Mail-in Ballot Application

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The deadline to apply for a Vote By Mail ballot by mail is October 29.

Due to that short timeline, if you would like to have a ballot mailed out to you, please print the application and bring it to the Clerk's Office at 20 Grove Street, Somerville, NJ 08876. You can still apply to receive a ballot in person until by 3 p.m. November 4th.

Please correct the fields below:

Please correct the field(s) marked in red below:

To request an application for a Mail-in Ballot, please complete this form in its entirety.

Contact Information

*

Contact Information

First Name

Last Name

Date of Birth

Email

Street Address

Municipality

*

I certify the above information is true and correct and I am the person requesting information.

Type Full Name for digital Signature

To receive a copy of your submission, please fill out your email address below and submit.
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