§ 16.1-07-06 — Application form

1. Application for an absent voter's or mail ballot must be made on a form, prescribed by
the secretary of state, to be furnished by the proper officer of the county, city, or school

district in which the applicant is an elector, or any form, approved by the secretary of
state, containing the following:
a. The applicant's name.
b. The applicant's current or most recent North Dakota residential address.
c. The applicant's mailing address.
d. The applicant's current contact telephone number, if available.
e. The election for which the ballot is being requested.
f. The date of the request.
g. An affirmation that the applicant has resided, or will reside, in the precinct for at
least thirty days next preceding the election and will be a qualified elector of the
precinct.
h. The applicant's signature, a notification the signature on this affidavit will be
compared to the signature on the affidavit on the envelope in which the absentee
ballot must be placed.
i. The designation of the individual's status as a citizen of this country and resident
of this state living outside the United States, a uniformed service member living
away from the individual's North Dakota residence, or an immediate family
member of the uniformed service member living away from the individual's North
Dakota residence.
j. The applicant's date of birth.
k. The identification number from one of the applicant's valid forms of identification,
a copy of the applicant's long-term care certificate, and, if necessary, a copy of
the applicant's supplemental identification under section 16.1-01-04.1.
2. If the applicant is unable to sign the applicant's name to the application, the applicant
shall mark (X) or use the applicant's signature stamp on the application in the
presence of a disinterested individual. The disinterested individual shall print the name
of the individual marking the X or using the signature stamp below the X or signature
stamp and shall sign the disinterested individual's own name following the printed
name together with the notation "witness to the mark".
3. If the applicant does not possess or cannot secure an approved form of identification
as provided for under section 16.1-01-04.1 due to a disability with which the individual
lives and which prevents the individual from traveling to obtain, the application also
must be signed by another qualified elector who, by signing, certifies that the applicant
is a qualified elector. The secretary of state shall prescribe the form of the certification
required under this subsection. An individual may not certify the qualifications of more
than four applicants in an election.
4. The application must include the following additional information if the individual
desires to access the ballot by electronic means:
a. Facsimile telephone number; or
b. Electronic mail address.
5. An incomplete application must be returned to the applicant for completion and
resubmission.
6. Except for the applicant's date of birth, identification card number, and any
supplemental documentation provided under section 16.1-01-04.1, the application is
an open record under section 44-04-18.