Homepage Blank New York Absentee Ballot Application Form
Outline

The New York Absentee Ballot Application form is a crucial document for voters who cannot be present at their polling place on election day. This form allows individuals to request an absentee ballot for various reasons, including being out of the county, illness, or other personal circumstances. To ensure that your application is processed smoothly, it is essential to follow the specific instructions provided. For instance, applications submitted in person must reach the county board of elections by the day before the election, while those sent by mail must arrive no later than 15 days prior. The form requires personal information, such as your name, address, and the reason for your absentee ballot request. Additionally, voters can indicate how they would like to receive their ballot, whether in person or by mail. If you have a permanent illness or disability, you can automatically receive ballots for future elections without needing to reapply. The form also includes a section for those who may need assistance in signing due to physical limitations. It’s important to certify that the information provided is accurate, as false statements can lead to penalties. Completing this form correctly ensures that your voice is heard, even when you cannot be physically present at the polls.

Sample - New York Absentee Ballot Application Form

MM/DD/YYYY
!pplicant Must Sign Below

New York State !bsentee Ballot !pplication

Please print clearly; See detailed instructions/

To receive an absentee ballot: In-Person - Application must be personally delivered to your county board of elections not later than the day before the election. By Mail - Application must be received by your county board of elections not later than the 15th day before the election.

The ballot itself must either be personally delivered to the board of elections in your county no later than the close of polls on election day, or postmarked by a governmental postal service not later than the day of the election and received no later than 7 days after the election/

BOARD USE ONLY:

Town/City/Ward/Dist:

_________________________________

Registration No: ____________________

Party: ____________________________

voted in office

 

1/

I am requesting, in good faith, an absentee ballot due to (check one reason):

absence from county or New York ity on election day

resident or patient of a Veterans Health

 

temporary illness or physical disability

!dministration Hospital

 

permanent illness or physical disability

detention in jail/prison, awaiting trial, awaiting

 

duties related to primary care of one or more

 

action by a grand jury, or in prison for a conviction

 

individuals who are ill or physically disabled

 

of a crime or offense which was not a felony

 

 

 

 

 

2/

absentee ballot(s) requested for the following election(s) .

 

Primary Election only

General Election only

 Special Election only

!ny election held between these dates. absence begins. _____/_____/_____

absence ends. _____/_____/_____

MM/DD/YYYY

MM/DD/YYYY

3/

last name or surname

 

 

 

 

 

 

first name

 

 

 

 

middle initial

 

 

suffix

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4/

date of birth MM/DD/YYYY

 

county where you live

 

 

 

 

phone number (optional)

 

email (optional)

 

 

 

 

_____ /_____ /_____

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5/

address where you live (residence) street

apt

 

 

city

 

 

state

zip code

 

 

 

 

 

 

 

 

 

 

 

 

 

NY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6/

Delivery of Primary Election allot (check one)

 

 

Deliver to me in person at the board of elections

I authorize (give name)._______________________________________ to pick up my ballot at the board of elections/

 

Mail ballot to me at. (mailing address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_______________________________________________________________________________________________________

 

 

street no/

street name

 

 

 

 

apt/

city

 

 

 

state

 

 

zip code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7/

Delivery of General (or Special) Election allot (check one)

Deliver to me in person at the board of elections

I authorize (give name)._______________________________________ to pick up my ballot at the board of elections/

 

Mail ballot to me at. (mailing address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

________________________________________________________________________________________________________

 

 

street no/

street name

 

 

 

 

apt/

city

 

 

 

state

 

 

zip code

8/

I certify that I am a qualified and a registered (and for primary, enrolled) voter- and that the information in this application is

true and correct and that this application will be accepted for all purposes as the equivalent of an affidavit and, if it contains a

 

material false statement, shall subject me to the same penalties as if I had been duly sworn/

 

Sign Here: X__________________________ Date ____/____/____

If applicant is unable to sign because of illness, physical disability or inability to read, the following statement must be executed. y my mark, duly witnessed hereunder, I hereby state that I am unable to sign my applica- tion for an absentee ballot without assistance because I am unable to write by reason of my illness or physical disability or because I am unable to read/ I have made, or have the assistance in making, my mark in lieu of my signature/ (No power of attorney or preprinted name stamps allowed/ See detailed instructions/)

Date ___/___/___ Name of Voter.____________________________________ Mark.___________________

MM/DD/YYYY

 

I, the undersigned, hereby certify that the above named voter affixed his or her mark to this application in my pres-

ence and I know him or her to be the person who affixed his or her mark to said application and understand that

this statement will be accepted for all purposes as the equivalent of an affidavit and if it contains a material false

statement, shall subject me to the same penalties as if I had been duly sworn/

_____________________________________________

______________________________________

_____________________________________________

(signature of witness to mark)

(address of witness to mark)

Board Use Only

 

 

2021 Absentee Ballot Application

Instructions:

Who may apply for an absentee ballot?

