Back

REQUEST FOR ABSENTEE BALLOT FOR MARCH 5, 2002

Name of absentee voter:                                                                        

Current address:                                                                                       

Address to which ballots are to be sent:                                                      

If applicant is other than absentee voter:

Name of applicant:                                                                                     

Address of applicant:                                                                                 

Relationship to absentee voter:                                                                    

Signature:                                             Date:                                           

                                                                                    (17 VSA 2532)