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absentee ballot for voting

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					                         EARLY VOTING BALLOT APPLICATION




I, __________________________________________, hereby request that an absentee ballot be
                       (Name)

mailed to me for the _________________ election occurring on __________. I am a registered
                    (Primary, General, Special)                          (Date)

voter residing at _______________________________________________________________ ,
                                        (Address, City, St. Zip)

my phone number is ___________________________________ and I am registered to vote as a:


       Republican         Democratic          Nebraska Party          Nonpartisan



The ballot should be mailed to me at _______________________________________________.
                                                          (Address, City, St., Zip)




                                                        _______________________________
                                                                 (Signature)

                                                        ___________________________
                                                                   (Date)

				
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posted:5/3/2009
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