"Application for absent voter ballot for:
[ ] The primary election to be held on ___________________ (Date).
[ ] The election to be held on _______ (Date).
[ ] All future elections. Automatically send me an absent voter ballot for each election.
(Check applicable election or elections)
I, .................................., am a United States citizen and a registered elector of the township of ............ or of the city of .................................., in the county of .................................. and state of Michigan, and I apply for an absent voter ballot to be voted by me at the election or elections as requested in this application.
Send absent voter ballot to me at: | |||
........................................... | |||
(Street No. or R.R. or Designated Address) | |||
........................................... | |||
(Post Office) | (State) | (Zip Code) | |
My registered address ...................................... | |||
(Street No. or R.R. or Participant Identification Number) | |||
...................................... | |||
(Post Office) | (State) | (Zip Code) | |
Date........................................................ | |||
I certify that I am a United States citizen and that | |||
the statements in this absent voter ballot application | |||
are true. | |||
...................................... | |||
(Signature) | |||
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.
An individual making a false statement in this absent voter ballot application is guilty of a misdemeanor. It is a violation of Michigan election law for an individual 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 the individual's credentials before entrusting your application with an individual claiming to have the clerk's authorization to return your application.
Certificate of Authorized Registered
Elector Returning Absent Voter
Ballot Application
I certify that my name is .................... and my address is .................... ; that I am delivering the absent voter ballot application of .................... at the applicant's 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.
_________________ | _________________________________________ |
(Date) | (Signature)" |
INSTRUCTIONS FOR APPLICANTS FOR ABSENT VOTER BALLOTS
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 may not receive an absent voter ballot.
Step 2. Deliver the application by 1 of the following methods:
MCL 168.759