I, First name* Last Name* , do hereby certify, under penalty of perjury, that I am a duly registered voter of the Caddo Nation of Oklahoma; that I will be eighteen (18) years of age or older on or before the date of the election; and that I am entitled to vote in the election to be held on July 11, 2026. I further certify that I am unable to appear in person at any of the four (4) designated polling locations on the date of the election for the reason indicated below.
Therefore, I am requesting a ballot to be sent to: Street Address Address Line 2 City State Zip