> Request Registration/Absentee Ballot > American Samoa
The Federal Post Card Application (FPCA) registers you to vote and
requests absentee ballots for all regularly scheduled Federal
elections for the calendar year in which it is submitted.
You may not need to fill out this entire form. Check out the instructions below to see what information your Territory requires.
Open Voter Registration/Absentee Ballot Request
(Opens in a new window and requires Adobe Reader 7)
Only the following blocks are required:
Block 1: Select the category that describes you.
Block 3: Name (Last, First, Middle)
Block 4: Sex
Date of Birth
Your valid American Samoa Driver's License number OR
your Social Security number is required for voter
registration. If you do not possess either of these
identification numbers, American Samoa shall assign a
number that will serve to identify you for voter registration
Block 5: Recommended but not required. Provide your
contact information to allow your local election official to
follow up if more information is required.
Block 6: American Samoa allows you to receive your ballot
by mail, email or fax. Please rank your preference of how
you would like to receive your absentee ballot. More
transmission options may be available .
Block 7: Complete street address of your American Samoa
voting residence. A post office box is not sufficient. If your
address includes a rural route, describe its location in Block
9. This address must be within the county where you claim
legal voting residence.
Block 8: Complete address where you want your ballot
sent, usually where you live now.
Block 9: Enter your age, current place of employment, and
a statement that the residence listed in Block 7 was acquired
with the intent to make American Samoa your legal
residence. Provide any information that may assist the local
election official in accepting this application.
Affirmation: Sign and date. There is no notary requirement
on elections for Federal offices.
If you choose to mail your FPCA, mail the form directly to:
Chief Election Officer P.O. Box 3970 Pago Pago, AS 96799
Don't know your county? Go to the county finder. Don't know your zip code? Go to the United States Postal Service website.
Optional: You may be able to use the Postage-Paid Envelope Template.
Open Postage-Paid Envelope Template
The postage-paid envelope may be used if mailed in the U.S. Postal System which includes all U.S. military post offices (APO/FPO) overseas or through the diplomatic pouch available at U.S. embassies/consulates. Affix appropriate postage if using international mail. Template must be printed on a number 10 or larger envelope.
If you choose to fax, it is recommended that you fax the form directly to 684-699-3574 or toll-free within the United States at 877-443-1302. You may also use our toll-free fax service:
Inside the U.S.? Fax to:1-800-368-8683(703) 588-2148 DSN 425-2148
Outside the U.S.? Show me a list of toll-free fax numbers.
If you choose to email, email the signed, scanned form as an attachment directly to Asgelect@samoatelco.com. You may also use our Electronic Transmission Service by sending the form as an attachment to email@example.com.
Open Fax/Email Coversheet
More Information on American Samoa's Absentee Voting Guidelines
American Samoa Election website
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Q: When mailing a Voter Registration/Absentee Ballot Request form to my State, do I have to pay postage?
Q: What is a postmark and how do I make sure I get one?
Q: When is the best time to apply for an absentee ballot?
Q: Must I submit a separate application for each election?
Last updated: 09.17.2013