"Request for Absentee Ballot - Public School Elections" - Delaware

Request for Absentee Ballot - Public School Elections is a legal document that was released by the Delaware Department of Elections - a government authority operating within Delaware.

Form Details:

  • Released on April 21, 2021;
  • The latest edition currently provided by the Delaware Department of Elections;
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State of Delaware – Request for Absentee Ballot – Public School Elections
Revised:  4/21/2021
Complete and sign this form 
School District: _______________________
- Select School District -
Affirmation
 
Election Date: ________________________ 
I do solemnly swear or affirm, under penalty of perjury, that the information contained 
herein is true and correct in every particular and that I am unable to go to a polling 
Please print legibly 
place during the forthcoming election for the reason checked below:   
Full name: __________________________________________ 
 I am in the public service of the US or the State of Delaware, or a citizen of the US
Address: 
temporarily residing outside the territorial limits of the US and the District of Columbia, or
such person's spouse or dependent when residing with or accompanying the person, or am
___________________________________________________
absent from this State because of illness or injury received while serving in the armed forces
___________________________________________________
of the US.
___________________________________________________ 
 I am in the armed forces of the US, the Merchant Marine of the US, attached to and serving
Date of birth: _______________________________________ 
with the armed forces of the US in the American Red Cross or United Service Organizations.
 Due to the nature of my business or occupation (includes students), including the business or
Phone number: _____________________________________ 
occupation of providing care to my parent, spouse, or child who is living at home and
Email: _____________________________________________ 
requires constant care due to illness, disability, or injury.
 I am sick or physically disabled.
Mail my ballot to this address, not to the one above: 
 I am absent from the district while on vacation.
____________________________________________________ 
 I am unable to vote at a certain time or on a certain day due to the tenets or teachings of my
____________________________________________________ 
religion.
I further swear or affirm, under penalty of perjury, that: 
____________________________________________________ 
1. I am a citizen of the United States,
2. I am a resident and citizen of the State of Delaware,
For Office use only 
I am 18 years old or older,
3.
Ballot type: _____________________________________ 
I reside within the geographic boundaries of the school district, and
4.
I will not vote or attempt to vote at a polling place on the day of the election.
Mail   In‐person    ID: __________________________ 
5.
Date affidavit mailed: _____________________________ 
My expected location on Election Day: _______________________________________________ 
Date affidavit returned: ___________________________ 
Voucher number: ________________________________ 
My Election Day phone number: _____________________________________ 
Date ballot mailed: _______________________________ 
Signature: ____________________________________________ 
Date ballot returned: _____________________________ 
Date: ________________________________________________ 
State of Delaware – Request for Absentee Ballot – Public School Elections
Revised:  4/21/2021
Complete and sign this form 
School District: _______________________
- Select School District -
Affirmation
 
Election Date: ________________________ 
I do solemnly swear or affirm, under penalty of perjury, that the information contained 
herein is true and correct in every particular and that I am unable to go to a polling 
Please print legibly 
place during the forthcoming election for the reason checked below:   
Full name: __________________________________________ 
 I am in the public service of the US or the State of Delaware, or a citizen of the US
Address: 
temporarily residing outside the territorial limits of the US and the District of Columbia, or
such person's spouse or dependent when residing with or accompanying the person, or am
___________________________________________________
absent from this State because of illness or injury received while serving in the armed forces
___________________________________________________
of the US.
___________________________________________________ 
 I am in the armed forces of the US, the Merchant Marine of the US, attached to and serving
Date of birth: _______________________________________ 
with the armed forces of the US in the American Red Cross or United Service Organizations.
 Due to the nature of my business or occupation (includes students), including the business or
Phone number: _____________________________________ 
occupation of providing care to my parent, spouse, or child who is living at home and
Email: _____________________________________________ 
requires constant care due to illness, disability, or injury.
 I am sick or physically disabled.
Mail my ballot to this address, not to the one above: 
 I am absent from the district while on vacation.
____________________________________________________ 
 I am unable to vote at a certain time or on a certain day due to the tenets or teachings of my
____________________________________________________ 
religion.
I further swear or affirm, under penalty of perjury, that: 
____________________________________________________ 
1. I am a citizen of the United States,
2. I am a resident and citizen of the State of Delaware,
For Office use only 
I am 18 years old or older,
3.
Ballot type: _____________________________________ 
I reside within the geographic boundaries of the school district, and
4.
I will not vote or attempt to vote at a polling place on the day of the election.
Mail   In‐person    ID: __________________________ 
5.
Date affidavit mailed: _____________________________ 
My expected location on Election Day: _______________________________________________ 
Date affidavit returned: ___________________________ 
Voucher number: ________________________________ 
My Election Day phone number: _____________________________________ 
Date ballot mailed: _______________________________ 
Signature: ____________________________________________ 
Date ballot returned: _____________________________ 
Date: ________________________________________________ 
State of Delaware – Request for Absentee Ballot – Public School Elections
How to fill out the form
Where to send it
Department of Elections – Kent County Office
1. Fill out the top left part of the form with your School District and Election
PO BOX 699
Date.
Dover DE 19903-0699
2. Enter your name, address and date of birth. You may include your phone
Phone: (302) 739-4498
number and email address in case your county elections office needs to
FAX: (302) 739-4515
contact you.
Email: absenteekc@delaware.gov
Department of Elections – New Castle County Office
3. If you need your ballot mailed to an address that is different from where
you live, please indicate your mailing address in the “Mail my ballot to” box.
PO BOX 7079
Wilmington DE 19803-0079
4. Pick the reason you need to vote absentee in the “Affirmation” section.
Phone: (302) 577-3464
5. Fill in where you will be and your phone number on Election Day.
Fax: (302) 577-6545
Email: absentee@delaware.gov
6. Sign and date the application.
Department of Elections – Sussex County Office
7. Send the completed form to your county elections office. Contact
PO BOX 457
information for these offices is in the next column.
Georgetown DE 19947-0457
Phone: (302) 856-5367
8. Your county elections office will mail your ballot when it is ready.
Fax: (302) 856-5082
9. Call or email your county elections office if you need help.
Email: absenteesc@delaware.gov
Important: Email, fax or mail the completed application to the Department of Elections Office in the County
where you live NO LATER THAN 4 DAYS BEFORE THE ELECTION.
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