California Vote-By-Mail Ballot Application Form (Page 3 of 3) in pdf

Primary Election, you will be provided a nonpartisan ballot containing only the names of candidates

for voter-nominated and nonpartisan offices and measures, if any, to be voted for at the

Presidential Primary Election.

Item 8. Any registered voter may receive a vote-by-mail ballot automatically in all future elections

by checking the Permanent Vote-By-Mail Voter box and initialing the line. Any voter can opt out of

the permanent vote-by-mail status at any time by contacting their county elections official directly.

Item 9. Sign and date in this order – month, day, year. No witness or notary required.

How to Submit the Application

Your Vote-By-Mail Ballot Application must be returned to your county elections official at least 7

days before the election. However, if you become ill or disabled during the final week before an

election, or find that you will be unable to go to your polling place on election day, you may request

that a vote-by-mail ballot be delivered to you by personally submitting a written application or letter

to your county elections official. The request must contain your name and residence address, the

address to which you want the ballot sent, the name and date of the election in which you would

like to vote, your signature, and the date. You may authorize another person to receive the ballot

from the elections official, and/or return the ballot to an elections official after you have voted it.

If this application is returned by mail, mail to: Calaveras County Elections, 891 Mountain Ranch Road, San

Andreas, CA 95249.

What Can be Preprinted on the Application

State law requires the voter to personally affix his or her signature and the address to which the

ballot is to be mailed.

If an organization is distributing the application, the name, address, and telephone number of the

organization authorizing distribution must be included on the application.

In order to ensure accuracy, each voter should fill out all of the information on the application.

However, any person, group, or organization distributing the application may preprint the following:



The printed name and home address of the voter as it appears on the Voter Registration

Form.



The name and date of the election for which the ballot is requested.



The name, address, and telephone number of the person, group, or organization

authorizing distribution of the application.

(Revised April 2016)

California Vote-By-Mail Ballot Application Form Page 3