# Ala. Code § 17-11-4: Section 17-11-4 Form and Contents of Application; Submission of Application > Alabama · Statutes · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-4 ## Section - **Citation:** Ala. Code § 17-11-4 - **Heading:** Section 17-11-4 Form and Contents of Application; Submission of Application - **Jurisdiction:** Alabama - **Kind:** Statutes - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Alabama Code / Title 17 / Chapter 11 / Section 17-11-4 ## Text (a) The application required in Section 17-11-3 shall be in a form prescribed and designed by the Secretary of State and shall be used throughout the state. The application form shall contain and require all of the following: (1) That the applicant submit sufficient information to identify the applicant. (2) The applicant’s name, residence address, and such other information as necessary to verify that the applicant is a registered voter. (3) A list of all felonies of moral turpitude, as provided in Section 17-3-30.1, and a requirement that the applicant declare that he or she is not barred from voting because of a disqualifying felony conviction or, if the applicant was convicted of a disqualifying felony, that the applicant’s right to vote has been restored. (4) An explanation of penalties for violations of this section. (b)(1) Any applicant may receive assistance in filling out the application as he or she desires, but each application shall be manually signed by the applicant, under penalty of perjury, and if he or she signs by mark, the application shall also include the name of the witness and the witness’s signature. (2) It shall be unlawful for any person to knowingly distribute an absentee ballot application to a voter which is prefilled with the voter’s name or any other information required on the application form. (c)(1) Completed applications may be submitted to the absentee election manager in any of the following ways, as further provided by rule of the Secretary of State: a. The applicant delivering the application in person. b. The applicant mailing the application by U.S. mail. c. The applicant sending the application by commercial carrier. (2) Except in situations governed by Section 17-11-3(f), it shall be unlawful for an individual to submit a completed absentee ballot application to the absentee election manager other than his or her own application, except that an application for a voter who requires emergency treatment by a licensed physician within five days before an election pursuant to Section 17-11-3 may be submitted to the absentee election manager by an individual designated by the applicant. (d)(1) Except in situations governed by Section 17-11-3(f), it shall be unlawful for a third party to knowingly receive a payment or gift for distributing, ordering, requesting, collecting, completing, prefilling, obtaining, or delivering a voter’s absentee ballot application. Any person who violates this subdivision shall be guilty of a Class C felony. (2) Except in situations governed by Section 17-11-3(f), it shall be unlawful for a person to knowingly pay or provide a gift to a third party to distribute, order, request, collect, prefill, complete, obtain, or deliver a voter’s absentee ballot application. Any person who violates this subdivision shall be guilty of a Class B felony. (e) Any voter who requires assistance to vote by reason of blindness, disability, or inability to read or write may be given assistance by an individual of the voter’s choice, other than the voter’s employer or agent of that employer or officer or agent of the voter’s union. (f) Voters voting by absentee ballot through the Uniformed and Overseas Citizens Absentee Voting Act are not subject to this section. The Secretary of State shall provide applications for absentee voting to military and overseas voters in accordance with Section 17-4-35. ## Nearby sections - [Ala. Code § 17-11-1 Section 17-11-1 “Circuit Clerk” Defined](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-1.md) - [Ala. Code § 17-11-2 Section 17-11-2 Absentee Election Manager](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-2.md) - [Ala. Code § 17-11-3 Section 17-11-3 Voting in Precinct, Etc., Where Elector’s Name Does Not Appear on Official List](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-3.md) - [Ala. Code § 17-11-3.1 Section 17-11-3.1 Qualified Voter with Permanent Disability Preventing Attendance at Polls](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-3.1.md) - [Ala. Code § 17-11-4 Section 17-11-4 Form and Contents of Application; Submission of Application](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-4.md) - [Ala. Code § 17-11-5 Section 17-11-5 Delivery of Absentee Ballots; Maintenance of Voter Lists](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-5.md) - [Ala. Code § 17-11-6 Section 17-11-6 Form of Absentee Ballots](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-6.md) - [Ala. Code § 17-11-7 Section 17-11-7 Form of Affidavit to Be Printed on Envelope - General, Special, or Municipal Elections](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-7.md) - [Ala. Code § 17-11-8 Section 17-11-8 Form of Affidavit to Be Printed on Envelope - Primary Elections](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-8.md) - [Ala. Code § 17-11-9 Section 17-11-9 Materials Furnished with Ballot; Delivery of Ballot to Absentee Election Manager](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-9.md) - [Ala. Code § 17-11-10 Section 17-11-10 Procedure Upon Receipt of Ballot by Absentee Election Manager; Counting of Ballots](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-10.md) - [Ala. Code § 17-11-11 Section 17-11-11 Officials for Counting of Absentee Ballots; Poll Watchers](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-11.md) - [Ala. Code § 17-11-12 Section 17-11-12 Delivery of Ballots, Envelopes, Etc. to Absentee Election Manager](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-12.md) - [Ala. Code § 17-11-13 Section 17-11-13 Disqualification of Circuit Clerk from Serving as Absentee Election Manager](https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-13.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_AL_T17_C11_S17-11-4. Check the current official text before relying on it. Not legal advice.