HomeMy Public PortalAbout2021-Vote-by-Mail-Application_2021040509294670122021 Vote by Mail Application
William Francis Galvin
Secretary of the Commonwealth
Voter
Information
1
Name.
Address of Voter Registration:
Watertown MA 02472
Date of Birth: Telephone Number
E-mail Address.
Ballot
Information
2
Ballot Mailing Address.
Ballot Party (For Primaries ONLY): [emocratic OR
'Republican
Assistance
(lf applicable)
3
F-1 Voter required assistance in completing application due to physical disability.
Assisting person's name -
Assisting person's address.
Signed (under penalty of perjury): Date.
Eligibility
Use this application to request to vote by mail in any election being held on or before March 31, 2021.
Completing the Application
1.
Voter Information — Provide your name, the address where you are registered to vote, and date of birth.
Telephone and email address are optional.
2. Ballot Information — Provide the address where you want the ballot mailed. If you are applying for a special state
primary ballot, choose a party ballot if you are not registered in a party (Independent).
3. Assistance — If you are assisting a voter in completing this application, complete this section.
4. Sign your name. If you require assistance in signing the application, you may authorize someone to sign your
name in your presence. That person must complete the assisting person's information in Section 3.
Submitting the Application
Send the completed application to the local election official at your city or town hall. Find contact information for local
election officials at www.sec.state.ma.us/ele or by calling 1 -800 -462 -VOTE (8683).
Applications can be mailed or hand -delivered. Applications may also be submitted electronically by fax or e-mail, as long
as your signature is visible.
Please allow ample mailing time for this application and for the ballot. Ballots must be returned to your local election
official by Election Day.