VOTE-BY-MAIL BALLOT REQUEST FORM VOTE BY MAIL IN FOUR

Kaiti Lenhart
FLAGLER COUNTY SUPERVISOR OF ELECTIONS
1769 E. Moody Boulevard, Building 2, Suite 101, Bunnell, FL 32110 • P.O Box 901, Bunnell, FL 32110
Phone: (386) 313-4170 • Fax: (386) 313-4171 • Online: www.FlaglerElections.com
VOTE BY MAIL IN FOUR EASY STEPS
TRACK YOUR BALLOT ONLINE!
Make sure your ballot was received by the Elections Office.
http://www.electionsfl.org/flagler/index.php?mais=Y
1. REQUEST
2. VOTE
3. SIGN
4. DELIVER
Any registered and qualified voter who
is eligible to vote in an election may cast
their vote by vote-by-mail ballot. An vote-bymail ballot may be requested for a specific
election or for all elections through the next
two regularly scheduled general elections.
The request can be made in person,
by postal mail, by electronic mail or by
telephone. Only the voter or designated
member of his or her immediate family or
legal guardian can request an vote-by-mail
ballot for the voter. The request deadline is
always the Wednesday prior to the Election.
The voter must personally vote their
ballot. Vote-by-mail ballots are mailed
35 days prior to each election to those
voters who have requested an vote-bymail ballot. Be sure the Elections Office
has your correct mailing address. Voteby-mail ballots are not forwarded by the
US Postal Service. Vote-by-mail ballots for
overseas military and overseas civilian
voters are mailed 45 days prior to an
The voter must sign the return envelope.
Power of attorney is not recognized for
vote-by-mail voting in the state of Florida.
The vote-by-mail ballot will not be counted
if the return envelope is not signed or if the
signature does not match the signature
we have in the voter registration file.
An unsigned vote-by-mail ballot may be
presented to the Canvassing Board for a
decision if this affidavit is received before
5:00 p.m. on the Monday prior to Election
Day: http://www.flaglerelections.com/
Portals/Flagler/pdfs/DS-DE_139.pdf
You must mail, personally deliver or
have someone else deliver your voteby-mail ballot inside the completed
mailing envelope to the Elections Office.
Sufficient postage is required if mailed.
Vote-by-mail ballots must be received
no later than 7:00 P.M. on the day of the
election. Vote-by-mail ballots cannot be
turned in at the polling place on Election
Day unless the voter himself wishes
to vote in person at the polls. If a voter
has requested an vote-by-mail ballot and
chooses to vote in person at the polls, the
vote-by-mail ballot is cancelled and the
ATTENTION VOTE-BY-MAIL VOTERS!
MAILING ADDRESS
REQUIRED!
Florida Statutes
Request for vote-by-mail ballots
101.62 (1)(b):
The supervisor may accept a
written or telephonic request
for an vote-by-mail ballot to be
mailed to an elector’s address
on file in the Florida Voter
Registration System from the
elector, or, if directly instructed
by the elector, a member of the
elector’s immediate family, or
the elector’s legal guardian; if
the ballot is requested to be
mailed to an address other than
the elector’s address on file in
the Florida Voter Registration
System, the request must be
made in writing and signed
by the elector. However, an
absent uniformed service voter
or an overseas voter seeking
an vote-by-mail ballot is not
required to submit a signed,
written request for an vote-bymail ballot that is being mailed
to an address other than the
elector’s address on file in
the Florida Voter Registration
System.
Florida law requires an vote-by-mail ballot request to an address other than the elector’s address on
file, must be submitted in WRITING and SIGNED by the voter. Please print, complete and return the
form below to request an vote-by-mail ballot.
VOTE-BY-MAIL BALLOT REQUEST FORM
Please send me vote-by-mail ballots for the following election(s): Check One
Specific Election: ________________
All Eligible Elections Through 2018
PLEASE PRINT CLEARLY
VOTER NAME: ___________________________________________ (REQUIRED)
(IF KNOWN)
DATE OF BIRTH: _____ /_____ / __________ (REQUIRED) VOTER ID
BALLOTS ARE NOT FORWARDED BY THE POSTAL SERVICE.
YOU MUST PROVIDE Street Address
___________________________________________
or PO Box:
YOUR BALLOT
___________________________________________
MAILING ADDRESS:
(REQUIRED)
City: ________________________ State: ________ Zip: __________
PHONE NUMBER: __________ - __________ - ______________ (OPTIONAL) Only for use by Elections Staff
x _______________________________________________________________________
VOTER SIGNATURE (REQUIRED)DATE
REQUESTS WITHOUT DATE OF BIRTH AND VOTER SIGNATURE CANNOT BE PROCESSED. COMPLETE REQUEST AND RETURN. FOR PRIVACY, USE AN ENVELOPE.
MAIL TO: SUPERVISOR OF ELECTIONS • P.O. BOX 901 • BUNNELL, FL 32110  EMAIL TO: [email protected]  FAX TO: (386) 313-4171
DELIVER TO: THE SUPERVISOR OF ELECTIONS OFFICE IN THE GOV’T SERVICES BUILDING •1769 E. MOODY BOULEVARD • BUILDING 2 • SUITE 101 • BUNNELL, FL 32110
GENERAL ELECTION
ELECTION DAY:
NOVEMBER 8, 2016
VOTE BY MAIL
REMEMBER
VOTING BY MAIL BALLOT
Power Of Attorney is not
Any registered voter may vote by mail. A mail ballot may be requested for a specific election or for all elections through recognized for mail voting
the next two regularly scheduled general elections. The request can be made in person, by telephone, by mail or
in the state of Florida.
by using the online form (visit www.FlaglerElections.com). Requested ballots are mailed approximately three weeks
before an election. Later requests are mailed as they are received. Only the voter or a designated member of his or her
immediate family or legal guardian can request a ballot for the voter. Immediate family means the voter’s spouse or the parent, child, grandparent,
or sibling of the voter or of the voter’s spouse. Mail ballots are not forwarded by the U.S. Postal Service so please provide your mailing address at
the time of the request.
A MAIL BALLOT IS NOT A SAMPLE BALLOT
Each household is mailed a sample ballot prior to each election, which can be used for reference at the polling place. A mail ballot is not a sample
ballot. If you have requested a mail ballot and decide to vote in person, bring your mail ballot with you to the polling place. The election poll workers
at the polling place will cancel your mail ballot and issue you a new ballot to vote at the polls.
VOTING & RETURNING A MAIL BALLOT
The voter must personally vote the ballot (unless assistance is required due to blindness or disability) AND sign the return envelope. An Elections
Office drop box is available at the entrance of our office for after hours drop off. Mail ballots must be returned by mail or hand-delivered so that
they reach the Elections Office by 7:00 P.M. on the day of the election.
Your Vote is Your Voice
REGISTER & VOTE IN EVERY ELECTION!