Absentee Ballot Request


		Absentee Ballot Request Form for Lake County Residents Voter's Personal Information * First name Middle name * Last name * Date of birth * E-mail address * Daytime phone number Voter ID number (if available) Requested Election(s) All Elections* or Presidential Preference Primary Primary General Election Special Election Other; Election name(s) or date(s): NOTE: A person selecting "ALL ELECTIONS" will be scheduled to receive ballots through the next two regularly scheduled general elections. This would mean that a person selecting "ALL ELECTIONS" prior to the November 4th, 2008 General election will be automatically scheduled to receive ballots for all elections through the 2010 General election. Voter's Lake County Residence Address Street address Apartment, lot, or unit number * City * Zipcode Mail Ballot To Ballots cannot be forwarded. Required only if different from address above. Street address Apartment, lot, or unit number City State Zipcode