Absentee Ballot Application Form

Voter's Last Name * Last Name Required
Voter's First Name * First Name Required
Home Address * Home Address Required
Apt./Unit #
City * City Required
State OHIO
Zip * Zip Code Required
County * County Required
Send Ballot to: (If different from home address or if P.O. Box must be used)
C/O Name
Address
Apt./Unit #
P.O. BOX
City
State
Zip

BIRTHDATE
Month Day Year
     

AND ONE OF THE FOLLOWING:

Ohio Drivers License Number   
Where is my Drivers License Number?
Last Four Digits of your Social Security Number  
Copy of a current and valid photo identification, a military identification, or a current (within the last 12 months) utility bill, bank statement, government check, paycheck, or other government document (other than a notice of voter registration mailed by a board of elections) that shows your name and current address.

 


I wish to vote in the following election:

*Please make a selection


This information is not required, however it will assist the Board of Elections in contacting you if there is a problem with your application.

Phone  
Email