

calendar year (see Chapter 2). 

Overseas electors may use a single FPCA or written

correspondence to request ballots for both the primary and

general election for Federal offices in a calendar year.

To register and request an absentee ballot, send a completed

FPCA to the municipal clerk so that it arrives not later than

the second Wednesday (13 days) before the election.

If you are already registered and only wish to request an

absentee ballot, send a completed FPCA to the municipal

clerk so that it arrives not later than the Friday before the

election. Or, you may request an absentee ballot by sending

a written request, making sure to include the information

needed on the FPCA (such as your full name, your legal

voting address in Wisconsin, where you wish the ballot to

be sent, signature, etc.). 

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by close of

polls on election day.

Local election officials mail out absentee ballots 30 days

before the primary election and 30 days before the

subsequent general election.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2.

D. Notary/Witness Requirements

FPCA: No notary or witness required.

Ballot Return Envelope: The certificate on the ballot

return envelope must be witnessed by one (1) adult U.S.

citizen. Include your date of birth.

E. Electronic Transmission of FPCAs 

and Ballots

 Wisconsin allows you to send the FPCA for absentee

ballot request by fax. However, you must then mail the

FPCA to the municipal clerk, making sure that it is

postmarked the same day that it is faxed.

 Wisconsin allows you to receive the blank ballot by

fax or e-mail.

 Wisconsin does not allow you to return the voted

ballot by fax or e-mail.

Please refer to Appendix C for specific instructions when

transmitting election materials electronically. Use the

following numbers:

DSN 223-5527

(703) 693-5527

1-800-368-8683

Additional international toll-free fax numbers are listed on

the inside back cover.

F. Special Write-In Absentee Ballot

Wisconsin provides a state special write-in absentee ballot

to overseas electors. This special write-in ballot will be sent

to those electors who request an absentee ballot not later

than 30 days before the election. 

Vote it by writing in the names of specific candidates or the

name of any recognized political party.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of treason, bribery, a felony, betting on

the outcome of an election, those under a guardianship

order, or persons who have been adjudicated to be

incapable of understanding the objectives of the electoral

process may not register or vote unless their civil rights

have been restored.

B. Cancellation of Registration

Registration may be canceled for failure to vote within the

four previous years.

C. Action on Registration Requests

Persons using the FPCA to register may be notified of

registration.

D. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Wisconsin shall provide you with

the reason(s) for the rejection. If registration is denied

contact the Municipal Clerk. If necessary, consult a legal

assistance officer or civilian counsel for advice.
Wisconsin 2004–05 Voting Assistance Guide

320

E. Voting By Citizens Who Have Never 

Lived in the U.S.

A U.S. citizen who was born abroad and who is eligible to

vote and who has never lived in the U.S. may register and

vote in the municipality where a parent would be eligible to

register and vote (for Federal offices only).

F. Where to Send it

Mail the FPCA to the Municipal Clerk in the city, town or

village of voting residence. Milwaukee voters should mail

the FPCA to the City Board of Election Commissioners.

Wisconsin has many municipal jurisdictions. A partial list

of major cities and villages follows. 

A complete list of Municipal Clerks, along with addresses

and telephone numbers, may be found on the Wisconsin

website on the World Wide Web. The address for the

Elections Division is “http://elections.state.wi.us/

municipalclerkslist.txt”. Or, you may contact the Federal

Voting Assistance Program at (703) 588-1584, 1-800-438-

8683 (VOTE), DSN 425-1584 (military) or by e-mail at

vote@fvap.ncr.gov.

City or Village Mailing Address Zip Code

City of Appleton 100 North Appleton Street 54911-4799

City of Beloit 100 State Street 53511-6234

City of Brookfield 2000 North Calhoun Road 53005-5095

City of Cudahy PO Box 100380 53110-6106

City of Eau Claire PO Box 5148 54702-5148

City of Fond du Lac PO Box 150 54936-0150

City of Franklin 9229 West Loomis Road 53132-9728

City of Green Bay 100 North Jefferson St., Rm 106 54301-5026

Village of Greendale 6500 Northway 53129-1827

City of Greenfield 7325 West Forest Home Ave. 53220-3396

City of Janesville PO Box 5005 53547-5005

City of Kenosha 625 52nd Street, Room 105 53140-3480

CIty of Kaukauna PO Box 890 54130-0890

City of La Cross 400 La Crosse Street 54601-3396

City of Madison 210 Martin Luther King Jr, Rm103 53703-3342

City of Manitowoc 900 Quay Street 54220-4543

City of Marshfield PO Box 727 54449-0727

Village of Menomonee Falls W156 N8480 Pilgrom Road 53051-3140

City of Milwaukee City Board of Election 

Commissioners

200 East Wells Street, Room 501 53202-3565

City of Neenah PO Box 426 54957-0426

City of New Berlin PO Box 510921 53151-0921

City of Oak Creek 8640 South Howell Avenue 53154-2948

City of Oshkosh PO Box 1130 54903-1130

City of Racine 730 Washington Avenue, #102 53403-1184

City of Sheboygan 828 Center Avenue 53081-4496

City of S. Milwaukee 2424 15th Avenue 53172-2499

City of Stevens Point 1515 Strongs Avenue 54481-3594

City of Superior 1316 North 14th Street, Ste. 200 54880-1776

City of Watertown PO Box 477 53094-0477

City of Wausau 407 Grant Street 54403-4783

City of Waukesha 201 Delafield Street 53188-3692

City of Wauwatosa PO Box 13068 53213-0068

City of West Allis 7525 West Greenfield Avenue 53214-4688

City of West Bend 1115 South Main Street 53095-4658

City of Wisconsin Rapids 444 West Grand Avenue 54495-2780

City or Village Mailing Address Zip Code

Make A Decision To Express Your Opinion - Vote

by CPT Maria S. Berger, USA, Springfield, Massachusetts
321

WYOMING

The Federal Post Card Application (FPCA) is the primary form for requesting registration and/or an absentee ballot from your

local election official. Read all instructions printed below and on the FPCA before completing and signing your application.

Application Instructions

Circled letters on the form above correspond to the instructions below. You must complete all shaded areas.

A Your Social Security number or your Wyoming

Driver’s License number is required for voter registration.

If you do not possess either of these identifications, the

State shall assign a number that will serve to identify you

for voter registration purposes.

B Do not leave blank. Enter “NA” if not applicable or if

you are a first time voter.

C Provide the complete street address of your Wyoming

voting residence. A post office box is not sufficient. If your

address includes a rural route, describe its location in Item

7. For example: “on Highway _____, 2 miles past Highway

_____, across the street from the _____ gas station.” This

address must be different from the one provided in Item 4

and must be within the county where you claim legal voting

residence.

D Print the complete address where you want your ballot

sent — usually your current mailing address. It must be

different from the address provided in Item 3.

E If you do not list a party affiliation, you cannot vote in

primary elections. You must indicate your political party

affiliation when applying for a primary ballot (Example:

Democrat, Republican) or write “none” in Item 6 of the

FPCA. Political party affiliation is not required if only

requesting absentee ballots for general elections.

F Check ONE box.

G Sign and date the FPCA. When signing, you are

swearing or affirming that the information is true and

correct.

FEDERAL POST CARD APPLICATION Federal Post Card Application

REGISTRATION AND ABSENTEE BALLOT REQUEST - FEDERAL POST CARD APPLICATION (FPCA) 

APPLICATION FOR STATE OF COUNTY OF CITY OR TOWNSHIP OF

I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE.

1. APPLICANT INFORMATION (See instruction 1.) 6.POLITICAL PARTY AFFILIATION (This information is required 

by most states to send you a ballot for primary elections. See 

instructions.)

a.TYPED OR PRINTED NAME (Last, First, Middle Initial) b.SEX c. RACE

d.DATE OF BIRTH e.SOCIAL SECURITY NUMBER f. OTHER IDENTIFICATION NO. (passport, ID card) 7. REMARKS (Provide additional information which will assist local 

election officials in determining your eligibility to register and vote. 

See instructions.) M M D D Y Y – –

2. I LAST VOTED or PLACE OF LAST REGISTRATION (Do not leave this section blank. See instructions.)

a.YEAR b.COUNTY, CITY, OR TOWNSHIP c. STATE d.VOTER REGISTRATION NO. (if known)

3. VOTING RESIDENCE (For military, legal residence. For overseas civilians, last

residence in U.S. IF USING RURAL ROUTE, SEE INSTRUCTIONS.)

a.LAST DAY OF RESIDENCY

MMDD Y Y

b.NUMBER AND STREET (do not use Post Office Box)

8. AFFIRMATION BY APPLICANT 

X only one: a, b, c or d c. CITY, TOWN OR VILLAGE d.STATE I swear/affirm, under penalty of perjury, that I am: (See instructions)

a. a member of the Uniformed Services or merchant marine on 

active duty, or an eligible spouse or dependent.

e.COUNTY OR PARISH f. ZIP CODE (9-digit, if known) b. a U.S. citizen temporarily residing outside the U.S.

c. a U.S. citizen overseas by virtue of employment or 

accompanying spouse or dependent.

4. MAIL ABSENTEE BALLOT TO: (Mailing address where you want the ballot to be sent.) d. other U.S. citizen residing outside the U.S.

e. I am a U.S. Citizen, eligible to vote in the above jurisdiction, and 

subscribe to any required state/local oath or statement.

f. I have not been convicted of a felony or other disqualifying offense 

or been adjudicated mentally incompetent, or if so, my voting rights 

have been reinstated.

g. I am not registering, requesting a ballot, or voting in any other 

jurisdiction in the U.S.

h. The information on this form is true and complete.

i. SIGNATURE OF APPLICANT j. DATE

M M D D Y Y

5. YOUR FAX NUMBER (If this application is faxed, include all international prefixes. See Instructions.) 9.WITNESS/NOTARY ADDRESS AND SIGNATURE

 (If required by state law)

DATE SIGNED

MMDDY Y

The information contained herein is for official use only. Any unauthorized release of this information may be punishable by law.

s

B

C

E

G

D

F

A
Wyoming 2004–05 Voting Assistance Guide

322

Notify Your Local Election Official About Your Current Mailing Address

I. UNIFORMED SERVICES I. Uniformed Services

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Wyoming and members of the Uniformed

Services and their family members. Uniformed Services are

defined as the U.S. Armed Forces, merchant marine,

commissioned corps of the Public Health Service and the

National Oceanic and Atmospheric Administration.

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).

To register temporarily, and request an absentee ballot, send

a completed FPCA to the county clerk anytime during the

year, except the day of the election. You may use a single

FPCA as an application for temporary registration and to

request absentee ballots for both the primary election and

the general election.

To register permanently, request the state voter registration

form from the county clerk on item 7 of the FPCA,

complete the form, and return it to the county clerk so that it

arrives not later than 30 days before the election.

If you are already permanently registered and only wish to

request an absentee ballot, send the completed FPCA to the

county clerk any time during the year, except the day of the

election. Alternatively, you may request ballots for the

primary and general elections from the county clerk by

telephone, e-mail or letter, by providing the information

listed in I.F. below.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by close of

polls on election day.

Local election officials mail absentee ballots beginning 40

days before the primary and general elections.

If you are outside the U.S. and have not received your state

ballot in a timely manner, use the Federal Write-In

Absentee Ballot. See instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting material are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

Wyoming does not allow electronic transmission of the

FPCA, the blank absentee ballot or the voted absentee

ballot.

F. Application For Ballot By Proxy

A qualified voter may apply for an absentee ballot in

person, in writing or by telephone. Request for a ballot may

be made on behalf of an absentee qualified voter by another

individual. In either instance, the information below must

be provided to the county clerk. No organization shall

obtain an absentee ballot for a voter.

 Name in full; social security number (optional);

residence by street, city, county and zip code; and date

of birth.

 The election for which the absentee ballot is requested.

 If a primary election, your political party.

 A statement that the applicant is entitled to vote in the

election.

 If not obtained in person by the voter, the address to

which the absentee ballot should be mailed or the

name of the person the voter designates in writing to

deliver the ballot to him/her.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

II. CIVILIANS OUTSIDE U.S. II. Civilians Outside U.S.

A. Who Can Do It

These procedures apply to persons who are U.S. citizens,

residents of Wyoming and overseas citizens. The term

“overseas citizen” means a U.S. citizen who resides outside

the U.S. and (but for such residence) would be qualified to

vote in Wyoming.

 Wyoming residents temporarily residing outside the

U.S. (for local, state and Federal office ballots)

 Overseas citizens last domiciled in Wyoming

immediately prior to leaving the U.S. (for Federal

office ballots only)

B. Registering and Requesting an 

Absentee Ballot

You should send an FPCA to your local election official

early every year and whenever you change your mailing

address (see Chapter 2).
2004–05 Voting Assistance Guide Wyoming

323

To register temporarily and request an absentee ballot, send

a completed FPCA to the county clerk anytime during the

year, except the day of the election. You may use a single

FPCA as an application for temporary registration and to

request absentee ballots for both the primary election and

the general election.

To register permanently, request the state voter registration

form from the county clerk on item 7 of the FPCA,

complete the form, and return it to the county clerk so that it

arrives not later than 30 days before the election.

If you are already permanently registered and only wish to

request an absentee ballot, send the completed FPCA to the

county clerk any time during the year, except the day of the

election. Alternatively, you may request ballots for the

primary and general elections from the county clerk by

telephone, e-mail or letter, by providing the information

listed in I.F. below.

C. Casting Your Vote

Ballot Return Deadline: Voted ballot must arrive by close of

polls on election day.

Local election officials mail absentee ballots beginning 40

days before the primary and general elections.

If you have not received your state ballot in a timely

manner, use the Federal Write-In Absentee Ballot. See

instructions in Chapter 2, page 12.

D. Notary/Witness Requirements

No registration or voting materials are notarized or

witnessed.

E. Electronic Transmission of FPCAs 

and Ballots

Wyoming does not allow electronic transmission of the

FPCA, the blank absentee ballot or the voted absentee

ballot.

F. Application For Ballot By Proxy

A qualified voter may apply for an absentee ballot in

person, in writing or by telephone. Request for a ballot may

be made on behalf of an absentee qualified voter by another

individual. In either instance, the information below must

be provided to the county clerk. No organization shall

obtain an absentee ballot for a voter.

 Name in full; social security number (optional);

residence by street, city, county and zip code; and date

of birth

 The election for which the absentee ballot is requested.

 If a primary election, your political party 

 A statement that the applicant is entitled to vote in the

election.

 If not obtained in person by the voter, the address to

which the absentee ballot should be mailed or the

name of the person the voter designates in writing to

deliver the ballot to him/her.

Instructions continue in Section III: Uniformed Services &

Civilians Outside U.S.

III. UNIFORMED SERVICES &

 CIVILIANS OUTSIDE U.S. III. Uniformed Services & Civilians Outside U.S.

A. Bars to Registration and Voting

Persons convicted of a felony (unless civil rights restored)

and persons judged mentally incompetent may not register

or vote.

B. Late Registration

Members of the Armed Forces or merchant marine (and

their spouses and dependents) who have been discharged or

have terminated their service less than 30 days prior to an

election, and who are otherwise eligible to register, may

temporarily register for only that election with registry

agents designated by the county clerk.

C. Cancellation of Registration

Permanent registration is canceled for failure to vote in any

general election or for changing voting residence from the

county or state more than 30 days before an election. A

notice of intent to cancel is sent to the voter.

D. Action on Registration Requests

Notice of denial is sent.

E. Action If Registration Is Denied

Upon denial of your voter registration application or

absentee ballot request, Wyoming shall provide you with

the reason(s) for the rejection. Persons denied registration

may appeal to a justice of the peace, county court or district

court. Consult a legal assistance officer or civilian counsel.

F. Where To Send It

Mail the FPCA to the County Clerk in your county of

voting residence, as listed below:

County County Seat Zip Code

Albany County Courthouse, Room 202, 

Laramie 82070

Big Horn County Courthouse, PO Box 31, Basin 82410-0031

Campbell PO Box 3010, Gillette 82717-3010

Carbon PO Box 6, Rawlins 82301-0006

Converse 107 North 5th Street, Douglas 82633-0900

Crook PO Box 37, Sundance 82729-0037

Fremont 450 North 2nd St., Room 220, Lander 82520-0090

Goshen PO Box 160, Torrington 82240-0160

Hot Springs 415 Arapahoe, Thermopolis 82443-2783

Johnson 76 North Main Street, Buffalo 82834-1883

Laramie PO Box 608, Cheyenne 82003-0608

Lincoln PO Box 670, Kemmerer 83101-0670
Wyoming 2004–05 Voting Assistance Guide

324

Natrona PO Box 863, Casper 82602-0863

Niobrara PO Box 420, Lusk 82225-0420

Park 1002 Sheridan, Cody 82414-3589

Platte PO Drawer 728, Wheatland 82201-0728

Sheridan 224 South Main Street, Suite B-2, 

Sheridan 82801-4855

Sublette PO Box 250, Pinedale 82941-0250

Sweetwater PO Box 730, Green River 82935-0730

Teton PO Box 1727, Jackson 83001-1727

Uinta PO Box 810, Evanston 82930-0810

Washakie PO Box 260, Worland 82401-0260

Weston 1 West Main, Newcastle 82701-2121

County County Seat Zip Code

Support Our Proven Freedom. Never Forget. VOTE!

by Devonna Mallouf, Civilian, Tulare County, California
325

APPENDIX A E

2004 PRIMARY ELECTIONS BY STATE

lectionDates

This chart lists the 2004 Presidential and State primary election dates in all the States, the

District of Columbia and U.S. Territories; primary runoff dates (if applicable); states with U.S.

Senate races; number of U.S. Representative seats up for re-election; and Gubernatorial races.

