Vote By Mail Ballot Request Form

Notice: If you are an overseas voter or are requesting a Vote by Mail ballot for an overseas voter, please click here.

This request is valid for only one (1) registered voter. If you are a qualified and registered voter, ballots will be mailed only for the elections checked. Vote by Mail ballots are mailed approximately 30 days prior to each election to those voters who have requested a ballot.
VOTE BY MAIL BALLOTS CANNOT BE FORWARDED. If you will not be at your Martin County address, please complete the MAIL BALLOT TO portion of this form with the address to which you want the ballot mailed.

( * Denotes a required field)

* Are you making this request for someone in your immediate family?
Yes Myself
Voter Information:
* Voter's First Name:
Voter's Middle Initial:
* Voter's Last Name:
* Voter's Birth Date (mm/dd/yyyy):
* Martin County Residence Address (No PO Box):
Voter's Apt, Lot, or Unit Number:
* Voter's City:
* Voter's ZIP Code:
Voter's email address:
Voter's Daytime Phone:
Voter ID Number(if available):


Mail Ballot to: (if different from above)

Street, PO Box, Rural Route:
Apartment, Lot, or Unit Number:
City:
State:
ZIP Code:

Vote by Mail ballots must be mailed to the current mailing address on file with the supervisor of elections, unless the voter is:
Absent from the county, and does not plan to return before the day of the election. Temporarily unable to occupy the residence because of natural disaster. In a hospital, assisted living facility, nursing home, short-term medical or rehabilitation facility, or correctional facility. Changing his or her current mailing address on file to: (If you are changing your residence address, please click here)
Street, PO Box, Rural Route:
Apartment, Lot, or Unit Number:
City, State, ZIP Code:

Status:
Civilian Overseas Military/Dependent Overseas Military/Dependent Stateside Not Applicable

Vote by Mail ballots requested:
08/24/2010 - Primary Election 11/02/2010 - General Election

135 SE Martin Luther King, Jr. Blvd. • Stuart, FL 34994 • P.O. Box 1257 • Stuart, FL 34995
772.288.5637 • Fax 772.288.5765 • TTY 772.692.7320
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