Alabama Application for Municipal Absentee Ballot
The following form is intended for intending to vote in municipal elections in the State of Alabama. The form is used to determine the voter’s eligibility.
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APPLICATION FOR MUNICIPAL ABSENTEE BALLOT __________________________________, ALABAMA I hereby make application for an absentee ballot so that I may vote in t\ he following election: I am applying for an absentee ballot because (check one box): When I apply for this absentee ballot, I understand that my name will be stricken from the list of qualified electors and, when I cast this absentee ballot, I understand that I will not be entitl\ ed to vote at my regular polling place. The voter may hand this application to the Absentee Election Manager. The voter may also forward this application to the Absentee Election Manager by U.S. Mail [§17-11-3 and §17-11-4, Code of Alabama, 1975]. READ PENALTIES ON BACK Voter’s Signature Witness Signature Print Witness Name Complete this section if voter signs by mark Mail my ballot to the address where I regularly receive mail, if different from the street address provided above Precinct where you vote (name and/or location of your polling place) Work Telephone Number Date of Birth Home Telephone Number General Voter Information - Please provide complete information so that we may verify your eligibili\ ty to vote. Municipal Election Special Municipal Election ( specify ) ____________________ For all registered voters n Absentee ballots for municipal elections more than 42 days apart must be\ requested on separate applications Street Address (address where you are registered to vote; do not use PO box) City ZIP Year Day Month ( ) ( ) Last Name (Please print) First Name Middle or Maiden Name Driver’s License Number Return this application to: S TAT E NUMBER IF NO DRIVER’S LICENSE NUMBER Last 4 digits of Social Security number E-mail Address FORM AV-M1 Municipal Runoff Election I will be out of the county or the state on election day. I have a physical illness or infirmity which prevents my attendance at the polls. I have a physical illness or infirmity which prevents my attendance at the polls. I am unable to access my assigned polling place due to a neurological, musculoskeletal, respiratory (incl\ uding speech organs), cardiovascular, or other life-altering disorder that affects my ability to perform manual tasks, stand for any length of time, \ walk unassisted, see, hear or speak and : a) I am an elderly voter aged 65 or older; or b) I am a voter with a disability. I work a shift which has at least ten (10) hours that coincide with th\ e polling hours at my regular polling place. I am enrolled as a student at an educational institution located outside\ the county of my personal residence, attendance at which prevents my attendance at the polls. I am a member of, or a spouse or dependent of a member of, the Armed Forces of the United States or am other - wise similarly qualified to vote absentee pursuant to the Uniformed and Overseas Citizens Absentee Voting Act,42 U.S.C. 1973ff. This application for an absentee ballot will be valid for all county, state, and federal elections held during this calendar year unless you specify an earlier expiration date here: _____\ __________________________. I have been appointed as an election officer at a polling place which is not my regular polling place. PENALTIES §17-17-24, Code of Alabama, 1975, as amended (a) Any person who willfully changes an absentee voter’s ballot to the extent that it does not reflect the voter’s true ballot, any person who willfully votes more than once by absentee\ ballot in the same election, any person who willfully votes for another voter or falsifies absentee ballot applications or verification documents so as to vote absentee, or any person who solicits, encourages, urges, or otherwise promotes illegal absentee voting, shall be guilty, upon conviction, of a Class C felony. Any person who willfully aids any person unlawfully to vote an absentee ballot, any person who knowingly and unla\ wfully votes an absentee ballot, and any voter who votes both an absentee and a regular ballot at any electio\ n shall be similarly punished. (b) Upon request by the local district attorney or the Secretary of S\ tate, the Attorney General shall provide investigating assistance in instances of absentee ballot or voti\ ng violations. (c) Nothing in this section shall be construed to impede or inhibit o\ rganized legal efforts to encourage voter participation in the election process or to discourage a candidate\ from encouraging electors to lawfully vote by absentee ballot.Relevant article from our knowledge database
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