Town of Pelham

6 Village Green

Pelham, NH 03076

Fax # 603-508-3096

APPLICATION FOR OFFICIAL TOWN OF PELHAM

ABSENTEE BALLOT

To the Town Clerk of PELHAM :  I                                                                                                

hereby apply for an official absentee voting ballot.  I am a duly qualified voter, and entitled

 to vote in the Town of Pelham New Hampshire.

Legal Address in Pelham, NH ____________________________________________________ 

Signature                                                                                                                                       

Mail Absentee ballot to:

          Name:                                                                                                               

          Address:                                                                                                            

         City or Town, State, Zip Code:                                                                           

Instructions:   This form must be filled out and mailed to:     Town Clerk's Office

                                                                                         6 Village Green

                                                                                         Pelham, NH 03076 

The Applicant  may mail or personally bring this form into the Town Clerk's Office:

If you mail the form:  The Town Clerk's Office will send the ballot to the address requested on this form

                                The Voter requesting the ballot may mail the ballot back to the Town Clerk's Office or

                                Personally return it to the Town Clerk's Office