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MI Absent Voter Ballot Application Mar. 10 Presidential Primary/Nov. 3 General
I am a United States citizen and a qualified and registered elector of the County and jurisdiction in the State of Michigan listed below, and
I apply for an official ballot, to be voted by me at the election(s) listed below.
Voter’s Registration Information:
Last Name First Name M.I.
County
City
Township
Street Address
Jurisdiction
MI
City Zip
Year of Birth
( )
Email Address
Phone #
Your e-mail address and phone number will be used only for official election purposes.
Select election(s) to receive ballot (required):
March 10 Presidential Primary and November 3 General or March 10 Presidential Primary only
Other Elections: Complete to join
permanent absent voter application list
I want to vote absentee in all elections. Automatically send me an application for
an absent voter ballot for all elections, including other elections in 2020.
Select only one ballot type for the Presidential Primary here (required):
Democratic Party Presidential Primary Ballot
Republican Party Presidential Primary Ballot
Ballot without Presidential Primary (If available, this choice is for voters not voting in the presidential primary who wish to vote on other proposals or candidates only.)
Voter’s Signature (Power of attorney is not acceptable):
I certify that I am a United States citizen and that the statements in this absent voter ballot application are true.
X / /
Signature Date
WARNING: You must be a United States citizen to vote. If you are not a United States citizen, you will not be issued an absent voter ballot. A person making a false statement in this
absent voter ballot application is guilty of a misdemeanor. It is a violation of Michigan election law for a person other than those listed in the instructions to return, offer to return, agree to
return, or solicit to return your absent voter ballot application to the clerk. An assistant authorized by the clerk who receives absent voter ballot applications at a location other than the
clerk’s office must have credentials signed by the clerk. Ask to see his or her credentials before entrusting your application with a person claiming to have the clerk’s authorization to return
your application.
[Only fill out if different from above]:
USPS will not forward your ballot. We can mail
Address 1
Date leaving for
this address:
/ /
Date of return:
/ /
Address 2
Date leaving for
this address:
/ /
Date of return:
/ /
Street Address
Street Address
City State Zip
City State Zip
Return this application to your city/township clerk. Find your clerk at mi.gov/vote.
Complete only
if assisting a
voter with
return of the
application
Certificate of Authorized Registered Elector Returning Absent Voter Ballot Application:
I certify that my name is ____________________________________________, date of birth is
____/____/____ and my address is _________________________________________________________;
that I am delivering the absent voter ballot application of _________________________________________
at his or her request; that I did not solicit or request to return the application; that I have not made any
markings on the application; that I have not altered the application in any way; that I have not influenced the
applicant; and that I am aware that a false statement in this certificate is a violation of Michigan election law.
X_______________________________________ ____/____/____
Signature of person assisting the voter Date
S E E O T H E R S I D E F O R M O R E I N S T R U C T I O N S
Clerk’s
Use Only
Wd/Pct
Mailed / /
Returned / /
Filed / /
Ballot No.
Clerk
1
Complete
Other
Check 1
2
3
Check
Sign
Return
Instructions for Absent Voter Ballot Applicants:
Step 1. After completely filling out the application, sign and date the application in the place
designated. Your signature must appear on the application or you will not receive an
absent voter ballot.
Step 2. Deliver the application by one of the following methods:
(a) Place the application in an envelope addressed to the appropriate clerk and deposit
it in the United States mail or with another public postal service, express mail
service, parcel post service, or common carrier. Proper postage is required. You may
also return the application by email or fax, as long as your signature is visible.
(b) Deliver the application personally to the clerk’s office, to the clerk, or to the clerk’s
authorized assistant.
(c) In either (a) or (b), a member of the immediate family of the voter including a
father-in-law, mother-in-law, brother-in-law, sister-in-law, son-in-law, daughter-in-
law, grandparent, or grandchild or a person residing in the voter’s household may
mail or deliver the application to the clerk for the applicant.
(d) If an applicant cannot return the application in any of the above methods, the
applicant may select any registered elector to return the application. The person
returning the application must sign and return the certificate at the bottom of the
application.
Moving between March and November? If so, you may want to consider applying for March only
and reapplying for November after you move. Here’s how to decide:
1. If you are moving within the same city or township and apply for both March and November,
then as long as you update your registration address by September, your clerk will send you a
ballot to the new address in November. You can still update your address after September, but
you will need to fill out additional paperwork before you get your ballot.
2. If you are moving to a different city or township, when you update your registration address,
your old clerk will cancel your absent voter ballot application for November and you’ll have to
reapply with the new clerk in your new city or township.
Remember, every time you move, you must update your voter registration address. It isn’t updated
automatically (unless you update your Michigan driver license or personal ID card address). Find out
how to update your registration address online at Michigan.gov/Vote. If you have a Michigan driver
license or personal ID card, you can update your address online.