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Your State may require you to specify a political party to vote in primary elections: Email

County

Previous name (if applicable)

5 7

Some States require your

full SSN. Check your State's pages in the Voting Assistance

Guide on FVAP.gov.

Contact

information

Include international

Ballot receipt

2 6 4

Last name

First name

Apt. #

3Legal name

City/Town/Village

Street Address Voting residence address

Usually your last U.S.

residence or your legal U.S. residence. See instructions.

Where to send my

ballot

This is your current mailing

address and should be different from above. If required, place a forwarding 8

Please print in black ink.

1

Make only 1 selection.

(In most States, you must be absent from your voting district to use this form). I am an activated National Guard member on State orders. I prefer to receive my ballot, as permitted by my State, by: I am a member of the Uniformed Services or Merchant Marine on active duty OR ), OMB No. 0704-0503

Birth date

DD

MMYYYY

Additional

requirements for your State

Such as: mail forwarding

address, additional email address/phone number, or other State required information. See Voting

Assistance Guide.

You must sign and send in.

knowledge. I understand that a material misstatement of fact in completion of this Witness signature / date if required by your State.

Middle name

I am an eligible spouse or dependent.

Email/Online

Telephone

State

Zip Code

OR Social Security Number

Mail

Signature

For any questions about this form, consult the Voting

Assistance Guide available in hard copy or on

FVAP.gov

I request an absentee ballot for all elections in which I am eligible to vote :

Signature

MMDDYYYY

Today's date MF

Political party

X outside the U.S.

Federal Post Card Application (FPCA)

See instructions

Instructions for Federal Post Card Application

Voter Registration and Absentee Ballot Request

The gray numbers and instructions below correspond to the gray numbered boxes on the face of the form.

1 one that best represents your current situation. 2 political party. 3 The information you enter for your name should match the information you normally put on legal or 4 While 5 or phone number in Box 9 if necessary. 6 7 8 unless you enter a forwarding address in Box 9. 9 From To International airmail postage is required if not mailed in the

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the Voting

FVAP.gov

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