ABSENTEE BALLOT APPLICATION
San Mateo County
November 7, 2006, California Gubernatorial General Election

Dear Voter,

Congratulations! I’m delighted that you’ve chosen to Vote Absentee. Over one-third of all voters in San Mateo County prefer to vote absentee (vote by mail) because it’s so convenient. Once people try it, they usually don’t vote any other way.

For your convenience, you may personally return your voted ballot at the Elections Offices at:

                          40 Tower Road , San Mateo or
                          555 County Center, 1^st Floor, Redwood City

Warren Slocum
Chief Elections Officer

Required information to complete this form.

Name: *	First	Last	Mailing Address (only if different from residence address)
Date of Birth: *	(mm/dd/yyyy)
Residence Address: *
City: *
Zip Code: *
Phone: **
E-Mail: **

* indicates required fields - ** indicates optional fields

VOTERS NOT AFFILIATED WITH A QUALIFIED POLITICAL PARTY (Nonpartisan or decline to state voters).

Nonaffiliated voters may request an absentee ballot other than non-partisan ballots for the following qualified political parties: Democratic, Republican, and American Independent. If you have any questions, call our office at 650.312.5222 or the Secretary of State at 1.800.345.VOTE (8683.)

I am not presently affiliated with any qualified political party, however, for this election ONLY, I request an absentee ballot for the political party indicated below:

Please type in the party ballot of your choice

A ballot will not be sent to you if this application is incomplete or inaccurate. If you have further questions concerning voting by mail, please call (650) 312-5222.

CERTIFICATION

By submitting this completed form, you affirm the following statement: "I have not applied for, nor do I intend to apply for, a vote-by-mail ballot from any other jurisdiction for this election. By submitting this application, I certify under the laws of the State of California that the name and residence address and information I have provided on this application are true and correct. I certify under penalty of perjury that the information on this application is true and correct. " Warning: Perjury is punishable by imprisonment in state prison for two, three or four years (CA Penal Code, Sec. 126).

Only the registered voter may apply for an absentee ballot. An application for an absentee ballot made by a person other than the registered voter is a criminal offense. This format is not to be used for mass reproduction by individuals, organizations or groups.

"I certify under penalty of perjury that the information on this application is true and correct."

If online submission fails, please print this form, sign below and deliver by mail, in person or by FAX.

________________________________________________________    Date: _______________________
Your signature as registered to vote

Registration & Elections Division
San Mateo County
40 Tower Road
San Mateo, CA 94402
Phone: (650) 312-5222
Fax: (650) 312-5348