The ballot envelope
Source version current through Nov 30, 2022
Later State Register activity may affect this section.
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BALLOT FOR MILITARY VOTER, NOVEMBER 2, 1976—STATEMENT
I do state (or affirm) that I am MUST CHECK ONE
of a voter in the actual military service of the state, or of the United States, accompanying or being with him or her and a resident of the same election district; and that on the date of the next general election I will be at least eighteen years of age and immediately preceding said date will have been a citizen of the United States, a resident of the State of New York and of the county, city or village in which I offer my vote for thirty days, and that I have not received or offered any compensation or reward for the giving or withholding of a vote at this election; that I have not made or become interested in any wager depending upon the result of this election; that I have not voted any other ballot for any candidate from any address other than hereinafter set forth; and that I have not been convicted of bribery or any infamous crime; or if so convicted, that I have been pardoned or my right of suffrage restored.
My voting address in the State of New York is:
Street and Number, or R.F.D
City, Village or Town
County
I hereby declare that the foregoing is a true statement to the best of my knowledge and belief.
Sign______
Date
(Voter must sign here)
County of
Name of Voter
Voting Address (street & number, if any)
City (or town) of_____ Ward
Assembly District____ Election District
IMPORTANT TO MILITARY VOTER: Be sure to indicate in (a), (b), (c), or (d) whether you are a serviceman or the spouse, parent or child of a serviceman in the statement before you sign your name at the end of the statement. YOU MUST SIGN THE STATEMENT ON THE REVERSE SIDE OF THIS ENVELOPE.