_________________________________
New York State !bsentee Ballot !pplicaon
Please print clearly;
This applicaon must either b
e personally delivered to your county board of elecons not
later than the
day before the
elecon, or postmarked by a governmental postal service
not later than 7th day before elecon day;
of
BOARD USE ONLY:
Town/City/Ward/Dist:
Registration No: ____________________
Party: ____________________________
voted in office
I am requesng, in good faith, an absentee ballot due to (check one reason):
NY
!pplicant Must Sign Below
Sign Here: X__________________________ Date ____/____/____
Board Use Only
2020 Absentee Ballot Application
MM/DD/YYYY MM/DD/YYYY
MM/DD/YYYY
MM/DD/YYYY
MM/DD/YYYY
