PAID PAID NON PROFIT ORG U.S. POSTAGE IOWA SECRETARY OF STATE NON PROFIT ORG U.S. POSTAGE ELECTRONIC SERVICE REQUESTED IOWA SECRETARY OF STATE SECRETARY OF STATE IOWAIOWA SECRETARY OF STATE 321 E.FIRST 12TH FLOOR, ST. FL. 1 LUCAS BUILDING 321 E. 12TH ST. DES MOINES, IA 50319-9029 DES MOINES, IA 50319 O F F I C I A L S TAT E O F I O WA Request your absentee ballot from your County Auditor by October 24 at 5:00 PM CT FIRST-CLASS MAIL FIRST-CLASS MAIL U.S. POSTAGE U.S. PAID POSTAGE PAID IOWA SECRETARY IOWA SECRETARY OF STATE OF STATE IMB-POSTAGE IMB-POSTAGE FIRST-CLASS MAIL U.S. POSTAGE PAID IOWA SECRETARY OF STATE IMB-POSTAGE MARK JAMESSAMPLE A VOTER 123 4321NORTH W DESSTREET MOINES AVE DES MOINES, IA50321 50301 MOINES IA FDADAFDTFTATDADAAATTFDDFFTFTDAFDTDADDTAFDDDAFDTATFFDAFFFFAAAFFATD Receive your absentee ballot from your County Auditor beginning on October 5 RECEIVE. PAID PAID PERMIT NO. 1195 IOWA SECRETARY DES MOINES, OF STATE IA NON NON PROFIT PROFITORG ORG U.S. U.S.POSTAGE POSTAGE Ensure your voted absentee ballot is postmarked on or before November 2 OR return to your County Auditor by November 3 at 9:00 PM CT RETURN. TRACK YOUR ABSENTEE BALLOT REQUEST AND BALLOT AT VOTERREADY.IOWA.GOV REQUEST. ABSENTEE BALLOT REQUEST FORM IOWA SECRETARY OF STATE FIRST FLOOR, LUCAS BUILDING 321 E. 12TH ST. DES MOINES, IA 50319 IOWA SECRETARY OF STATE FIRST FLOOR, LUCAS BUILDING ELECTRONIC SERVICE REQUESTED 321 E. 12TH ST. DES MOINES, IA 50319 ELECTRONIC SERVICE REQUESTED FDADAFDTFTATDADAAATTFDDFFTFTDAFDTDADDTAFDDDAFDTATFFDAFFFFAAAFFATD JAMES A VOTER 4321 W DES MOINES AVE DES MOINES IA 50321 FDADAFDTFTATDADAAATTFDDFFTFTDAFDTDADDTAFDDDAFDTATFFDAFFFFAAAFFATD JAMES A VOTER 4321 W DES MOINES AVE DES MOINES IA 50321 DATDAFTDATADFAADDDTTAFDADAFATDDDDTFATAFAFDDTTDFTATTDFTATADADFTTFA VARIABLE COUNTY NAME VARIABLE COUNTY ADDRESS VARIABLE CITY STATE ZIPCODE DATDAFTDATADFAADDDTTAFDADAFATDDDDTFATAFAFDDTTDFTATTDFTATADADFTTFA VARIABLE COUNTY NAME POLK COUNTY AUDITOR ND VARIABLE COUNTY ADDRESS 120 2 AVENUE VARIABLE CITY DES MOINES, IASTATE 50309 ZIPCODE LEARN MORE AT POLLWORKER.IOWA.GOV HELP YOUR COMMUNITY AND GET PAID! WOULD YOU CONSIDER BEING A PRECINCT ELECTION OFFICIAL THIS YEAR? 7. Track your absentee ballot request and absentee ballot at voterready.iowa.gov. 6. Follow the instructions to vote and return your ballot when you receive it in the mail from your County Auditor. SEAL STRIP The Voter Verification Number (ID Number) is either your Iowa Driver’s License or Non-Operator’s ID Number OR the four-digit Voter PIN located on your Iowa Voter ID Card. Any Voter may request an Iowa Voter ID Card or Voter PIN by contacting their County Auditor’s Office. 5. Place the sealed envelope in the mail as soon as possible to ensure enough time for your ballot to be mailed to you. The Absentee Ballot Request must be received by your County Auditor no later than Saturday, October 24 at 5:00 PM CT if you want to receive a ballot by mail. 4. Detach the postage-paid envelope, insert the completed and signed Absentee Ballot Request, and seal the envelope which is addressed to your County Auditor. 2. Read the instructions on the back side of the enclosed Absentee Ballot Request, provide all the necessary information, and be sure to sign it. In order to receive an absentee ballot for the November 3 General Election, you MUST provide the following information: (1) Name; (2) Date of birth; (3) Iowa residential address; (4) Voter Verification Number (ID Number); (5) The name OR date of the election for which you are requesting an absentee ballot; (6) Signature. 