2023 Vote By Mail Application

Source page 1

Canton, Massachusetts
                          2023 Vote by Mail Application
Section 1- Voter Information:
   Name:
   Address of Voter Registration:
   Ballot Mailing Address (if different):
   Date of Birth:                                  Phone Number (optional):
   E-mail Address (optional):

Section 2 - Ballot Information:
   Elections:
        All elections this year
        April 4th Annual Town Election Only




Section 3 - Assistance:
   Voter required assistance in completing application due to physical disability.
        Assisting person’s name:
        Assisting person’s address:
   This application is being made by a family member.
        Relationship to Voter:

      Signed (under penalty of perjury):                                               Date:

Completing the Application
1. Voter Information – Provide your name, the address where you are registered to vote, your ballot mailing
   address (if different) and date of birth.
2. Ballot Information – Choose which ballot(s) you want to receive by mail.
   Choose a primary ballot option if you are not registered in a party.
3. Assistance – If you’re helping someone complete this application, or you’re requesting a ballot for a family
   member, fill out this section.
4. Sign your name – If you can’t sign your name, you may ask someone to sign your name in your presence.
Submitting the Application
Send this completed application to the Town Clerk's Office, 801 Washington Street, Canton, MA 02021,
or email application to elections@town.canton.ma.us, or deposit application in drop box outside Town Hall.
Application Deadlines
This application must reach your local election office by 5 p.m. on the fifth business day before Election Day.