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STATE OF OHIO
MONTGOMERY COUNTY BOARD OF ELECTIONS
ABSENTEE BALLOT APPLICATION FORM

GENERAL INSTRUCTIONS AND INFORMATION


Use of this form is optional. To be valid, an application must include the voters name, voting residence address, date of birth, and signature; the election for which the ballot is requested and, if a partisan primary election, the voters political party affiliation; and one of the following: Ohio Driver's license number, last 4 digits of voter's social security number, or a copy of the voter's current and valid photo identification or a copy of a current utility bill, bank statement, government check, paycheck or other government document that shows the voter's name and address.

An application by mail must be received by your County Board of Elections by noon on the third day before the election. Applications by the voter in person must be received by the close of regular board office hours the day before the election. Applications for persons who are hospitalized by a medical emergency will be accepted until 3 p.m. on Election Day.

Your completed ballot must be delivered to your County Board of Elections in person by you or a near relative, or by mail not later than the close of polls on Election Day. Exception: If the voter is outside of the United States on election day, the ballot envelope must signed or postmarked prior to the close of polls and received by the board no later than 10 days after the election or 20 days after the presidential primary election.

If you request an absentee ballot, you will not be allowed to vote a regular ballot or turn in your voted absentee ballot at the polling place on Election Day. You may vote a provisional ballot at the polling location. Your provisional ballot will only be counted if your absentee ballot is never returned.

This document may be reproduced.

Once you have submitted your information, your ABSENTEE BALLOT APPLICATION form will appear on your screen. Print your application form.

DO NOT FORGET TO SIGN AND DATE YOUR ABSENTEE BALLOT APPLICATION FORM BEFORE MAILING IT TO THE BOARD OF ELECTIONS.

Please mail to:
Montgomery County Board of Elections
Absentee Ballot Department
P.O. Box 8705
Dayton, Ohio 45481-8705

Please read the entire form before you complete it.

Applicant's Name
Home Address
City, Village, or Post Office
County
Zip code
Mail Ballot To (if different from home address):
Name/Care of
Address
P.O. Box
City
State
Zip code
 
You MUST provide your birthdate: (enter MM/DD/YYYY) AND ONE of the following:
  • Your OHIO driver's license number:
  • OR: The last 4 digits of your social security number:
  • OR: Copy of current and valid photo identification, a current utility bill, bank statement, government check, paycheck or other government document that shows your name and address.

I wish to vote in the following election:

All Elections in 2008
Primary Election:
March 4, 2008

Party:
Democrat
Republican
Issues Only
Other Party (specify)


General Election:
November 4, 2008

Special Election:
August 5, 2008

DO NOT FORGET TO SIGN AND DATE YOUR ABSENTEE BALLOT APPLICATION FORM BEFORE MAILING IT TO THE BOARD OF ELECTIONS.

PLEASE CLICK ON THE "PREVIEW ABSENTEE FORM AND PRINT" BUTTON TO VIEW THE FORM. THEN USE YOUR PRINT FUNCTION IN ORDER TO PRINT THE FORM THAT WILL BE MAILED TO THE MONTGOMERY COUNTY BOARD OF ELECTIONS.