Absentee Ballot Application

Please read the following instructions carefully before completing the application.
I understand that I must be affiliated with or authorized to vote the political party’s
ballot that I request.
Who is eligible to vote absentee:
Any person who is registered to vote may vote by absentee ballot (See Utah Code 20A-3-301).

How to apply for an absentee ballot:

For absentee voting in statewide general and primary elections (held in even-numbered years), this application must be
filed by-mail or in person in the office of the voter’s county clerk. For municipal primary and general elections (held in odd
numbered years), the application should be filed by-mail or in person in the office of the city clerk or recorder*.
*Salt Lake County voters should file their form with the Salt Lake County Clerk’s Office.

When to apply for an absentee ballot:

Following are the deadlines for submission of the absentee voter ballot application:

1. For regular absentee voting, the clerk should receive this application no later than the Friday before the election.

2. For voters who are overseas, the clerk should receive this application no later than 20 days before the election.

3. For persons voting an absentee ballot at the office of the clerk or recorder, the clerk should receive this
application no later than the Friday before the election.

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NOTE: This application form must be received by the clerk or recorder no later than Friday before election or 20 days before election for persons who
are overseas.

_________________________________________________________________ _________/_________/_________
Name (required) Last First Middle Date of Birth (month/day/year)

____________________________________________________________________________________________________
Home Address City State Zip Code

I, a qualified elector residing in ________________ County at the above address, apply for an official absentee ballot to be voted by me at the
following election(s):
____ Municipal General Election ____ Regular General Election ____ Special Election
____ Municipal Primary Election ____ Regular Primary Election ____ Western States Presidential Primary

If you are requesting an absentee ballot for a primary election, please complete the following section:

I, a qualified elector, residing in ____________ County at the above address, apply for an official absentee ballot for the
_________________ political party to be voted by me at the primary election.

I understand that I must be affiliated with or authorized to vote the political party’s ballot that I request.

I would like my name placed on the permanent absentee voter list: ____Yes ____ No

Please mail my absentee ballot to the following address: _______________________________________________

_______________________________________________
_______________________________________________
_______________________________________________
Please sign below:
______________________________________ _________/_________/_________
Voter’s Signature Month Day Year
Last Updated 05/2009

FOR OFFICE USE ONLY

Voter ID#_____________________Voting Precinct________________Ballot Number _________________Ballot Format _________________Date Voted _______________