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pdfFederal 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, noting that you had previously sent in
this ballot. Your election official 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, KS,
LA, NH, NJ, NM, NY, PA, PR, RI, SD, TX, WI, WV, and WY. If your state
or territory is listed, complete a Federal Post Card Application (FPCA)
online at FVAP.gov.
Use this form if you are:
On active duty in the Uniformed
Services or Merchant Marine
An eligible spouse or dependent
A U.S. citizen living outside the
United States
If you already registered and requested a ballot, send in the Voter
Information page and the Official Backup Ballot.
Please be aware that some states will accept this form as
registration and as an absentee ballot request for future elections.
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. DO NOT write a PO Box # in section 2.
• Most states allow you to provide a Driver’s License number
or the last 4 digits of your SSN. New Mexico, Tennessee, and
Virginia require a full SSN.
• If you cannot receive mail at your current mailing address,
please specify a mail forwarding address.
• Many states require you to specify a political party to vote in
primary elections. This information may be used to register
you with a party.
• Section 6 Requirements: Puerto Rico requires your mother’s
and father’s first name. If registering in Vermont you must
acknowledge the following by writing in section 6: “I swear or
affirm that I have taken the Vermont Voter’s Oath.” Additional
state guidelines can be found at FVAP.gov.
• Remember to sign the bottom of the Voter Information page!
Agency Disclosure Statement
The public reporting burden for this collection of
information, OMB Control Number 0704-0502, is
estimated to average 15 mintues per response,
including the time for reviewing instructions,
searching existing data sources, gathering and
maintaining the data needed, and completing
and reviewing the collection of information. Send
comments regarding the burden estimate or burden
reduction suggestions to the Department of Defense,
Washington Headquarters Services, at whs.mc-alex.
[email protected].
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 SUBMIT YOUR FORM TO THE E-MAIL
ADDRESS ABOVE.
Privacy Advisory
When completed, this form contains personally
identifiable information and is protected by the
Privacy Act of 1974, as amended.
2. Carefully fill out and seal your Official Backup Ballot.
• DO NOT sign your ballot or include any personal information.
Keep your ballot anonymous.
• If using a self-sealing form, remove the adhesive liner, fold and
seal tightly.
• If you printed out the form, fold the voted ballot and seal it in an
envelope marked “ballot enclosed”.
3. Assemble your documents for mailing.
• Put your Voter Information page and Official Backup Ballot into
the mailing envelope.
• You can find the address for your election office at FVAP.gov.
• All states accept this form by mail and many states accept this
form by email and fax. See your state’s guidelines at FVAP.gov.
Questions?
Email: [email protected]
Voter Information
Federal Write-In Absentee Ballot (FWAB)
Print clearly in blue or black ink, please see back for instructions.
Have you already registered and
requested an absentee ballot?
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 -OR- I am an eligible spouse or dependent.
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 intent to return is uncertain.
I am a U.S. citizen living outside the country, and I have never lived in the United States.
Mr.
Miss
Suffix (Jr., II)
Mrs.
Ms.
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 different from mailing address)
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 are your preferences for future elections?
A. Do you want to register and
request a ballot for all elections
you are eligible to vote in?
Yes
No
B. How do you want to
receive voting materials
from your election office?
Mail
Email or online
Fax
C. What is your
political party for
primary elections?
6. What additional information must you provide?
Alabama requires two witness signatures; Alaska, Virginia and Wisconsin, require one witness signature. Puerto Rico and Vermont need
more information, see back for instructions. Additional state guidelines can be found 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.DRAFT), 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 federal candidates and races go to
FVAP.gov.
Instructions
• The FWAB is intended to serve as a backup ballot. It can be used to vote for federal offices. Refer to your state or
local election official for any special ballot instructions (e.g., instant runoff voting or ranked choice voting).
• State laws vary on the use of the FWAB for state and local contests. Learn more online at FVAP.gov.
• DO NOT write your name or any identifying number (SSN, driver’s license) on this ballot.
• 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.
• Photocopy this page if you require additional room for candidates or ballot initiatives.
Federal offices
President and Vice President
U.S. Senator
U. S. Representative, Delegate, or
Resident Commissioner to Congress
Other offices
Office
Candidate name
Political party
Ballot initiatives or other items
Standard Form 186 (Rev.DRAFT), OMB No. 0704-0502
Official Ballot
Federal Write-In Absentee Ballot
Private
Fold your ballot and keep it private. Put it in the envelope.
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 Type | application/pdf |
File Modified | 2021-08-16 |
File Created | 2021-08-16 |