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Get Application for Absentee Ballot

) (HOME ADDRESS) (POST OFFICE) (ZIP CODE) (COUNTY) (MUNICIPALITY) (WARD) (DISTRICT) (OCCUPATION) (DATE OF BIRTH) I have lived at this address since State or Federal Government employees check here ( ). MAIL BALLOT TO ME AT THE FOLLOWING ADDRESS (STREET ADDRESS) (POST OFFICE) (STATE) (ZIP CODE) I HEREBY APPLY FOR AN ABSENTEE BALLOT FOR THE FOLLOWING REASON: ABSENCE FROM THE MUNICIPALITY COMPLETE SECTION A SECTION A ABSENCE FROM THE MUNICIPALITY.

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