Absentee Ballot Request Form
(for Collier County Residents Only)

  1. Complete the form below.
  2. Provide an exact mail address for the three week period prior to each election. Absentee Ballots can NOT be forwarded by the United States Postal Service.
  3. Absentee Ballots returned as undeliverable by the United States Postal Service may cancel other Absentee Ballot requests on file requiring you to make your request again.
  4. Click the Submit button at the bottom.
  5. Fill out and submit a separate form for each voter requesting an absentee ballot.
* Denotes a required field.
Last Name * First Name * M.I.
Date of Birth *  
 //  
Mail Ballot(s) to: *   Collier County address: *
 Street Address
 Apt. #
 City,StateZipCountry		  Street Address
 Apt. #
  City, State Zip
Email address: Phone:
   ()  -

Check the boxes next to the Election(s)
for which you are requesting an absentee ballot: *


-Aug. 26, 2008 Primary Election
-Nov. 4, 2008 General Election
-Request absentee ballots for all elections through the next two regularly scheduled general elections.

Provide an exact mail address for the three week period prior to each election.
Absentee Ballots can NOT be forwarded by the United States Postal Service.
Absentee Ballots returned as undeliverable by the United States Postal Service may cancel other Absentee Ballot requests on file requiring you to make your request again.
 

Requested by:
Last Name * First Name * M.I.
   
Select Relationship to Voter receiving this ballot: *

 
Address Phone:


,
 
() -
 

* Denotes a required field.

Rev. 01/23/08

 


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Jennifer J. Edwards
Collier Government Complex. 3301 Tamiami Trail East, Rev. Dr. Martin Luther King Jr. Building. Naples, Florida 34112-4907
Phone: (239) 252-8450  -  Fax (239) 774-9468
Email: SupervisorOfElections@CollierGov.net

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