Each absentee ballot shall be returned to the municipal clerk, inserted in an inner envelope which shall be capable of being sealed and which shall have printed on its face a form containing the following statements:

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Terms Used In Connecticut General Statutes 9-137

  • Election: means any electors' meeting at which the electors choose public officials by use of voting tabulators or by paper ballots as provided in section 9-272. See Connecticut General Statutes 9-1
  • Municipal clerk: means the clerk of a municipality. See Connecticut General Statutes 9-1
  • Municipality: means any city, borough or town within the state. See Connecticut General Statutes 9-1
  • Referendum: means (1) a question or proposal which is submitted to a vote of the electors or voters of a municipality at any regular or special state or municipal election, as defined in this section, (2) a question or proposal which is submitted to a vote of the electors or voters, as the case may be, of a municipality at a meeting of such electors or voters, which meeting is not an election, as defined in subsection (d) of this section, and is not a town meeting, or (3) a question or proposal which is submitted to a vote of the electors or voters, as the case may be, of a municipality at a meeting of such electors or voters pursuant to section 7-7 or pursuant to charter or special act. See Connecticut General Statutes 9-1

“I hereby state under the penalties of false statement in absentee balloting that I am eligible to vote at the primary, election or referendum in the municipality in which this absentee ballot is to be cast and that I expect to be unable to appear at my polling place on the day of such primary, election or referendum for one or more of the following reasons: (1) My active service in the armed forces; (2) my absence from the town in which I am eligible to vote; (3) sickness; (4) physical disability; (5) the tenets of my religion which forbid secular activity on the day of such primary, election or referendum; or (6) my duties as a primary, election or referendum official.

Date ….

…. (Signature)”