Each person must apply for themselves/ It is a felony to make a false statement in an application for an absentee ballot, to attempt to cast an illegal ballot, or to help anyone to cast an illegal ballot/

Information for military and overseas voters:

If you are applying for an absentee ballot because you or your family are in the military or because you currently reside overseas, do not use this application/ You are entitled to special legal provisions if you apply using the Federal Postcard !pplication (FPCA)/ For more information about military/overseas voting, contact your local board of elections or refer to the Military and Federal Voting sections at. http.//www/elections/ny/gov/Voting/html

Where and when to return your application:

Applications for an absentee ballot that will be delivered in-person at the county board of elections to the voter or an agent of the voter must be received not later than the day before the election. Applications for a ballot to be delivered by mail to the voter must be received at the county board of elections no later than 15 days before the election. If the address of your county board of elections is not provided on this form, contact information for your local election office can be found on the New York State oard of Elections’ website, under “ounty oards of Election” directory at. http.//www/elections/ny/gov/ountyoards/html

Options available to you if you have an illness or disability:

If you check the box indicating your illness or disability is permanent, once your application is ap- proved you will automatically receive a ballot for each election in which you are eligible to vote, without having to apply again/ You may sign the absentee ballot application yourself, or you may make your mark and have your mark witnessed in the spaces provided on the bottom of the appli- cation/ Please note that a power of attorney or printed name stamp is not allowed for any voting purpose/

When your ballot will be sent:

Your absentee ballot materials will be sent to you beginning 46 days before federal, state, county, city or town elections in which you are eligible to vote/ If you applied after this date, your ballot will be sent immediately after your completed and signed application is received and processed by your local board of elections/ If you provide dates in section 2, identifying the time frame within which you will be absent from your county or from the ity of New York, you will be sent a ballot for any primary, general, special election or presidential primary election which might occur during the time frame you have specified/ If you prefer, you may designate someone to pick up your ballot for you, by completing the required information in section 6 and/or section 7, as appropriate/ ontact your local county board of elections if you have not received your ballot/

Form Information

Fact Name Details
Application Deadline (In-Person) The application must be delivered to the county board of elections by the day before the election.
Application Deadline (By Mail) Applications must be received by the county board of elections no later than 15 days before the election.
Ballot Submission Deadline The completed ballot must be delivered to the board of elections by the close of polls on election day or postmarked by election day and received within 7 days after.
Eligibility to Apply Only the voter may apply for their absentee ballot; it is illegal to submit an application on behalf of another person.
Reasons for Absentee Voting Valid reasons include absence from the county, illness, physical disability, or detention in jail.
Permanent Illness Provision If a permanent illness is indicated, the voter will automatically receive ballots for future elections without reapplying.
Witness Requirement If the applicant cannot sign due to disability, a witness must attest to their mark on the application.
Military and Overseas Voters Military and overseas voters should use the Federal Postcard Application (FPCA) instead of this form.
State Governing Laws The application process is governed by New York Election Law, specifically Article 9.
Application Processing Time Ballots are sent beginning 46 days before elections; late applications will be processed immediately upon receipt.

Detailed Guide for Filling Out New York Absentee Ballot Application

Completing the New York Absentee Ballot Application form is a straightforward process. This application allows you to request an absentee ballot for upcoming elections. Follow the steps below to fill out the form correctly.

  1. Provide your reason for requesting an absentee ballot: Check the box that applies to your situation. You can choose from reasons such as absence from the county, illness, or other specified conditions.
  2. Indicate the election(s) for which you are requesting a ballot: Select one or more options for the type of election (Primary, General, Special) and provide the dates of your absence if applicable.
  3. Fill in your personal information: Write your last name, first name, middle initial, and suffix. Then, enter your date of birth and county of residence.
  4. Provide your contact information: Optionally, include your phone number and email address.
  5. Enter your residential address: Fill in your street address, apartment number (if applicable), city, state, and zip code.
  6. Choose how you want to receive your ballot: For both the Primary and General (or Special) elections, select one of the delivery options: in-person at the board of elections, authorized pickup by someone else, or mail to your address.
  7. Certify your application: Sign the form to confirm that you are a qualified and registered voter. Include the date of your signature.
  8. If applicable, have a witness sign: If you cannot sign due to illness or disability, have a witness complete the required section confirming they observed your mark.

