Vote-by-Mail Ballot Application
1. Name and address
2. Date of birth (must be provided)
3. Identification (must provide one of the options below)
4. Choose election (check only one - you must complete a separate application for each election)
5. Signature (must be provided)
OR
Your Ohio driver’s license number:
(Begins with 2 letters and ends with 6 numbers)
Copy of a current and valid photo identification, a military identification, or
a current (within the last 12 months) utility bill, bank statement, government
check, paycheck, or other government document (other than a notice of
voter registration mailed by a board of elections) that shows your name and
current address.
The last four digits of your Social Security number:
All registered voters may vote
by mail.
To receive a Vote-by-Mail ballot,
you must complete all five sections
and return this application to the
Board of Elections.
Instructions
Your application must be
received by noon on the last
Saturday before Election Day.
To account for delivery delay,
return the application at least
seven days before the election.
Deadline
You can track the status of your
Vote-by-Mail application and
ballot on our website at:
www.443vote.us
Questions?
Call 216-443-VOTE (8683)
Track your ballot
• I understand that, per Ohio law, the board of elections must receive this request no later than noon on
the Saturday before Election Day. To account for possible delivery delay, return the application to the
board of elections at least seven days before the election.
• I understand that if an absentee ballot is mailed to me and I change my mind and go to my polling
place to vote on Election Day, I will be required to vote a provisional ballot.
• I understand that if I do not provide the board with all of the required information, my application
cannot be processed.
• I hereby declare, under penalty of election falsification, that I am a qualified elector and the statements
above are true.
X
(Sign Here) (Date Signed)
Please return your Vote-by-Mail
application to:
Board of Elections
PO Box 89448
Cleveland, OH 44101-6448
You can also return your
application in person to the
Board of Elections, which is
located at 2925 Euclid Avenue
in Cleveland, Ohio.
A secure drop box is located
in the parking lot behind our
building and is accessible 24
hours a day.
Returning your application
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE.
Zip Code
Name
Home Address (no P.O. Boxes or polling place addresses)
City Zip Code
Address / P.O. Box
City
(Month) (Day) (Year)
OR
Mailing address (if dierent than home address):
Primary Election
General Election
Special Election
Party:
Libertarian
Do not write today’s date!
VBM 5020_8.26.20
E-Mail Phone
CUYAHOGA COUNT Y
*
*
Nonpartisan or issues only
Contact information will be used by the board of elections to contact you in a timely manner if your application is incomplete.
Are you interested in serving as
a poll worker on Election Day?
Important: If selecting a partisan ballot in a primary election, the ballot will include all questions and issues which the voter is eligible to vote.
Call 216-443-3277
