Village of Farmingdale !bsentee Ballot !pplication
Inc. Village of Farmingdale
361 Main Street, Farmingdale, NY 11735
Please print clearly; See detailed instructions on back.
This application must either be personally delivered to the Village Clerk not later than the day before the election, or
postmarked by a governmental postal service not later than 7th day before election day; be
received by the Village Clerk .
I am requesng, in good faith, an absentee ballot due to (check one reason):
!pplicant Must Sign Below
Sign Here: X__________________________ Date ____/____/____
Board Use Only
2015 Absentee Ballot Application