Monday – Friday 8 a.m. to 4 p.m.
P. O. Box 226 – Lewistown, Illinois 61542-0226 firstname.lastname@example.org
Enclosed if your application to absentee vote.
Information that has been printed on the top of this form is obtained from your voter registration record. Please check your name and address information carefully. If there is a discrepancy, please contact the election department at 547-3041, EXT. 119 or 120.
In the middle left hand side of the application, the address has been filled in (where the ballot is to be mailed). If the address is not correct, please cross through that information and write the correct address on the lines. On the middle right hand side, please fill in the date, sign your name, and print your name.
Do not cut your application half!
Please return the application to our office as soon as possible in the enclosed return envelope. Once we received your application, the ballot will be mailed to you for voting.