3957
TAKOMA PARK

THIS SECTION APPLIES TO ELECTIONS FOR ALL CANDIDATES,
CHAPTER AMENDMENTS AND OTHER QUESTIONS AT ANY ELECTION
HELD IN ANY YEAR.

(4) APPLICATIONS FOR ABSENTEE BALLOTS: A
QUALIFIED VOTER DESIRING TO VOTE AT ANY ELECTION AS AN
ABSENTEE VOTER SHALL MAKE APPLICATION IN WRITING TO THE
CITY CLERK FOR AN ABSENTEE BALLOT, WHICH APPLICATION MOST
BE RECEIVED NOT LATER THAN TEN (10) DAYS BEFORE THE
ELECTION. THE APPLICATION SHALL CONTAIN AN AFFIDAVIT,
WHICH NEED NOT BE UNDER OATH, BUT WHICH SHALL SET FORTH
THE FOLLOWING INFORMATION UNDER PENALTY OF PERJURY:

(I)    THE VOTER'S NAME AND RESIDENCE ADDRESS,
INCLUDING STREET AND NUMBER, IF ANY;

(II)   THAT THE PERSON IS A QUALIFIED VOTER AT
THE RESIDENCE ADDRESS GIVEN;

(III)  IF THE PERSON VOTED AT THE PRECEDING
ELECTION, THE RESIDENCE ADDRESS FROM WHICH HE VOTED.

(5) APPLICATION FORMS:

(I)    THE CITY CLERK SHALL USE THE FORMS
PRESCRIBED BY THE STATE ADMINISTRATIVE BOARD OF ELECTION
LAWS AND RELATED AFFIDAVITS AND STATEMENTS; THEY SHALL BE
PROVIDED BY THE CITY CLERK TO ANY QUALIFIED VOTER UPON
REQUEST.

(II)   THE CITY CLERK SHALL USE FORMS
PRESCRIBED BY THE STATE ADMINISTRATIVE BOARD OF ELECTION
LAWS FOR "APPLICATION FOR ABSENTEE REGISTRATION AND
BALLOT," "APPLICATION FOR ABSENTEE BALLOT BY REGISTERED
VOTER," "APPLICATION FOR EMERGENCY ABSENTEE BALLOT BY
REGISTERED VOTER," AND BELATED AFFIDAVITS AND STATEMENTS,
MAKING SUCH ADJUSTMENTS AS MAY BE REQUIRED TO DESIGNATE
THE CITY CLERK AS THE PERSON TO WHOM THOSE APPLICATIONS
ARE MADE.

(III)  THE APPLICATION FOR ALL OTHER ABSENTEE
VOTERS SHALL BE IN THE FOLLOWING FORM:

(DATE)

CITY CLERK, CITY OF TAKOMA PARK, MARYLAND

I,_______(NAME) , HEREBY APPLY FOR A CITY OF

TAKOMA PARK ABSENTEE BALLOT FOR THE ELECTION
TO BE HELD ON (DATE) I WILL NOT BE ABLE

TO VOTE IN PERSON BECAUSE ______(STATE REASON)

MY HOME ADDRESS IS (NO. AND STREET) ,
TAKOMA PARK, MARYLAND, AND MY VOTING DISTRICT,