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Your First Name:
Your Last Name:
Your Address:
City: Metamora

Date:

To:
Peggy Rapp
Woodford County Clerk
115 N Main St
Room 202
Eureka, IL
61530-1274

Dear Peggy Rapp: I am a resident of Woodford County and I will be unable to vote in person on Election Day. Therefore, I am requesting an absentee ballot form. If you could please send me this form as soon as possible, it would be greatly appreciated. I look forward to participating in the upcoming election. Thank you for your help.

Sincerely,________________________________
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Signed:___________________________________
                    Signature