Form SF 186 SF 186 Federal Write-In Absentee Ballot

Federal Write-In Absentee Ballot (FWAB)

FWAB_Final_20170907

FWAB

OMB: 0704-0502

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Federal Write-In Absentee Ballot
If you do not receive your absentee ballot in enough time to
meet your State’s deadlines, use this ballot as a backup. If you
send in this ballot and receive your State’s ballot later, you
should fill out and return your State ballot as well. Your election
office will count only one ballot.
The following require you to register and request an absentee
ballot before filling out this form: AL, AS, AR, CT, FL, GU, HI,
ID, IL, IN, IA, KS, LA, MI, NH, NJ, NM, NY, PA, PR, RI, TX, VT,
WV, and WY. If your State or territory is listed, complete a
Federal Post Card Application (FPCA) online at FVAP.gov.
If you already registered and requested a ballot, send in the
Voter Information page and the Official Backup Ballot.

Use this form if you are:
On active duty in the Uniformed
Services or Merchant Marine
An eligible spouse or dependent
On active duty in the National
Guard under State orders
(some States only)
A U.S. citizen living outside the
United States

You can vote wherever you are. This is how.
1. Fill out your Voter Information page completely and accurately.
•	 Your U.S. voting residence address is used to determine where
you are eligible to vote absentee. For military voters, it is
usually your last address in your State of legal residence. For
overseas citizens, it is usually the last place you lived before
moving overseas. You do not need to have any current ties
with this address.
•	 Most States allow you to provide a Driver’s License number or
the last 4 digits of your SSN. Some States require a full SSN.
See your State’s guidelines at FVAP.gov.
•	 Most States require you to specify a political party to vote in
primary elections. This information may be used to register
you with a party.
•	 Remember to sign the bottom of the Voter Information page!
2. Carefully fill out your Official Backup Ballot.
•	 DO NOT sign your ballot or include any personal information.
Keep your ballot anonymous.
•	 Remove the adhesive liner from the top and sides of your ballot.
•	 Fold and seal tightly.
3. Assemble your documents for mailing.
•	 Put your Voter Information page and Official Backup Ballot into
the envelope.
•	 You can find the address for your election office at FVAP.gov.
•	 All States accept this form by mail, but they vary on email
and fax. See your State’s rules in the Voting Assistance Guide
online at FVAP.gov.

Agency Disclosure Statement
The public reporting burden for this collection of
information is estimated to average 15 minutes per
response, including time to review instructions,
gathering and maintaining the data needed,
and completing and reviewing the collection of
information. Send comments regarding this burden
estimate or any other aspect of this collection of
information, including suggestions for reducing the
burden to: Department of Defense, Washington
Headquarters Services, Executive Services
Directorate, Information Management Division, 4800
Mark Center Dr., East Tower, Suite 03F09, Alexandria,
VA 22350-3100. [OMB Control #0704-0502].
Respondents should be aware that notwithstanding
any other provision of law, no person shall be subject
to any penalty for failing to comply with a collection of
information if it does not display a currently valid OMB
control number. DO NOT RETURN YOUR FORM TO
THE ADDRESS ABOVE.

Privacy Act Statement
Authority: The authority to collect your personal
information on this form comes from 52 U.S.C. §
20301, “Uniformed and Overseas Citizens Absentee
Voting Act (UOCAVA).”
Principal purpose: This form serves as a write-in
absentee ballot for elections for Federal office or
other elections provided by State law or special
provisions for all persons covered by UOCAVA.
Routine use(s): There is no retention of this
information by the Federal government. Completed
forms are sent by you to an appropriate State
election official.
Disclosure: Your disclosure of personal information
is voluntary. However, failure to provide the
requested information may result in the Federal
Write-In Absentee Ballot not being recognized and
therefore not counted.

Questions? Email [email protected]

Voter Information
Federal Write-In Absentee Ballot (FWAB)
Print clearly in blue or black ink.

Have you already registered and
requested an absentee ballot?

Yes
No

Some States allow you to use this form to register and request
ballots for future elections. Visit FVAP.gov for more details.

