Absentee Ballot Request Form (Subject To Eligibility)
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1Absentee Ballot Request Form (subject to eligibility)*
I request an absentee ballot for
______________________________________________________________________________________ Election.
Absentee ballot requests must be received by the local lodge no later than 30 days before the local lodge’s June 2012 polling date.
Must be filled out completely to be accepted. Please print. Please mail to me at the following address.
Name _______________________________________________________________________________________
Street Address _______________________________ City_________________________ State ____ Zip __________
Company ___________________________ File No. ____________________ Dept.__________________________
*
o
Because:
I reside more than 25 miles from the designated polling place
o
o
I am confined due to a verified illness
I will be on vacation—Valid only for active employees.
o
I will be on official IAM business
o
I will be on an employer travel assignment
o
I will be on family leave
o
I will be on military leave
Signature ___________________________________________________________________________________
( Must be signed )
All members are encouraged to verify mailing addresses with local lodges.
Absentee Ballot Mailing Addresses
LOCAL 75
Kathleen Domzalski, 4710 Boncrest Dr., East Williamsville, NY 14221
LOCAL 1781
Recording Secretary, P.O. Box 1764, Burlingame, CA 94011-1764
LOCAL 0141
Tiffany Lopez, Rec. Secretary, 9335 Middlebelt Rd., Romulus, MI 48174
LOCAL 1782
Recording Secretary, LL 1782, P.O. Box 281617, San Francisco, CA 94128
LOCAL 0368
Frank Fiorentino, Rec. Secretary, 4200 SW 95th Ave., Davie, FL 33328
LOCAL 1826
Dean Gaul, 910 E. 1st Ave., Indianola, IA 50125
LOCAL 0561
LOCAL 1833
Geraldine Burke, 4829 NE 79th St., Kansas City, MO 64119
Recording Secretary P.O. Box 69, Newport, MN 55055
LOCAL 0601
Recording Secretary 500 W Int’l Airport Rd., Ste C, Anchorage, AK 99518
LOCAL 1885
Recording Secretary Nicholas McCarthy, P.O. Box 55247, Portland, OR 97238
LOCAL 0731
Recording Secretary, 277 Tallulah Ave., Jacksonville, FL 32208
LOCAL 1886
Recording Secretary, P.O. Box 5446, Denver, CO 80217
LOCAL 0804
Recording Secretary, Wm. Cates, 3444 Ebenezer Rd., Cincinnati, OH 45248
LOCAL 1904
Members put into LL 1487
LOCAL 0811
P.O. Box 60564, Houston, TX 77205
LOCAL 1905
Recording Secretary, P.O.Box 20188, New Orleans, LA 70141
LOCAL 0845
LOCAL 1932
Recording Secretary, 1055 Whitney Ranch Rd., Ste. 240, Henderson, NV 89014
Susan Cole, 12109 Hawthorne Blvd., Hawthorne, CA 90250
LOCAL 0846
Gemma Martin, P.O. Box 8736, Baltimore, MD 21240
LOCAL 1979
Recording Secretary, 1934 Hau St. Honolulu, HI 96819
LOCAL 0914
LOCAL 2198
Gabriela (Bill) Imbemba P.O. Box 163, Winkatunk, NJ 07765
Recording Secretary, P.O. Box 34543, Houston, TX 77234
LOCAL 0949
Cory Walker 12365 St. Charles Rd., Bridgeton, MO 63044
LOCAL 2208
Recording Secretary, P.O. Box 189, Bedford, TX 76095
LOCAL 1018
Jennifer Blake, 22 W. 9th Road, Broad Channel, New York 11639
LOCAL 2210
Recording Secretary, LL 2210, 9502 Computer Dr. Ste.239, SanAntonio, TX 78229
LOCAL 1044
LOCAL 2294
James Shannon, 330 Backbone Rd., Clinton, PA 15026
Recording Secretary, 2346 S Lynhurst Dr. Ste B-207, Indianapolis, IN 46241
LOCAL 1287
Alice Porter, Recording Sec, 2261 S. Redwood Rd., Ste 8, West Valley, UT 84119
LOCAL 2319
Recording Secretary,, P.O Box 1116, Oldsmar, FL 34677
LOCAL 1322
LOCAL 2334
Steven Jenkins RS; 168-12 127th Ave. #6, Jamaica, NY 11434
Members Put Into LL 804
LOCAL 1351
Recording Secretary, P.O. Box 69447, Seattle, WA 98168
LOCAL 2339-G P.O. Box 3660, Hagatna, GU 96932
LOCAL 1445
Joe Krasko Rec. Sec. 15 Leighton Lane Manchester, NJ 08759
LOCAL 2444
Recording Secretary 1001 S Marshall ST. Box 16, Winston-Salem, NC 27101
LOCAL 1487
LOCAL 2508
Recording Secretary, P.O. Box 2650, Des Plaines, IL 60018
Recording Secretary, LL 2508, P.O.Box 622075, Orlando, FL 32862
LOCAL 1635
Nancy Jakubzak, 315 Pine SE, Albuquerque, NM 87106
LOCAL 2559
2737 W Baseline Rd. Ste 22, Tempe, AZ 85283
LOCAL 1725
LOCAL 2665
Recording Secretary,, 3100C Piper Lane, Charlotte, NC 28208
Recording Secretary, Midfield Local Lodge, 805 S. Glynn St. Ste. 127-343, Fayetteville, GA 30214
LOCAL 1726
Dominic Nese, Frank Celona Bldg., 830 Saratoga St., E.Boston, MA 02128
LOCAL 2725
Recording Secretary, P.O. Box 1799, Rio Grande, PR 00745
LOCAL 1731
Recording Secretary, P.O Box 81560, Cleveland, OH 44181
LOCAL 2765
Recording Secretary, 5150 Kearney Mesa Rd., San Diego, CA 92111
LOCAL 1759
LOCAL 2909
Recording Secretary 1037 Sterling Rd. Herdon, VA 20170
Recording Secretary, P.O. Box 950051, Oklahoma City, OK 73195
LOCAL 1776
Rick Anderson, Recording Secretary, 251 Jansen Ave. Essington, PA 19029
All members are encouraged to verify mailing addresses with local lodges.
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