EMERGENCY ABSENTEE VOTING

Absentee ballots issued in the last 6 days prior to an election and on Election Day are called Emergency Absentee Ballots. These ballots cannot be issued by mail.

To obtain an Emergency Absentee Ballot, the voter or the voter’s authorized representative must provide a written request for the ballot to the Registrar of Voters office.

The request must contain the information shown on the form below:

EMERGENCY VOTING APPLICATION

(Elections Code Section 3021)

TO: REGISTRAR OF VOTERS, ORANGE COUNTY

On the day of the election to be held on _________________________, I will be unable to go to my polling place and I authorize ________________________________________, to obtain my ballot and deliver it to me. I understand this ballot may not be mailed but must be returned to the elections official or to any polling place in Orange County prior to 8 p.m. on Election Day.

Voter’s Printed Name: ___________________________________________________________

Voter’s Printed Address: __________________________________________________________

City and Zip: ___________________________________________________________________

I certify under penalty of perjury that the foregoing is true and correct.

Voter’s Signature: _______________________________________________________________

Executed by me at ____________________, California this ____ day of ______________, 19___.

Signature of person authorized to receive ballot: _______________________________________

An authorized representative for purposes of the Emergency Absentee Ballot provisions (ballots issued during the last 6 days before an election and on Election Day) is not limited to a relative of the voter.

The Registrar of Voters office is located at:

1300-C South Grand Avenue
Santa Ana, CA 92705
(714) 567-7600

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