Request Registration/Absentee Ballot
Fill out the Voter Registration/Absentee Ballot Request
You may not need to fill out this entire form. Check out the instructions below to see what information your state requires.
Open Voter Registration/Absentee Ballot Request
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What do I fill in?
Only the following blocks are required:
Block 1: Select the category that describes you.
Block 2.a: Name (Last, First, Middle); Block 2.e: Date of Birth
Block 2.d: This information is requested from some states by the Department of Justice in its enforcement of the Voting Rights Act and the National Voter Registration Act. Enter the choice that best describes you from the following list: AI = American Indian or Alaskan Native; AP = Asian or Pacific Islander not Native Hawaiian; B = Black, not of Hispanic Origin; H = Hispanic; M = Multi-racial; NH = Native Hawaiian; W = White, not of Hispanic Origin; O = Other
Blocks 2.f. and 2.g: Your valid Pennsylvania Driver's License number or the last four digits of your Social Security number is required for voter registration. If you do not possess either of these identification numbers, the State shall assign a number that will serve to identify you for voter registration purposes.
Block 3.a through 3.e: Complete street address of your Pennsylvania voting residence. A post office box is not sufficient. If your address includes a rural route, describe its location in Block 6. This address must be different from the one provided in Block 4 and must be within the county where you claim legal voting residence.
Block 4.a: Complete address where you want your ballot sent – usually your current mailing address. It must be different from the address you provided in Block 3.
Block 4.c: Check how you would like to receive your absentee ballot (mail or fax). If you do not make a selection, then your local election official will mail your ballot to you. Pennsylvania allows you to receive your ballot by fax if in a designated hostile fire, imminent danger pay, combat zone or qualified hazardous duty area.
Block 5: Enter your political party affiliation or write "none" if you want to vote in primary elections. If you want to change your political party affiliation, submit a completed Voter Registration/Absentee Ballot Request form indicating your new party preference to the local election official.
Block 6: Submission of this form serves as a request to receive ballots for all Federal elections held through the next two regularly scheduled general elections. If you do not wish to receive ballots for that length of time, you may request a ballot for each election for Federal office held in the next election year OR a ballot for only the next scheduled election for Federal office by noting your choice here. A State Write-In Absentee Ballot is available, see Step 3 for details. Provide any additional comments for your election official here.
Block 7: Sign and date. No notary/witness required.
Submission Options
You must mail your Voter Registration/Absentee Ballot Request to a specific election official. Find your county or city in the list below to locate your election official.
Open Election Official Address List
Don't know your county? Go to the county finder.
Don't know your zip code? Go to the United States Postal Service website.
Optional: You may be able to use the Postage-Paid Envelope Template.
Open Postage-Paid Envelope Template
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The postage paid envelope may be used if mailed in the U.S. Postal System, which includes all U.S. Military post offices (APO/FPO) overseas or through the diplomatic pouch available at U.S. embassies/consulates. Affix appropriate postage if using international mail. Template must be printed on a number 10 or larger envelope.
If you choose to fax, you MUST also sign and mail the request
Fax
If you choose to fax, it is recommended that you fax the form directly to your local election official (fax numbers can be found on Pennsylvania State Election website). You may also use our toll-free fax service:
Inside the U.S.? Fax to:
1-800-368-8683
(703)-693-5527
DSN 223-5527
Outside the U.S.? Show me a list of toll-free fax numbers.
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Follow-up
- Check the "Important Dates" section at the top of this page for registration, ballot request, and voted ballot return deadlines.
- Want to receive your ballot by fax? Pennsylvania allows you to receive your ballot by fax in certain situations. Write your fax number in section 2 of the form, and check your preference in Block 4c.
- If you have not received your absentee ballot in a timely manner use the Federal Write-In Absentee Ballot.
- In addition to mailing a regular ballot, Pennsylvania provides a Special Write-In Absentee Ballot 50 days before the primary election and 70 days before the general election to any voter unable to vote using the regular absentee voting process due military service or because they reside in a remote area. This ballot allows you to vote for local, state and Federal offices. To request it, write in Block 6: "I am unable to vote during the regular absentee balloting period by reason of performing military service in an extremely remote or isolated area of the world. I request a special write-in absentee ballot."