“Register and Vote”

State

Presidential

Primary

(or Preference)

State

Primary

State

Runoff Primary

(if necessary)

Alabama

Alaska

American Samoa

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

District of Columbia

Florida

Georgia

Guam

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Puerto Rico

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Virgin Islands

Washington

West Virginia

Wisconsin

Wyoming

June 1

February 3

May 18

March 2

March 2

February 3

January 13

March 9

March 2

May 25

March 16

May 4

May 18

March 9

March 2

March 2

March 9

February 3

June 8

May 11

September 7

January 27

June 8

June 1

March 2

May 4

March 2

February 3

May 18

April 27

TBD

March 2

February 3

June 1

February 10

March 2

March 2

February 10

March 2

May 11

February 17

June 1

August 24

November 9

September 7

May 18

March 2

August 10

August 10

September 11

September 14

August 31

July 20

September 4

September 18

May 25

March 16

May 4

June 8

August 3

May 18

September 18

June 8

March 2

September 14

August 3

September 14

March 9

August 3

June 8

May 11

September 7

September 14

June 8

June 1

September 14

May 4

June 8

March 2

July 27

May 18

April 27

September 14

June 8

June 1

August 5

March 2

June 22

September 14

June 8

September 11

September 14

May 11

September 14

August 17

GENERAL ELECTION

FEDERAL OFFICES

U.S. Senate U.S. Representative

State

Governor

June 29

November 23

June 8

August 10

March 30

June 1

August 24

June 22

June 15 (Secondary Elect)

April 20

September 25

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Yes

No

No

No

No

Yes

No

No

Yes

Yes

No

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Yes

Yes

No

No

Yes

Yes

No

Yes

No

Yes

No

7

1

1 Delegate

8

4

53

7

5

1

1 Delegate

25

13

1 Delegate

2

2

19

9

5

4

6

7

2

8

10

15

8

4

9

1

3

3

2

13

3

29

13

1

18

5

5

19

1 Res Commissioner

2

6

1

9

32

3

1

11

1 Delegate

9

3

8

1

No

No

Yes

No

No

No

No

No

Yes

No

No

No

No

No

No

No

Yes

No

No

No

No

No

No

No

No

No

No

Yes

Yes

No

No

Yes

No

No

No

Yes

Yes

No

No

No

No

Yes

No

No

No

No

No

Yes

Yes

No

No

Yes

Yes

No

No

This election information is current as of September2003. Contact yourVoting AssistanceOfficer

or check the FVAPWebsite at www.fvap.gov for updates.

The General Election is Tuesday, November 2.
2004 Primary Elections by State 2004–05 Voting Assistance Guide

326
327

APPENDIX B

2004 PRESIDENTIAL AND STATE PRIMARIES BY MONTH1

1. (P) Presidential Primary, (S) State Primary

JANUARY

District of Columbia 01/13 (P)

New Hampshire 01/27 (P)

FEBRUARY

Arizona 02/03 (P) 

Delaware 02/03 (P) 

Missouri 02/03 (P) 

Oklahoma 02/03 (P)

South Carolina 02/03 (P)

Tennessee 02/10 (P)

Virginia 02/10 (P)

Wisconsin 02/17 (P)

Puerto Rico TBD (P)

MARCH

California 03/02 (P,S)

Connecticut 03/02 (P)

Georgia 03/02 (P)

Maryland 03/02 (P,S)

Massachusetts 03/02 (P)

New York 03/02 (P)

Ohio 03/02 (P,S)

Rhode Island 03/02 (P)

Texas 03/02 (P,S)

Vermont 03/02 (P)

Washington 03/02 (P)

Florida 03/09 (P)

Louisiana 03/09 (P)

Mississippi 03/09 (P,S)

Illinois 03/16 (P,S)

APRIL

Pennsylvania 04/27 (P,S)

MAY

Indiana 05/04 (P,S)

North Carolina 05/04 (P,S)

Nebraska 05/11 (P,S)

West Virginia 05/11 (P,S)

Arkansas 05/18 (P,S)

Kentucky 05/18 (P,S)

Oregon 05/18 (P,S)

Idaho 05/25 (P,S)

JUNE

Alabama 06/01 (P,S)

New Mexico 06/01 (P,S)

South Dakota 06/01 (P,S)

Iowa 06/08 (S)

Maine 06/08 (S)

Montana 06/08 (P,S)

New Jersey 06/08 (P,S)

North Dakota 06/08 (S)

South Carolina 06/08 (S)

Virginia 06/08 (S)

Utah 06/22 (S)

JULY

Georgia 07/20 (S)

Oklahoma 07/27 (S)

AUGUST

Kansas 08/03 (S)

Michigan 08/03 (S)

Missouri 08/03 (S)

Tennessee 08/05 (S)

Colorado 08/10 (S)

Connecticut 08/10 (S)

Wyoming 08/11 (S)

Alaska 08/24 (P,S)

Florida 08/31 (S)

SEPTEMBER

Guam 09/04 (S)

Arizona 09/07 (S)

Nevada 09/07 (P,S)

Delaware 09/11 (S)

Virgin Islands 09/11 (S)

District of Columbia 09/14 (S)

Massachusetts 09/14 (S)

Minnesota 09/14 (S)

New Hampshire 09/14 (S)

New York 09/14 (S)

Rhode Island 09/14 (S)

Vermont 09/14 (S)

Washington 09/14 (S)

Wisconsin 09/14 (S)

Hawaii 09/18 (S)

Louisiana 09/18 (S)

OCTOBER

No Primaries Scheduled

NOVEMBER

American Samoa 11/09 (S)

DECEMBER

No Primaries Scheduled

It’s Your Future. VOTE For It!

— SSgt Stephanie Csornok, USAF, Misawa, Japan

First Place 2003 Slogan Contest Winner
2004 Presidential and State Primaries By Month 2004–05 Voting Assistance Guide

328
329

APPENDIX C

ELECTRONIC TRANSMISSION OF ELECTION MATERIALS

NOTE: Please refer to individual state guidelines in

Chapter 3 to determine if a specific state allows electronic

transmission of official election materials. Please read all

instructions carefully.

If a state allows electronic transmission of official election

materials, it may allow:

1. the citizen to fax the FPCA for registration and/or

ballot request,

2. the citizen to be sent the absentee ballot by fax,

3. the citizen to return the voted ballot by fax,

4. or any combination of 1), 2) and 3).

Any other written correspondence involving voter

registration or elections may be faxed to local election

officials in any state.

To Send the FPCA by Fax

1. Complete and sign the FPCA legibly using dark ink

as indicated in Chapter 3, according to each state’s

requirements.

2. Fax both sides of the FPCA using a copy of the fax

transmittal cover sheet included in this Appendix, or

other cover sheet containing similar information,

indicating sender’s full name, fax number (DSN and

Commercial, if available) and telephone number.

3. Use a separate transmittal cover sheet including the

number of pages being transmitted for each FPCA.

More than one FPCA with cover sheet may be faxed in

a single transmission if they have the same destination.

4. After faxing, mail the completed FPCA to the local

election official address as listed in Chapter 3 even if it

may not meet the state’s registration deadline.

To Receive the Absentee Ballot by 

Fax

Ballots will be faxed where allowed by state law from the

local election official to the individual’s fax machine or to

an office or command fax machine as indicated on the

ballot request, for delivery to addressee (voter).

The voter should follow all instructions provided by the

local election official in marking and executing the ballot.

To Return the Voted Absentee 

Ballot by Mail

It is preferred that the voter return the voted ballot to the

local election officials by mail, even if the ballot has been

sent to the voter by fax.

To return by mail a voted ballot that has been sent to the

voter by fax, use the security envelope and ballot

transmittal envelope from the Federal Write-In Absentee

Ballot (SF-186), if available. Detach the envelopes from the

rest of the form. The voter should then place the voted

ballot in the security envelope, seal it and place the sealed

security envelope in the transmittal envelope and mail it

immediately to the local election official. 

If SF-186 forms are not readily available, use two plain

envelopes. Mark one as the security envelope and the other

as the transmittal envelope for mailing. Follow the

instructions provided with the ballot.

The voter should vote in private and seal the ballot in the

security envelope without any assistance whenever

possible.

To Return the Voted Absentee 

Ballot by Fax

If the voter determines there is not sufficient time to return

the ballot by mail and the state allows receipt of a voted

ballot by fax, the voted ballot may be transmitted by fax.

The voter should follow the instructions provided by the

local election official in marking and executing the ballot.

Mark the ballot and print legibly in dark ink or type.

The voter must understand that by faxing the voted ballot,

he/she is waiving the right to secrecy of the ballot. The

voter must sign a statement on the fax transmittal cover

page indicating, “I understand that by faxing my voted

ballot I am voluntarily waiving my right to a secret ballot.”

This must be followed by the signature of voter and the

date. The voter is advised to obtain and retain a facsimile

receipt of the date and time the voted ballot was faxed

successfully.

Use a copy of the fax transmittal cover sheet included in

this Appendix, or other cover sheet containing similar

information, indicating the name, telephone number and fax

number of the sender, the name and SSN of the voter, and

the complete destination address for the ballot (as found

under the respective state headings in Chapter 3).

IMPORTANT: Voting Assistance Officers are

reminded that they are performing duties in an official

capacity and are obliged to protect the integrity of the
Electronic Transmission of Election Materials 2004–05 Voting Assistance Guide

330

electoral process and the confidentiality of the voter and

his/her vote.

Voting materials described for any state may be transmitted

through the following numbers:

(800) 368-8683

(703) 693-5527

DSN 223-5527

Additional international toll-free fax numbers are listed on

the inside back cover.

By using the above numbers to electronically transmit any

election materials, an audit trail is maintained.

Assistance Available

Questions concerning policy for use of the system may be

directed to the Federal Voting Assistance Program at any of

the following numbers: DSN 425-1584, (703) 588-1584, or

(800) 438-8683. Overseas citizens may contact the FVAP

on the international toll-free numbers listed on the inside

back cover of this Guide and on the FVAP website at

www.fvap.gov. All written correspondence should be

directed to the Director, Federal Voting Assistance Program,

Department of Defense, 1155 Defense Pentagon,

Washington, DC 20301-1155 or by e-mail to

vote@fvap.ncr.gov.
2004–05 Voting Assistance Guide Electronic Transmission of Election Materials

331

SAMPLE TRANSMISSION SHEET

 

Official Election Materials — Electronic Transmission Sheet 

Transmittal (Cover) Sheet from Absentee Voter to Local Election Official

 

TO:

City/County Board of Elections State

Telephone Number 

Fax Number 

Street Address 

City State Zip Code

–

From:

Last Name

First Name Middle Name

Telephone Number

Fax Number

Social Security Number (###-##- Date of Birth (MM/DD/ 

–– / /

Mailing Address

City State or Country

Unit/Ship Postal Code/APO/FPO

Email Address

 

Service (Circle One): Army Navy Air Force Marine Corps Coast Guard Other _______________________________

 

If a VOTED BALLOT is being faxed, sign below:

“I understand that by faxing my voted ballot I am voluntarily waiving my right to a secret ballot.”

Signature ___________________________________________________ Date _____________________________

 

Number of pages being transmitted, including this sheet ____________

Fax to one of these numbers:

703-693-5527, 1-800-368-8683, or DSN 223-5527

Federal Voting Assistance Program Use Only — DO NOT Complete this Section

Date Received _______________________ Time Received _______________________

Date Sent _______________________ Time Sent _______________________

Transaction Number _______________________ Processed By ____________________________

Include as much of the 

local election official’s 

information as possible 

to insure prompt 

delivery.

Important: Complete 

this section in its 

entirety. It will enable 

the election official to 

get in touch with the 

voter if necessary.

The voter must sign 

here when faxing a 

voted ballot and 

understand that the right 

to secret ballot is waived 

when using this service.

Fax transmissions to 

one of these official fax 

numbers, or the fax 

numbers listed on the 

inside back cover.

Do not fill in this 

section.

If applicable, indicate 

branch of service. This 

will help to locate voter 

in case of deployment.

Indicate the total 

number of pages sent, 

including this cover 

sheet.

Electronic Transmission Sheet

from the Absentee Voter to the Local Election Official 

(shown reduced)
Electronic Transmission of Election Materials 2004–05 Voting Assistance Guide

332
 

Official Election Materials — Electronic Transmission Sheet 

Transmittal (Cover) Sheet from Absentee Voter to Local Election Official

 

TO:

City/County Board of Elections State

Telephone Number 

Fax Number 

Street Address 

City State Zip Code

–

From:

Last Name

First Name Middle Name

Telephone Number

Fax Number

Social Security Number (###-##- Date of Birth (MM/DD/ 

–– / /

Mailing Address

City State or Country

Unit/Ship Postal Code/APO/FPO

Email Address

 

Service (Circle One): Army Navy Air Force Marine Corps Coast Guard Other _______________________________ 

If a VOTED BALLOT is being faxed, sign below:

“I understand that by faxing my voted ballot I am voluntarily waiving my right to a secret ballot.”

Signature ___________________________________________________ Date _____________________________

 

Number of pages being transmitted, including this sheet ____________

Fax to one of these numbers:

703-693-5527, 1-800-368-8683, or DSN 223-5527

Federal Voting Assistance Program Use Only — DO NOT Complete this Section

Date Received _______________________ Time Received _______________________

Date Sent _______________________ Time Sent _______________________

Transaction Number _______________________ Processed By ____________________________
Electronic Transmission of Election Materials 2004–05 Voting Assistance Guide

334
335

APPENDIX D

UNIFORMED AND OVERSEAS CITIZENS ABSENTEE

VOTING ACT (UOCAVA)

(As modified by the National Defense Authorization Act for 

Fiscal Year 2002 and the Help America Vote Act of 2002)

TITLE I — REGISTRATION AND VOTING

BY ABSENT UNIFORMED SERVICE

VOTERS AND OVERSEAS VOTERS IN

ELECTIONS FOR FEDERAL OFFICE

SEC. 101. FEDERAL RESPONSIBILITIES. 

(a) PRESIDENTIAL DESIGNEE. — The President shall

designate the head of an executive department to have

primary responsibility for Federal functions under this title.

(b) DUTIES OF PRESIDENTIAL DESIGNEE. — The

Presidential designee shall — 

(1) consult State and local election officials in

carrying out this title, and ensure that such

officials are aware of the requirements of this Act;

(2) prescribe an official post card form, containing

both an absentee voter registration application and

an absentee ballot application, for use by the

States as required under section 102(4); 

(3) carry out section 103 with respect to the Federal

write-in absentee ballot for overseas voters in

general elections for Federal office;

(4) prescribe a suggested design for absentee ballot

mailing envelopes for use by the States as

recommended in section 104; 

(5) compile and distribute (A) descriptive material on

State absentee registration and voting procedures,

and (B) to the extent practicable, facts relating to

specific elections, including dates, offices

involved, and the text of ballot questions; 

(6) not later than the end of each year after a

Presidential election year, transmit to the President

and the Congress a report on the effectiveness of

assistance under this title, including a separate

statistical analysis of uniformed services voter

participation, a separate statistical analysis of

overseas nonmilitary participation, and a

description of State-Federal cooperation; and

(7) prescribe a standard oath for use with any

document under this title affirming that a material

misstatement of fact in the completion of such a

document may constitute grounds for conviction

of perjury.

(c) DUTIES OF OTHER FEDERAL OFFICIALS. —

(1) IN GENERAL. — The head of each Government

department, agency, or other entity shall, upon

request of the Presidential designee, distribute

balloting materials and otherwise cooperate in

carrying out this title.

(2) ADMINISTRATOR OF GENERAL

SERVICES. — As directed by the Presidential

designee, the Administrator of General Services

shall furnish official post card forms (prescribed

under subsection (b)) and Federal write-in

absentee ballots (prescribed under section 103). 

SEC. 102. STATE RESPONSIBILITIES.

(a) IN GENERAL.—Each State shall —

(1) permit absent uniformed services voters and

overseas voters to use absentee registration

procedures and to vote by absentee ballot in

general, special, primary, and runoff elections for

Federal office; 

(2) accept and process, with respect to any election for

Federal office, any otherwise valid voter

registration application and absentee ballot

application from an absent uniformed services

voter or overseas voter, if the application is

received by the appropriate State election official

not less than 30 days before the election; 

(3) permit overseas voters to use Federal write-in

absentee ballots (in accordance with section 103)

in general elections for Federal office; 

(4) use the official post card form (prescribed under

section 101) for simultaneous voter registration

application and absentee ballot application; and

(5) if the State requires an oath or affirmation to

accompany any document under this title, use the

standard oath prescribed by the Presidential

designee under section 101(b)(7).

(b) DESIGNATION OF SINGLE STATE OFFICE TO

PROVIDE INFORMATION ON REGISTRATION

AND ABSENTEE BALLOT PROCEDURES FOR

ALL VOTERS IN THE STATE.—

(1) In general. Each State shall designate a single

office which shall be responsible for providing

information regarding voter registration

procedures and absentee ballot procedures to be
Uniformed And Overseas Citizens Absentee Voting Act (UOCAVA) 2004–05 Voting Assistance Guide

336

used by absent uniformed services voters and

overseas voters with respect to elections for

Federal office (including procedures relating to the

use of the Federal write-in absentee ballot) to all

absent uniformed services voters and overseas

voters who wish to register to vote or vote in any

jurisdiction in the State.

(2) Recommendation regarding use of Office to

Accept and Process Materials.—Congress

recommends that the State office designated under

paragraph (1) be responsible for carrying out the

State’s duties under this Act, including accepting

valid voter registration applications, absentee

ballot applications, and absentee ballots (including

Federal write-in absentee ballots) from all absent

uniformed services voters and overseas voters

who wish to register to vote or vote in any

jurisdiction in the State.

