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CADDO NATION OF OKLAHOMA CADDO NATION GENERAL ELECTION BOARD P.O. BOX 324 GRACEMONT, OK. 73042 NEW VOTER REGISTRATION AND/OR REQUEST FOR ABSENTEE BALLOT Name________________________________ Phone____________________ Street Address_________________________ City__________________ State______Zip______ Caddo Enrollment #___________ Blood Quantum:_________ Voter ID # _______ Date of Birth _____/_____/______ Please check at least one of the following: _______ New voter-- I have never before registered to vote. _______ Re-registration-- I have summit county colorado buyers previously registered and would like to register again because I have not voted in the past two elections and my name was removed from the list of registered voters. _______ New card-- I am a registered voter and would like to have a new voter's identification card. _______ I am updating your files with current information (change of name, address, phone number, etc.) _______ I am requesting an absentee ballot for the following: (please check one) _______Temporary Absentee voter - I am a qualified resident voter and will not be able to vote in my district on the day of the next election due to illness, travel, etc. _______ Permanent Absentee Voter - I am a qualified Breckenridge resident voter and request to become a permanent absentee voter because I am 65 years of age or older, or have infirmities which make it difficult for me to vote "in person" at the polling place in my district. _______Nonresident Status - I am a registered voter who resides more than thirty-five (35) miles from the nearest polling place. (Qualifies permanent absentee voter) As an enrolled member of the Caddo Nation Tribe of Colorado, I do hereby request that I receive an absentee ballot and/or be added to the register of real estate qualified voters of the Caddo Nation Tribe. I understand that I will be eligible to vote during the Caddo Nation Tribal elections, both general and referendum, according to my conscience concerning issues and elections of the tribal officials. Signature___________________________________ Date___________________ This registrant has met the requirements for registration and a qualified voter of the Caddo Indian Tribe of Oklahoma. _____________________________________ Date___________________________ Signature of the Caddo Election Board Registrarp>