Ohio Absentee Ballot Application

DATE
OHIO VOTER
180 E BROAD ST
COLUMBUS, OH 43215
Dear Voter,
l e
Ohio has long been a national leader in making it easy to vote and hard to cheat. For nearly 20 years, voters have
had a choice in how and when they cast a ballot. If you choose not to vote in person, state law allows you to vote
p
securely by mail.
m
The next statewide election is coming up on Tuesday, November 5, 2024. If you’re registered to vote and prefer
to vote by mail, please complete the absentee ballot request form on the back of this letter. Be sure to provide
sa
all the required information including your phone number and/or email address in case any follow-up is required.
Don’t forget to sign it!
To accommodate for possible postal delays, we recommend that you return the absentee ballot request form
to your county board of elections no later than October 25, 2024. Once you do, you can track the secure
processing of your request and ballot at VoteOhio.gov/Track.
Remember, if you don’t wish to vote by mail, you can still vote in person. Early voting is available at your county
board of elections beginning on October 8, 2024, and Election Day is Tuesday, November 5, 2024. If you do
choose to vote in person, be sure to bring a current government-issued photo ID. Information on acceptable
forms of identification can be found at VoteOhio.gov.
Make sure your voice is heard!
Yours in service,
Frank LaRose
Ohio Secretary of State Learn more at
3 Ways to Vote
Early in-person (Oct. 8 – Nov. 3)
Absentee by mail (Oct. 8 – Nov. 4)
Election Day (Tuesday, Nov. 5)
OHIO COUNTY BOARD OF ELECTIONS PLEASE MAKE SURE

1234 CONSTITUTION WAY
DEMOCRACY, OHIO 12345 Û THIS ADDRESS SHOWS
IN THE WINDOW OF
YOUR RETURN ENVELOPE.
SOS 0564 (2024)

Form 11-A Prescribed by the Ohio Secretary of State (02/07/2023)
Absentee Ballot Application

R.C. 3509.03 please print clearly (highlighted fields are required)
1) Your name
VOTER NAME LOCAL ID #
2) Your contact information (recommended)

Contact information will be used by the board of elections to contact you in a timely manner if your application is incomplete.
Telephone Number: Email:
e
3) Your home address at which you are registered to vote (no P.O. Boxes or polling place addresses)
l
VOTER ADDRESS
p
VOTER CITY, VOTER STATE VOTER ZIP VOTER COUNTY
4) The address where you receive mail (if different than above)
a m
Street Address (or P.O. Box):
s
City: State: ZIP:
5) Your date of birth:
6) Your identification
Provide ONE of the following:
A. Write in the last four digits of your Social Security number:
B. Write in your Ohio driver's license number or state ID card number:
C. A COPY of a different form of current photo identification (a driver's license, state ID card, or interim ID form
issued by the Ohio BMV; a US passport or passport card; or a US military ID card, Ohio National Guard ID card, or
US Department of Veterans Affairs ID card). The copy of the photo ID must include images of the front and back,
except for a passport which must include the passport's identification page.
7) Election in which you would like to vote (you must complete a separate application for each election)
November General Election

X November 5, 2024
If a primary election is selected, indicate the type of ballot you would like to receive by selecting ONE of the following:
Democratic Republican Issues Only
Important: If selecting a partisan ballot in a primary election, the ballot will include all questions and issues which the voter is eligible to vote.
8) Affirmation
• I understand that, per Ohio law, the board of elections must receive this request no later than the close of business seven
days before Election Day.
• I understand that if an absentee ballot is mailed to me and I change my mind and go to my polling place to vote on
Election Day, I will be required to vote a provisional ballot.
• I understand that if I do not provide the board with all of the required information, my application cannot be processed.
• I hereby declare, under penalty of election falsification, that I am a qualified elector and the statements above are true.
Signature X
Today's Date:
9) I am interested in serving as a poll worker on Election Day. (optional) Yes No
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE.

Ohio Absentee Ballot Application

Uploaded by

Copyright:

Available Formats

Ohio Absentee Ballot Application

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Ohio Absentee Ballot Application

Uploaded by

Copyright:

Available Formats

DATE

Make sure your voice is heard!

OHIO COUNTY BOARD OF ELECTIONS PLEASE MAKE SURE

SOS 0564 (2024)

Absentee Ballot Application

VOTER NAME LOCAL ID #

2) Your contact information (recommended)

5) Your date of birth:

November General Election

9) I am interested in serving as a poll worker on Election Day. (optional) Yes No

WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE.

You might also like