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Pennsylvania Application for Mail-In Ballot

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Form Overview

This document is the official application for a mail-in ballot in Pennsylvania. It consists of three pages:

  1. Page 1: The application form itself, requiring personal details, address, identification, and a declaration.
  2. Page 2: Instructions on how to submit the application, important deadlines, identification requirements, and contact information.
  3. Page 3: A directory of addresses for County Mail-in Ballot Offices across Pennsylvania.

How to Apply and Submit

  • Submission: Completed applications must be returned to the local county board of elections.
  • Website: For more information or to find your specific county office, visit www. VotesPA. com/county.
  • Contact: Call 1-877-VOTESPA (1-877-868-3772) for assistance.

Critical Deadlines

  • Application Deadline: The application must be received by the county board of elections by 5:00 PM on the Tuesday before the election.
  • Ballot Return Deadline: The completed ballot must be received by the county board of elections by 8:00 PM on election day.
  • Note: Postmarks do not count for either deadline.

Identification Requirements

To apply, you must provide one of the following in the "Identification" section:

  • Your PA Driver’s License or PennDOT issued photo ID card number.
  • If you do not have a PA Driver’s License or PennDOT ID, you must provide the last four digits of your Social Security number.
  • If you have neither: You must check the box stating "I do not have a PA driver's license or a PennDOT ID card or a Social Security number" and enclose a photocopy of an acceptable ID.

Annual Mail-In Ballot Request

  • You can request to receive mail-in ballot applications automatically every year.
  • If selected, you will receive an application to renew your request annually. Once approved, you do not need to submit a new application for each election.

Important Warning

  • If you receive and return a mail-in ballot by the deadline, you may not vote at your polling place on election day.
  • If you are unable to return your voted mail-in ballot by the deadline, you may vote a provisional ballot at your polling place on election day.

Assistance

  • If you are unable to sign the declaration due to illness or physical disability, you may have assistance.
  • A witness must sign the "Help with this form" section, providing their name, address, and signature.

County Office Directory (Page 3)

The document lists contact information for mail-in ballot offices in all Pennsylvania counties, including:

  • Address: Street address or P. O. Box.
  • City/State/Zip: Location details.
  • Phone Number: Contact number for the county office.

Examples include:

  • Adams County: 117 Baltimore St, Gettysburg PA 17325
  • Allegheny County: 542 Forbes Ave, Pittsburgh PA 15219
  • Philadelphia County: 430 Court St, New Castle PA 16101
  • York County: 28 E Market St, York PA 17401

For a complete list of email addresses and updated contacts, visit www. votesPA. com/county.

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