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ABSENTEE BALLOT FORM

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You still need to fill out, sign, stamp and mail your form.
INSTRUCTIONS:

MAIL THIS FORM TO:

Williamson County Administrator of


Elections
1320 W MAIN ST STE 140
FRANKLIN, TN 37064-3700

DEADLINE:

Fill out the form on the next page completely.

Sign the form. This is very important!

Mail or hand-deliver your completed application


to your Local Election Official as soon as
possible.

Your completed application must be received


not just postmarked by the deadline.

If you are concerned that the application may


not arrive in time, call your Local Election
Official and ask if you can fax or email in your
application.

Submit this form as soon as possible.

7 days before Election Day.


We recommend submitting this form
as soon as possible.

IF YOU HAVE QUESTIONS:

WARNINGS:
- If you registered to vote by mail, you
must vote in person in the first
Tennessee election in which you vote.
If you registered in person, you may
vote absentee in your first election.

Your Local Election Official is the best person


to contact if you need help.

Chad Gray
(615) 790-5711
Chadg@williamson-tn.org
M-F: 8a-4:30p Central

OVERSEAS OR MILITARY VOTERS

PROBLEMS VOTING?

Overseas and military voters can register to vote


and get their absentee ballot at the same time
by visiting FVAP.gov. Overseas and military voters
should not use the attached form. This form is
only for US-based voters.

You have the right to vote. If anyone is preventing


you from voting, please call the Election Protection
Hotline for free and nonpartisan advice:
1.866.OUR.VOTE

2008-2016 Vote.org. Vote.org is a 501(c)(3) registered non-profit organization and does not support or oppose any political candidate or party. http://vote.org

Form ID: 631802 / 4535 / Williamson County / TN / 37067

TENNESSEE BY-MAIL ABSENTEE BALLOT REQUEST FORM


Revised January 2016

You can mail, fax, or email your completed request form to your local County Election Commission Office. Do not apply any
sooner than 90 days before Election Day. This application is due no later than 7 days before the election in which you wish to
vote by mail.
First name

Middle name

Saad
Date of Birth

Last name

Suffix

khalid
Social Security Number

12/25/1995
Phone number

6155212726

Email address

saad1225@gmail.com

Where in Tennessee are you registered to vote?


Street Address

601 Huffine Manor Cir


City/Town

Franklin

State

Zip Code

37067

TN

Where should your absentee ballot be mailed?


Street Address:
City/Town

State

Zip Code

Which election do you need an absentee ballot for?


q General Election
q Democratic Primary
q Republican Primary
q Other (specify the date):
Why are you unable to vote in person? (please check one)
q I am over 60 years of age.
q I will be outside of this county during all hours of early voting and Election Day (must include mailing address outside
county to mail absentee ballot).
q I am enrolled as a full-time student (or spouse of a student) at an institution inside Tennessee and outside the county
where I am registered.
q I am a voter with a disability and my polling place is inaccessible.
q I reside in a licensed facility, outside the county, providing relatively permanent domiciliary care (Nursing Home).
q I am hospitalized, ill or physically disabled and because of such condition, I am unable to appear at my polling place
for this election.
q I am a caretaker of a person who is hospitalized, ill or physically disabled.
q I am a candidate.
q I am on jury duty in a state or federal court.
q I am serving as an election official or a member or employee of the election commission on Election Day.
q I am observing a religious holiday that prevents me from voting early or on Election Day.
q I have a Commercial Drivers License (CDL) (or spouse of a person possessing a CDL) or a Transportation Worker
Identification Credential (TWIC), will be out of county during early voting & Election Day, & have no specific out-ofcounty or out-of-state address to receive mail during this time. Enclosed is a copy of my CDL or my spouses CDL or
my TWIC card. The CDL # is

Signature of voter:

Date:

This application was created by LongDistanceVoter.org based on the requirements outlined at http://sos.tn.gov/products/elections/how-doi-request-absentee-ballot . NOT FOR REDISTRIBUTION: This form is for individual use only. No part of the content herein may
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