(c) REPORT ON NUMBER OF ABSENTEE

BALLOTS TRANSMITTED AND RECEIVED. — Not

later than 90 days after the date of each regularly scheduled

general election for Federal office, each State and unit of

local government which administered the election shall

(through the State, in the case of a unit of local government)

submit a report to the Election Administration Commission

(established under the Help America Vote Act of 2002) on

the combined number of absentee ballots transmitted to

absent uniformed services voters and overseas voters for

the election and the combined number of such ballots which

were returned by such voters and cast in the election, and

shall make such report available to the general public.

(d) REGISTRATION NOTIFICATION.—With respect

to each absent uniformed services voter and each overseas

voter who submits a voter registration application or an

absentee ballot request, if the State rejects the application or

request, the State shall provide the voter with the reasons

for the rejection.

SEC. 103. FEDERAL WRITE-IN ABSENTEE

BALLOT FOR OVERSEAS VOTERS IN

GENERAL ELECTIONS FOR FEDERAL

OFFICE.

(a) IN GENERAL. — The Presidential designee shall

prescribe a Federal write-in absentee ballot (including a

secrecy envelope and mailing envelope for such ballot) for

use in general elections for Federal office by overseas

voters who make timely application for, and do not receive,

States, absentee ballots.

(b) SUBMISSION AND PROCESSING. — Except as

otherwise provided in this title, a Federal write-in absentee

ballot shall be submitted and processed in the manner

provided by law for absentee ballots in the State involved.

A Federal write-in absentee ballot of an overseas voter shall

not be counted. —

(1) if the ballot is submitted from any location in the

United States; 

(2) if the application of the overseas voter for a State

absentee ballot is received by the appropriate State

election official less than 30 days before the

general election; or 

(3) if a State absentee ballot of the overseas voter is

received by the appropriate State election official

not later than the deadline for receipt of the State

absentee ballot under State law. 

(c) SPECIAL RULES. — The following rules shall apply

with respect to Federal write-in absentee ballots:

(1) In completing the ballot, the overseas voter may

designate a candidate by writing in the name of the

candidate or by writing in the name of political

party (in which case the ballot shall be counted for

the candidate of that political party). 

(2) In the case of the offices of President and Vice

President, a vote for a named candidate or a vote

by writing in the name of a political party shall be

counted as a vote for the electors supporting the

candidate involved. 

(3) Any abbreviation, misspelling, or other minor

variation in the form of the name of a candidate or

a political party shall be disregarded in

determining the validity of the ballot, if the

intention of the voter can be ascertained. 

(d) SECOND BALLOT SUBMISSION;

INSTRUCTION TO OVERSEAS VOTER. — An

overseas voter who submits a Federal write-in absentee

ballot and later receives a State absentee ballot, may submit

the State absentee ballot. The Presidential designee shall

assure that the instructions for each Federal write-in

absentee ballot clearly state that an overseas voter who

submits a Federal write-in absentee ballot and later receives

and submits a State absentee ballot should make every

reasonable effort to inform the appropriate State election

official that the voter has submitted more than one ballot.

(e) USE OF APPROVED STATE ABSENTEE

BALLOT IN PLACE OF FEDERAL WRITE-IN

ABSENTEE BALLOT. — The Federal write-in absentee

ballot shall not be valid for use in a general election if the

State involved provides a State absentee ballot that — 

(1) at the request of the State, is approved by the

Presidential designee for use in place of the

Federal write-in absentee ballot; and 

(2) is made available to overseas voters at least 60

days before the deadline for receipt of the State

ballot under State law. 
2004–05 Voting Assistance Guide Uniformed And Overseas Citizens Absentee Voting Act (UOCAVA)

337

(f) CERTAIN STATES EXEMPTED. — A State is not

required to permit use of the Federal write-in absentee

ballot, if, on and after the date of the enactment of the title,

the State has in effect a law providing that —

(1) a State absentee ballot is required to be available

to any voter described in section 107(5)(A) at least

90 days before the general election involved; and 

(2) a State absentee ballot is required to be available

to any voter described in section 107(5)(B) or (C),

as soon as the official list of candidates in the

general election is complete. 

SEC. 104. USE OF SINGLE APPLICATION

FOR ALL SUBSEQUENT ELECTIONS.

(a) IN GENERAL.—If a State accepts and processes an

official post card form (prescribed under section 101)

submitted by an absent uniformed services voter or

overseas voter for simultaneous voter registration and

absentee ballot application (in accordance with section

102(a)(4)) and the voter requests that the application be

considered an application for an absentee ballot for each

subsequent election for Federal office held in the State

through the next 2 regularly scheduled general elections for

Federal office (including any runoff elections which may

occur as a result of the outcome of such general elections),

the State shall provide an absentee ballot to the voter for

each such subsequent election.

(b) EXCEPTION FOR VOTERS CHANGING

REGISTRATION.—Subsection (a) shall not apply with

respect to a voter registered to vote in a State for any

election held after the voter notifies the State that the voter

no longer wishes to be registered to vote in the State or after

the State determines that the voter has registered to vote in

another State.

(c) REVISION OF OFFICIAL POST CARD FORM.—

The Presidential designee shall revise the official post card

form (prescribed under section 101) to enable a voter using

the form to—

(1) request an absentee ballot for each election for

Federal office held in a State during a year; or

(2) request an absentee ballot for only the next

scheduled election for Federal office held in a

State.

(d) NO EFFECT ON VOTER REMOVAL

PROGRAMS.—Nothing in this section may be construed

to prevent a State from removing any voter from the rolls of

registered voters in the State under any program or method

permitted under section 8 of the National Voter Registration

Act of 1993.

(e) PROHIBITION OF REFUSAL OF APPLICATION

ON GROUNDS OF EARLY SUBMISSION.—A State

may not refuse to accept or process, with respect to any

election for Federal office, any otherwise valid voter

registration application or absentee ballot application

(including the postcard form prescribed under section 101)

submitted by an absent uniformed services voter during a

year on the grounds that the voter submitted the application

before the first date on which the State otherwise accepts or

processes such applications for that year submitted by

absentee voters who are not members of the uniformed

services.

SEC. 105. ENFORCEMENT.

The Attorney General may bring a civil action in an

appropriate district court for such declaratory or injunctive

relief as may be necessary to carry out this title. 

SEC. 106. EFFECT ON CERTAIN OTHER

LAWS.

The exercise of any right under this title shall not affect, for

purposes of any Federal, State, or local tax, the residence or

domicile of a person exercising such right. 

SEC. 107. DEFINITIONS.

As used in this title, the term —

(1) “absent uniformed services voter” means — 

(A) a member of a uniformed service on active

duty who, by reason of such active duty, is

absent from the place of residence where the

member is otherwise qualified to vote; 

(B) a member of the merchant marine who, by

reason of service in the merchant marine, is

absent from the place of residence where the

member is otherwise qualified to vote; and

(C) a spouse or dependent of a member referred

to in subparagraph (A) or (B) who, by reason

of the active duty or service of the member,

is absent from the place of residence where

the spouse or dependent is otherwise

qualified to vote; 

(2) “balloting materials” means official post card

forms (prescribed under section 101), Federal

write-in absentee ballots (prescribed under section

103), and any State balloting materials that, as

determined by the Presidential designee, are

essential to the carrying out of this title; 

(3) “Federal office” means the office of President or

Vice President, or of Senator or Representative in,
Uniformed And Overseas Citizens Absentee Voting Act (UOCAVA) 2004–05 Voting Assistance Guide

338

or Delegate or Resident Commissioner to, the

Congress

(4) “member of the merchant marine” means an

individual (other than a member of a uniformed

service or an individual employed, enrolled, or

maintained on the Great Lakes or the inland

waterways) — 

(A) employed as an officer or crew member of a

vessel documented under the laws of the

United States, or a vessel owned by the

United States, or a vessel of foreign-flag

registry under charter to or control of the

United States; or 

(B) enrolled with the United States for

employment or training for employment, or

maintained by the United States for

emergency relief service, as an officer or

crew member of any such vessel; 

(5) “overseas voter” means — 

(A) an absent uniformed services voter who, by

reason of active duty or service is absent

from the United States on the date of the

election involved; 

(B) a person who resides outside the United

States and is qualified to vote in the last

place in which the person was domiciled

before leaving the United States; or

(C) a person who resides outside the United

States and (but for such residence) would be

qualified to vote in the last place in which

the person was domiciled before leaving the

United States;

(6) “State” means a State of the United States, the

District of Columbia, the Commonwealth of

Puerto Rico, Guam, the Virgin Islands, and

American Samoa;

(7) “uniformed services” means the Army, Navy, Air

Force, Marine Corps, and Coast Guard, the

commissioned corps of the Public Health Service,

and the commissioned corps of the National

Oceanic and Atmospheric Administration; and 

(8) “United States”, where used in the territorial

sense, means the several States, the District of

Columbia, the Commonwealth of Puerto Rico,

Guam, the Virgin Islands, and American Samoa. 

TITLE II — POSTAL, CRIMINAL, AND

GENERAL PROVISIONS

SEC. 201. AMENDMENTS TO TITLE 39,

UNITED STATES CODE.

(a) IN GENERAL. — Chapter 34 of title 39, United States

Code, is amended by adding at the end of the following new

section:

“§ 3406. Balloting materials under the Uniformed and

Overseas Citizens Absentee Voting Act

“(a) Balloting materials under the Uniformed and Overseas

Citizens Absentee Voting Act (individually or in bulk) —

“(1) shall be carried expeditiously and free of

postage; and

“(2) may be mailed at a post office established

outside the United States under section 406 of this

title, unless such mailing is prohibited by treaty or

other international agreement of the United States. 

“(b) As used in this section, the term `balloting materials'

has the meaning given that term in section 107 of the

Uniformed and Overseas Citizens Absentee Voting Act.”.

(b) TECHNICAL AMENDMENTS. —

(1) The table of sections for chapter 34 of title 39,

United States Code, is amended by adding at the

end the following new item: 

“3406. Balloting materials under the Uniformed

and Overseas Citizens Absentee Voting Act.” 

(2) The first sentence of section 2401(c) of title 39,

United States Code, is amended —

(A) by striking out “3405” and inserting in lieu

thereof “3406”; and 

(B) by striking out “the Overseas Citizens Voting

Rights Act of 1975, and the Federal Voting

Assistance Act of 1955". 

(3) Section 3627 of title 39, United States Code, is

amended — 

(A) by striking out “3405” and inserting in lieu

thereof “3406”; and 

(B) by striking out “under the Federal Voting

Assistance Act of 1955 or under the

Overseas Citizens Voting Rights Act of

1975". 
2004–05 Voting Assistance Guide Uniformed And Overseas Citizens Absentee Voting Act (UOCAVA)

339

(4) Section 3684 of title 39, United States Code, is

amended by striking out, “or of the Federal Voting

Assistance Act of 1955". 

SEC. 202. AMENDMENTS TO TITLE 18,

UNITED STATES CODE.

(a) IN GENERAL. — Chapter 29 of title 18, United States

Code, is amended by adding at the end the following new

sections:

“§ 608. Absent uniformed services voters and overseas

voters

 “(a) Whoever knowingly deprives or attempts to deprive

any person of a right under the Uniformed and Overseas

Citizens Absentee Voting Act shall be fined in accordance

with this title or imprisoned not more than five years, or

both.

 “(b) Whoever knowingly gives false information for the

purpose of establishing the eligibility of any person to

register or vote under the Uniformed and Overseas Citizens

Absentee Voting Act, or pays or offers to pay, or accepts

payment for registering voting under such Act shall be fined

in accordance with this title or imprisoned not more than

five years, or both.

“§ 609. Use of military authority to influence vote of

member of Armed Forces

 “Whoever, being a commissioned, noncommissioned,

warrant, or petty officer of an Armed Force, uses military

authority to influence the vote of a member of the Armed

Forces or to require a member of the Armed Forces to

march to a polling place, or attempts to do so, shall be fined

in accordance with this title or imprisoned not more than

five years, or both. Nothing in this section shall prohibit

free discussion of political issues or candidates for public

office.”

(b) TECHNICAL AMENDMENT. — The table of

sections for chapter 29 of title 18, United States Code, is

amended by adding at the end the following:

“608. Absent uniformed services voters and

overseas voters. 

“609. Use of military authority to influence vote of

member of Armed Forces.” 

SEC. 203. REPEALS.

The Federal Voting Assistance Act of 1955 (42 U.S.C.

1973cc et seq.) and the Overseas Citizens Voting Rights Act

of 1975 (42 U.S.C. 1973dd et seq.) are repealed.

SEC. 204. EFFECTIVE DATE.

The amendments and repeals made by this Act shall apply

with respect to elections for Federal office that occur after

January 1, 2004.
Uniformed And Overseas Citizens Absentee Voting Act (UOCAVA) 2004–05 Voting Assistance Guide

340
2004–05 Voting Assistance Guide Probable State Income Tax Liability

341

APPENDIX E

PROBABLE STATE INCOME TAX LIABILITY

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343

I. States with No Foreign Tax Credit or Exemption Provision . . . . . . . . . . . . . . . . . . 344

Alabama . . . . . . . . . . . . . . . . . . . . . . . . 344

California. . . . . . . . . . . . . . . . . . . . . . . . 344

District of Columbia. . . . . . . . . . . . . . . . 344

Mississippi . . . . . . . . . . . . . . . . . . . . . . 345

New Hampshire . . . . . . . . . . . . . . . . . . 345

New Jersey . . . . . . . . . . . . . . . . . . . . . 345

Tennessee . . . . . . . . . . . . . . . . . . . . . . 345

II. States Granting an Income Tax Credit for Foreign Income Tax Paid . . . . . . . . . . . 346

Arizona . . . . . . . . . . . . . . . . . . . . . . . . . 346

Hawaii . . . . . . . . . . . . . . . . . . . . . . . . . . 347

Indiana . . . . . . . . . . . . . . . . . . . . . . . . . 348

Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . . 348

Maine . . . . . . . . . . . . . . . . . . . . . . . . . . 349

Massachusetts . . . . . . . . . . . . . . . . . . . 349

Montana . . . . . . . . . . . . . . . . . . . . . . . . 350

New Mexico . . . . . . . . . . . . . . . . . . . . . 350

North Carolina . . . . . . . . . . . . . . . . . . . 351

Oregon . . . . . . . . . . . . . . . . . . . . . . . . . 351

Pennsylvania . . . . . . . . . . . . . . . . . . . . 352

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law . . 352

Arkansas. . . . . . . . . . . . . . . . . . . . . . . . 352

Colorado . . . . . . . . . . . . . . . . . . . . . . . . 353

Connecticut. . . . . . . . . . . . . . . . . . . . . . 353

Delaware. . . . . . . . . . . . . . . . . . . . . . . . 354

Georgia . . . . . . . . . . . . . . . . . . . . . . . . . 354

Idaho. . . . . . . . . . . . . . . . . . . . . . . . . . . 355

Illinois . . . . . . . . . . . . . . . . . . . . . . . . . . 355

Kansas . . . . . . . . . . . . . . . . . . . . . . . . . 356

Kentucky . . . . . . . . . . . . . . . . . . . . . . . . 356

Louisiana . . . . . . . . . . . . . . . . . . . . . . . 357

Maryland . . . . . . . . . . . . . . . . . . . . . . . . 358

Michigan . . . . . . . . . . . . . . . . . . . . . . . . 358

Minnesota . . . . . . . . . . . . . . . . . . . . . . . 359

Missouri . . . . . . . . . . . . . . . . . . . . . . . . 359

Nebraska . . . . . . . . . . . . . . . . . . . . . . . 360

New York . . . . . . . . . . . . . . . . . . . . . . . 360

North Dakota . . . . . . . . . . . . . . . . . . . . 361

Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . 361

Oklahoma. . . . . . . . . . . . . . . . . . . . . . . 362

Rhode Island . . . . . . . . . . . . . . . . . . . . 362

South Carolina . . . . . . . . . . . . . . . . . . . 363

Utah . . . . . . . . . . . . . . . . . . . . . . . . . . . 363

Vermont . . . . . . . . . . . . . . . . . . . . . . . . 364

Virginia . . . . . . . . . . . . . . . . . . . . . . . . . 364

West Virginia . . . . . . . . . . . . . . . . . . . . 365

Wisconsin. . . . . . . . . . . . . . . . . . . . . . . 365

IV. States Having No Income Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366

Alaska . . . . . . . . . . . . . . . . . . . . . . . . . . 366

Florida. . . . . . . . . . . . . . . . . . . . . . . . . . 366

Nevada . . . . . . . . . . . . . . . . . . . . . . . . . 366

South Dakota . . . . . . . . . . . . . . . . . . . . 366

Texas . . . . . . . . . . . . . . . . . . . . . . . . . . 366

Washington . . . . . . . . . . . . . . . . . . . . . 366

Wyoming . . . . . . . . . . . . . . . . . . . . . . . 366
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

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343

STATE INCOME TAXATION OF MILITARY PERSONNEL AND

UNITED STATES CITIZENS RESIDING OUTSIDE OF THE

UNITED STATES

Introduction

This report examines and summarizes the laws of the fifty

states and the District of Columbia respecting the taxation

of income of United States citizens domiciled within the

state but residing abroad. The report is divided into four

substantive sections. Section I discusses the law of states

with no foreign tax credit or exemption provision. Section

II analyzes the laws of states which grant an income tax

credit for foreign income tax paid to a foreign country. In

many cases, these states merely permit credit of any taxes

paid outside of the state, whether to other states or to

foreign governments. Section III describes the laws of the

states which exempt income earned abroad to the same

extent as such income is exempted by federal law. Section

IV lists the seven states which have no income tax. Since

no income tax is imposed, there can really be no substantive

discussion of the treatment of United States citizens

domiciled in the state but residing abroad. States which tax

only certain types of income, such as dividends and interest

(see discussions of New Hampshire and Tennessee), are

discussed under the general tax provisions in Section I.