3. Detach the edge of the Absentee Ballot Request marked with “DETACH THIS FORM. INSTRUCTIONS ON BACK.” 1. If you already have submitted an Absentee Ballot Request for the November 3 General Election, you do not need to send another one. VOTING ABSENTEE BY MAIL Visit voterready.iowa.gov or call your POLK County Auditor at (515) 286-3247 to learn more. Vote in your polling place where social distancing and safety measures will be in place. Polls will be open 7:00 AM – 9:00 PM on November 3. Visit voterready.iowa.gov to find your polling place and REMEMBER TO BRING YOUR ID! VOTE ON ELECTION DAY Vote in your County Auditor’s office where social distancing and safety measures will be in place. In-person absentee voting is available October 5 – November 2. REMEMBER TO BRING YOUR ID! VOTE ABSENTEE IN PERSON Vote at home to practice social distancing and help slow the spread of COVID-19. See form below. County Auditors can begin mailing absentee ballots on October 5. Your Absentee Ballot Request must be received by your County Auditor no later than October 24 at 5:00 PM CT. VOTE ABSENTEE BY MAIL YOUR OPTIONS INCLUDE You are receiving this Voter Education Mailer because you are a registered voter. Choose your voting plan for the November 3, 2020 General Election. A MESSAGE FROM THE IOWA SECRETARY OF STATE DETACH THIS FORM. INSTRUCTIONS ON BACK. OR Zip: Suffix: County: Voters who do not appear in the Iowa Dept. of Transportation’s Driver’s License or Non-Operator ID files are mailed an Iowa Voter Identification Card at the time of registration. Any voter may request a Voter Identification Card. Revised July 2020 For Office Use Only 1 General 1 / 0 0 2 Primary Democratic 3 / 2 0 Email: State: Republican City/School Special: Zip: DO NOT ADD THIS CONTACT INFO TO MY VOTER RECORD Signature: X Date: I swear or affirm that I am the person named above and I am a registered voter or I am entitled to register at the address listed on this form. I am eligible to receive and vote an absentee ballot for the election indicated above. Check one political party: OR Election Date: Country (other than USA): City: Mailing Address/P.O. Box: You must be registered to vote in the county to receive an absentee ballot. If you are registered to vote in the county, this form will be used to update your voter registration if the information provided on this form is different than the information on your registration record. City: Home Street Address (include apt, lot, etc. if applicable): ELECTION DATE OR TYPE Choose only one election. REQUESTER AFFIDAVIT Powers of attorney do not have legal authority to request an absentee ballot on behalf of another. / Middle: Four-digit Voter PIN (can be found on Voter Identification Card): Phone: PRIMARY ELECTION ONLY / Iowa Driver’s License or Non-Operator ID Number: Date of Birth (month, day, year): First: Last: CONTACT INFO Important WHERE YOUR ABSENTEE BALLOT SHOULD BE MAILED If different than above YOUR IOWA RESIDENTIAL ADDRESS ID NUMBER Complete One YOUR NAME AND DATE OF BIRTH STATE OF IOWA OFFICIAL ABSENTEE BALLOT REQUEST FORM PLEASE TEAR OFF TO RETURN. PLEASE TEAR OFF TO RETURN. - Four digit Voter PIN located on the voter’s Iowa Voter ID Card - Iowa Driver’s License or Non-Operator ID Number OR Name Date of birth Iowa residential address Voter Verification Number (ID Number) If you have questions about absentee voting, please contact your County Auditor. All voters are encouraged to provide their phone number and/or email address in the event their County Auditor needs to confirm any information on the request form. - Any voter may request an Iowa Voter ID Card by contacting their County Auditor’s Office 5. The name OR date of the election for which you are requesting an absentee ballot 6. Party affiliation - only required for Primary Elections, which are held in even numbered years 7. Signature 1. 2. 3. 4. In order to receive an absentee ballot, a registered voter MUST provide the following necessary information: A registered voter may make written application to their County Auditor for an absentee ballot. A written application for a mailed absentee ballot must be received by the voter’s County Auditor no later than 5:00 p.m. 10 days before a General Election or 11 days before any other election. ABSENTEE BALLOT REQUEST FORM INSTRUCTIONS