HB 144 - AS INTRODUCED
2021 SESSION
21-0112
11/06
HOUSE BILL 144
AN ACT relative to absentee ballot request forms.
SPONSORS: Rep. Bergeron, Hills. 29
COMMITTEE: Election Law
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ANALYSIS
This bill modifies the absentee ballot request forms and absentee ballot envelopes.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
 HB 144 - AS INTRODUCED
21-0112
11/06
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty One
AN ACT relative to absentee ballot request forms.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 1 Absentee Voting; Application Forms. Amend RSA 657:4 to read as follows:
2 657:4 Absentee Ballot Application Forms.
3 I. Prior to any state election, except the presidential primary election, the secretary of
4 state shall prepare the appropriate application forms for absentee ballots worded in substantially
5 the following form. The secretary of state shall insert the names of all parties qualified as set forth
6 in RSA 652:11 in the list of parties on the application form. The secretary of state shall prepare the
7 application forms in such quantity as he or she deems necessary:
8 Absence (Excluding Absence Due to Residence Outside the United States), Religious Observance,
9 and Disability:
10 I hereby declare that (check one):
11 _____ I am a duly qualified voter who is currently registered to vote in this town/ward.
12 _____ OR I am unable to register to vote in person because I am absent from the [town/city]
13 city, town, unincorporated place, or ward where I am domiciled and will be until after the next
14 election, or I am unable to register in person due to a disability, and request that the forms
15 necessary for absentee voter registration be sent to me with the absentee ballot.
16 I will be entitled to vote by absentee ballot because (check one):
17 _____ I plan to be absent on the day of the election from the city, town, [or] unincorporated place,
18 or ward where I am domiciled.
19 [_____ I am requesting a ballot for the presidential primary election and I may be absent on the
20 day of the election from the city, town, or unincorporated place where I am domiciled, but the date of
21 the election has not been announced. I understand that I may only make such a request 14 days
22 after the filing period for candidates has closed, and that if I will not be absent on the date of the
23 election I am not eligible to vote by absentee ballot.
24 ____ I cannot appear in public on election day because of observance of a religious commitment.]
25 _____ I am unable to vote in person due to a disability[.], confinement, observance of a
26 religious commitment, or
27 [_____ I cannot appear at any time during polling hours at my polling place] because of an
28 employment obligation. For the purposes of this application, the term "employment" shall include
29 the care of children and infirm adults, with or without compensation.
30 [For use only on the Monday immediately prior to the election:] _____ I cannot appear at my
31 polling place on election day because the National Weather Service has issued a winter storm
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1 warning, blizzard warning, or ice storm warning for election day applicable to my city, town, [or]
2 unincorporated place [and either (check one):
3 ______ I am elderly or infirm or I have a physical disability, and would otherwise vote in person
4 but I have concerns for my safety traveling in the storm.
5 ______ I anticipate that school, child care, or adult care will be canceled, and would otherwise
6 vote in person but will need to care for children or infirm adults], or ward.
7 Any person who votes or attempts to vote using an absentee ballot who is not entitled to vote by
8 absentee ballot shall be guilty of a misdemeanor. RSA 657:24.
9 I am requesting an official absentee ballot for the following election (check one):
10 [_____ Presidential Primary to be held on __________________
11 (MM/DD/YYYY)
12 (The date may appear as blank when the date is not known.)]
13 _____ State Primary Election to be held on __________________
14 (MM/DD/YYYY)
15
16 For primary elections, I am a member of or I am now declaring my affiliation with the
17 (check one):
18 _____ Republican Party
19 _____ Democratic Party
20 _____ (name of any party determined by the secretary of state to have achieved official
21 status under RSA 652:11)
22 and am requesting a ballot for that party's primary.
23
24 _____ State General Election to be held on______________________
25 (MM/DD/YYYY)
26
27 [For primary elections, I am a member of or I am now declaring my affiliation with the (check
28 one):
29 _____ Republican Party
30 _____ Democratic Party
31 _____ (name of any party determined by the secretary of state to have achieved official status
32 under RSA 652:11)
33 and am requesting a ballot for that party's primary.]