The first three sections are divided into a discussion of the

definitions of domicile and residency for state income tax

purposes, the tax base used by the state, and the probable

income tax obligation in each of these states for

domiciliaries residing abroad. In addition, special note is

made where state domicile or residency is determined in

whole or in part by voting within the state and where

special rules apply to military personnel.

In regard to the special rules applicable to military

personnel, a number of states merely refer to the tax

provisions of the Soldiers' and Sailors' Civil Relief Act of

1940, presently found at 50 U.S.C. App. 574. Generally,

this section provides that for state income tax purposes, an

individual does not lose domicile in a specific state solely

"by reason of being absent therefrom in compliance with

military or naval orders . . . . " The same law also provides

that, for state income tax purposes, an individual does not

acquire residence or domicile solely because of location

under military orders. The Act further states that, where an

individual is not deemed to reside or be domiciled in a state,

military income will be treated by that state as non-resident

income not earned within the state.

Section 911 of the Internal Revenue Code (IRC) permits

United States citizens who reside abroad to exclude from

their gross income up to $80,000 of foreign earned income

in tax year 2003 and a certain recognized amount for

housing. This exclusion applies to taxpayers living abroad

who were present in a foreign country or countries for 330

days out of any 12 consecutive months. The housing cost

amount is the excess of the taxpayer's expenses over a base

housing amount. The base housing amount is equal to 16

percent of the salary of a GS-14 government employee. As

of January 1, 2003, this salary is $72,381 so that the current

base housing amount would be $11,580.96. Housing costs

provided by an employer may also be excluded from the

gross income of the employee. In line with this, IRC § 119

provides that lodging furnished in an overseas camp may be

excluded from the employee's income. It should be noted

that neither exclusion is applicable to wages paid by the

United States government even if the Federal employee is

residing abroad.

Most states, and the District of Columbia, have signed

agreements with the Treasury Department which provide

for the withholding of state income taxes from the pay of

service members. The text of the standard agreement may

be found at 31 CFR § 215.6 - 13 (2001). The following

states do not have standard agreements with the Treasury

Department to withhold state income taxes from the pay of

members of the armed services: Alaska, Florida, Nevada,

South Dakota, Texas, Washington, and Wyoming.

The information contained in this report is accurate through

the end of the 2002 legislative session of each state.
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

344

I. States with No Foreign Tax Credit or Exemption Provision

State Income Tax Coverage Tax Base Probable Tax Obligation

Alabama Domicile, maintaining a permanent place of abode within 

the State, or spending in the aggregate more than seven 

months of the year within the State. Ala. Code tit. 40, § 18-

2(7). 

Voting in Alabama is a factor considered by the courts in 

determining whether an individual is domiciled in Alabama 

for tax purposes. State ex rel. Rabren v. Baxter, 46 Ala. 

App. 134, 239 So. 2d 206 (1970).

The Alabama Tax Regulations state that military personnel 

domiciled in Alabama continue to be domiciliaries 

irrespective of their period of absence or actual place of 

residence until proof of change of domicile or residence 

has been made. If domicile has changed, the burden of 

proof is on the taxpayer though he owns no property, earns 

no income, and has no place of abode in Alabama. Ala. 

Tax. Regs.,§ 810-3-2-.01.

The entire net income of domiciliaries 

and residents as defined by the 

statute. Ala. Code tit. 40, § 18-2.

Non-residents taxable on income 

from property owned or business 

transacted in Alabama. Ala. Code tit. 

40, § 18-2(6).

Resident military personnel taxable 

on entire net income except income 

received for active combat duty. Ala. 

Code tit. 40, § 18-3.

Non-resident military personnel are 

not taxed on military pay received 

while stationed in Alabama.

Wives of military personnel taxable on 

income earned within the State. 

Military personnel taxable on nonmilitary income earned within the 

State.

All military retirement payments are 

exempt from state income taxation. 

Ala. Code tit. 40, § 18-20

Residents -- Subject to State 

income tax on all income.

Non-residents -- Taxable on 

income from property owned 

or business transacted in 

Alabama.

Resident military personnel --

Subject to State income tax 

on all income except income 

received for active combat 

duty.

Non-resident military 

personnel -- Subject to State 

income tax on non-military 

income earned within the 

State.

Wives of military personnel --

Taxable on income earned 

within the State.

California Residents -- The term “resident” for income tax purposes 

includes: (a) every individual who is in the state for other 

than a temporary or transitory purpose, and (b) every 

individual domiciled in the state who is outside the state for 

a temporary or transitory purpose. If such person is absent 

for at least 18 months under an employment dated contract 

they are not considered to be outside the state for a 

temporary or transitory purposes (This exception does not 

apply to those who receive over $200,000 in unearned 

income in a tax year). Any individual who is a resident of 

the state continues to be a resident even though 

temporarily absent from the state. An individual domiciled 

in California is absent from the state for a temporary 

purpose if such absence is by reason of (1) holding an 

elected or appointed office in the Federal Government or 

(2) working on the staff of an elected officer of the 

legislative branch of the U.S. Government. Cal. Rev. & Tax 

Code § 17014.

Every individual who spends in the aggregate more than 

nine months of the taxable year within the state is 

presumed to be a resident. Cal. Rev. & Tax Code § 17016

The entire taxable income of a 

resident of the state. Cal. Rev. & Tax 

Code § 17041(a). The entire taxable 

income of a non-resident of the state 

which is derived from sources within 

the state. Cal. Rev. & Tax Code § 

17041(b).

Non-resident military personnel are 

not taxed on military income received 

while stationed in California. 

Spouses of military personnel taxable 

on income derived from sources 

within the state.

Gross income shall not include 

compensation for military service 

performed by a non-resident and 

attributable to a resident spouse 

solely by application of any 

community property law or rule. Cal. 

Rev. & Tax Code § 17140.5.

Military hazardous duty pay which is 

exempt under IRC § 112 is 

specifically exempt from the state 

income tax. Cal. Rev. & Tax Code § 

17142.5

Residents -- Subject to state 

income tax on all taxable 

income. Non-residents -- 

Subject to state income tax 

on all taxable income derived 

from sources within the state.

Resident military personnel --

Subject to state income tax 

on all taxable income.

Non-resident military 

personnel -- Subject to state 

tax on non-military taxable 

income derived from sources 

within the state.

Wives of military personnel --

Subject to state income tax 

on all taxable income derived 

from sources within the state.

District of 

Columbia

Residents -- The term “resident” is defined as every 

individual domiciled within the District on the last day of the 

taxable year, and every other individual who maintains a 

place of abode within the District for more than 183 days of 

the taxable year, whether domiciled in the District or not. 

D.C. Code tit. 47, § 1801.4. Under an earlier District of 

Columbia tax law, the Supreme Court held that whether or 

not a person votes where he claims domicile is highly 

relevant, but by no means controlling on the question 

whether he is domiciled in the District of Columbia, nor is 

failure to vote elsewhere conclusive that domicile is in the 

District. District of Columbia v. Murphy, 314 U.S. 441 

(1941); see also District of Columbia v. Woods, 465 A.2d 

385 (1983).

See Soldiers' and Sailors' Civil Relief Act.

The entire net income of residents. 

D.C. Code § 47-1806.1.

The District of Columbia is precluded 

from levying a non-resident income 

tax by Public Law 93-198, 602(a), 87 

Stat. 813; D.C. Code § 1-233(a)(5); § 

47-1801.4.

See IRC § 104(a)(4).

Residents -- Subject to D.C. 

income tax on net income.

Non-residents -- Not subject 

to the income tax.

Military personnel -- Not 

subject to income tax on 

pensions or annuities up to 

$3000. D.C. Code § 47-

1803.2
2004–05 Voting Assistance Guide Probable State Income Tax Liability

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Mississippi Residents and non-residents -- The term “resident” is 

defined as any person domiciled in the state and any other 

person who maintains a legal or actual residence within the 

state. Miss. Code § 27-7-3(e).

The term “non-resident” is defined as any natural person 

whose domicile and place of abode is without the state. 

Miss Code § 27-7-3(f). The Mississippi Tax Regulations 

define “legal resident” as one who maintains a place of 

abode in Mississippi or who exercises legal rights such as 

voting. One can be a legal resident though domiciled 

elsewhere. Miss. Tax Reg. 1.27-7-3(5)(c); State Tax 

Commission of the State of Mississippi v. Earnest, 627 

So.2d 313 (1993).

The Mississippi Tax Regulations state that members of the 

armed forces who claim Mississippi as their state of legal 

residence/domicile are liable for Mississippi income tax on 

their income. Non-resident members of the armed forces 

stationed in Mississippi who realize income from nonmilitary sources within the state must file a non-resident 

Individual Income Tax Return. Miss. Tax Regs. § 1.27-7-

15(34).

The entire net income of residents. 

Miss. Code § 27-7-5. The entire net 

income of non-residents from sources 

within Mississippi. Miss. Code § 27-

7-15(3).

Mississippi excludes from gross 

income: (1) the first $500 per month 

received as compensation for active 

service in a combat zone or during 

hospitalization as a result of such 

service and; (2) hazardous duty 

combat pay to members of the armed 

forces. Miss. Code § 27-7-15(4)(j), 

(n).

The entire income of spouses of 

military personnel of non-military pay 

from sources within Mississippi is 

taxable. Miss. Tax Regs. § 1.27-7-

15(34).

Residents -- Subject to tax on 

their entire net income.

Non-residents -- Subject to 

tax on their entire net income 

from sources within 

Mississippi.

Military personnel -- Not 

subject to income tax on: (1) 

the first $500 per month 

compensation for active 

service in a combat zone or 

during hospitalization as a 

result of such service and (2) 

hazardous duty combat pay.

Spouses of military personnel 

-- Subject to tax on nonmilitary pay from sources 

within Mississippi.

New 

Hampshire

Taxes inhabitants or residents on interest and dividend 

income. N.H. Rev. Stat. Ann. § 77:3.

Interest and dividend income over 

$2,400 per year. N.H. Rev. Stat. Ann. 

§ 77:5.

No mention is made of military 

personnel.

Inhabitants or residents -- 

Subject to tax on interest and 

dividends over $2,400.

New Jersey Residents -- “Residents” means (1) domiciliaries unless 

they maintain no permanent place of abode in the state, 

maintain a permanent place of abode elsewhere, and 

spend an aggregate of not more than 30 days in the state 

or (2) persons not domiciled in New Jersey who maintain a 

permanent place of abode in the state and spend an 

aggregate of more than 183 days in the state, unless such 

individual is in the armed forces of the United States. N.J. 

Stat. Ann.§ 54A:1-2(m).

Non-residents -- “Non-resident” means a taxpayer who is 

not a resident. N.J. Stat. Ann.§ 54A:1-2(n).

Residents -- New Jersey gross 

income as defined by statute. N.J. 

Stat. Ann. § 54A:5-1.

Non-residents -- Specified categories 

of New Jersey gross income to the 

extent they are earned, received or 

acquired from New Jersey sources. 

N.J. Stat. Ann. § 54A:5-8.

New Jersey excludes from gross 

income: (1) pensions and annuities 

for personal injuries or sickness 

resulting from active service in the 

armed forces of the United States; (2) 

compensation for service in the 

armed forces of the United States to 

an individual not domiciled in New 

Jersey; (3) mustering-out payments to 

members of the armed forces of the 

United States; and military pensions 

and survivor benefit payments. N.J. 

Stat. Ann. §§ 54A:6-6, 6-7, and 6-26.

Resident -- Subject to tax on 

their entire New Jersey gross 

income. 

Non-residents -- Subject to 

tax on the specified 

categories of New Jersey 

gross income from New 

Jersey sources.

Military personnel -- Resident 

- subject to tax on entire 

income.

Non-resident -- not subject to 

tax on military income. 

Subject to tax on specified 

New Jersey gross income 

from New Jersey sources.

Tennessee Persons in the state -- The term “person” is defined as 

every natural person, inhabitant, resident (any person who 

has a legal domicile in Tennessee), and every person who 

maintains a place of residence for more than six months in 

the tax year (regardless of what place such person may 

claim as legal domicile). Tenn. Code § 67-2-101(5).

(1) The income of persons in the 

State from dividends on stock and 

interest on bonds. Tenn. Code Ann. § 

67-2-102.

No interest or penalties may be 

assessed against service member 

serving in combat zone or 

hospitalized as result of injury in a 

combat zone. Tenn. Code § 67-2-

114(a).

Persons in the state -- 

Subject to tax on dividends 

from stock and interest on 

bonds.

Resident military -- Subject to 

tax on dividends from stock 

and interest on bonds.

I. States with No Foreign Tax Credit or Exemption Provision

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

346

II. States Granting an Income Tax Credit for Foreign Income Tax Paid

State Income Tax Coverage Tax Base Probable Tax Obligation

Arizona Residents and certain non-residents -- The term 

“resident” includes: (1) every individual who is in the 

state for other than a temporary or transitory purpose, 

and (2) every individual domiciled in the state who is 

outside the state for a temporary or transitory purpose. 

Every individual who spends in the aggregate more than 

nine months of the taxable year within the state is 

presumed to be a resident. Ariz. Rev. Stat. Ann. §§ 43-

104(14), 43-104(19).

See Soldiers' and Sailors' Civil Relief Act. 50 U.S.C. 

App. § 574.

The entire taxable income of every 

resident and the entire taxable 

income of every non-resident which is 

derived from sources within the state. 

Ariz. Rev. Stat. Ann. § 43-1011. Since 

Arizona computes its own taxable 

income from federal adjusted gross 

income, the exclusions under §§ 911-

912 of the IRC for income from 

sources without the United States are 

apparently adopted by into the 

computation of Arizona taxable 

income. Any combat pay not already 

excluded by § 112 of the IRC is 

specifically excluded . Ariz. Rev. Stat. 

Ann. § 43-1022(19).

Residents are allowed a credit only 

for taxes paid to the other state or 

country on income derived from 

sources within that state or country 

which is taxable under the foreign 

laws without regard to the residence 

or domicile of the recipient. No credit 

is allowed if the other state or country 

allows residents of Arizona a credit 

against taxes imposed by that state or 

country for taxes paid to Arizona. 

Ariz. Rev. Stat. Ann. § 43-1071.

Non-residents are allowed a credit 

against Arizona taxes on income 

derived from sources within Arizona 

only if (1) the foreign country does not 

tax income of residents of Arizona 

derived from sources within that 

country or (2) allows residents of 

Arizona credit against taxes imposed 

by that country on such income for 

taxes paid to Arizona. Ariz. Rev. Stat. 

Ann. § 43-1096.

Residents -- Subject to tax on 

entire net income with §§ 

911-912 and § 112 

exclusions and the possibility 

of receiving a credit for 

foreign taxes paid.

Non-residents -- Subject to 

tax on net income derived 

from sources within Arizona 

with the possibility of 

receiving a credit for foreign 

taxes paid on such income.
2004–05 Voting Assistance Guide Probable State Income Tax Liability

347

Hawaii Residents and certain non-residents -- A “resident” is 

defined as every individual who resides in the state for 

other than a temporary or transitory purpose. Every 

individual who is in the state more than 200 days of the 

taxable year in the aggregate is presumed to be a 

resident. This presumption may be overcome by 

evidence satisfactory to the Department of Taxation that 

the individual maintains a permanent place of abode 

outside of the state and is in the state for a temporary or 

transitory purpose. No person shall be deemed to have 

gained or lost a residence simply because of his 

presence or absence in compliance with military or naval 

orders. Haw. Rev. Stat. § 235-1.

The entire income of all residents. 

The income received or derived from 

property owned, personal services 

performed, trade or business carried 

on, and any and every other source in 

the state by a non-resident. Haw. 

Rev. Stat. § 235-4(a), (b). Because 

Hawaii computes its own taxable 

income from federal adjusted gross 

income, the exclusions under § 911 of 

the IRC for income from sources 

without the United States are 

apparently adopted into the 

computation of Hawaii taxable 

income. Section 912 exclusions are 

specifically added back into Hawaii 

adjusted gross income. Haw. Rev. 

Stat. § 235-7(b).

Residents are allowed a credit for 

taxes paid to an other state or 

country, which are paid on income 

derived from sources outside the 

state. The credit is not allowed for 

taxes paid on income excluded under 

§ 911. Haw. Rev. Stat. § 235-55(a).

Because Hawaii computes its own 

taxable income from federal adjusted 

gross income, the exclusion under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently incorporated into 

the computation of Hawaii taxable 

income.

The first $1,750 of income to 

members of the armed forces 

reserves is also excluded from gross 

income. Haw. Rev. Stat. § 235-

7(a)(7)

Residents -- Subject to tax on 

all income with § 911 and § 

112 exclusions, and with the 

possibility of a credit for 

foreign taxes paid.

Non-residents -- Subject to 

tax on income derived from 

sources within Hawaii, with 

the possibility of a credit for 

foreign taxes paid.

Military personnel -- Subject 

to tax on military 

compensation with the 

exclusion of combat pay.

II. States Granting an Income Tax Credit for Foreign Income Tax Paid

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

348

Indiana Residents and non-residents -- The term “resident” is 

defined as any individual who was domiciled in the state 

during the taxable year, or any individual who maintains 

a permanent place of residence in the state and spends 

more than 183 days of the taxable year within the state. 

Ind. Stat. § 6-3-1-12.

The term “non-resident” is defined as any person who is 

not a resident of Indiana. Ind. Stat. § 6-3-1-13.

See Soldiers' and Sailors' Civil Relief Act.

