# Ind. Code § 3-11-4-5.1: Application form; contents > Indiana · Statutes · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-5.1 ## Section - **Citation:** Ind. Code § 3-11-4-5.1 - **Heading:** Application form; contents - **Jurisdiction:** Indiana - **Kind:** Statutes - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Indiana Code / Title 3 / Article 11 / Chapter 4 / Section 3-11-4-5.1 ## Text Sec. 5.1. (a) The election division shall prescribe the form of an application for an absentee ballot. (b) This subsection does not apply to the form for an absentee ballot application to be submitted by an absent uniformed services voter or overseas voter that contains a standardized oath for those voters. The form of the application for an absentee ballot must do all of the following: (1) Require the applicant to swear to or affirm under the penalties of perjury that all of the information set forth on the application is true to the best of the applicant's knowledge and belief. (2) Require a person who assisted with the completion of the application to swear to or affirm under the penalties of perjury the statements set forth in section 2(k) of this chapter. (3) Serve as a verified statement for a voter to indicate a change of name under IC 3-7-41. The form must require the applicant to indicate the applicant's previous name. (4) Set forth the penalties for perjury. (c) The form prescribed by the election division shall require that a voter who: (1) requests an absentee ballot; and (2) is eligible to vote in the precinct under IC 3-10-11 or IC 3-10-12; must include the affidavit required by IC 3-10-11 or a written affirmation described in IC 3-10-12. (d) The election division shall approve absentee ballot application forms that comply with this subsection and section 2 of this chapter and permit the applicant to indicate a change of name under subsection (b). (e) The form prescribed by the election division must include a statement that permits an applicant to indicate whether: (1) the applicant has been certified and is currently a participant in the address confidentiality program under IC 5-26.5-2; and (2) the applicant's legal address is the address set forth in the applicant's voter registration. If the applicant confirms these statements, the applicant may indicate the address of the office of the attorney general as the address to which the absentee ballot is to be mailed. (f) This subsection applies to an application to receive an absentee ballot: (1) by mail under IC 3-11-10-24; or (2) in the form of an application to vote before an absentee voter board under IC 3-11-10-25 at the voter's place of confinement or the residence of the voter. If the voter wishes to submit an application under this section in an electronic format using a module of the statewide voter registration system, the voter must include a telephone number at which the voter can be reached to submit the application. (g) The application form for an absentee ballot must enable the applicant to provide the applicant's electronic mail address. However, an applicant's failure to provide an electronic mail address is not a reason for denial of the absentee ballot application. As added by P.L.8-1992, SEC.19. Amended by P.L.17-1993, SEC.11; P.L.12-1995, SEC.77; P.L.2-1996, SEC.142; P.L.103-2005, SEC.4; P.L.1-2006, SEC.5; P.L.121-2012, SEC.2; P.L.219-2013, SEC.35; P.L.194-2013, SEC.53; P.L.64-2014, SEC.42; P.L.169-2015, SEC.99; P.L.74-2017, SEC.47; P.L.193-2021, SEC.37; P.L.115-2022, SEC.4; P.L.140-2023, SEC.4. ## Nearby sections - [Ind. Code § 3-11-4-0.5 When an absentee ballot is considered sent to a voter](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-0.5.md) - [Ind. Code § 3-11-4-1 Entitlement to vote by absentee ballot in clerk's office or satellite office; conditions](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-1.md) - [Ind. Code § 3-11-4-1.5 Application of chapter to certain voters](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-1.5.md) - [Ind. Code § 3-11-4-2 Application for absentee ballot; assistance; providing an application; identification numbers; handling; affidavits](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-2.md) - [Ind. Code § 3-11-4-2.1 False, fictitious, or fraudulent absentee ballot application; delivery to county election board; sworn statement; county election board action](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-2.1.md) - [Ind. Code § 3-11-4-2.2 Providing identification numbers and temporary credential information; updating voter registration record; confidentiality](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-2.2.md) - [Ind. Code § 3-11-4-3 Time periods during which an application for absentee ballot may be received; forwarding application to county where voter is registered to vote](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-3.md) - [Ind. Code § 3-11-4-4 Manner of making application; furnished forms; fax and electronic mail applications](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-4.md) - [Ind. Code § 3-11-4-5 Repealed](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-5.md) - [Ind. Code § 3-11-4-5.1 Application form; contents](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-5.1.md) - [Ind. Code § 3-11-4-5.2 Direct mailings including application for absentee ballot; required information about sender of communication](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-5.2.md) - [Ind. Code § 3-11-4-5.5 Election division designated as single office for voter registration and absentee ballot procedures for overseas and absent uniformed services voters; MOVE exception](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-5.5.md) - [Ind. Code § 3-11-4-5.7 Military and Overseas Voter Empowerment Act; delegation of authority to counties; designation of communications means; providing applications to voters; security and privacy of application requests; providing information to voters; free access system](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-5.7.md) - [Ind. Code § 3-11-4-5.8 Voter with print disabilities; requesting voter registration application, absentee ballot application; use of electronic mail or web publication](https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-5.8.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_IN_T3_A11_C4_S3-11-4-5.1. Check the current official text before relying on it. Not legal advice.