Fill - Free fillable FORM AV-R1: APPLICATION FOR ABSENTEE BALLOT PDF form

Primary Election or Presidential Preference Primary

Select one:

APPLICATION FOR ABSENTEE BALLOT

______________________ COUNTY, ALABAMA

I hereby make application for an absentee ballot so that I may vote in the following election:

I am applying for an absentee ballot because (check at least one box):

I expect to be out of the county or the state on election day.

I have a physical illness or inrmity which prevents my attendance at the polls. [ID Required]

*I have a physical illness or inrmity which prevents my attendance at the polls. I am unable to access my assigned polling place due to a

neurological, musculoskeletal, respiratory (including speech organs), cardiovascular, or other life-altering disorder that affects my ability to

perform manual tasks, stand for any length of time, walk unassisted, see, hear or speak and:

a) I am an elderly voter aged 65 or older; or

b) I am a voter with a disability.

*[ID Not Required]

I expect to work a shift which has at least ten (10) hours that coincide with the polling hours at my regular polling place.

I am enrolled as a student at an educational institution located outside the county of my personal residence,

attendance at which prevents my attendance at the polls.

I am a member of, or a spouse or dependent of a member of, the Armed Forces of the United States or am otherwise similarly qualied to vote

absentee pursuant to the Uniformed and Overseas Citizens Absentee Voting Act, 52 U.S.C. § 20302. [ID Not Required]

This application for an absentee ballot will be valid for all county, state, and federal elections held during this calendar year unless you

specify an earlier expiration date here: _______________________________.

I have been appointed as an election ofcer at a polling place which is not my regular polling place.

I am a caregiver for a family member to the second degree of kinship by afnty or consanguinity and the family member is conned to his or her

home.

I am currently incarcerated in prison or jail and have not been convicted of a felony involving moral turpitude. (See back for felonies involving

moral turpitude.)

Democratic Party

Mail my ballot to the address where I regularly receive mail, if different from the street address provided above

Precinct where you vote (name and/or location of your polling place)

Work Telephone Number

Date of Birth

Home Telephone Number

General Voter Information - Please provide complete information so that we may verify your eligibility to vote.

Republican Party

Other ____________

Amendments Only

General Election Special Election (specify) __________________________

For all registered voters

n Absentee ballots for elections more than 42 days apart must be requested on separate applications, unless you are a member of the

armed forces, or a spouse or dependent of such person, or you are a United States citizen residing overseas, or are permanently

disabled.

n An application submitted by a member of the armed forces, or a spouse or dependent of such person, or a United States citizen

residing overseas is valid for all county, state and federal elections in the current calendar year. An application submitted by a citizen

with a permanent disability is valid for all municipal, county, state, and federal elections in the current calendar year.

Street Address (address where you are registered to vote; do not use PO box) City ZIP

YearDayMonth

( )

Last Name (Please print)

First Name

Middle or Maiden Name

Driver’s License Number

STATE

NUMBER

IF NO DRIVER’S LICENSE NUMBER

Last 4 digits of

Social Security

number

E-mail Address

FORM AV-R1

Date Revised 09/03/2019

State

Primary Runoff Election

Select one:

Democratic Party

Republican Party

Other ____________

Amendments Only

Democratic Party

Republican Party

If a primary or runoff, check one:

Please note that a copy of your valid photo identication must be submitted along with this application.

When I apply for this absentee ballot, I understand that my name will be stricken from the list of qualied electors and, when I cast this

absentee ballot, I understand that I will not be entitled to vote at my regular polling place.

The voter may hand this application to the Absentee Election Manager. The voter may also forward this application to the Absentee Election Manager by U.S.

Mail or commercial carrier [§17-11-3 and §17-11-4, Code of Alabama, 1975].

READ PENALTIES ON BACK

Voter’s Signature

Witness Signature

Print Witness Name

Complete this

section if voter

signs by mark



Revised 2019.06.18

Please note that only one application may be placed in the same envelope.

Return this application to:

CRIMES INVOLVING MORAL TURPITUDE

Pursuant to Code of Alabama (1975) Section 17-3-30.1

• Murder – Section 13A-5-40 (A) 1-19

• Murder (Non-Capital, Reckless, Felony Murder, etc.) – Section

13A-6-2

• Manslaughter – Section 13A-6-3 Exceptions: 13A-6-20 (A) (5)

