Board Of Elections

Absentee Ballot Application Form

Separate applications must be completed for each election. Applications must be printed and submitted to our office. By law, no emailed or faxed copies can be accepted. Please mail or drop off your application to: 520 Justice Drive Lebanon, Ohio 45036. For your convenience we have a 24 hour drop box.

Voter Info

Voter's Last Name

* Last Name Required

Voter's First Name

* First Name Required

Home Address

* Home Address Required

Apt./Unit #

City

* City Required

State

OHIO

Zip

* Zip Code Required

County

* County Required

BIRTHDATE:

Month

Day

Year

Other Mailing Address

Send Ballot to: (If different from home address or if P.O. Box must be used)

C/O Name

Address

Apt./Unit #

P.O. BOX

City

State

Zip

AND ONE OF THE FOLLOWING:

Ohio Drivers License Number
Where is my Drivers License Number?

Last Four Digits of your Social Security Number

Copy of a current and valid photo identification, a military identification, or a current (within the last 12 months) utility bill, bank statement, government check, paycheck, or other government document (other than a notice of voter registration mailed by a board of elections) that shows your name and current address.
* Please remember to attach one of the above listed items when you print, sign and mail in your application.

Election Selection

I wish to vote in the following election: *Please make a selection

Optional Info

This information is not required, however it will assist the Board of Elections in contacting you if there is a problem with your application.

Phone

I am interested in serving as a poll worker on Election Day. (optional)

YesNo