This application must be received
by the Santa Cruz County Elections Department
in person, by mail, by FAX or by clicking SUBMIT below:
SANTA CRUZ COUNTY ELECTIONS DEPARTMENT 701 OCEAN ST RM 210
SANTA CRUZ CA 95060-4076
831-454-2060 / FAX: 831-454-2445
Ballots
will not be mailed out until May 5, 2008
Returning this application to anyone other than your elections official
may cause delay that could interfere with your right to vote. * * * PRESS TAB TO ADVANCE TO NEXT FIELD * * *
First name Middle Name or Initial Last name
2. DATE OF BIRTH
mm/dd/yyyy
3 E-MAIL: (Required by our office for contact purposes and will be kept confidential)
6. MAILING ADDRESS FOR BALLOT
(If different from above):
Number and Street or P.O. Box Number
City, State Zip Code
7. If you are not affiliated with a qualified party, please complete the following statement:
I am NOT affiliated with any qualified political party. However, for this
primary election ONLY, I request an absentee ballot for the following Party (please select one party only):
Democratic Party
Republican Party
American Independent Party
Unaffiliated Voter = no party ballot just non-partisan contests
There were no qualified candidates for the partisan offices for the American Independent Party. Therefore, pursuant to Elections Code Section 8004, if you select the American Independent Party option, you will be provided a nonpartisan ballot only.
For more information on unaffiliated voters, Please Click Here or call toll-free, 1-866-282-5900
8. CERTIFICATION. "I have not applied for, nor
do I intend to apply for, a vote-by-mail ballot from any other jurisdiction for this
election. By submitting this application, I certify under the laws of the State of
California that the name and residence address and information I have provided on this
application are true and correct.
9. Only the registered voter himself or herself may apply
for an absentee ballot. An application for an absentee ballot made by a person other than
the registered voter is a criminal offense.
A
BALLOT WILL NOT BE SENT TO YOU IF THIS APPLICATION IS INCOMPLETE OR INACCURATE.
10. Any voter may
apply for PERMANENT ABSENT VOTER STATUS (§3201). Check here to receive a
vote-by-mail ballot for all future elections.