The entire federal adjusted income of 

residents, with adjustments not herein 

relevant. Ind. Stat. § 6-2.1-2-2. 

Since Indiana computes its own 

taxable income from federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC for income 

from sources without the United 

States are apparently adopted into 

the computation of Indiana taxable 

income. Ind. Stat.§ 6-2.1-2-2. The 

federal adjusted gross income of nonresidents derived from sources within 

Indiana. Ind. Stat. § 6-2.1-2-2.

Indiana also gives its residents and 

non-residents a credit against Indiana 

income tax for taxes paid to another 

state or foreign country on income 

subject to tax in Indiana. Ind. Stat. §§ 

6-3-3-3, 6-3-1-25.

Indiana allows a deduction of $2,000 

per year from adjusted gross income 

for individuals who are members of 

the United States armed forces. 

Military retirees over 60 years of age 

may deduct $2,000 in retirement or 

survivors' benefits. Ind. Stat. § 6-3-2-

4.

Residents -- Subject to tax on 

federal adjusted gross 

income (above the 

exclusions under §§ 911-912 

of the IRC) with the possibility 

of a credit for foreign taxes 

paid.

Non-residents -- Subject to 

tax on federal adjusted gross 

income derived from sources 

within Indiana, with the 

possibility of a credit for 

foreign taxes paid.

Military personnel and 

merchant marine -- Subject to 

tax on military compensation 

with stated exclusions.

Iowa Residents and non-residents -- The term “resident” is 

defined as any individual domiciled in the state, and any 

other individual who maintains a permanent place of 

abode with the state. Iowa Code § 422.4(15). The term 

“non-resident” includes all individuals who are not 

residents. Iowa Code § 422.4(10).

The Iowa tax regulations state that unless there is 

evidence to the contrary, one will be presumed to be 

domiciled in the state if he or she exercises the right to 

vote, uses homestead credit or military exemption, or 

otherwise exercises his or her rights to suffrage. Iowa 

Tax Regs. subrule 38.1(9); In the Matter of Fox, 1996 

Iowa Tax LEXIS 1996.

See Soldiers' and Sailors' Civil Relief Act.

The entire income of the residents 

defined as federal adjusted gross 

income, with certain adjustments not 

herein relevant. Iowa Code § 422.7. 

Since Iowa computes its own net 

income from federal adjusted gross 

income, the exclusions under §§ 911-

912 of the IRC for income from 

sources without the United States are 

apparently adopted into the 

computation of Iowa net income. 

The net income of non-residents 

derived from sources within Iowa. 

Iowa Code §§ 422.5(j); 422.8(2).

Iowa also provides a credit against 

Iowa tax for taxes paid to another 

state or foreign country on income 

subject to tax in Iowa. Iowa Code § 

422.8(1).

Since Iowa computes its own taxable 

income from federal adjusted gross 

income, the exclusion under § 112 of 

the IRC for compensation received for 

active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone or 

was hospitalized as a result of an 

injury incurred in such service is 

apparently adopted into computation 

of Iowa taxable income. Iowa Code § 

422.7

Residents -- Subject to tax on 

federal adjusted gross 

income (above the 

exclusions under §§ 911-912 

of the IRC) with the possibility 

of a credit for foreign taxes 

paid.

Non-residents -- Subject to 

tax on federal adjusted gross 

income derived from sources 

within Iowa, with the 

possibility of a credit for 

foreign taxes paid.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

II. States Granting an Income Tax Credit for Foreign Income Tax Paid

State Income Tax Coverage Tax Base Probable Tax Obligation
2004–05 Voting Assistance Guide Probable State Income Tax Liability

349

Maine Residents and non-residents -- The term “resident” is 

defined as an individual who is domiciled in Maine; or 

who is not domiciled in Maine, but maintains a 

permanent place of abode in Maine and spends in the 

aggregate more than 183 days of the taxable year in this 

state, unless he is in the armed forces of the United 

States. Me. Rev. Stat. tit. 36 § 5102.

The term “non-resident” is defined as an individual who 

is not a resident. Me. Rev. Stat. tit. 36 § 5102.

See Soldiers' and Sailors' Civil Relief Act.

The taxable income of residents is 

defined as federal adjusted gross 

income allocated to state sources 

with certain modifications not herein 

relevant. Since Maine computes its 

own taxable income from federal 

adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into the computation of 

Maine taxable income. Me. Rev. Stat. 

tit. 36 § 5121.

The portion of federal adjusted gross 

income of non-residents derived from 

sources within the state. Me. Rev. 

Stat. tit. 36 § 5142.

A resident is allowed a tax credit for 

taxes paid to another state or foreign 

country. Me. Rev. Stat. tit. 36 § 

5217A.

If a taxpayer is regarded as a resident 

of Maine and another jurisdiction for 

the purpose of personal income 

taxation, the tax assessor shall 

reduce the tax on that portion of the 

taxpayer's income which is subjected 

to tax in both jurisdictions, provided 

that the other taxing jurisdiction 

allows a similar reduction. Me. Rev. 

Stat. tit. 36 § 5128.

Since Maine computes its own 

taxable income from federal adjusted 

gross income, the exclusion under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently adopted into the 

computation of Maine taxable income. 

Me. Rev. Stat. tit. 36 § 5121.

Residents -- Subject to tax on 

taxable income in excess of 

the exclusions under §§ 911-

912 of the IRC with the 

possibility of a reduction of 

taxes for taxes paid to 

another jurisdiction.

Non-residents -- Subject to 

tax on the portion of federal 

adjusted gross income 

derived from sources within 

Maine with the possibility of a 

reduction in taxes for taxes 

paid to another jurisdiction.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

Massachusetts Residents and certain non-residents -- The term 

“resident” or inhabitant is defined as (1) any natural 

person domiciled in the Commonwealth or (2) a nondomiciled natural person who has a permanent place of 

abode and spends over one hundred and eighty three 

days in the Commonwealth. The term “non-resident” is 

defined as any natural person whose domicile is outside 

the Commonwealth. Mass. Gen. L. Ann. ch. 62, § 1(f).

The Massachusetts Board of Tax Appeals has ruled that 

change of domicile from the Commonwealth to a foreign 

country requires greater proof of intent to abandon 

domicile than a change of domicile between states of the 

United States. Farr v. Commissioner, 1 Mass. B.T.A. 467 

(1932).

See Soldiers' and Sailors' Civil Relief Act.

The taxable income of residents 

defined as federal adjusted gross 

income. However, Massachusetts 

does not allow the exclusion of 

income from sources without the 

United States in the computation of 

Massachusetts taxable income. 

Mass. Gen. L. Ann. ch. 62 § 

2(a)(1)(C). Massachusetts allows a 

credit for taxes paid to other states or 

the Dominion of Canada or any of its 

provinces, with certain limitations. 

Mass. Gen. L. Ann. ch. 62 § 6(a).

The portion of federal adjusted gross 

income of non-residents derived from 

sources within Massachusetts. Mass. 

Gen. L. Ann. ch. 62 § 5A(a).

The compensation paid to military 

personnel for active duty shall be 

deemed to be from sources other 

than sources within the 

Commonwealth. Mass. Gen. L. Ann. 

ch. 62 § 5A(c).

Residents -- Subject to tax on 

federal adjusted gross 

income without the exclusion 

under § 911 of the IRC for 

income derived from sources 

without the United States. A 

credit for taxes paid to other 

states or Canada or its 

provinces is allowed.

Non-residents -- Subject to 

tax on the portion of federal 

adjusted gross income 

derived from sources within 

Massachusetts.

Military personnel--

Compensation paid to 

military personnel for active 

duty shall be deemed to be 

from sources other than 

sources within the 

Commonwealth.

II. States Granting an Income Tax Credit for Foreign Income Tax Paid

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

350

Montana Residents and non-residents -- The term “resident” is 

defined as any natural person domiciled in the state or 

who maintains a permanent place of abode within the 

state even though temporarily absent from the state and 

who has not established a residence elsewhere. Mont. 

Code tit. 15 § 30-101(16).

See Soldiers' and Sailors' Civil Relief Act.

(1) The entire adjusted gross income 

of residents defined as federal 

adjusted gross income with certain 

modifications not herein relevant. 

Since Montana defines its adjusted 

gross income in terms of federal 

adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into the computation of 

Montana adjusted gross income. 

Mont. Code tit. 15 § 30-111.

(2) The entire earned income of nonresidents derived from sources within 

Montana. Mont. Code tit. 15 § 30-

131.

(3) Montana excludes remuneration 

paid for active service as a member of 

the armed forces of the United States 

from the definition of taxable wages 

for residents. Mont. Code tit. 15 § 

30-116(2).

Residents are allowed a credit for 

taxes paid to other states or foreign 

countries. Mont. Code tit. 15 § 30-

124.

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusion 

of §§ 911-912 of the IRC. 

Foreign credit is allowed.

Non-residents -- Subject to 

tax on net income derived 

from sources within Montana.

Military personnel -- Not 

subject to tax on military 

compensation.

New Mexico Residents and non-residents -- The term “resident” is 

defined as an individual who is domiciled in the state 

during any part of the taxable year. Any person who, on 

or before the last day of the taxable year, changes his 

place of abode to a place without the state with the bona 

fide intention of continuing actually to abide permanently 

without the state is not a resident. N. Mex. Stat.§ 7-2-

2(S).

The term “non-resident” is defined as every individual not 

a resident of the state. N. Mex. Stat.§ 7-2-2(Q).

See Soldiers' and Sailors' Civil Relief Act.

(1) The net income of every resident 

defined in terms of federal taxable 

income with certain modifications not 

herein relevant. Since New Mexico 

defines its tax base in terms of federal 

taxable income, the exclusions under 

§§ 911-912 of the IRC for income 

derived from sources without the 

United States are apparently adopted. 

N. Mex. Stat. § 7-2-3.

(2) The net income of every nonresident derived from sources within 

New Mexico. N. Mex. Stat. § 7-2-3. 

New Mexico defines “state” to include 

foreign country. N. Mex. Stat. § 7-2-

2(U).

(3) New Mexico also allows residents 

a credit for taxes paid to another 

state. N. Mex. Stat. § 7-2-13.

Since New Mexico computes its own 

taxable income from federal adjusted 

gross income, the exclusion under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently adopted into the 

computation of New Mexico taxable 

income. N. Mex. Stat. § 7-2-2.

Residents -- Subject to tax on 

net income above the 

exclusions under §§ 911-912 

of the IRC with the possibility 

of a credit for taxes paid to 

another state.

Non-residents -- Subject to 

tax on net income derived 

from sources within New 

Mexico.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

II. States Granting an Income Tax Credit for Foreign Income Tax Paid

State Income Tax Coverage Tax Base Probable Tax Obligation
2004–05 Voting Assistance Guide Probable State Income Tax Liability

351

North Carolina Residents and non-residents -- The term “resident” is 

defined as an individual who is domiciled in the state for 

other than a temporary or transitory purpose. Absent 

other evidence, residence in the state for over 183 days 

of the taxable year raises the presumption that the 

individual is a resident. N.C. Gen. Stat. § 105-134.1(12).

The term “non-resident” is defined as any individual who 

is not a resident. N.C. Gen. Stat. § 105-134.1(9).

See Soldiers' and Sailors' Civil Relief Act.

(1) The net income of residents as 

defined under N.C. Gen. Stat. § 105-

134.5(a). Because North Carolina 

defines its adjusted gross income in 

terms of federal adjusted gross 

income, the exclusions under §§ 911-

912 of the IRC for income from 

sources without the United States are 

apparently adopted into the 

computation of North Carolina 

adjusted gross income

(2) The net income of non-residents 

for income derived from sources 

within North Carolina. N.C. Gen. Stat. 

§ 105-134.5(b).

North Carolina allows its residents a 

credit against taxes paid to another 

state or foreign a country in certain 

instances. N.C. Gen. Stat. § 105-151.

Residents -- Subject to tax on 

net income with the 

possibility of a tax credit for 

taxes paid to another state or 

foreign country.

Non-residents -- Subject to 

tax on net income derived 

from sources within North 

Carolina.

Military personnel -- Subject 

to tax on military 

compensation.

Oregon Residents and non-residents -- The term “resident” is 

defined as: (1) an individual who is domiciled in this state 

unless he (A) maintains no permanent place of abode in 

this state, (B) does maintain a permanent place of abode 

elsewhere, and (C) spends in the aggregate not more 

than 30 days in the taxable year in this state; or (2) an 

individual who is not domiciled in this state, but 

maintains a permanent place of abode in this state and 

spends in the aggregate more than 200 days of the 

taxable year in this state, unless he proves that he is in 

the state only for a temporary or transitory purpose. Ore. 

Rev. Stat. § 316.027(1)(a), (b).

A non-resident is an individual who is not a resident. 

Ore. Rev. Stat. § 316.022(4).

(1) The entire taxable income of 

residents defined as federal taxable 

income with certain modifications not 

herein relevant. Since Oregon 

defines its own taxable income in 

terms of federal taxable income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

incorporated into the computation of 

Oregon taxable income. Ore. Rev. 

Stat. §§ 316.007, 316.037.

(2) The taxable income of nonresidents derived from sources within 

Oregon. Ore. Rev. Stat. §§ 316.117, 

316.127.

Oregon also gives to residents a 

credit against Oregon income taxes 

for taxes imposed on the taxpayer by 

another state. Ore. Rev. Stat. § 

316.082.

A modified foreign tax credit is 

allowed. Ore. Rev. Stat. § 316.690.

(3) Oregon subtracts from federal 

taxable income the first $3,000 of 

income compensation (other than 

pension or retirement pay) for active 

service in the Armed Forces of the 

United States. All compensation for 

the initial and concluding years of 

active service in the Armed Forces of 

the United States is deducted from 

adjusted gross income. Ore. Rev. 

Stat.§ 316.680(c).

Residents -- Subject to tax on 

federal taxable income above 

the exclusions under § 911-

912 of the IRC and with the 

possibility of a credit for 

foreign taxes paid.

Non-residents -- Subject to 

tax on federal taxable income 

derived from sources within 

Oregon.

Military personnel -- Subject 

to tax on military 

compensation above the first 

$3,000.

II. States Granting an Income Tax Credit for Foreign Income Tax Paid

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

352

Pennsylvania Residents and non-residents -- The term “resident” is 

defined to include both (1) domiciliaries, unless the 

domiciliary maintains no permanent place of abode 

within the Commonwealth, maintains a permanent place 

of abode outside the Commonwealth and resides within 

the Commonwealth for less than thirty days of the 

taxable year, and (2) non-domiciliaries maintaining a 

permanent place of abode within the Commonwealth for 

more than 183 days of the taxable year. Pa. Stat. tit. 72 

§ 7301(p).

“Non-resident” is defined as any individual who is not a 

resident. Pa. Stat. tit. 72 7301(m).

See Soldiers' and Sailors' Civil Relief Act.

(1) The entire income of residents 

defined under Pa. Stat. tit. 72 § 7303.

(2) The income of non-residents 

derived from sources within 

Pennsylvania. Pa. Stat. tit. 72 § 

7303.

Pennsylvania allows residents a 

credit for taxes paid to another state 

or foreign country on income also 

subject to tax in Pennsylvania. Pa. 

Stat. tit. 72 §§ 7301(t), 7314.

Military compensation for active duty 

performed outside of Pennsylvania is 

exempt from taxation. Pa. Stat. tit. 72

§ 7303(a)(1).

Residents -- Subject to tax on 

income with a credit for taxes 

paid to another state or 

foreign country on income 

also subject to tax in 

Pennsylvania.

Non-residents -- Subject to 

tax on income from sources 

within Pennsylvania.

Military personnel -- Subject 

to tax on military income 

except for compensation for 

active duty performed outside 

of Pennsylvania.

II. States Granting an Income Tax Credit for Foreign Income Tax Paid

State Income Tax Coverage Tax Base Probable Tax Obligation

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation

Arkansas Residents and non-residents -- The term “resident” is 

defined to include any natural person domiciled in the state 

and any natural person who maintains a permanent place 

of abode in the state and spends in the aggregate more 

than six months of the taxable year within the state. Ark. 

Code Ann. § 26-51-102(9).

The Arkansas Tax Regulations state that a domicile does 

not end by physical absence alone and is presumed to 

continue until a new domicile is legally established. The 

regulations contain a fact sheet listing the various factors 

to be taken into consideration in determining whether a 

new domicile has been established. The elements of a 

new domicile on the fact sheet include: voter registration 

and exercise of suffrage during the last three elections, 

domicile of birth, physical presence, expressed intention, 

family residence, duty causing absence from Arkansas, 

state licenses, location of substantial real and property 

holdings, community affiliations, business interests, bulk or 

necessary purchases, utility or telephone deposits, and 

local taxes and licenses. Ark. Tax. Reg., Art. 1.84-

2002(10). The Arkansas Tax Regulations state that any 

resident member of the armed forces who at the time of the 

induction into such service was a resident of this state, 

continues to be a resident of this state, even though he or 

she has been inducted into the armed service outside of 

the state and does not return to the state until after such 

service is ended. A member of the armed service who at 

the time of induction was a resident in any state other than 

Arkansas is for income tax purposes a non-resident even 

though he was inducted into the service within Arkansas 

and he remains in the service within Arkansas. Ark. Tax. 

Reg., Art. 1.84-2010.

The entire income of every resident 

as defined by the statute. Ark. Code 

Ann. § 26-51-201(a). 

The exclusion and allowance of IRC 

§§ 911 & 912 as they were in effect 

on January 1, 1989 are specifically 

adopted for purposes of computing 

Arkansas income tax. Ark. Code 

Ann. § 26-51-310. 

The entire net income of nonresidents from all property owned, 

and from every business, trade or 

occupation carried on in Arkansas. 

