2008 REQUEST FOR ABSENTEE BALLOT

You must be a LEGAL RESIDENT AND a REGISTERED VOTER IN SHELBURNE to vote here.

Shelburne Town Clerk's Office
5420 Shelburne Rd
P.O. Box 88
Shelburne, VT 05482-0088

For Absentee voter(s) use only

Choose Election from drop down menu:

* Choose Meeting/Election

Designate Party Ballot (for Presidential Primary Only)

Democrat

Republican

* 1. Name of Absentee Voter

2. Name of 2nd Absentee Voter

Mailing Address:

* Legal Residence (Street Name)

Shelburne, VT 05482

* If we need to reach you: Telephone #:

* VOTING DISTRICT of Legal Residence:

5-1

5-2

(if different):

* Signature:

* Date:

For Issuing Office Use Only

Ballots
Disbursed:

1

2

Voted in Person
Date:

Ballots
Disbursed:

1

2

TakeOut Ballots
Date:

Ballots
Disbursed:

1

2

Mailed Ballots
Date:

A voter who expects to be an early or absentee voter, or an authorized person on behalf of such voter, may apply for an early voter absentee ballot until 5:00 PM or the closing of the Town Clerk's office on the day preceding the election. 17 V.S.A. (A) (Amended 2001, No. 471, &3.) and 2534.

Revised 01/25/08

* Indicates Response Required