Application for Absentee Ballot
___________________ FIRE DISTRICT
ABSENTEE BALLOT APPLICATION
MAIL OR DELIVER TO: _____________________ FIRE DISTRICT
_____________________________
_________________, NEW YORK _______
TELEPHONE #_____________________
VOTER ADDRESS IN FIRE DISTRICT
NAME ____________________________________
ADDRESS _________________________________
CITY/STATE ___________________ ZIP _________
I AM A REGISTERED VOTER IN __________________ FIRE DISTRICT, COUNTY OF _____________. I DO APPLY FOR AN ABSENTEE BALLOT FOR ALL ELECTIONS FOR WHICH I AM QUALIFIED.
I KNOW OF NO REASON WHY I AM NO LONGER QUALIFIED TO VOTE.
SEND BALLOT TO: ______________________________________________________
_________________________________________________________...
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