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Application to Vote by Mail
Kathy Michael, McLean County Clerk
**Reminder: McLean County has two Election Authorities. Our office handles all but City of Bloomington. Click HERE for the Bloomington Election Commission's Vote by Mail information.**
Last Name  
First Name  
Address 1  
Address 2
City  
State (abbreviated)  
Zip  
County  
Email Address  
Date of Birth (mm/dd/yyyy)(optional)*  
Phone Number(optional)*
To be voted at the Consolidated Election
Date of Election April 4, 2017
Precinct(optional)*
*Optional information; even though this is not required, providing it may aid in the processing of your ballot.

I certify that I reside at the address specified above, in the stated precinct and county, that I have lived at such address for 30 days or more preceding this election, that I am lawfully entitled to vote in such precinct at said election to be held therein, and that I wish to vote by absentee ballot.

I hereby make application for an official ballot or ballots to be voted by me at such election, and I agree that I shall return such ballot or ballots to the official issuing the same prior to the closing of the polls on the date of the election or, if returned by mail, postmarked no later than midnight preceding election day, for counting no later than during the period for counting provisional ballots, the last day of which is the 14th day following election day.

I understand that this application is made for an official absentee ballot or ballots to be voted by me at the election specified in this application and that I must submit a separate application for an official absentee ballot or ballots to be voted by me at any subsequent election.

Under penalties as provided by law pursuant to 10 ILCS 5/29-10, the undersigned certifies that the statements set forth in this application are true and correct.


 
Marking this signature box is in lieu of my signature


Address to which ballot should be mailed (if different from above)

Mail Address
Mail Address Cont.
Mail City
Mail State
Mail Zip
Kathy Michael
McLean County Clerk
PO Box 2400
Bloomington, IL 61702-2400


Ballots will not be available until the end of February. If you have not heard from us or received your ballot by March 2, 2017 please call our office at 309-888-5899. This application MUST be received by March 30, 2017.