Form Sel-2 - Swcd-Resident Absentee Ballot Request Form - Ohio Soil And Water Conservation Commission

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SEL-2

& W

HIO

OIL

ATER

ONSERVATION

OMMISSION

_____________ SWCD - Resident Absentee Ballot Request Form

County residents wishing to vote absentee by mail may use this form to request an absentee ballot. All requests must be

received by the local SWCD Office not sooner than 21 days and not less than 5 days prior to the election.

County residents wishing to vote absentee in person at the local SWCD Office must complete this absentee ballot request form

not sooner than 21 days prior to the election and no later than time posted by the local SWCD Office in the election legal notice.

Per Ohio Revised Code 940.04 the ___________________ Soil & Water Conservation District Board

of Supervisors, will hold an election for _______ supervisors to be held on _____________________.

To process this Absentee Ballot Request, the informational box below must be completed by the voter.

I, ______________________________, hereby apply for an absentee ballot and registration envelope

print legal name

from the ___________________________Soil and Water Conservation District. I hereby certify that I am

an eligible voter in this special election as I meet the criteria of being at least 18 years of age and reside

within the county’s jurisdictional boundaries.

_________________________________________________

________________________________

Legal Signature

Date

Please note: Submitted Absentee Ballot Request Forms must contain the voter’s legal and original signature to be valid. Thus, any Absentee Ballot Request Forms not

having a legal and original signature will be deemed invalid. Faxes, email or scanned Absentee Ballot Request Forms will not be accepted and will deemed invalid.

If requesting an absentee ballot and registration envelope to be mailed to you, please complete the following:

Name:

______________________________________________

Street Address:

______________________________________________

City:

______________________________________________

State & Zip Code:

______________________________________________

To be processed and have a ballot mailed to you, please mail the completed Absentee Ballot Request Form to the

following address:

_______________________________ SWCD