Voter Registration and Absentee Ballot Request

1. Who are you?

I request an absentee ballot for all elections in which I am eligible to vote AND:*

First Name

Last Name

Middle Name

Suffix

Previous Names

Gender

Birth Date

2. What is your address in the U.S. State or territory where you are registering to vote and requesting an absentee ballot?

Street Address

Unit Type

Unit #

City

State Montana

Zip Code

County

3. Where are you now? You must give your CURRENT address to receive your voting materials.

If the mailing address is different than above.

Street Address

Unit Type

Unit #

City/Town/Village

State/Province

Zip Code

Country

4. What is your contact information? This is so election officials can reach you about your request.

Email

Phone

Alternative Email

Fax

5. What is your voting preference? Select one.

How do you want to receive voting materials from your election office?

6. What additional information must you provide?

You may use this space to clarify your voter information. Montana does not require additional information. For more information see https://www.fvap.gov

7. You must read and sign this statement.

The information on this form is true, accurate, and complete to the best of my knowledge. I understand that a material misstatement of fact in completion of this document may constitue grounds for conviction of perjury.
I am a U.S. citizen, at least 18 years of age (or will be by the day of the elction), eligible to vote in the requested jurisdiction, and
I am not disqualified to vote due to having been convicted of a felony or other disqualifying offense, nor have I been adjudicated mentally incompetent; or if so, my voting rights have been reinstated; and
I am not registering, requesting a ballot, or voting in any other jurisdiction in the United States, except the jurisdiction cited in this voting form.
You do not need to print and sign if you enter the last four of your SSN or your DL number

8. Personal Identification

You must provide either a Montana-issued ID number or the last four digits of your Social Security Number

Social Security Number (last 4 digits only)

Montana Driver's License or State ID