1. Who are you? Pick one.
For absent Uniformed
Service members, their
families, and citizens
residing outside the
United States.
Last name

I am on active duty in the Uniformed Services or Merchant Marine -ORI am an eligible spouse or dependent.
I am an activated National Guard member on State orders.
I am a U.S. citizen living outside the country, and I intend to return.
I am a U.S. citizen living outside the country, and my return is uncertain.
I am a U.S. citizen living outside the country, and I have never lived in the United States.
Female
Sex
Suffix (Jr., II)
Male

First name

Previous names (if applicable)

Middle name

Birth date (MM/DD/YYYY)

Social Security Number

Driver’s license or State ID #

/

/

2. What is your U.S. voting residence address?
Your voting materials will not be sent to this address. See instructions on other side of form.
Street address

Apt #

City, town, village

State

County

ZIP

3. Where are you now? You must give your CURRENT contact information.
Your mailing address. (Different from above)

Your mail forwarding address. (If applicable)

4. What is your contact information? This is so election officials can reach you about your request.
Provide the country code and area code with your phone and fax number. Do not use a Defense Switched Network (DSN) number.
Email:

Phone:

Alternate email:

Fax:

5. What is your voting preference for future elections?
Do you want to register and
request a ballot for all elections
you are eligible to vote in?

Yes
No

How do you want to
receive voting materials
from your election office?

Mail
Email or online
Fax

What is your
political party for
primary elections?

6. What additional information must you provide?
The following need more information: Alabama, Alaska, Arizona, Puerto Rico, Virginia, and Wisconsin. (Ex. Witness signature, etc.)
You may also use this space to clarify your voter information. See the Voting Assistance Guide online at FVAP.gov.

7. You must read and sign this statement.
I swear or affirm, under penalty of perjury, that:
The information on this form is true, accurate, and complete to the best of my knowledge. I understand that a material misstatement of fact in
completion of this document may constitute grounds for conviction of perjury.
I am a U.S. citizen, at least 18 years of age (or will be by the day of election), eligible to vote in the requested jurisdiction, and
I am not disqualified to vote due to having been convicted of a felony or other disqualifying offense, nor have I been adjudicated mentally
incompetent; or if so, my voting rights have been reinstated; and
I am not registering, requesting a ballot, or voting in any other jurisdiction in the United States, except the jurisdiction cited in this voting form.
In voting, I have marked and sealed this ballot in private and have not allowed any person to observe the marking of this ballot, except those
authorized to assist voters under State and Federal law.

Sign here

X

This information is for official use only. Any unauthorized release may be punishable by law.

Today’s date
(MM/DD/YYYY)
Previous editions are obsolete.

/

/

Standard Form 186 (Rev.09-2017), OMB No. 0704-0502

Official Backup Ballot
Federal Write-In Absentee Ballot (FWAB)
Print clearly in blue or black ink.

Vote by writing the NAME or PARTY of the
candidates you choose. To find out about
specific candidates and races go to
FVAP.gov.

Instructions
•	This ballot can be used to vote for federal offices.
•	DO NOT write your name or any identifying number (SSN, driver’s license) on this ballot.
•	Photocopy this page if you require additional room for candidates or ballot initiatives.
•	If you are voting in American Samoa, Guam, Puerto Rico, or the U.S. Virgin Islands, you may vote for Delegate or
Resident Commissioner, and in presidential primaries. State laws vary about using the FWAB for other offices like
Governor or Mayor. Learn more online at FVAP.gov.
Federal offices
President and Vice President

U.S. Senator
U. S. Representative, Delegate, or
Resident Commissioner to Congress
Non-federal offices
Office

Candidate name

Political party

Ballot initiatives

Standard Form 186 (Rev.09-2017), OMB No. 0704-0502

Official Ballot
Federal Write-In Absentee Ballot

Fold your ballot and keep it private. Put it in the envelope.

Private

Before you seal this envelope:

STOP

1.	Sign and fold your Voter Information page.
2.	Fold and seal your Official Backup Ballot.
3.	Put both inside this envelope, and mail it
to your election office. The address can be
found at FVAP.gov.

1
Voter
Information

Voter
Information
Fold in half

2
Ballot

Official Ballot
Private
Fold and seal

3
Voter
Information
Official Ballot
Private

Mailing
Envelope

For election officials:
This is an official Federal Write-In Absentee Ballot
authorized by 52 U.S.C. § 20301.
If you have questions about it, contact your State officials.

NO POSTAGE NECESSARY IN THE U.S. MAIL – DMM 703.8.0

(Fill in the address of your election office. The address can be found online at FVAP.gov.)

To

YYYY

OFFICIAL ABSENTEE BALLOTING MATERIAL – FIRST CLASS MAIL

MM

I have enclosed my ballot for the __ /____ election.

International airmail postage is required if not mailed using the
U.S. Postal Service, APO/FPO/DPO system, or diplomatic pouch.

(Your name and mailing address.)

From

PAR AVION

U.S. Postage Paid
39 USC 3406


File Typeapplication/pdf
File TitleFWAB2017_20170724.indd
File Modified2017-09-07
File Created2017-09-07

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