Ark. Code Ann. § 26-51-202(a).

Resident military personnel taxable 

on all income except for the first 

$6,000 of service pay. Ark. Code 

Ann. § 26-51-306(a)(1). Non-resident 

military personnel taxable on net 

income from non-military sources 

earned within the state. Ark. Code 

Ann. § 26-51-306(b).

IRC §§ 112 and 692, concerning 

taxation of combat pay and pay of 

military personnel for the year they 

die in combat, are adopted and these 

types of income are not included in 

the $6,000 exemption. Ark. Code 

Ann. § 26-51-306(a)(4).

Residents-- Subject to state 

income taxation on federal 

adjusted gross income 

(above the exclusions under 

§§ 911-912 of the IRC).

Non-residents -- Subject to 

state income tax on all net 

income from sources within 

the state as previously 

defined.

Resident military personnel --

Subject to state income tax 

on entire income except for 

the first $6,000 of service 

pay. Combat pay is exempt 

and all income in the year of 

death in combat is exempt.
2004–05 Voting Assistance Guide Probable State Income Tax Liability

353

Colorado Resident individuals and non-residents -- The term 

“resident” individual means a natural person who maintains 

a permanent place of abode within the state and who 

spends in the aggregate more than six months of the 

taxable year within the state. A “non-resident” individual 

means an individual other than a resident individual. Colo. 

Rev. Stat. § 39-22-103(8).

The Colorado Tax Regulations state that domicile is a 

factual matter and that the individual's intent controls. The 

Regulations also state that domicile, once established, is 

not lost until a new domicile is established. Colo. Rev. Stat. 

§ 39-22-103(8).

See Soldiers' and Sailors' Civil Relief Act.

The entire federal adjusted gross 

income of resident individuals, with 

certain modifications not herein 

relevant. Colo. Rev. Stat. § 39-22-

104. Since Colorado computes its 

own taxable income from federal 

adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States and the exclusion 

under § 112 of the IRC for 

compensation received for active 

service as a member of the armed 

forces of the United States for any 

month during which such member 

served in a combat zone are 

apparently adopted into the 

computation of Colorado taxable 

income. Colo. Rev. Stat. § 39-22-

104.

The entire federal adjusted gross 

income of non-resident individuals 

derived from sources within Colorado. 

Colo. Rev. Stat. § 39-22-109.

For purposes of determining income 

tax liability, Colorado disregards the 

time period during which an individual 

is a member of the armed forces of 

the United States:

(1) commencing with a declaration of 

war by Congress and ending twelve 

months after the termination of the 

war; and (2) when an individual is 

serving in an area designated as a 

combat zone and a period of one 

hundred and eighty days after such 

service. Colo. Rev. Stat. § 39-22-610.

Colorado subtracts retirement pay, 

pensions and annuities of members 

of the armed forces to the extent 

included in federal adjusted gross 

income not to exceed $24,000 in any 

one taxable year. Colo. Rev. Stat. § 

39-22-104(f).

Resident individuals -- 

Subject to state income 

taxation on federal adjusted 

gross income (above the 

exclusions under §§ 911-912 

of the IRC).

Non-resident individuals -- 

Subject to state income tax 

on federal adjusted gross 

income attributable to 

sources within Colorado.

Military personnel -- Subject 

to tax on military pay with 

stated exclusions.

Connecticut Residents -- “Resident” means (1) domiciliaries unless they 

maintain no permanent place of abode in the state, 

maintain a permanent place of abode elsewhere and 

spend in the aggregate not more than 30 days of the 

taxable year in the state and (2) non-domiciliaries who 

maintain a permanent place of abode in the state and are 

in the state for an aggregate of more than 183 days. Conn. 

Gen. Stat. Ann. § 12-701(a)(1).

“Non-resident” is defined as any individual who is not a 

resident. Conn. Gen. Stat. Ann. § 12-701(a)(2).

See Soldiers' and Sailors' Civil Relief Act.

The entire federal adjusted gross 

income of resident individuals, with 

certain modifications not herein 

relevant. Conn. Gen. Stat. Ann. §§ 

12-700 and 701(a)(19) & (20).

Since Connecticut computes its own 

taxable income from federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC for income 

from sources without the United 

States and the exclusion under § 112 

of the IRC for compensation received 

for active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone are 

apparently adopted into the 

computation of Connecticut taxable 

income. Conn. Gen. Stat. Ann. § 12-

700.

The entire federal adjusted gross 

income of non-resident individuals 

derived from sources within 

Connecticut. Conn. Gen. Stat. Ann. § 

12-700.

Resident individuals -- 

Subject to state income 

taxation on federal adjusted 

gross income (above the 

exclusions under §§ 911-912 

of the IRC).

Non-resident individuals -- 

Subject to state income tax 

on federal adjusted gross 

income attributable to 

sources within Connecticut.

Military personnel -- Subject 

to tax on military pay with 

stated exclusions.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

354

Delaware Resident individuals and non-resident individuals. A 

“resident individual” is defined as one who is domiciled in 

the state for any part of the taxable year to the extent of the 

period of such domicile; or maintains a place of abode in 

the state and spends more than 183 days of the taxable 

year in the state. Del. Code Ann. § 30-1103.

A “non-resident individual” is defined as one who is not a 

resident individual of the state. Del. Code Ann. § 30-1104.

The Delaware Superior Court has held that an individual 

who had moved to Washington, D.C. to take employment, 

but who continued to vote in Delaware had abandoned his 

Delaware domicile. The court found that the voting, which 

it termed "illegal," did not prove Delaware domicile. 

Mitchell v. Delaware State Tax Commissioner, 42 A.2d 19 

(Del. Supr. Ct. 1945).

See Soldiers' and Sailors' Civil Relief Act.

The entire taxable income of every 

resident individual defined as such 

individual's federal adjusted gross 

income with certain modifications not 

herein relevant. Del. Code Ann. §§ 

30-1102 and 30-1105.

Since Delaware computes its own 

taxable income from federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC for income 

from sources without the United 

States and the exclusion under § 112 

of the IRC for compensation received 

for active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone are 

apparently adopted into the 

computation of Delaware taxable 

income.

The taxable income of a non-resident 

individual defined as that part of his 

federal adjusted gross income 

derived from sources within the State. 

Del. Code Ann. § 30-1102(a).

Resident individuals -- 

Subject to state income 

taxation on federal adjusted 

gross income (above the 

exclusions under §§ 911-912 

of the IRC).

Non-resident individuals -- 

Subject to state income tax 

on federal adjusted gross 

income attributable to 

sources within Delaware.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

Georgia Residents and taxable non-residents -- The term “resident” 

is defined to include "legal residents" of the state on 

December 31 of the taxable year in question, persons 

residing in the state on a "more or less regular basis" on 

December 31 of the taxable year under consideration, and 

persons residing in the state in the aggregate for 183 days 

or part-days for the taxable year. Ga. Code § 48-7-1(10).

“Taxable non-residents” are defined to include the 

following: (1) every individual who is not otherwise a 

resident of Georgia for income tax purposes and who 

regularly, and not casually or intermittently, engages within 

Georgia, himself or by means of employees, agents or 

partners, in employment, trade, business, professional, or 

other activity for financial gain or profit, including the rental 

of real or personal property located within Georgia or for 

use within Georgia; and (2) every individual who is not 

otherwise a resident of Georgia for income tax purposes 

and who sells, exchanges or otherwise disposes of 

tangible property which at that time has a taxable situs 

within Georgia, or of intangible property which has 

acquired at the time a business or commercial situs within 

Georgia. "Taxable non-resident" as defined herein does not 

include a legal resident of another state whose only activity 

for financial gain or profit in Georgia consists of performing 

services in Georgia for an employer where the 

remuneration for such services does not exceed five 

percent of the income received by such person for 

performing services in all places during any taxable year; 

Ga. Code § 48-7-1(11)(A) & (B).

See Soldiers' and Sailors' Civil Relief Act.

The taxable net income of all 

residents defined as federal adjusted 

gross income less items not herein 

relevant. Since Georgia computes its 

own taxable net income on the basis 

of federal adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into the computation of 

Georgia taxable net income. Ga. 

Code § 48-7-27.

The federal exclusion under § 112 of 

the IRC for compensation received for 

active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone or 

was hospitalized as a result of an 

injury incurred in such service is 

specifically adopted into the 

computation of Georgia taxable 

income. Ga. Code § 48-7-36.

Residents -- Subject to tax on 

federal adjusted gross 

income (above the 

exclusions under §§ 911-912 

of the IRC).

Taxable non-residents -- 

Subject to tax on net taxable 

income derived from certain 

specified activities within 

Georgia.

Military personnel -- Subject 

to tax as residents on federal 

adjusted gross income less 

specified items.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
2004–05 Voting Assistance Guide Probable State Income Tax Liability

355

Idaho Residents, and part-year resident. The term “resident” is 

defined as any individual who during the taxable year has 

been domiciled in Idaho or has maintained an abode in 

Idaho for the entire tax year and spent more than 270 days 

of that year in the state. An individual will not be 

considered a resident if during a 15 month period he is 

absent from the state for at least 445 days, is not present 

in the state for more than 60 days, did not maintain an 

abode for his family in the state, was not absent to serve 

as an elected official, and did not claim Idaho as his tax 

home for federal income tax purposes. Ida. Code § 63-

3013.

The term “part-year resident” is defined as an individual 

who has changed his domicile either to or from Idaho and 

who has resided in Idaho for over a day. Ida. Code § 63-

3013A .

The term “non-resident” is defined as any individual who is 

not a resident or part-year resident. Ida. Code § 63-3014.

See Soldiers' and Sailors' Civil Relief Act.

Taxable income of residents defined 

as taxable income under § 63 of the 

IRC. Since Idaho computes its 

taxable income from federal taxable 

income, §§ 911-912 of the IRC for 

income from sources without the 

United States are apparently adopted 

into the computation of Idaho taxable 

income. Ida. Code 63-3022.

The taxable income of non-residents 

and part-year residents to the extent it 

is attributable to certain specified 

activities within Idaho. Ida. Code § 

63-3026A.

Not subject to tax on active duty 

compensation for services performed 

outside of the state, Ida. Code § 63-

3022(h), or retirement benefits, Ida. 

Code § 63-3022A(4).

Residents -- Subject to tax on 

federal taxable income 

(above the exclusions under 

§§ 911-912 of the IRC).

Non-residents and part-year 

residents -- Subject to tax on 

federal taxable income 

attributable to certain sources 

within Idaho.

Military personnel -- Not 

subject to tax on active duty 

compensation for services 

performed outside of the 

state.

Illinois Residents, part-year residents -- The term “resident” is 

defined as any individual who is in the state for other than 

a temporary or transitory purpose during the taxable year 

or who is domiciled in the state, but is absent from the 

state for a temporary or transitory purpose during the 

taxable year. 35 ILCS § 5/1501(20).

The term “part-year resident” is defined as an individual 

who became a resident during the taxable year or ceased 

to be a resident during the taxable year. 35 ILCS § 5/1501 

(17).

The term “non-resident” is defined as a person who is not a 

resident. 35 ILCS § 5/1501 (14).

See Soldiers' and Sailors' Civil Relief Act.

The entire federal adjusted gross 

income of residents, with certain 

modifications not herein relevant. 

Since Illinois computes its own base 

income from federal adjusted gross 

income, the exclusions under §§ 911-

912 of the IRC for income from 

sources without the United States are 

apparently adopted into the 

computation of Illinois base income. 

35 ILCS § 5/203.

All income of part-year residents and 

non-residents attributable to certain 

activities within Illinois. 35 ILCS §§ 5/

301, 304.

Illinois deducts from gross income 

any compensation paid to a resident 

who is a member of the armed forces 

of the United States while on active 

duty. 35 ILCS § 5/203(a)(2)(E). 

Compensation received by any 

resident under any governmental 

retirement or disability plan is also 

deducted from gross income. 35 

ILCS § 5/203(a)(2)(F).

Residents -- Subject to tax on 

federal adjusted gross 

income (above the 

exclusions under §§ 911-912 

of the IRC).

Non-residents and part year 

residents -- Subject to tax on 

all income attributable to 

certain activities within 

Illinois.

Military personnel -- Illinois 

deducts from gross income 

any compensation paid to a 

resident who is a member of 

the armed forces while on 

active duty.

Military retirees are not taxed 

on retirement or disability 

income.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

356

Kansas Resident individuals and non-residents -- A“resident 

individual” is defined as a natural person who is domiciled 

in the state. A natural person who spends in the aggregate 

more than six months of the taxable year within the state is 

presumed to be a resident. Kan. Stat. Ann. § 79-32, 

109(b).

The term “non-resident” is defined as an individual other 

than a resident individual. Kan. Stat. Ann. § 79-32, 109(b).

The Kansas tax regulations state that voting is prima facie

evidence of domicile in Kansas. Kan. Tax Reg. 92-12-4.

See Soldiers' and Sailors' Civil Relief Act.

(1) The taxable income of a resident 

individual defined as such individual's 

federal adjusted gross income for the 

taxable year, with certain 

modifications not herein relevant. 

Kan. Stat. Ann. § 79-32, 110.

(2) The taxable income of nonresident individuals defined as that 

portion of federal adjusted gross 

income derived from sources within 

Kansas. Kan. Stat. Ann. § 79-32, 

110.

Since Kansas computes its own 

taxable income from federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC for income 

from sources with the United States 

and the exclusion under § 112 of the 

IRC for compensation received for 

active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone or 

was hospitalized as a result of an 

injury incurred in such service are 

apparently adopted into the 

computation of Kansas taxable 

income. 

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusions 

under §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on that portion of federal 

adjusted gross income 

derived from sources within 

Kansas.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

Kentucky Residents and non-residents -- The term “resident” is 

defined as an individual domiciled within the state or an 

individual who is not domiciled in the state, but maintains a 

place of abode in the state and spends in the aggregate 

more than 183 days of the taxable year within the state. Ky. 

Rev. Stat.§ 141.010(17).

The term “non-resident” is defined as any individual who is 

not a resident of the state. Ky. Rev. Stat. § 141.010(18). 

The Kentucky tax regulations specify that an individual who 

is permitted to file a federal income tax return as a nonresident citizen, and who immediately prior to residing in a 

foreign country was domiciled in Kentucky, is considered a 

Kentucky resident and must file a resident individual 

income tax return. Ky. Tax Reg. 103 KAR 17:010. See 

also, the following two opinions of the Kentucky Attorney 

General relating to this subject: Op. Atty. Gen. Ky. (July 

12, 1939); Op. Atty. Gen. Ky. (May 12, 1960).

See Soldiers' and Sailors' Civil Relief Act.

(1) The entire net income of every 

resident individual defined as such 

individual's federal adjusted gross 

income with certain modifications not 

herein relevant. Ky. Rev. Stat. § 

141.020(1).

(2) That portion of federal adjusted 

gross income of non-residents 

derived from sources within Kentucky. 

Ky. Rev. Stat. § 141.020(4).

Since Kentucky computes its own 

taxable income from federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC for income 

from sources without the United 

States and the exclusion under § 112 

of the IRC for compensation received 

for active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone or 

was hospitalized as a result of an 

injury incurred in such service are 

apparently adopted into the 

computation of Kentucky taxable 

income. Ky. Rev. Stat. § 141.020.

Residents -- Subject to tax on 

federal adjusted gross 

income (above the 

exclusions under §§ 911-912 

of the IRC).

Non-residents -- Subject to 

tax on federal adjusted gross 

income derived from sources 

within Kentucky.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
2004–05 Voting Assistance Guide Probable State Income Tax Liability

357

Louisiana Residents and non-residents -- The term “resident” is 

defined as every natural person domiciled in the state, and 

every other natural person who maintains a permanent 

place of abode within the state or who spends in the 

aggregate more than six months of the taxable year within 

the state. La. Rev. Stat. § 47-31.

The Louisiana Tax Regulations state that domicile is a 

factual determination of intent to remain in or return to 

Louisiana. Examples in the Regulations indicate that an 

individual may spend large portions of his or her time 

outside of Louisiana without relinquishing domicile. La. 

Inc. Tax Regs. 31.2.

See Soldiers' and Sailors' Civil Relief Act.

The entire federal adjusted gross 

income of resident individuals, with 

certain modifications not herein 

relevant. La. Rev. Stat.§ 47-293.

Since Louisiana computes its own 

taxable income from federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC for income 

from sources without the United 

States are apparently adopted into 

the computation of Louisiana taxable 

income. La. Rev. Stat. § 47-293(6).

The net income of non-residents 

earned or derived from sources within 

the state. La. Rev. Stat. §§ 47-241, 

and 47-293(7).

The gross income of military 

personnel does not include pensions 

or annuities for sickness incurred in 

the armed forces. La. Rev. Stat. § 47-

46(4).

Military pay of non-resident 

servicemen stationed within Louisiana 

is not taxable by Louisiana. See 

Soldiers' and Sailors' Relief Act, 

supra.

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusions 

under §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on net income derived 

from sources within 

Louisiana.

Resident military personnel -- 

Subject to tax on military 

compensation except for 

pensions or annuities for 

personal injuries or sickness 

incurred in the armed forces.

Non-resident military 

personnel -- Subject to tax on 

non-military pay from sources 

within Louisiana.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

358

Maryland Residents and non-residents -- The term “resident” is 

defined as any individual domiciled in the state on the last 

day of the taxable year, and every other individual who, for 

more than six months of the taxable year, maintains a 

place of abode within the state, whether domiciled in the 

state or not. Md. Tax & Rev. Code Ann. § 10-101(h).

The term “non-resident” means an individual who is not a 

resident. Md. Tax & Rev. Code Ann. § 10-101(g).