34 Please print:
35 Applicant's Name:
36 __________________________________________________
37 (Last) (First) (Middle) (Sr., Jr., II., III)
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1 Applicant's Voting Domicile (home address):
2 ___________________________________________________________________________
3 (Street Number) (Street Name) (Apt/Unit) (City/Town) (Ward) (Zip Code)
4 Mail the ballot to me at this address (if different than the home address):
5 ___________________________________________________________________________
6 (Street Number) (Street Name) (Apt/Unit) (City/Town) (Ward) (Zip Code)
7 Applicant's Phone Number : _________________________
8 Applicant's Email Address : __________________________
9 Applicant's Signature: _________________________________
10 Date Signed: ___________________________
11 (MM/DD/YYYY)
12
13 Applicant's Phone Number (optional): _____________
14 Applicant's Email Address (optional): _____________
15
16 I attest that I assisted the applicant in executing this form because he or she has a disability.
17 Signature ____________________
18 Print Name ____________________
19 [If your absentee ballot application or affidavit envelope has the printed name and signature of a
20 person who assisted you with voting, your signature will not be compared to your signature on the
21 absentee ballot affidavit to verify your identity. Otherwise, if your signatures do not appear to be
22 made by the same person, your absentee ballot may not be counted.
23 The applicant must sign this form to receive an absentee ballot. Any person who witnesses and
24 assists a voter with a disability in executing this form shall print and sign his or her name in the
25 space provided on the application form. The moderator will not compare the voter's signature on the
26 application with the signature on the absentee ballot affidavit when a person assisting the voter has
27 signed the statement on the absentee ballot application or affidavit envelope that assistance was
28 provided.]
29 II. The federal official post card form shall constitute the form made available by
30 the secretary of state pursuant to RSA 654:20 for absentee ballot applications by UOCAVA
31 voters.
32 657:4-a Presidential Primary Absentee Ballot Application Form.
33 I. Prior to the presidential primary election, the secretary of state shall prepare the
34 appropriate application forms for absentee ballots worded in substantially the following
35 form. The secretary of state shall insert the names of all parties qualified as set forth in
36 RSA 652:11 in the list of parties on the application form. The secretary of state shall
37 prepare the application forms in such quantity as he or she deems necessary:
 HB 144 - AS INTRODUCED
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1 Absence (Excluding Absence Due to Residence Outside the United States), Religious
2 Observance, and Disability:
3
4 I hereby declare that (check one):
5 _____ I am a duly qualified voter who is currently registered to vote in this city, town,
6 unincorporated place, or ward.
7 _____ OR I am unable to register to vote in person because I am absent from the city,
8 town, unincorporated place, or ward where I am domiciled and will be until after the next
9 election, or I am unable to register in person due to a disability, and request that the forms
10 necessary for absentee voter registration be sent to me with the absentee ballot.
11
12 I will be entitled to vote by absentee ballot because (check one):
13 _____ I plan to be absent on the day of the election from the city, town, unincorporated
14 place, or ward where I am domiciled.
15 _____ I am unable to vote in person due to a disability, confinement, observance of a
16 religious commitment, or because of an employment obligation. For the purposes of this
17 application, the term "employment” shall include the care of children and infirm adults,
18 with or without compensation.
19 _____ I cannot appear at my polling place on election day because the National Weather
20 Service has issued a winter storm warning, blizzard warning, or ice storm warning for
21 election day applicable to my city, town, unincorporated place, or ward.
22 Any person who votes or attempts to vote using an absentee ballot who is not entitled to
23 vote by absentee ballot shall be guilty of a misdemeanor. RSA 657:24.
24 I am requesting an official absentee ballot for the presidential primary to be held on
25 (MM/DD/YYYY). (The date may appear as blank when the date is not known.)
26 I am a member of or I am now declaring my affiliation with the (check one):
27 _____ Republican Party
28 _____ Democratic Party
29 _____ (name of any party determined by the secretary of state to have achieved official
30 status under RSA 652:11)
31 and am requesting a ballot for that party's primary.
32
33 Please print:
34 Applicant's Name:
35 __________________________________________________
36 (Last) (First) (Middle) (Sr., Jr., II., III)
37 Applicant's Voting Domicile (home address):
 HB 144 - AS INTRODUCED
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1 ___________________________________________________________________________
2 (Street Number) (Street Name) (Apt/Unit) (City/Town) (Ward) (Zip Code)
3 Mail the ballot to me at this address (if different than the home address):
4 ___________________________________________________________________________
5 (Street Number) (Street Name) (Apt/Unit) (City/Town) (Ward) (Zip Code)
6
7 Applicant's Signature: _______________________________
8 Date Signed: _______________________
9 (MM/DD/YYYY)
10
11 Applicant's Phone Number (optional) : _________________________
12 Applicant's Email Address (optional): __________________________
13 I attest that I assisted the applicant in executing this form because he or she has a
14 disability.
