Application Form for Absentee Ballot

(a)Application for an absentee ballot shall be made substantially in the following form: COL10/29/2021 CH. 10 ABSENT VOTING “APPLICATION FOR ABSENTEE BALLOT TO BE VOTED AT THE ELECTION ON GUAM ON THE _________________ DAY OF ________, 20_____ District or Municipality __________________. I, (Print or type full name) ____________________________, do solemnly swear that I am a resident of Guam and of the district or municipality of ___________________________, and that I am a duly qualified elector entitled to vote at said election; that I am not voting in any other jurisdiction; that I understand the prohibitions against and the penalty for voting in any election of Guam if I vote in another U.S. jurisdiction; that my occupation is _________; and that on account of ____________________, I cannot be at the polls on election day; I hereby make application for an official ballot to be voted by me at such election, and that I will return said ballot to the office of the Guam Election Commission before the time of the closing of the polls on election day. SIGNED _______________________________ DATED this ______ day of ________, 20______. (Permanent Mailing Address) Full Name: _______________________________ Address: _______________________________ _______________________________ Date of Birth: _______________________________ (Present Mailing Address) Full Name: _______________________________ Address: _______________________________ COL10/29/2021 CH. 10 ABSENT VOTING Date of Birth: _______________________________ Subscribed and sworn to before me this ____ day of ______, 20___. _______________________________________ Print or Type Full Name ___________________________________ Signature __________________________ Title or Rank Mailing Address _______________________ _______________________ _______________________”

(b)Any application from elsewhere other than Guam shall be fully completed and documented in accordance with Election Commission regulations that applicant is entitled to vote under the provisions of this Chapter.

(c)Any applicant who fails to complete and document his or her application for a ballot in accordance with Commission regulations shall be denied a ballot, and his or her name will be stricken from the register of qualified voters in accordance with Chapter 3 of this Title.