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RM COMPLETELY COULD DELAY YOUR APPLICATION) Election, or Runoff: / /20 FOR PRIMARY ELECTIONS ONLY, CHOOSE A PARTY BALLOT (check only one): APPLICATION DATE DATE OF BIRTH DAYTIME CONTACT NUMBER (optional) / / / / DEMOCRATIC REPUBLICAN ( ) - NAME AS REGISTERED LAST ADDRESS AS REGISTERED STREET # EMAIL ADDRESS(required for UOCAVA Voter requesting electronic transmission) FIRST CITY MIDDLE ZIP CODE Mail the ballot to my.

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