CITY OF HOMER
ABSENTEE BALLOT APPLICATION
You may mail this application or drop it off at City Hall-491 E. Pioneer Avenue, Homer, Alaska, 99603. You
may also fax it to 907-235-3143, or email it to clerk@ci.homer.ak.us
Applications will not be accepted
without a signature per HCC 4.30.030(1)
Please Print or Type and only one person per form/request.
Name:
Phone Number:
City of Homer, Alaska Residential Address:
(Physical Address Only. No PO Boxes)
Send my ballot to the following address:
OR
Fax Number:
OR
Email:
This application is for the following City of Homer elections:
General Municipal Election Run-Off Election Special Election
General Elections are held the first Tuesday in October; Run-Off Elections are scheduled if needed on the first Tuesday after the
first Monday in November; Special elections are scheduled as needed.
Voter Identification: You must provide at least one of the following:
Voter Registration Number Birth Date:
Last 4 numbers of your Social Security No.
Oath:
I declare that I am a legal resident of the City of Homer, Alaska and possess the qualifications of a legal
voter of the State and City.
Signature: Date:
Your signature is required for this application to be valid.
OFFICE USE ONLY
District/Precinct
Date Ballot Sent or Faxed
Date Ballot Received
Comments
click to sign
signature
click to edit
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