Application to Vote by Mail
Print and return completed and signed form to:

Plumas County Elections Department
520 Main Street, Room 102
Quincy, CA 95971

Attention: This form must be completed entirely or a ballot may not be issued to you.

I hereby request a Vote By Mail ballot for the
Date of Election
Type of Election
The address where I live in Plumas County
Residence Address
City and Zip Code
Please mail my ballot to
Address
City
State
Zip
I am not presently affiliated with any political party.  However, for  the primary election only, I request a vote by mail ballot for the Party. *

* In order to determine which parties allow Decline to State voters to vote in their primary elections, contact the Secretary of State's toll free number: 1-800-345-VOTE.  Elections Code Section 3006(c)
MUST BE SIGNED TO BE VALID
Print name
Signature
Date of Birth
Day Phone:

PERMANENT VOTE BY MAIL VOTER STATUS

State law now allows any voter who so requests to be a Permanent Vote By Mail Voter.  If you check the Permanent Vote By Mail Voter box on the Application for a Vote by Mail Ballot, a Vote by Mail Ballot will automatically be sent to you for future elections.  Failure to vote in a statewide election will cancel your Permanent Vote By Mail Voter Status and you will need to reapply.

Yes, I am requesting Permanent Vote By Mail Status.

For further information please call (530) 283-6256 or (530) 283-6129