Complete Back-up Federal Write-In Absentee Ballot

Nebraska allows you to use the Federal Write-In Absentee Ballot (FWAB) for registration and voting in primary, special, run-off, and general elections for Federal, State, and local offices and non-candidate ballot issues. Feel free to use the FWAB to vote anytime before an election.

Open Back-up Federal Write-In Absentee Ballot

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What do I fill in?

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

Block 1: Nebraska allows you to use this form for registration.

Block 2: Select the category that describes you.

Block 3: Name (Last, First, Middle). If you are a married woman who has assumed her husband's surname, write your maiden name here.

Block 4: Date of Birth Your valid Nebraska Driver's License number OR the last four digits of your Social Security number is required for voter registration. If you do not possess either 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 you are using this form to register and wish to vote in primary elections, you must enter your political party affiliation. If you want to change your political party affiliation, submit a completed Federal Post Card Application indicating your new party preference to the local election official no later than the third Friday before the election.

Block 7: Complete street address of your Nebraska 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: Enter your current mailing address.

Block 9: Provide any information that may assist the local election official in accepting this ballot or 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

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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. If you receive your ballot and you don’t think that it will arrive at the county election office by the deadline, contact your county election office to see if you can submit your voted ballot by fax or email. 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.

If you choose to fax or email, you should also sign and mail your original request, however, it is not required for processing of form.

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 Nebraska State Election website). Include ballot, voter affirmation, and cover sheet with secrecy waiver. You may also use our toll-free fax service:

Inside the U.S.? Fax to:
1-800-368-8683
(703)696-2148
DSN 426-2148

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

Email

If you choose to email, email the signed, scanned form directly to your local election official. Email addresses can be found on Nebraska State Election website. Include ballot, voter affirmation, and cover sheet with secrecy waiver. You may also use our Electronic Transmission Service by sending the form as an attachment to ets@fvap.gov.

Open Fax/Email Coversheet

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• 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.