Scheduling Order Page 7
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11of primary, name and address of present residence or hospital at which hospitalized. When
such application is received by the Secretary of the Commonwealth, it shall be forwarded to
the proper county board of elections.
The application for an official absentee ballot for any primary or election shall be made on
information supplied over the signature of the bedridden or hospitalized veteran as required in
the preceding subsection. Any qualified registered elector, including a spouse or dependent
referred to in subsection (l) of section 1301, who expects to be or is absent from the
municipality of his residence because his duties, occupation or business require him to be
elsewhere on the day of any primary or election and any qualified registered elector who is
unable to attend his polling place on the day of any primary or election because of illness or
physical disability and any qualified registered bedridden or hospitalized veteran in the county
of residence, or in the case of a county employe who cannot vote due to duties on election day
relating to the conduct of the election, or in the case of a person who will not attend a polling
place because of the observance of a religious holiday, may apply to the county board of
elections of the county in which his voting residence is located for an Official Absentee Ballot.
Such application shall be made upon an official application form supplied by the county board
of elections. Such official application form shall be determined and prescribed by the Secretary
of the Commonwealth of Pennsylvania.
(1) The application of any qualified registered elector, including spouse or dependent
referred to in subsection (l) of section 1301, who expects to be or is absent from the
municipality of his residence because his duties, occupation or business require him to be
elsewhere on the day of any primary or election, or in the case of a county employe who
cannot vote due to duties on election day relating to the conduct of the election, or in the case
of a person who will not attend a polling place because of the observance of a religious
holiday, shall be signed by the applicant and shall include the surname and given name or
names of the applicant, his occupation, date of birth, length of time a resident in voting district,
voting district if known, place of residence, post office address to which ballot is to be mailed,
the reason for his absence, and such other information as shall make clear to the county board
of elections the applicant's right to an official absentee ballot.
(2) The application of any qualified registered elector who is unable to attend his polling
place on the day of any primary or election because of illness or physical disability and the
application of any qualified registered bedridden or hospitalized veteran in the county of
residence shall be signed by the applicant and shall include surname and given name or names
of the applicant, his occupation, date of birth, residence at the time of becoming bedridden or
hospitalized, length of time a resident in voting district, voting district if known, place of
residence, post office address to which ballot is to be mailed, and such other information as
shall make clear to the county board of elections the applicant's right to an official ballot. In
addition, the application of such electors shall include a declaration stating the nature of their
disability or illness, and the name, office address and office telephone number of their
attending physician: Provided, however, That in the event any elector entitled to an absentee
ballot under this subsection be unable to sign his application because of illness or physical
disability, he shall be excused from signing upon making a statement which shall be witnessed
by one adult person in substantially the following form: I hereby state that I am unable to sign
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