Mohave County - Early Ballot Request Form

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Please fill in all the fields below and press the "request early ballot" button. The information will be emailed to the Voter Registration Department and they will send the early ballot package following receipt and verification of the request. Any person may assist you with your Early Ballot. If you have any questions please call us at 928-753-0767.

SPECIAL NOTE: Please be advised that the state law has changed. Early ballot request forms must be physically received in this office no later than 5:00 p.m. on the 11th day preceding an election.

* Indicates field is required.

* First Name: * Middle Name:

* Last Name:

* Address:

* City: * State:

* Zip Code: * Phone:

* Date of Birth: * Birth Place:

Permanent Absentee: A letter is required which includes
your name, address, date of birth, phone number and signature.
Mail to:
Mohave County Voter Registration, PO Box 7000,
Kingman, AZ 86402

* Early ballot request for:

* Primary

* General

* Presidential Preference

* Other

* Party Preference:

* Mailing Address:

* (If different than residence address)

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