The State of New Hampshire

TOWN OF STRATHAM

APPLICATION FOR OFFICIAL TOWN ABSENTEE BALLOT

To the city or town clerk of  Stratham , I ________________________________

                                                                        (Print your Name)

hereby apply for an official absent voting ballot.   I am a duly qualified voter, and __am__   entitled to vote in city or town of  Stratham.

Mail absent voter’s ballot to:

(Signature) ______________________________

(Street and number) _________________________________________

(City or town, state, zip and country) ____________________________________

Return this form by mail  to:             Stratham Town Clerk

                                                            10 Bunker Hill Avenue

                                                            Stratham NH  03885

. . .. .. . ..........