ABSENTEE BALLOT TOWN OF BRENTWOOD

TO THE CLERK OF  Brentwood:  I ____________________________

                                                                        (Print Name)                                                             

AM A DULY QUALIFIED VOTER AND ENTITLED TO VOTE IN

Brentwood.

MAIL ABSENTEE VOTER’S BALLOT TO:

(SIGNATURE) ______________________________

(STREET AND NUMBER) _______________________________

(TOWN, STATE, ZIP AND COUNTRY) _______________________________

Return this form by mail to:        Brentwood Town Clerk

                                                            Dalton Road

                                                            Brentwood NH  03833