Request to be Placed on the Permanently Disabled Absentee List

  • I, (First Name, Last Name), declare that I am a resident and registered voter of Cape Girardeau County, Missouri, and am permanently disabled. I hereby request that my name be placed on the election authority’s list of voters qualified to participate as absentee voters pursuant to section 115.284, and that I be delivered an absentee ballot application for each election in which I am eligible to vote.