VBM Application Requests DEALDLINE IS FRIDAY. YOU MUST EMAIL OR FA
.YOU MUST EMAIL OR FAX the Application at this point. You also must MAIL the paper form within four days!
DEADLINE TO GET A MAIL BALLOT APPLICATION IN IS FRIDAY. If you are requesting a ballot now, please go to https://reg.vote/tdvbm.html and print the application and mail it immediately. We do not have time to mail it to you before deadline.
VOLUNTEERS: You can print the application from the system above. You can deliver to the voter the application for their signature, and then mail it for them (but fill in the box for Assistant).

If you have questions, call Glen Maxey 512-656-6337

Name of the person filling in this form, if not the voter. (We are getting apps of people not registered to vote, so we need to ask questions!) *
Your answer
Phone of the person entering request, if not the voter: *
Your answer
Email of the person entering request, if not the voter: *
Your answer
County *
Your answer
Voter's full name (No nicknames, please!): *
Your answer
Voter's reason for voting by mail, which must include one of these reasons: (Note: Because of time contraints, if you are requesting a ballot for being out of county, you should download it from MyTexasVotes.com and mail it directly. *
Voter's registration address: *
Your answer
Voter's registration city: *
Your answer
Voter registration zip: *
Your answer
Voter phone (if known):
Your answer
Voter's date of birth (mm-dd-xxxx) (if known):
Your answer
Voter's registration number (if known):
Your answer
Voter email (if known):
Your answer
Any special information about this application we need to know?
Your answer
Is mailing address the same as registration address? *
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