Once you have completed the form, make sure to submit it according to the guidelines provided. This may involve mailing it to your county board of elections or delivering it in person. Ensure you meet the deadlines for submission to receive your absentee ballot in time.

Obtain Answers on New York Absentee Ballot Application

  1. What is the New York Absentee Ballot Application form?

    The New York Absentee Ballot Application form allows voters to request an absentee ballot. This is essential for those unable to vote in person on election day due to various reasons such as being out of the county, illness, or disability.

  2. How can I submit my absentee ballot application?

    You can submit your application in two ways:

    • In-Person: Deliver your application to your county board of elections no later than the day before the election.
    • By Mail: Your application must be received by your county board of elections no later than 15 days before the election.
  3. What are the reasons I can request an absentee ballot?

    You can request an absentee ballot for several reasons, including:

    • Absence from your county or New York City on election day
    • Being a resident or patient at a Veterans Health Administration Hospital
    • Temporary or permanent illness or physical disability
    • Detention in jail or prison, awaiting trial, or awaiting action by a grand jury
    • Primary care duties for individuals who are ill or physically disabled
  4. When will I receive my absentee ballot?

    Your absentee ballot will be sent to you starting 46 days before federal, state, county, city, or town elections. If you apply after this date, your ballot will be sent immediately after your application is processed.

  5. Can I authorize someone to pick up my ballot?

    Yes, you can authorize someone to pick up your ballot by providing their name in the appropriate section of the application. Make sure to check the box indicating that you are granting them permission.

  6. What if I have a permanent illness or disability?

    If you have a permanent illness or disability, once your application is approved, you will automatically receive a ballot for each election in which you are eligible to vote. You do not need to apply again for future elections.

  7. What happens if I cannot sign the application?

    If you are unable to sign due to illness or disability, you may make your mark on the application. This mark must be witnessed by someone who can certify that you are the person making the mark.

  8. Are there any penalties for providing false information?

    Yes, it is a felony to make a false statement in an absentee ballot application. This includes attempting to cast an illegal ballot or assisting someone else in doing so. Always ensure that the information you provide is accurate.

  9. What if I am in the military or overseas?

    If you are a military member or reside overseas, do not use this application. Instead, you should apply using the Federal Postcard Application (FPCA) to access special legal provisions. For more information, contact your local board of elections or visit the Military and Federal Voting sections of the New York State Board of Elections website.

Common mistakes

Filling out the New York Absentee Ballot Application can be straightforward, but many people make common mistakes that can lead to delays or disqualification. One frequent error is failing to sign the application. The signature is a critical part of the process, and without it, the application cannot be processed. Make sure to sign your name clearly in the designated area.

Another mistake is not providing accurate dates for your absence. Applicants often overlook the section where they must specify when their absence begins and ends. Incorrect or missing dates can lead to complications, as the election office needs this information to determine your eligibility for absentee voting.

Many people also forget to check the appropriate box indicating their reason for requesting an absentee ballot. This section is crucial because it informs the election officials of your situation. Without this information, your application may be deemed incomplete.

Providing incorrect personal information is another common issue. Ensure that your name, address, and date of birth are accurate. Mistakes in these areas can cause confusion and may prevent you from receiving your ballot on time.

Some applicants fail to include their contact information, such as a phone number or email address. While this information is optional, it can be beneficial for the election office to reach you if there are any questions or issues with your application.

Another mistake is misunderstanding the delivery options for your ballot. Applicants sometimes do not specify how they want their ballot delivered. Be clear about whether you want to pick it up in person or have it mailed to you. This choice should be indicated in the appropriate section of the application.

Additionally, people often neglect to double-check the submission deadlines. Applications must be received by the county board of elections by specific dates, and missing these deadlines can result in losing the opportunity to vote absentee.

Finally, some individuals mistakenly think they can use a power of attorney or preprinted name stamps to sign the application. This is not allowed. If you cannot sign due to a disability, you must have a witness present to attest to your mark. Understanding these requirements is essential to ensure your application is valid.

Documents used along the form

The New York Absentee Ballot Application form is a crucial document for voters who cannot attend polling places on election day. To ensure a smooth voting process, several other forms and documents may be required or helpful in conjunction with the absentee ballot application. Below is a list of these documents, each briefly described for clarity.