Evidence that a person has registered to vote in Maryland 

is ordinarily persuasive evidence that such person is 

domiciled in Maryland. Comptroller of the Treasury v. 

Lenderking, 268 Md. 613, 303 A.2d 402 (1973); Roberts v. 

Lakin, 340 Md. 147, 665 A.2d 1024 (1995).

See Soldiers' and Sailors' Civil Relief Act.

(1) The taxable net income of 

residents defined as federal adjusted 

gross income with certain 

modifications not herein relevant. 

Since Maryland defines its taxable net 

income in terms of federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC for income 

from sources without the United 

States are apparently adopted into 

Maryland taxable income. Md. Tax & 

Rev. Code Ann. §§ 10-206, 10-401.

(2) The portion of a non-resident's 

federal adjusted gross income 

derived from sources within and 

without the state. Md. Tax & Rev. 

Code Ann. § 10-401.

Since Maryland computes its own 

taxable income from federal adjusted 

gross income, the exclusion under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently adopted into the 

computation of Maryland taxable 

income. Md. Tax & Rev. Code Ann.§ 

10-401

Military residents may deduct the first 

$15,000 of military pay attributable to 

military service outside the United 

States. This deduction is reduced 

dollar-for-dollar for each dollar earned 

over $15,000. Md. Tax & Rev. Code 

Ann.§ 10-207(p).

Military retirees with federal adjusted 

gross income under $22,500 may 

deduct $2,500 from taxable income 

subject to certain conditions. Md. Tax 

& Rev. Code Ann. 10-207(q).

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusions 

under §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on the portion of federal 

adjusted gross income 

derived from sources within 

Maryland.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

Michigan Residents and non-residents -- The term “resident” is 

defined as an individual domiciled in the state. “Domicile” 

is defined as the place where a person has his true, fixed, 

and permanent home and principal establishment to which, 

whenever absent therefrom, he intends to return, and 

domicile continues until another permanent establishment 

is established. If an individual lives in the state for at least 

183 days during the taxable year or more than _ the days 

during the taxable year of less than 12 months, he is 

deemed a resident individual domiciled in the state. Mich. 

Comp. L. Ann. § 206.18.

Non-resident -- The term “non-resident” is defined as any 

individual who is not a resident. Mich. Comp. L. Ann. § 

206.14.

See Soldiers' and Sailors' Civil Relief Act.

(1) The taxable income of residents 

defined as taxable income for federal 

income tax purposes. However, 

Michigan generally taxes only income 

allocable to certain activities and 

sources within Michigan. Also, since 

Michigan defines its taxable income 

for federal income tax purposes, the 

exclusions for income earned without 

the United States under §§ 911-912 of 

the IRC would apply. Mich. Comp. L. 

Ann. §§ 206.30, 206.110. 

(2) The taxable income of nonresidents to the extent allocable to 

sources within Michigan. Mich. 

Comp. L. Ann.§§ 206.51, 206.110.

Michigan allows the deduction, to the 

extent included in federal adjusted 

gross income, of compensation, 

including retirement benefits, received 

for services in the armed forces of the 

United States. Mich. Comp. L. Ann.§ 

206.30(e). 

Residents -- Subject to tax on 

federal adjusted gross 

income allocable to sources 

within Michigan above the 

exclusions of §§ 911-912 of 

the IRC.

Non-residents -- Subject to 

tax on taxable income 

allocable to sources within 

Michigan.

Military personnel -- Michigan 

does not tax military 

compensation or retirement 

income from service in the 

armed forces.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
2004–05 Voting Assistance Guide Probable State Income Tax Liability

359

Minnesota Residents and non-residents -- The term “resident” is 

defined as an individual domiciled in the state or any 

individual maintaining a place of abode within the state and 

who spends over half of the tax year in Minnesota. An 

individual is not a resident for the period of time that the 

individual is qualified under § 911(d)(1) of the IRC. Minn. 

Stat. § 290.01(7). 

The Minnesota Tax Regulations state that voting in 

Minnesota is presumptive evidence of residence, but may 

be overcome by facts contrary to the presumption of 

residence. Minn. Tax. Reg. 1.6001;

See Soldiers' and Sailors' Civil Relief Act.

The gross income of residents 

defined as federal adjusted gross 

income with certain modifications not 

herein relevant. Since Minnesota 

defines its gross income in terms of 

federal adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into the computation of 

Minnesota gross income. Minn. Stat. 

§§ 290.01(19) et seq.

The net income of non-residents 

allocable to sources within Minnesota. 

Min. Stat. §§ 290.01(22)(2); 

290.06(2c)(e).

Since Minnesota computes its own 

taxable income from federal adjusted 

gross income, the exclusion under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently adopted into 

computation of Minnesota taxable 

income. Minn. Stat. § 290.01

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusion 

under §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on federal adjusted gross 

income allocable to sources 

within Minnesota.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

Missouri Residents and non-residents -- The term “resident” is 

defined as an individual who is domiciled in this state, 

unless he (1) maintains no permanent place of abode in 

this state, (2) does maintain a permanent place of abode 

elsewhere, and (3) spends in the aggregate not more than 

thirty days of the taxable year in this state, or who is not 

domiciled in this state, but maintains a permanent place of 

abode in this state and spends the in the aggregate more 

than 183 days of the taxable year in this state. Mo. Stat. § 

143.101.

The term “non-resident” is defined as an individual who is 

not a resident of this state. Mo. Stat. §. 143.101.

See Soldiers' and Sailors' Civil Relief Act.

The Missouri taxable income of 

residents calculated on the basis of 

federal adjusted gross income with 

modifications. Since Missouri 

computes its taxable income from 

federal adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into the computation of 

Missouri taxable income. Mo. Stat. § 

143.121.

The income of non-residents derived 

from sources within Missouri. Mo. 

Stat. § 143.181(1).

Since Missouri computes its own 

taxable income from federal adjusted 

gross income, the exclusion under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently adopted into 

computation of Missouri taxable 

income. Mo. Stat. § 143.121

Residents -- Subject to tax on 

Missouri taxable income, 

which excludes income from 

sources without the United 

States in the same manner 

as §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on income derived from 

sources within Missouri.

Military personnel -- Subject 

to tax on payments for 

service in the armed services 

with stated exclusions.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

360

Nebraska Residents and non-residents -- The term “resident” is 

defined as an individual who is domiciled in the state or 

who maintains a permanent place of abode within the state 

and spends in the aggregate more than six months of the 

taxable year within the state. Neb. Rev. Stat. § 77-

2714.01(7).

The term “non-resident” is defined as an individual who is 

not a resident of this state. Neb. Rev. Stat.§ 77-

2714.01(4).

See Soldiers' and Sailors' Civil Relief Act.

(1) The entire taxable income of 

residents defined as federal taxable 

income with certain modifications not 

herein relevant. Neb. Rev. Stat. § 77-

2716. Since Nebraska computes its 

tax base in terms of federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC are apparently 

adopted.

(2) The federal adjusted gross income 

of non-residents derived from sources 

within Nebraska. Neb. Rev. Stat. § 

77-2733. 

The federal exclusion under § 112 of 

the IRC for compensation received for 

active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone or 

was hospitalized as a result of an 

injury incurred in such service is 

adopted specifically into the 

computation of Nebraska taxable 

income. Neb. Rev. Stat. § 77-27,123.

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusions 

under §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on federal adjusted gross 

income derived from sources 

within Nebraska.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

New York Residents and non-residents -- The term “resident” is 

defined as: (1) an individual who is domiciled in the state 

unless he maintains no permanent place of abode in the 

state and spends not over 30 days of the taxable year 

within the state, or he is present in a foreign country for at 

least 450 days of a 548 day period, and during such 548 

day period he is not in the state for more than 90 days and 

does not maintain a permanent place of abode in the state 

where his spouse or minor children are present for 90 days 

or more, and other conditions, or (2) an individual who is 

not domiciled in the state, but maintains a permanent place 

of abode within the state and spends in the aggregate 

more than 183 days of the taxable year within the state, 

unless such individual is in active service in the armed 

forces of the United States. N.Y. Tax Law § 605(b)(1).

The term “non-resident” is defined as an individual who is 

not a resident. N.Y. Tax Law § 605(b)(2).

See Soldiers' and Sailors' Civil Relief Act.

(1) The adjusted gross income of 

residents is defined as federal 

adjusted gross income with certain 

modifications not herein relevant. 

Since New York defines its own 

adjusted gross income in terms of 

federal adjusted gross income, the 

exclusions for income earned from 

sources without the United States are 

apparently adopted into the 

computation of New York adjusted 

gross income. N.Y. Tax Law. § 612.

(2) The federal adjusted gross income 

of non-residents derived from sources 

within New York. N.Y. Tax Law § 631.

Military compensation of one not 

domiciled in New York is not to be 

considered income derived from New 

York sources. N.Y. Tax Law § 631(e).

Since New York computes its own 

taxable income from federal adjusted 

gross income, the exclusion under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently adopted into the 

computation of New York taxable 

income. N.Y. Tax Law § 612.

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusion 

under §§ 911-912 of the IRC. 

Non-residents -- Subject to 

tax on federal adjusted gross 

income derived from sources 

within New York.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
2004–05 Voting Assistance Guide Probable State Income Tax Liability

361

North Dakota Residents and non-residents -- The term “resident” is 

defined as any natural person domiciled in the state and 

any other natural person who maintains a permanent place 

of abode within the State and spends in the aggregate 

more than seven months of the income year within the 

state. A full-time active duty member of the armed forces 

assigned to a military installation in this state, or the 

spouse of such a person, is not a resident simply by 

reason of voting in an election in the state. N.D. Code § 

57-38-01(6).

See Soldiers' and Sailors' Civil Relief Act.

(1) The taxable income of residents 

defined in terms of federal taxable 

income with certain modifications not 

herein relevant. Since North Dakota 

defines its own taxable income in 

terms of federal taxable income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into the computation of 

North Dakota taxable income. N.D. 

Code § 57-38-01.2.

Taxable income is reduced by: (a) an 

amount up to $1,000, received as 

payment for services performed while 

on active duty in the armed forces of 

the United States, as payment for 

attending military meetings as a 

member of the National Guard, or of a 

reserve unit; and (b) any amount up 

to $5,000 received by any person fifty 

years or older as retired military pay 

for service in the United States armed 

forces or reserve components 

thereof, reduced by any amount 

received pursuant to the Federal 

Social Security Act. N.D. Code § 57-

38-01.2(l). 

The net income of non-residents 

derived from sources within North 

Dakota. N.D. Code § 57-38-03.

Also, persons serving in the armed 

forces, except field grade and general 

officers who are stationed outside of 

any state or the District of Columbia 

for not less than thirty days during the 

tax year, shall be allowed an 

additional reduction of up to $300 per 

month for services performed while 

on active duty at such location. N.D. 

Code § 57-38-01.2(1)(k);.

Residents -- Subject to tax on 

federal taxable income above 

the exclusions under §§ 911-

912 of the IRC.

Non-resident -- Subject to tax 

on net income from sources 

within North Dakota.

Military personnel -- Taxable 

income is reduced by: (a) any 

amount up to $1,000, 

received by any person as 

payment for services 

performed while on active 

duty in the armed forces of 

the United States, or as 

payment for attending military 

meetings as a member of the 

National Guard, or of a 

reserve unit; and (b) any 

amount up to $5,000 

received by any person fifty 

years or older as retired 

military pay for service in the 

United States armed forces 

or reserve components 

thereof, reduced by any 

amount received pursuant to 

the Federal Social Security 

Act.

Also, persons serving in the 

armed forces, except field 

grade and general officers, 

who are stationed outside of 

any state or the District of 

Columbia for not less than 

thirty days during the taxable 

year, shall be allowed an 

additional reduction of up to 

$300 per month for services 

performed while on active 

duty at each location.

Ohio Residents and non-residents -- The term “resident” is 

defined as an individual who is domiciled in this state. 

Ohio Code tit. 57 § 5747.01(I). One is presumed domiciled 

in the state if one spent over 183 nights in the state during 

12 consecutive months. One is presumed not domiciled if 

one spent less than 120 nights in the state during 12 

consecutive months.. Ohio Code tit. 57 § 5747.24.

The term “non-resident” is defined as an individual who is 

not a resident. Ohio Code tit. 57 § 5747.01(J).

See Soldiers' and Sailors' Civil Relief Act.

The adjusted gross income of 

residents defined as federal adjusted 

gross income with certain 

modifications not herein relevant. 

Since Ohio defines its own adjusted 

gross income in terms of federal 

adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into the computation of Ohio 

adjusted gross income. Ohio Code 

tit. 57 § 5747.01(A).

The adjusted gross income on nonresidents derived from sources within 

Ohio. Ohio Code tit. 57 § 5747.01.

The federal exclusion under § 112 of 

the IRC for compensation received for 

active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone or 

was hospitalized as a result of an 

injury incurred in such service is 

adopted specifically into the 

computation of Ohio taxable income. 

Ohio Code tit. 57 § 5747.02.4.

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusions 

under §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on adjusted gross income 

derived from sources within 

Ohio.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

362

Oklahoma Residents and non-residents -- The term “resident” is 

defined as any individual who is domiciled in the state. Any 

individual who spends in the aggregate more than seven 

months of the taxable year within the state shall be 

presumed a resident. Okla. Stat. tit. 68 § 2353(4).

The term “non-resident individual” is defined as an 

individual, other than a resident individual with special 

provisions for foreign earned income. Okla. Stat. tit. 68 § 

2353(4).

See Soldiers' and Sailors' Civil Relief Act.

(1) The taxable income of residents 

defined on the basis of federal 

adjusted gross income with certain 

modifications not herein relevant. 

Since Oklahoma bases its taxable 

income on federal adjusted gross 

income, the exclusions under §§ 911-

912 of the IRC for income from 

sources without the United States are 

apparently adopted into the 

computation of Oklahoma taxable 

income. Okla. Stat. tit. 68 §§ 

2353(3), 2355.

(2) The federal adjusted gross income 

of non-residents derived from sources 

within Oklahoma. Okla. Stat. tit. 68 § 

2362.

(3) In any taxable year the first $1,500 

received by any person from the 

United States as salary or 

compensation in any form (other than 

a pension) as a member of any 

component of the armed forces of the 

United States shall be deducted from 

taxable income. Okla. Stat. tit. 68 § 

2358(D)(5).

Residents -- Subject to tax on 

taxable income above the 

exclusions under §§ 911-912 

of the IRC.

Non-residents -- Subject to 

tax on taxable income 

derived from sources within 

Oklahoma.

Military personnel -- Subject 

to tax on military 

compensation above the first 

$1,500.

Rhode Island Residents and non-residents -- The term “resident” is 

defined to include both (1) domiciliaries, and (2) nondomiciliaries who maintain a permanent place of abode 

within the state and reside in the state for more than 183 

days of the taxable year other than as a member of the 

armed forces of the United States. R.I. Gen. Laws § 44-

30-5(a).

The term non-resident is defined as an individual who is 

not a resident. R.I. Gen. Laws § 44-30-5(b).

See Soldiers' and Sailors' Civil Relief Act.

(1) The Rhode Island income of 

residents is defined as federal 

adjusted gross income with certain 

modifications not herein relevant. 

Since Rhode Island defines its own 

taxable income in terms of federal 

adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC are apparently adopted into the 

computation of Rhode Island taxable 

income. R.I. Gen. Laws § 44-30-

12(a).

(2) The taxable income on nonresidents derived from sources within 

Rhode Island. R.I. Gen. Laws § 44-

30-32(a).

Since Rhode Island computes its own 

taxable income from federal adjusted 

gross income, the exclusions under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently adopted into the 

computation of Rhode Island taxable 

income. R.I. Gen. Laws § 44-30-12.

Residents -- Subject to tax on 

taxable income above the 

exclusions under §§ 911-912 

of the IRC.

Non-residents -- Subject to 

tax on taxable income 

derived from sources within 

Rhode Island.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
2004–05 Voting Assistance Guide Probable State Income Tax Liability

363

South 

Carolina

Resident and non-resident -- The term “resident” means 

any individual who is domiciled in the state. The term 

“non-resident” means an individual other than a resident or 

part year resident. S.C. Code § 12-6-30(2).

Resident - the entire taxable income 

on the basis of federal adjusted gross 

income with certain modifications, 

S.C. Code § 12-6-560. No exclusion 

under § 912 is allowed. S.C. Code § 

12-6-1120(5). Non-resident - subject 

to tax on property owned or business 

carried on in South Carolina. S.C. 

Code § 12-6-1720.

Retirees may deduct up to $3,000 of 

retirement income that is taxable by 

South Carolina or irrevocably choose 

to defer annual retirement income 

deduction until the year the taxpayer 

reaches sixty-five years of age. S.C. 

Code § 12-6-1170(1).

Since South Carolina computes its 

own taxable income from federal 

adjusted gross income, the 

exclusions under § 112 of the IRC for 

compensation received for active 

service as a member of the armed 

forces of the United States for any 

month during which such member 

served in a combat zone or was 

hospitalized as a result of an injury 

incurred in such service is apparently 

adopted into the computation of 

South Carolina taxable income. S.C. 

Code § 12-6-560.

Residents -- Subject to tax on 

taxable income above the 

exclusion under § 911 of the 

IRC.

Non-residents -- Subject to 

tax on taxable income 

derived from sources within 

South Carolina.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exclusions.

Utah Residents and non-residents -- The term “resident” is 

defined to include domiciliaries, and individuals not 

domiciled in the state and residing within the state in the 

aggregate for over 183 days of the taxable year. Utah 

Code § 59-10-103(j).

The term non-resident is defined as an individual who is 

not a resident of the state. Utah Code § 59-10-103(g).