15 Signature ____________________
16 Print Name ____________________
17 II. The federal official post card form shall constitute the form made available by
18 the secretary of state pursuant to RSA 654:20 for absentee ballot applications by UOCAVA
19 voters.
20 657:4-b Identification and Penalties.
21 [II.(a)] I. Any person, other than the city or town clerk or the secretary of state, that
22 publishes, mails, or distributes in any manner any written communication that contains a form or
23 post card which a reasonable person would consider as intended to be used by the recipient of the
24 communication to submit a request for an absentee ballot shall identify who is publishing, mailing,
25 or distributing the communication, and attach a copy of the form prepared by the secretary of state
26 pursuant to paragraph I of this section to the communication or include in the communication a
27 complete facsimile of the form prepared by the secretary of state pursuant to paragraph I of this
28 section.
29 [(b)] II. Any person that publishes, mails, or distributes forms as described in
30 subparagraph (a) as part of any communication that is made for the purpose of promoting the
31 success or defeat of a candidate or candidates or measure or measures, as defined in RSA 664:2,
32 shall be identified in the same manner as political advertising under RSA 664:14.
33 [(c)] III. Any person that violates this paragraph shall be subject to a civil penalty not to
34 exceed $1,000, to be imposed in the manner set forth in RSA 659:34, III-V.
35 [III. The federal official post card form shall constitute the form made available by the
36 secretary of state pursuant to RSA 654:20 for absentee ballot applications by UOCAVA voters.]
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1 2 Absentee Ballots and Related Materials; Absence, Religious Observance, and Disability.
2 Amend RSA 657:7 to read as follows:
3 657:7 Absence, Religious Observance, and Disability. Prior to any state election, the secretary
4 of state shall prepare the following forms in such quantity as he deems necessary:
5 I. Absence, religious observance, and disability absentee ballots as provided in RSA 656:33.
6 II. Affidavit envelopes of sufficient size to contain the ballots on which shall be printed the
7 following:
8 [(a)] Absence from City or Town or Inability to Vote in Person. A person voting by
9 absentee ballot because of absence from the city or town in which he or she is entitled to vote, or
10 who is unable to vote in person, shall fill out and sign the following certificate:
11 I do hereby certify under the penalties for voting fraud set forth below that I am a voter in the
12 city or town of _______________, New Hampshire, in ward __________; that I will be unable to appear
13 at any time during polling hours at my polling place because [I will be working on election day, or I
14 am voting on the Monday immediately prior to the election, the National Weather Service has
15 issued] I plan to be absent on the day of the election from the voting district in which I am
16 domiciled, or I am unable to vote due to a disability, confinement, observance of a religious
17 commitment, an employment obligation, because of a winter storm [warning], blizzard
18 [warning], or ice storm warning, [and I am elderly or infirm, have a physical disability,] or because I
19 have to care for children or infirm adults, [or I will be otherwise absent on election day from said city
20 or town and will be unable to vote in person;] that I have carefully read (or had read to me because I
21 am disabled or blind) the instructions forwarded to me with the ballot herein enclosed, and that I
22 personally marked the ballot within and sealed it in this envelope (or had assistance in marking the
23 ballot and sealing it in this envelope because I am disabled or blind). [For the purposes of this
24 certification, the term "working" shall include the care of children and infirm adults, with or without
25 compensation.]
26 (Signature) ____________________________
27 In accordance with RSA 659:34, the penalty for knowingly or purposefully providing false
28 information when registering to vote or voting is a class A misdemeanor with a maximum sentence
29 of imprisonment not to exceed one year and a fine not to exceed $2,000. Fraudulently registering to
30 vote or voting is subject to a civil penalty not to exceed $5,000.
31 [(b) Absence Because of Religious Observance or Physical Disability. A person voting by
32 absentee ballot because of religious observance or physical disability shall fill out and sign the
33 following certificate:
34 I do hereby certify under the penalties for voting fraud set forth below that I am a voter in the
35 city or town of ____________, New Hampshire, in ward ____________; that I will be observing a
36 religious commitment which prevents me from voting in person or that on account of physical
37 disability I am unable to vote in person; that I have carefully read (or had read to me because I am
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