and 13A-6-21

• Assault 1st Degree – Section 13A-6-20

• Assault 2nd Degree – Section 13A-6-21

• Kidnapping 1st Degree – Section 13A-6-43

• Kidnapping 2nd Degree – Section 13A-6-44

• Rape 1st Degree – Section 13A-6-61

• Rape 2nd Degree – Section 13A-6-62

• Sodomy 1st Degree – Section 13A-6-63

• Sodomy 2nd Degree – Section 13A-6-64

• Sexual Torture – Section 13A-6-65.1

• Sexual Abuse 1st Degree – Section 13A-6-66

• Sexual Abuse 2nd Degree – Section 13A-6-67

• Sexual Abuse of a child less than 12 years old – Section 13A-6-

69.1

• Enticing a child to enter a vehicle, house, etc. for immoral pur-

poses – Section 13A-6-69

• Facilitating solicitation of unlawful sexual conduct with a child –

Section 13A-6-121

• Electronic solicitation of a child – Section 13A-6-122

• Facilitating the on-line solicitation of a child – Section 13A-6-123

• Traveling to meet a child for an unlawful sex act – Section 13A-

6-124

• Facilitating the travel of a child for an unlawful sex act – Section

13A-6-125

• Human Trafcking 1st Degree – Section 13A-6-152

• Human Trafcking 2nd Degree – Section 13A-6-153

• Terrorism – Section 13A-10-152

• Soliciting or providing support for an act of terrorism – Section

13A-10-153

• Hindering prosecution of terrorism – Section 13A-10-154

• Endangering the water supply – Section 13A-10-171

• Possession, manufacture, transport, or distribution of a destructive

device or bacteriological weapon, or

biological weapon – Section 13A-10-193

• Selling, furnishing, giving away, delivering, or distribution of a

destructive device, a bacteriological

weapon, or biological weapon to a person who is less than 21 years

of age – Section 13A-10-194

• Possession, manufacture, transport, or distribution of a detonator,

explosive, poison, or hoax device –

Section 13A-10-195

• Possession or distribution of a hoax device represented as a

destructive device or weapon –

Section 13A-10-196 (c)

• Attempt to commit an explosives or destructive device or bacterio-

logical or biological weapons crime –

Section 13A-10-197

• Conspiracy to commit an explosives or destructive device or bacterio-

logical or biological weapons crime –

Section 13A-10-198

• Hindrance or obstruction during detection, disarming, or destruction

of a destructive device or weapon –

Section 13A-10-199

• Possession or distribution of a destructive device or weapon intended

to cause injury or destruction –

Section 13A-10-200

• Treason – Section 13A-11-2

• Dissemination or public display of obscene matter containing visual

depiction or persons under 17 years of

age involved in obscene acts – Section 13A-12-191

• Possession and possession with intent to disseminate obscene matter

containing visual depiction of persons

under 17 years of age involved in obscene acts – Section 13A-12-192

• Parents or guardians permitting children to engage in production of

obscene matter – Section 13A-12-196

• Production of obscene matter containing visual depiction of persons

under 17 years of age involved in

obscene acts – Section 13A-12-197

• Distribution, possession with intent to distribute, production of ob-

scene material, or offer or agreement to

distribute or produce – Section 13A-12-200.2

• Trafcking in cannabis, cocaine, or other illegal drugs or trafcking in

amphetamine and

methamphetamine – Section 13A-12-231

• Bigamy – Section 13A-13-1

• Incest – Section 13A-13-3

• Torture or other willful maltreatment of a child under the age of 18 –

Section 26-15-3

• Aggravated child abuse – Section 26-15-3.1

• Prohibited acts in the offer, sale, or purchase of securities – Section

8-6-17

• Burglary 1st Degree – Section 13A-7-5

• Burglary 2nd Degree – 13A-7-6

• Theft of Property 1st Degree – Section 13A-8-3

• Theft of Property 2nd Degree – Section 13A-8-4

• Theft of Lost Property 1st Degree – Section 13A-8-7

• Theft of Lost Property 2nd Degree – Section 13A-8-8

• Theft of trademarks or trade secrets – Section 13A-8-10.4

• Robbery 1st Degree – Section 13A-8-41

• Robbery 2nd Degree – Section 13A-8-42

• Robbery 3rd Degree – Section 13A-8-43

• Forgery 1st Degree – Section 13A-9-2

• Forgery 2nd Degree – Section 13A-9-3

• Aggravated Theft by Deception – Section 13A-8-2.1

• Any crime as dened by the laws of the United States or by the laws

of another state, territory, country, or

other jurisdiction, which, if committed in this state, would constitute

one of the offenses listed in this subsection.

PENALTIES

§17-17-24, Code of Alabama, 1975, as amended

(a) Any person who willfully changes an absentee voter’s ballot to the extent that it does not reect the voter’s true ballot, any person who willfully

votes more than once by absentee ballot in the same election, any person who willfully votes for another voter or falsies absentee ballot applications or verication

documents so as to vote absentee, or any person who solicits, encourages, urges, or otherwise promotes illegal absentee voting, shall be guilty, upon conviction, of a

Class C felony. Any person who willfully aids any person unlawfully to vote an absentee ballot, any person who knowingly and unlawfully votes an absentee ballot, and

any voter who votes both an absentee and a regular ballot at any election shall be similarly punished.

(b) Upon request by the local district attorney or the Secretary of State, the Attorney General shall provide investigating assistance in instances of absentee

ballot or voting violations.

(c) Nothing in this section shall be construed to impede or inhibit organized legal efforts to encourage voter participation in the election process or to

discourage a candidate from encouraging electors to lawfully vote by absentee ballot.

Fill Online, Printable, Fillable, Blank FORM AV-R1: APPLICATION FOR ABSENTEE BALLOT Form

Related forms

Fillable FORM AV-R1: APPLICATION FOR ABSENTEE BALLOT

Fill Online, Printable, Fillable, Blank FORM AV-R1: APPLICATION FOR ABSENTEE BALLOT Form

Related forms

First 20 documents completely FREE!