See Soldiers' and Sailors' Civil Relief Act.

(1) The taxable income of residents is 

defined in terms of federal taxable 

income with certain modifications not 

herein relevant. Since Utah defines 

its own taxable income in terms of 

federal taxable income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into Utah taxable income. 

Utah Code §§ 59-10-104 & 112.

Since Utah computes its own taxable 

income from federal taxable income, 

the exclusion under § 112 of the IRC 

for compensation received for active 

service as a member of the armed 

forces of the United States for any 

month during which such member 

served in a combat zone or was 

hospitalized as a result of an injury 

incurred in such service is apparently 

adopted into the computation of Utah 

taxable income. Utah Code §§ 59-10-

104 & 116.

Residents -- Subject to tax on 

taxable income above the 

exclusions under §§ 911-912 

of the IRC.

Non-residents -- Subject to 

tax on taxable income 

derived from sources within 

Utah.

Military personnel -- Subject 

to tax on military pay with 

stated exclusions.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

364

Vermont Residents -- The term “resident” is defined to include both 

(1) domiciliaries, and (2) non-domiciliaries who maintain a 

permanent place of abode within the state and reside 

within the state for more than 183 days of the taxable year. 

Vt. Stat. tit. 32 § 5811(11)(A)(i), (ii).

Non-resident -- anyone not a resident. Vt. Stat. tit. 32 § 

5811(9).

See Soldiers' and Sailors' Civil Relief Act.

(1) The adjusted gross income of 

residents is defined as federal 

adjusted gross income. Since 

Vermont defines its adjusted gross 

income in terms of federal adjusted 

gross income, the exclusions under 

§§ 911-912 of the IRC for income 

from sources without the United 

States are apparently adopted into 

the computation of Vermont adjusted 

gross income. Vt. Stat. tit. 32, §§ 

5811(1), 5822, 5823.

(2) The adjusted gross income of nonresidents derived from sources within 

Vermont. Vt. Stat. tit. 32, § 5823.

(3) Adjusted gross income does not 

include military pay for full-time active 

duty with the armed services outside 

of the state. Vt. Stat. tit. 32 § 

5823(a)(2).

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusions 

under §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on federal adjusted gross 

income derived from sources 

within Vermont.

Military personnel -- Not 

subject to tax on military pay 

for full-time active duty 

service performed outside of 

the state.

Virginia Residents and non-residents -- The term “resident” is 

defined as an individual domiciled in the Commonwealth 

and a person who maintains an abode in the state for more 

than 183 days of the taxable year. Va. Code § 58.1-302.

Persons in the armed forces of the United States stationed 

on military or naval reservations within Virginia who are not 

domiciled in Virginia and who maintain no place of abode 

in Virginia shall not be held liable to income taxation for 

compensation received from military or naval service. Va. 

Code § 58.1-321(B).

(1) The taxable income of residents 

defined in terms of federal adjusted 

gross income with certain 

modifications not herein relevant. 

Since Virginia defines its taxable 

income in terms of federal adjusted 

gross income, the exclusion under §§ 

911-912 of the IRC are apparently 

adopted into the computation of 

Virginia taxable income. The first 

$15,000 of military pay is excluded 

from income, with a dollar for dollar 

reduction in the exclusion for income 

over $15,000. Va. Code § 58-1-322.

(2) The taxable income of nonresidents derived from sources within 

the state. Va. Code § 58-1-325.

The federal exclusion under § 112 of 

the IRC for compensation received for 

active service as a member of the 

armed forces of the United States for 

any month during which such 

member served in a combat zone or 

was hospitalized as a result of an 

injury incurred in such service is 

specifically adopted into the 

computation of Virginia taxable 

income. Va. Code § 58-1-322.

Virginia grants a tax credit for taxes 

paid to a foreign country on retirement 

income. Va. Code § 58-1-332.1.

Residents -- Subject to tax on 

federal adjusted gross 

income above the exclusion 

under §§ 911-912 of the IRC.

Non-residents -- Subject to 

tax on taxable income 

derived from sources within 

the state.

Military personnel -- Subject 

to tax on military pay with 

stated exclusions.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
2004–05 Voting Assistance Guide Probable State Income Tax Liability

365

West Virginia Residents and non-residents -- The term “resident” is 

defined to include: (1) domiciliaries, unless they maintain 

no permanent place of abode within the state, maintain a 

permanent place of abode outside the state, and spend not 

more than 30 days of the taxable year in the state, and (2) 

non-domiciliaries who maintain a permanent place of 

abode within the state and reside within the state for more 

than 183 days of the taxable year. W. Va. Code § 11-21-

7(a).

“Non-resident” is defined to mean an individual who is not 

a resident. W. Va. Code § 11-21-7(b).

See Soldiers' and Sailors' Civil Relief Act.

(1) The taxable income of residents 

defined in terms of federal adjusted 

gross income with modifications not 

herein relevant. Since West Virginia 

defines its own taxable income in 

terms of federal adjusted gross 

income, the exclusions under §§ 911-

912 of the IRC for income from 

sources outside the United States are 

apparently incorporated into the 

definition of West Virginia taxable 

income. W. Va. Code §§ 11-21-11(a), 

12.

(2) The taxable income of nonresidents derived from sources within 

West Virginia. W. Va. Code §§ 11-21-

30, 32.

Since West Virginia computes its own 

taxable income from federal adjusted 

gross income, the exclusion under 

Section § 112 of the IRC for 

compensation received for active 

service as a member of the armed 

forces of the United States for any 

month during which such member 

served in a combat zone or was 

hospitalized as a result of an injury 

incurred in such service is apparently 

adopted into computation of West 

Virginia taxable income. W. Va. Code 

§ 11-21-11

Residents -- Subject to tax on 

taxable income above the 

exclusions under 911-912 of 

the IRC.

Non-residents -- Subject to 

tax on taxable income 

derived from sources within 

West Virginia.

Military personnel -- Subject 

to tax on such compensation 

with stated exclusions.

Wisconsin Residents and non-residents -- The term “resident” is 

defined as a domiciliary. Wis. Stat. § 71.02(1).

See Soldiers' and Sailors' Civil Relief Act.

(1) The taxable income of residents 

defined in terms of federal adjusted 

gross income with certain 

modifications not herein relevant. 

Since Wisconsin defines its own 

taxable income in terms of federal 

adjusted gross income, the 

exclusions under §§ 911-912 of the 

IRC for income from sources without 

the United States are apparently 

adopted into the computation of 

Wisconsin taxable income. Wis. Stat. 

§§ 71.01(13) & 71.05.

(2) The taxable income of nonresidents derived from sources within 

Wisconsin. Wis. Stat. §§ 71.01 & 

71.02. Non-residents domiciled 

without Wisconsin who derive income 

from performing personal services 

within Wisconsin shall be excluded 

from having to pay Wisconsin tax to 

the extent that the home domicile 

taxes the income. Wis. Stat. § 

71.05(2).

Since Wisconsin computes its own 

taxable income from federal adjusted 

gross income, the exclusion under § 

112 of the IRC for compensation 

received for active service as a 

member of the armed forces of the 

United States for any month during 

which such member served in a 

combat zone or was hospitalized as a 

result of an injury incurred in such 

service is apparently adopted into 

computation of Wisconsin taxable 

income. Wis. Stat. § 71.05.

Residents -- Subject to tax on 

taxable income above the 

exclusions under §§ 911-912 

of the IRC.

Non-residents -- Subject to 

tax on taxable income 

derived from sources within 

Wisconsin.

Military personnel -- Subject 

to tax on military 

compensation with stated 

exemption.

III. States Exempting Income Earned Abroad to the Same Extent as Federal Law

(Sections 911-912 of the Internal Revenue Code)

State Income Tax Coverage Tax Base Probable Tax Obligation
Probable State Income Tax Liability 2004–05 Voting Assistance Guide

366

IV. States Having No Income Tax

STATES: Alaska

Florida

Nevada

South Dakota

Texas

Washington

Wyoming
367

APPENDIX F

DEFINITIONS

These definitions are conventional explanations; they may vary depending on state law.

Affidavit

A sworn statement in writing, usually made under oath or

affirmation, before an authorized officer, notary or court

official.

Attest

To witness the signing of a document.

Ballot

A sheet of paper or the like on which a voter marks his or

her choice. 

Closed Primary

A primary election in which a voter must declare a political

party affiliation and vote that party's ballot in the primary

election. 

Congressional District

A division of a state, based on population, electing one

member to the U.S. House of Representatives. There are

435 Congressional districts in the United States. 

Constituent

Those citizens who are represented by the office holder

they elect.

Constitutional Amendment

A proposed change or addition to a state constitution.

Domicile (Voting Residence)

The place where a person has a true, fixed, and permanent

home or ties, and to which, whenever absent, has the

intention of returning. It is the address that generally ties the

voter into the precinct in which the voter intends to vote. 

Elector

A qualified voter. Also used for the 538 members of the

Electoral College.

Electoral Vote

The votes cast for President and Vice President by

presidential electors in what is known popularly as the

Electoral College. The total electoral vote is 538, with 270

needed to win the election. Traditionally, by law or custom,

the candidate who wins the most popular votes in a state

wins all of that state's electoral votes.

Electronic Transmission Service

Processing center which electronically routes applications

for registration and ballots to local election officials; blank

ballots to voters; and voted ballots to local election officials,

as prescribed by state laws. The Service is administered by

the Federal Voting Assistance Program. 

Family Member

Based on the UOCAVA language we can define a “family

member” as “a spouse or dependent of a member of the

uniformed services or the merchant marine, who is absent

from the place of residence where the spouse or dependent

is qualified to vote by reason of the active duty or service of

the uniformed services or merchant marine member.” 

Federal Ballot

Lists candidates for Federal office only — President/Vice

President, Senator, and member of the U.S. House of

Representatives. 

Federal Post Card Application

A simultaneous registration and absentee ballot request

used by U.S. citizens voting pursuant to the Uniformed and

Overseas Citizens Absentee Voting Act.

Federal Write-In Absentee Ballot

A special ballot, available from Voting Assistance Officers,

enabling voters to write in their candidate preference for

President/Vice President, U.S. Senate, and U.S.

Representative/Delegate. Some states have expanded use of

this form beyond these offices. Consult Chapters 2 and 3 of

this Guide for details. 

Full Ballot

Lists candidates for Federal, state and local office plus local

questions and issues.

General Election

An election held to choose candidates nominated in the

primary (or by convention or caucus), for Federal, state, and

local office. 
Definitions 2004–05 Voting Assistance Guide

368

Majority

A number greater than half of the total votes cast.

Members of the Merchant Marine

Crew members of ships registered under the U.S. flag,

including persons in training or enrolled to be crew

members, but in most states not including those on ships

confined to the Great Lakes and inland waters. Students of

the Merchant Marine Academy are not included.

Members of the Uniformed Services

Members of the U.S. Army, Navy, Marine Corps, Air Force,

Coast Guard, and the commissioned corps of the Public

Health Service and the National Oceanic and Atmospheric

Administration. This includes Cadets and Midshipmen of

the Service academies. 

Municipal Election

An election held in a city or town to vote for local officials

or on questions of local interest.

Notary Public

A notary public (notary) is a public officer who is

commissioned to administer oaths and authenticate

signatures.

Open Primary

A primary election in which voters may vote for the

candidates of any party listed on the ballot. 

Party Platform

A statement of basic principles put forth by a political party,

usually at its national convention, to be adopted by its

candidates in the election campaign.

Plurality 

The number of votes cast for a candidate who obtains the

greatest number of votes, though not a majority, in a contest

of more than two candidates.

Popular Vote

The numerical vote of the people, as distinguished from the

electoral vote.

Presidential Electors

In the Presidential election held the first Tuesday after the

first Monday in November of every fourth year, each state

chooses as many presidential electors as it has Senators and

Representatives in Congress. The District of Columbia

chooses three presidential electors. The electors comprise

the Electoral College, which elects the President and Vice

President, the only elective Federal officials not elected by

direct majority vote of the people.

Primary or Primary Election

An election held before a general election to nominate a

political party's candidates for office. In some states, other

officials, such as delegates to party conventions, are elected

at this time. Dates for primaries are set by the states and

vary from state to state. In some, a separate primary is held

by each of the principal parties; in others, only the major

political parties hold a primary.

Proxy

A person authorized to request or complete registration

forms or to obtain an absentee ballot on behalf of another

person. A proxy may not cast a ballot for another person.

Referendum 

A method of submitting a legislative measure to the voters

for approval or rejection.

Registration

The process whereby a prospective voter is required to

establish identity and residence prior to an election in order

to be declared eligible to vote.

Residence 

The place where a person currently resides, regardless of an

intent to remain there permanently. 

(see Domicile above)

Runoff

An election held in some states if no one candidate for an

office receives a majority (or specified percentage) of votes

to win the election.

Special Election

An election that is specially scheduled to fill an office that

has become vacant before the term of its expiration.

State

For purposes of this Guide, “state” includes all of the

following political jurisdictions: 

a. The 50 states 

b. The District of Columbia

c. The Commonwealth of Puerto Rico

d. The territories of American Samoa, Guam, and the

Virgin Islands.
2004–05 Voting Assistance Guide Definitions

369

State Special Write-In Absentee Ballot

Available from local election officials and used by certain

voters who know in advance that they will not be able to

receive and return the regular absentee ballot in time to be

counted because of their remote location or special

assignment.

Sworn To

A statement “sworn to” is one made under oath or

affirmation before a notary or other authorized person that

the statement is true.

Voting Residence

The voter's domicile, generally. However, the voting

residence of a U.S. citizen voting pursuant to the Uniformed

and Overseas Citizens Absentee Voting Act and no longer

domiciled in the United States will be the place in which he

or she was last domiciled immediately prior to his or her

departure from the United States.

Write-In

A method of voting for a person whose name is not on the

ballot. Federal and state write-in absentee ballots are

available — see your Voting Officer and State Guide pages

for details.

371

FVAP TOLL-FREE PHONE AND FAX NUMBERS FROM OVERSEAS

When local assistance is unavailable, please call the Federal Voting Assistance Program. During non-business hours, citizens

may leave a message. When doing so, please leave sufficient information to allow us to get back in touch with you in a timely

manner. Tell us what country you are calling from, a complete telephone number including international prefixes, and your email address (if available).

The United States, Canada, Guam, Puerto Rico and the U.S. Virgin Islands share one set of Toll-Free Numbers:

Phone: 1-800-438-8683, Fax: 1-800-368-8683

These toll-free numbers are current as of September 2003. Check the FVAP website at www.fvap.gov for updates.

COUNTRY TELEPHONE NUMBER FAX NUMBER

American Samoa 633-2872, then dial 800-323-8180 Not available

Antigua 1-8778333886 Not available

Australia 1-800-127-668 1-800-887-858

Austria 0800-293478 0800-292502

Bahamas 1-8778333886 1-8665605844

Bahrain 800-687 800-921

Barbados 1-800-534-2104 Not available

Belgium 0800-76834 0800-72216

Bermuda 1-8778333886 Not available

Brazil 000814-550-3742 00081-4-550-4354

Canada 1-800-438-8683 1-800-368-8683

Cayman Islands 1-8778333886 Not available

Chile 800-201844 123-0-020-2892

China 10-800-120-0241 10-800-120-0855

Colombia 01-980-915-4710 01-800-915-5253

Costa Rica 0800-0120204 0800-012-1163

Denmark 80-882544 8088-4568

Dominican Republic 1-8001561554 1-8881562004

Finland 0-800-1-19515 0-800-1-17346

France 0800-917-304 0800-916-557

Germany 0800-1007428 0800-1002793

Greece 00800-12-5268 00800-12-5816

Guyana 1-8778333886 1-8665605844

Hong Kong 800-908809 800-968820

Hungary 06-800-13824 06-800-14980

Indonesia 001-803-011-2583 001-803-011-3094

Ireland 1-800-55-5189 1-800-300015

Israel 1-800-9203230 1-800-9213783

Italy 800-874729 800-783943

Jamaica 1-800-6663819 1-800-9266606

Japan 00531-120076 00531-1-20833

Japan - Yokohama 00531-1208-96 Not available

Korea 00798-14-800-4399 00798-14-800-5648

Latvia 800-0154 800-0069

Luxembourg 8002-9087 Not available

Malaysia 1-800-80-3709 Not available

Marshall Islands 1-8778333886 Not available

Mexico 001-8778333886 001-8665605844

Netherlands Antilles 001-8778333886 Not available

Netherlands 0800-0249769 0800-0223962

New Zealand 0800-441388 0800-445874

Nicaragua 001-800-2201349 001-800-2201638

Norway 800-15501 800-18037

Panama 001-800-5071351 001-800-507-1671

Philippines 105-11, then dial 800-323-8180 Not available

Poland 0-0-800-1112-561 00-800-1112004

Portugal 08008-12816 800-8-12463

Russia 8-10-8002-0283011 Not available

Singapore 800-1203425 800-1203862

South Africa 080-09-97300 080-09-90857

Spain 900-961-668 900-961800

St. Kitts & Nevis 1-8778333886 Not available

St. Lucia 1-877-833-3886 1-866-560-5844

St. Vincent 1-877-8333886 Not available

Sweden 020-79-6876 020-79-1472

Switzerland 0800-895623 0800-564752

Taiwan 0080-13-9817 00801-13-7287

Thailand 001-800-12-0663305 001-800-12-066-4459

Trinidad & Tobago 1-800-934-7340 Not available

Turkey 008 00151 1163 00-800-151-1139

United Kingdom 08-001698035 08-000280262

United States 1-800-438-8683 1-800-368-8683

Uruguay 000-413-598-2492 000-413-598-2820

Venezuela 0800 100 3602 Not available