Absentee Ballot Request

The form below is only for voters who are currently registered to vote in Seminole County.

Absentee Ballot Request Form

Please fill out the form completely to notify our office of an absentee ballot request. Use the Tab key, not the Enter key, to move from field to field. When you have completed the form, press the "Submit" button below. If you have any questions about this form or about changing your address, please e-mail us at elections@voteseminole.org.

ONLY THE VOTER OR A MEMBER OF THE IMMEDIATE FAMILY OR THE LEGAL GUARDIAN OF THE VOTER CAN REQUEST AN ABSENTEE BALLOT.

NOTE: The last day to request that an absentee ballot be mailed to you is 6 days prior to an election. After that time, ballots may be picked up at the Supervisor of Elections Office during regularly scheduled business hours.

Voter Information

Voter Registration Number (If Known)

First Name

Middle Name

Last Name

Birthdate (Format YYYY-MM-DD)

Example: 2012-02-05

Telephone Number

Email Address

Example: username@domain.com

Permanent Seminole County Residence Address (Required)

Residence Address

Residence Address2

Residence City

Residence State Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Middle East Armed Forces Europe Armed Forces Pacific

Residence Zip

Permanent Mailing Address

If different than residence address.

Mailing Address

Mailing Address2

Mailing City

Mailing State Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Middle East Armed Forces Europe Armed Forces Pacific

Mailing Zip

Residence and/or mailing address listed above is a new address, please update. (Only the voter can make this change.) 

Absentee Status

Absentee Status Select One Civilian Civilian Overseas Military Dependent Overseas Military Dependent Stateside Military Overseas Military Stateside

Overseas and Military/Military Dependent Voters

Prefered Method In Which To Receive Ballot

Email (to email address above) Fax (to fax number below) Mail (to postal address below)

Fax Number

Address To Mail Absentee Ballot To

If different than permanent residence or mailing address.

Mail To Address

Mail To Address2

Mail To City

Mail To State Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Middle East Armed Forces Europe Armed Forces Pacific

Mail To Zip

Please indicate for which elections you would like to receive an absentee ballot.

Ballots for All Elections

All elections through the next two
regularly scheduled general elections.

Yes No

Ballot for Next Election Only

Only the next election
for which I am eligible.

Yes No

Requester Identification

REQUEST BY AN IMMEDIATE FAMILY MEMBER OR LEGAL GUARDIAN

In addition to the information provided above, Florida law requires all of the following information to be provided if an immediate family member or legal guardian has been directed by the voter to request an absentee ballot.

I am the voter for whom this request is being made. I am a family member of the voter for whom this request
is being made (section below must be completed).

Requester Information

Requester Driver's License Number

Requester First Name

Requester Middle Name

Requester Last Name

Requester Telephone

Requester Email

Example: username@domain.com

Requester Address

Requester Address

Requester Address2

Requester City

Requester State Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Middle East Armed Forces Europe Armed Forces Pacific

Requester Zip

Requester Relationship Status

Requester Relation Select One Child Grandparent Legal Guardian Parent Sibling Spouse Spouse's Child Spouse's Grandparent Spouse's Parent Spouse's Sibling

Authorized Absentee Ballot Requester Affirmation

Read the statement below and check the box to affirm the statement is true before selecting "submit" below.

I affirm that I am the voter listed above requesting the absentee ballot, or have been instructed by said voter to request her/his absentee ballot, and have provided all of the required information, and the information I have supplied above is true and correct, to the best of my knowledge.

I Affirm the above. 

Additional Comments

Comments

Maximum length 1000 characters.