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RequestsforabsenteeballotswillbeacceptedfromthecloseofnominationsonWednesday,April6,2011,throughnoonon
Monday,May2,2011.FormoreinformationcontactLeoJ.Purcell,ElectionJudge,at6174771606,fax:6172655510;or
Email:ElectionJudge@ibew103.com
(PLEASETYPEORPRINTCLEARLY)
DATE:___________________________________________
NAME:___________________________________________ UNIONCARD#:__________________
ADDRESS:___________________________________________________________________________
CITY:____________________________________________STATE:_______ZIPCODE:___________
PHONE:()______________________________
Mr.LeoJ.Purcell,ElectionJudge
Local103,IBEW
256FreeportStreet
Dorchester,MA02122
RE:AbsenteeBallotLocalUnion103,IBEW,Election
DearBrotherPurcell:
SinceIwillbeunabletovisitthepollsonElectionDay,Saturday,May7,2011,Iamrequestingthatan
absentee ballot be mailed to me at the above address. In addition, please forward any information
regardingtheuseofthisballot.
ItismyunderstandingthatfollowingtheelectionofMay7,unlessIhaveselectedanalternativebelow,I
will automatically receive another absentee ballot, at this same address, for a runoff election on
May28,2011,shouldarunoffelectionberequiredunderourbylaws.
_____ Alternative One: I do not want an absentee ballot for the runoff election of
May28,2011,forwardedtome.
_____ Alternative Two: I would like an absentee ballot for the runoff election of
May28,2011,butwouldpreferthatitbeforwardedtotheaddresslistedbelow.
ADDRESS:___________________________________________________________________________
CITY:____________________________________________STATE:_______ZIPCODE:___________
Thankyouinadvanceforyourcooperationinthisrequest.
Fraternally,
_____________________________
(signature)