Absentee Request Form (PDF)




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Author: Charlene Ligon

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Request Form to Receive Absentee Preference Card
1. The request form is available for download from
http://nebraskacaucus2016.org/forms/, from the NDP and from county chairs. Fill out
and print.
2. The request form must be returned to the NDP (421 South 9th St, Suite 233, Lincoln,
NE 68508) for validation. Request forms must be in NDP office no later than Feb 24th
this would allow enough time for NDP to verify the voter, send the voter the
preference card, and give the voter time to return the card.
3. The Presidential Preference Card must reach the NDP by March 1st.
4. The NDP will send all of the Presidential Preference Cards on March 2rd to the
appropriate county chair or if there isn’t a county chair to the person in charge of the
requesting voter’s caucus. All Preference cards will be delivered electronically in a pdf
file-- preferred method and will work for anyone with an email--or by US Post Office,
FEDEX, or UPS with tracking or by carrier.
Note: A database will be established to track date of receipt of the request form, the
date the preference card was sent to the voter, the date the preference card was
returned to the NDP by the voter. The voter will be able to access the database and
look up his/her information. A link will be available on both the NDP site and the NDP
Caucus site.

Request Form to Receive Absentee Preference Card
Nebraska Democratic Party
421 South 9th St, Suite 233 · Lincoln, NE 68508
Phone 402-434-2180 · www.nebraskademocrats.org
Nebraska Democratic Caucus 2016
Saturday, March 5, 2016
Return to the Nebraska Democratic Party at the address above

You must be a registered Democrat to Caucus with an absentee card.
________________________________________________________________________
Printed Name of Voter
Date of Birth
_________________________________________________________________________
Home Address of Voter
City
State
Zip
Address where card is to be sent: ____________________________________________
(If different than above)
____________________________________________
____________________________________________
______________________
Telephone

______________________________________________
Email Address

I am registered as a Democrat to vote in the State of Nebraska. I cannot attend the Caucus on
the day of said Caucus; therefore, I request a Presidential Preference Card for the Presidential
Preference Caucus to be held on Saturday, March 5, 2016.
I cannot attend because (check one):
____Homebound
____Disabled or infirmed
____Out of my Caucus area due to military service
____Out of my Caucus area as a student
____Other________________________

Voter’s Signature: ______________________________________________________






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