ABSENTEEBALLOTDESIGNEEFORM

Overview
Florida Statute 101.62(4)(b)4 allows an elector to designate in writing, a person (called a designee) to pick up an absentee ballot from the Elections Office (or from one of the branch offices when open) for the elector.  A ballot may be picked up by a designee no earlier  than 4 days prior to Election Day or on Election Day.  The elector must state the name of the designee in the written document and that he or she is authorized to pick up an absentee ballot for the elector.  If the designee is an immediate family member, the elector must state the relationship in the document. The elector must also sign the document. The designee must present their own signed picture ID when presenting the document to the Elections Department. The designee must complete an Affidavit for a Designee to Obtain an Absentee Ballot while at the office.  A person may not pick up more than 2 ballots per election, unless they are for immediate members of their family (see Florida Statute101.62(4)(b)4 referenced above). No person may pickup and remove from the Election's Office their own ballot (Florida Statute101.657).

Instructions
This form may be used by the elector to designate a designee to pickup their ballot.  The elector may print this form, complete and sign it (very important) and give it to the person  designated to pickup his or her absentee ballot .Instruct the designee that they must have a signed, picture identification in order to pickup the ballot.  The following  form must be signed by the elector and must be hand-delivered to the Elections Department by the designee.  It may also be faxed to the elections office prior to the designee coming to the office.

To be completed by the Elector

 I   designate (insert name of designee) to pick up an absentee ballot for the election to be held on (insert date of election) for me. 

Designee's  Relationship To The Elector (select one)

£ Is not a member of my immediate family

£ Is a member of my immediate family and is my (select one)

£Spouse               £Parent                £Brother            £Sister

£Child                  £Brother-in-Law   £Sister-in-Law

£Mother-in-Law   £Father-in-Law    £Grandparent  £Grandparent-in-Law

Elector's Signature (required)