Deliver an absentee ballot to me by U.S. mail, or hand-
delivery if requested in person, for all federal, state, and
county ofces and all state and county referenda.
UOCAVA APPLICATION FOR ABSENTEE BALLOT
FOR USE ONLY BY INDIVIDUALS VOTING PURSUANT TO THE
UNIFORMED AND OVERSEAS CITIZENS ABSENTEE VOTING ACT
______________________ COUNTY, ALABAMA
I am applying for an absentee ballot because I am a member of, or a spouse or dependent of a member of, the Armed
Forces of the U.S. or am a U.S. citizen residing overseas and am qualied to vote by absentee ballot pursuant to the
Uniformed and Overseas Citizens Absentee Voting Act,
52 U.S.C. § 20302.
When I apply for this absentee ballot, I understand that my name will be stricken from the list of qualied 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
Print Witness Name
section if voter
signs by mark
If requesting mail delivery of a ballot, provide a mailing address, 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
By signing this application, I am attesting that I am a member
of, or spouse or dependent of a member of, the United
States Armed Forces or I am a United States citizen residing
I understand that this application will be valid for all county,
state and federal elections to be held during this calendar
year. For election cycles that span multiple calendar years,
this application will be valid for the entire election cycle.
If I wish to waive this right and have this application expire
earlier, I am providing an expiration date below. For example,
I might choose an earlier expiration date if I expect a change
of duty station effective after the next election but before the
end of the year.
Deliver an absentee ballot to me by electronic
transmission for all federal, state, and county ofces and
all state and county referenda. I have provided an e-mail
Month / Day / Year
This application should expire on
Type of Ballot (select one) Duration of Absentee Ballot Application
Street Address (address where you are registered to vote; do not use PO box)
Last Name (Please print)
Middle or Maiden Name
Driver’s License Number
Return this application to:
IF NO DRIVER’S LICENSE NUMBER
Last 4 digits of
Reason for Requesting to Vote by Absentee Ballot
Date Revised: 07/23/2019
Primary Election or Presidential Preference Primary
Primary Runoff Election
Special Election (specify) _________________
Delivery of Ballot (select one)
If a primary or runoff, check one:
Please note that only one application may be placed in the same envelope.
General Voter Information - Please provide complete information so that we may verify your eligibility to vote.