  • Voter Registration Form: This form registers individuals to vote in New York. It must be completed and submitted before the registration deadline to ensure eligibility for upcoming elections.
  • Federal Post Card Application (FPCA): This application is specifically designed for military and overseas voters. It allows them to register to vote and request an absentee ballot simultaneously.
  • Affidavit of Identity: If there are questions about a voter's identity, this affidavit can be used to affirm their identity and eligibility to vote, particularly in cases of discrepancies.
  • Ballot Tracking Information: This document provides voters with details on how to track the status of their absentee ballot, ensuring they know when it has been mailed and received.
  • Absentee Ballot Instructions: These instructions guide voters on how to properly fill out and submit their absentee ballot, including deadlines and return options.
  • Request for Military Ballot: Military members and their families can use this form to request a specific ballot designed for military voters, ensuring they receive the correct materials.
  • Change of Address Form: If a voter has moved, this form updates their registration details to ensure they receive their absentee ballot at the correct address.
  • Witness Statement: If a voter is unable to sign the absentee ballot application due to a disability, a witness must complete this statement to validate the voter's mark in lieu of a signature.

These documents support the absentee voting process and help ensure that all eligible voters can participate in elections, even when they cannot be physically present at polling places. Familiarity with these forms can enhance the voting experience and ensure compliance with election laws.

Similar forms

  • Voter Registration Form: Like the absentee ballot application, the voter registration form collects personal information such as name, address, and date of birth. Both documents require the applicant's signature to verify identity and ensure the accuracy of the provided information.
  • Federal Post Card Application (FPCA): This form is specifically for military and overseas voters. Similar to the absentee ballot application, it allows voters to request an absentee ballot. Both forms require a declaration of eligibility and may be submitted by mail or in person.
  • Vote by Mail Application: This document enables voters to request a mail-in ballot for elections. Much like the absentee ballot application, it requires details about the voter's identity and the election for which the ballot is requested. Both forms emphasize deadlines for submission to ensure timely delivery of ballots.
  • Emergency Ballot Application: This application is used when voters are unable to apply for a regular absentee ballot due to unforeseen circumstances. Similar to the absentee ballot application, it requires personal information and a signature, but it often has expedited processing to accommodate urgent situations.

Dos and Don'ts

When filling out the New York Absentee Ballot Application form, it’s important to follow specific guidelines to ensure your application is processed smoothly. Here are six things you should and shouldn’t do:

  • Do print your information clearly.
  • Don’t forget to sign your application. Your signature is crucial for validation.
  • Do submit your application in person or by mail, ensuring it meets the deadlines.
  • Don’t use a power of attorney or preprinted name stamps; these are not allowed.
  • Do check the appropriate box for your reason for requesting an absentee ballot.
  • Don’t provide false information. This could lead to serious legal consequences.

By following these guidelines, you can help ensure your absentee ballot application is completed correctly and submitted on time.

Misconceptions

Misconception 1: You can apply for an absentee ballot anytime.

In reality, the application must be submitted by specific deadlines. If you are delivering it in person, it must be received by the county board of elections the day before the election. If applying by mail, the application must arrive at least 15 days before the election.

Misconception 2: You can use a power of attorney to submit the application.

This is incorrect. Each voter must apply for their own absentee ballot. A power of attorney or printed name stamp is not allowed for voting purposes.

Misconception 3: You can apply for an absentee ballot for someone else.

This is not permitted. Each individual must submit their own application for an absentee ballot. Attempting to apply on behalf of another person can lead to legal penalties.

Misconception 4: Once you apply for an absentee ballot, you don’t need to worry about future elections.

If you have a permanent illness or disability, you will automatically receive a ballot for each election. However, if your condition is temporary, you must apply for each election separately.

Misconception 5: The absentee ballot will be sent immediately after you apply.

Your ballot materials will be sent starting 46 days before elections. If you apply after this period, your ballot will be sent as soon as your application is processed.

Misconception 6: You can vote in person if you requested an absentee ballot.

If you request an absentee ballot, you must use that ballot to vote. Voting in person after requesting an absentee ballot can invalidate your vote.

Key takeaways

Filling out the New York Absentee Ballot Application form can be straightforward if you keep these key points in mind:

  • Deadline Awareness: Submit your application in-person by the day before the election or by mail at least 15 days prior.
  • Personal Delivery: If you choose to deliver your application in person, ensure it reaches your county board of elections directly.
  • Eligibility Reasons: Clearly check the reason for your absentee ballot request, such as illness or being out of the county on election day.
  • Delivery Options: Decide how you want to receive your ballot—whether by mail, in-person, or through an authorized person.
  • Signature Requirement: Sign your application; if you cannot sign due to disability, you may make a mark with a witness present.
  • Automatic Ballot Receipt: If your disability is permanent, you won’t need to reapply for future elections; you’ll automatically receive ballots.
  • Ballot Processing: Expect your absentee ballot materials to be sent starting 46 days before elections, or immediately if you apply later.
  • Contact Information: If you have questions or need assistance, reach out to your local county board of elections.