EARLY BALLOT REQUEST FORM 2018 - Platte …

1 EARLY BALLOT REQUEST form (formerly Absentee BALLOT ) Print this form , complete & SIGN the form . Then either mail, fax, email or deliver in person to: Diane M. Olmer, Platte County Election Commissioner Box 513 2610 14th Street Columbus, NE 68602-0513 Phone: 402 563-4908 Fax: 402 564-7733 Email: ____I will vote in office today. _____I will take BALLOT /s with me. ____Please mail BALLOT /s. ** I, _____, hereby REQUEST that an EARLY BALLOT be mailed to me for the _____election occurring on _____. (Primary, General, Special) (Date) I am a registered voter residing at _____ (Address) _____ (Address) _____ (City, State, Zip Code)

2 The BALLOT should be mailed to me at _____ (Address) _____ (Address) _____ (City, State, Zip Code) _____ (Signature of voter) _____ _____ (Signature of person acting as agent) (Relationship of agent to voter) _____ Office Use: Precinct (Phone #) Party: Supr#: _____ : (Date) NRD: BALLOT Type: **For Nonpartisans ONLY: If you wish to vote in this primary election for Senator and/or House of Representative, you may REQUEST a partisan BALLOT as stated in 32 912 (2) from one of the political parties by checking the appropriate box.

3 (For the 2018 Primary, the Democratic Party opened its Primary Election to nonpartisans, so that BALLOT may contain federal, state and county offices. The Republican & Libertarian ballots, requested by nonpartisans, will contain only federal office candidates.) Democratic Libertarian Republican If voting in the office, I the above signed voter, declare under penalty of election falsification, that the BALLOT or ballots contained no voting marks of any kind when I received them, and I caused the BALLOT or ballots to be marked, deposited by an election official into the sealed BALLOT box. ** (The REQUEST for an EARLY BALLOT to be mailed to a voter must be received by the Election Office no later than the close of business on the second Friday preceding the election.)

4 The last day to vote EARLY in the Election Office is the day before the election. An agent can pick up a BALLOT for a voter up until 7PM election day)