Complete Back-up Federal Write-In Absentee Ballot

Arizona allows you to use the Federal Write-In Absentee Ballot (FWAB) for both registration and voting in primary, general, and special elections for Federal office.

Open Back-up Federal Write-In Absentee Ballot

(Opens in a new window and requires Adobe Reader 7)

What do I fill in?

Only the following blocks of the Voter's Declaration/Affirmation are required:

Block 1: Arizona allows you to use this form for registration only if you are eligible to register and vote in the State, and if you provide proof of citizenship as described in the instructions for Block 6 of the FPCA.

If you need to include a photocopy, mail or fax it to your local election office along with your FWAB. Do not send original documents. Photocopies will not be returned to you.

Block 2: Select the category that describes you

Block 3: Name (Last, First, Middle)

Block 4: Date of Birth

Your Arizona Driver's License number, Non-Operating Identification License number OR the last four digits of your Social Security number is required for voter registration. If you do not possess any of these identification numbers, the State shall assign a number that will serve to identify you for voter registration purposes.

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: If using this form to register, enter your political party affiliation or write undeclared or non-partisan. If you are a registered non-partisan or undeclared, you must indicate which party ballot you want to receive in the future.

Block 7: Complete street address of your Arizona voting residence. A post office box is not sufficient. If your address includes a rural route, describe its location in Block 9. For example, "2mi past Highway ___, across the street from the ___ gas station." This address must be within the county where you claim legal voting residence.

Block 8: Enter your current mailing address.

Block 9: If you are using this form to register to vote in Arizona, or if you are registered and move to a different Arizona county, you must provide ONE of the following for proof of citizenship or your FWAB will be rejected:

• Arizona Driver’s License number or Non-Operating Identification License number issued after October 1, 1996.
• Alien Registration Number from Certificate of Naturalization.
• Indian Census Number, Bureau of Indian Affairs Card Number, Tribal Treaty Card Number, or Tribal Enrollment Number.
• A legible photocopy of a birth certificate that verifies citizenship and supporting legal documentation (i.e. marriage certificate) if the name on the birth certificate is not the same as your current legal name
• A legible photocopy of pertinent pages of a U.S. passport identifying the applicant
• A legible photocopy of a Driver’s License or Non- Operating License from another State within the U.S. if the license indicates proof of citizenship
• A legible photocopy of a Tribal Certificate of Indian Blood or Tribal/Bureau of Indian Affairs Affidavit of birth

If you need to include a photocopy, mail or fax it along with your FPCA to your local election official. Do not send original documents. Photocopies will not be returned to you.

Provide any information that may assist the local election official in accepting this application.

Affirmation: Sign and date. No witness or notary required.

Once the ballot is complete, fold and place it in the security envelope and seal. Place only the voted ballot in the security envelope and do not write on the security envelope. Insert the sealed security envelope and the Voter's Declaration/Affirmation into the mailing envelope and seal.

Envelope Templates

Open Security Envelope Template

Open Postage-Paid Envelope Template

(Opens in a new window and requires Adobe Reader 7)

The postage-paid envelope may be used 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

Mail

You must mail your back-up Federal Write-In Absentee Ballot to your local election official. Find your county or city in the address list below to locate your election official.

Open Election Official Address List

Don't know your county? Go to the county finder. Don't know your zip code? Go to the United States Postal Service website.

Fax

If you choose to fax, it is recommended that you fax the form directly to your local election official (fax numbers can be found on Arizona's State Election website). Only certain counties in Arizona allow faxing. You may also use our toll-free fax service:

Inside the U.S.? Fax to:
1-800-368-8683
(703)-693-5527
DSN 223-5527

Outside the U.S.? Show me a list of toll-free fax numbers

Open Fax Coversheet

(Opens in a new window and requires Adobe Reader 7)

Secure Ballot Upload System

If you choose to submit your FWAB using Arizona’s secure ballot upload system, you must have received a user id and password from your local election official. Local election official contact information can be found at: http://www.azsos.gov/election/county.htm.

• Want to submit your Federal Write-In Absentee Ballot by fax? Remember that by faxing your voted ballot you are waiving your right to secrecy.
• If using our Electronic Transmission Service you must use the Fax Coversheet.
• If you receive your State absentee ballot after submitting your Federal Write-In Absentee Ballot, fill it out and return it. The State absentee ballot will be counted instead of the back-up ballot if it's received in time.