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Vote By Mail Ballot Application
Registered Name

Date of Birth

Residence Address

Mailing Address

If different from above.

Cross-Over Party

Permanent Vote-by-Mail

Vote By Mail Application Acknowledgement*


- OR -


By clicking [Apply Electronically], I certify under penalty of perjury under the laws of the State of California that the residence address on this application are true and correct and that I have not applied for a Vote-by-Mail ballot for this election by any other means.