SPECIAL APPLICATION TO VOTE ABSENTEE / EARLY

FOR STOW, MA Annual Town Election, SATURDAY, MAY 8, 2021

NO-EXCUSE VOTE BY MAIL has been extended by state law & is available to ALL STOW VOTERS
(We expect to start mailing ballots on April 15, 2021 – the process will take several days.)

Valid for Election: MAY 8, 2021 COMPLETE ONE FORM FOR EACH VOTER – REAL SIGNATURE REQUIRED
Voter
Information Name:
Voter Registration Deadline Legal Voting Residence:
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is April 16 8pm
1 STOW, MA 01775
Register, Check & Update your
voter info online:
Date of Phone
Birth: Number:
https://www.sec.state.ma.us/OVR
/ Email Address:
Ballot Mail Ballot To: SAME AS
Information 2 ABOVE

Special Voter required assistance in completing application due to physical disability.

Circumstances
(if applicable) Assisting Person’s Name:
Assisting Person’s Address:

3 The application is being made by a family member or house/roommate of the voter.

Relationship to Voter:
Voter admitted to a healthcare facility after noon on the 5th day before the election.
Voter designates the following
person to hand-deliver ballot:

Signed (under penalty of perjury): Date:

Eligibility: EVERY registered voter in Stow, MA is eligible to request an absentee/early ballot for the 5/08/21 election.

* THIS APPLICATION SHOULD ONLY BE COMPLETED IF THE VOTER WISHES TO VOTE BY MAIL
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Completing the Application: (In Person polling hours are on Sat. May 8 10am-4pm Center School, 403 Great Road)
1. Voter Information – Provide your name, legal voting address, and date of birth.
Telephone and email are optional but very helpful in case we need to contact you about your application.
2. Ballot Information: check “SAME AS ABOVE” OR provide the address where you want the ballot mailed.
3. Special Circumstances: If applicable, check the appropriate box and complete the necessary information
for person assisting voter, relationship to voter, or designated person to deliver ballot.
4. Voter signs their name & fills in date. MUST BE A REAL SIGNATURE (not an electronic signature)
Voter may authorize someone to sign their name in their presence – that person must complete the
assisting person’s information in Section 3.
Options for Submitting the Application to the Stow Town Clerk
1. Mail application to Stow Town Clerk, 380 Great Road, Stow, MA 01775
2. Email the application (pdf or picture file) to vote@stow-ma.gov
3. Fax application attn: Stow Town Clerk to 978-897-4534
4. Drop Off application: use the mail slot on the front door of the Stow Town Building at 380 Great Road
REGISTRAR USE ONLY: We certify that the voter for whom this application is being made appears to be eligible to vote in the
Annual Town Election on Saturday, May 8, 2021 from the address listed on the application.