EFTA01199511.pdf

btto://www.vlyote.goy/content/remiest-ahcentee-hallnt Military Status - Civilian Name - Jeffrey Edward Eostein Phone - 340-775-8100 Email - I don't know which one von want to lice Gender - Male Last 4 digits of Social Security St - Date of Birth - January 20, 1953 Place of Birth - Brooklyn, New York Voting District - I St. Thomas Local Physical Address - Little St. James Island, US Virgin Islands' Party Affiliation. Please choose your political party - No Party Local Physical addres1 s - Little St. James Island. US Virgin Islands Telephone - I 340-77S-R1 Fax - I 340- Email Address - Which one do you wan tot use? Mail to Address - Where do you want the ballot sent to so you can vote? Reason for requesting Ballot - h. Any person who has not been out of the election district for more than 90 days orior to the date of the election for which ahcentee status is sought Request ballot for the following elections - General Method of preference for receiving ballot -How do you want to get your ballot - Mailed, faxed or emailed' EFTA01199511 Electronic Signature - You need to out your name here and send it in electronically from your comp_oter EFTA01199512