<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s953db133-eee3-4981-8e74-6476d00cd7caP0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.s953db133-eee3-4981-8e74-6476d00cd7caC0 { background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s953db133-eee3-4981-8e74-6476d00cd7caC0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s953db133-eee3-4981-8e74-6476d00cd7caC0-000001 { background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; 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text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 16pt; line-height: 108%; } p.s953db133-eee3-4981-8e74-6476d00cd7caP0-000007 { margin-top: 0; margin-bottom: 0; margin-left: 0.40in; margin-right: 0; text-indent: -0.40in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 16pt; line-height: 108%; } p.s953db133-eee3-4981-8e74-6476d00cd7ca000008 { margin-top: 0; margin-bottom: 0; margin-left: 0.90in; margin-right: 0; text-indent: -0.25in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.s953db133-eee3-4981-8e74-6476d00cd7ca000009 { background: white; font-family: Wingdings; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; display: inline-block; text-indent: 0; width: 0.250in; } span.s953db133-eee3-4981-8e74-6476d00cd7caC0-000010 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">    </span><a href="https://sdlegislature.gov/Rules?Rule=05:02:10:01.03"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000000">5:02:10:01.03</span></a><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">.  </span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001"> </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">Combined absentee ballot application/return envelope.</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> The application for an in-office absentee ballot </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">must</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> be printed in the following form on an envelope used for sealing the voted ballot:</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000003"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">APPLICATION FOR IN-OFFICE ABSENTEE BALLOT</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000003"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">___________________ COUNTY, SOUTH DAKOTA</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">My printed name as it appears on the voter registration list is:____________________________</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">My voter registration residence address is: ___________________________________________</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">                                                        (address)            (city)</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">If your voter registration address is a commercial mail receiving agency, mail forwarding service, or other post office box, please provide a description of the location of your residence in the space provided:______________________________________________________________</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Check the election for which you are requesting an absentee ballot:</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000004"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">  Primary        If you are registered as an independent </span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">or no party affiliation voter </span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">and are requesting a primary ballot, you may have a choice of ballots. Please </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">choose</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> one of the following: </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">(Here list ballot choices.)</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000006"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">  General</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000006"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">  Municipal</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000006"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">  School</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000006"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">  Special ___________________(specify jurisdiction)</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">If request is for a municipal or school election:</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000006"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">I have lived in that jurisdiction at least 30 days in the last year. Yes </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> No </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000007"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">I am a full-time postsecondary student who resided in that jurisdiction immediately prior to leaving for postsecondary education. Yes </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> No </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0-000007"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">I am on active duty </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">as a member of the armed forces</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> and my home of record is in that jurisdiction. Yes </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> No </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000005">¡%</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">I, under penalty of impersonating a registered voter (</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">2</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> years imprisonment and $</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">4</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">,000 fine), state that I am the person named above, these statements made by me are true and correct, and that I will vote the ballot which will be enclosed in this envelope.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">_____________________________________                        ___________________</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Voter Signature                                                            Date</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">INSTRUCTIONS TO THE VOTER</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7ca000008"><span class="s953db133-eee3-4981-8e74-6476d00cd7ca000009">§ð</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Mark your ballot privately.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7ca000008"><span class="s953db133-eee3-4981-8e74-6476d00cd7ca000009">§ð</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Do not fold your ballot.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7ca000008"><span class="s953db133-eee3-4981-8e74-6476d00cd7ca000009">§ð</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Place your ballot in this envelope and seal it securely.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7ca000008"><span class="s953db133-eee3-4981-8e74-6476d00cd7ca000009">§ð</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Return the envelope immediately to the person in charge of the election.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">Auditor Office Use Only:</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Voter Precinct: ________</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Type of ID: _________</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">Printer</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">'</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">s Note: When this form is printed for primary, general, or other county elections, reference to municipal and school elections may be omitted. The instruction to "not fold your ballot" may be changed if the ballot is to be folded.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">    </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">Source:</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> 32 SDR 225, effective July 3, 2006; 33 SDR 230, effective July 1, 2007; 36 SDR 112, effective January 11, 2010</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">; 52 SDR 32, effective September 29, 2025; 52 SDR 32, effective January 1, 2026</span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">    </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">General Authority:</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=12-1-9"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">12-1-9</span></a><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">(8), </span><a href="https://sdlegislature.gov/Statutes?Statute=12-19-2.5"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">12-19-2.5</span></a><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">    </span><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000001">Law Implemented:</span><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=12-4-1.3"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">12-4-1.3</span></a><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=12-19-2"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">12-19-2</span></a><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=12-19-2.1"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">12-19-2.1</span></a><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=12-19-2.5"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">12-19-2.5</span></a><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=12-19-9.1"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">12-19-9.1</span></a><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=12-26-7"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">12-26-7</span></a><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7caC0">, </span><a href="https://sdlegislature.gov/Statutes?Statute=22-6-1"><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0-000010">22-6-1</span></a><span class="s953db133-eee3-4981-8e74-6476d00cd7caC0">.</span></p><p dir="ltr" class="s953db133-eee3-4981-8e74-6476d00cd7caP0"><span xml:space="preserve" class="s953db133-eee3-4981-8e74-6476d00cd7ca000002"> </span></p></div></body></html>