Request Registration/Absentee Ballot

The Federal Post Card Application (FPCA) registers you to vote and requests absentee ballots for all regularly scheduled Federal elections for the calendar year in which it is submitted.

You may not need to fill out this entire form. Check out the instructions below to see what information your Territory 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 3: Name (Last, First, Middle)

Block 4: Sex

Date of Birth

Your valid American Samoa Driver's License number OR your Social Security number is required for voter registration. If you do not possess either of these identification numbers, American Samoa shall assign a number that will serve to identify you for voter registration purposes.

Block 5: Recommended but not required. Provide your contact information to allow your local election official to follow up if more information is required.

Block 6: American Samoa allows you to receive your ballot by mail, email or fax. Please rank your preference of how you would like to receive your absentee ballot. More transmission options may be available .

Block 7: Complete street address of your American Samoa voting residence. A post office box is not sufficient. If your address includes a rural route, describe its location in Block 9. This address must be within the county where you claim legal voting residence.

Block 8: Complete address where you want your ballot sent, usually where you live now.

Block 9: Enter your age, current place of employment, and a statement that the residence listed in Block 7 was acquired with the intent to make American Samoa your legal residence. Provide any information that may assist the local election official in accepting this application.

Affirmation: Sign and date. There is no notary requirement on elections for Federal offices.

Mail

If you choose to mail your FPCA, mail the form directly to:

Chief Election Officer
P.O. Box 3970
Pago Pago, AS 96799

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.

Fax

If you choose to fax, it is recommended that you fax the form directly to 684-699-3574 or toll-free within the United States at 877-443-1302. You may also use our toll-free fax service:

Inside the U.S.? Fax to:
1-800-368-8683
(703) 588-2148
DSN 425-2148

Outside the U.S.? Show me a list of toll-free fax numbers.

Email

If you choose to email, email the signed, scanned form as an attachment directly to Asgelect@samoatelco.com. You may also use our Electronic Transmission Service by sending the form as an attachment to ets@fvap.gov.

Open Fax/Email Coversheet

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• If you have not received your absentee ballot in a timely manner use the Federal Write-In Absentee Ballot.