Complete Back-up Federal Write-In Absentee Ballot

Utah 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

(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: Utah allows you to use this form for registration.

Block 2: Select the category that describes you.

Block 3: Name (Last, First, Middle)

Block 4: Date of Birth

Enter your valid Utah Driver's License number, the last four digits of your Social Security number, OR your State voter registration number.

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 7: Complete street address of your Utah 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. 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 Utah's State Election website. Utah allows you to fax this form if you affirm in Block 6 that you are in a hostile fire zone or other area where mail service is unreliable and not sufficient for timely mail service may fax this form. 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

Email

You may choose to email this form only if you are in a hostile fire zone or other area where mail service is unreliable. It is recommended that you email the form directly to your local election official. Email addresses can be found on Utah State Election website.

If you fax or email, you must waive the right to a secret ballot and affirm it in writing on the fax/email cover sheet. Write in “I understand that by electronically transmitting my voted ballot I am voluntarily waiving my right to a secret ballot” and either: “I affirm that I am currently deployed in a hostile fire zone” OR “I affirm that I am currently deployed in an area where the mail service is unreliable and not sufficient to accommodate timely mail service.”

Open Fax/Email Coversheet

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• Want to submit your Federal Write-In Absentee Ballot by fax or email? 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. You must sign the secrecy waiver.
• 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.