Please do not send this page

Sign and date. No witness signature required.

Election Dates
Federal Elections Deadlines - California
Registration* Ballot Request Ballot Return

By Mail: Postmarked by Return by Mail: Postmarked

U.S. Senate Special General October 21, 2024 Received by by** November 5, 2024
November 5, 2024 By Online or Fax: Received October 29, 2024 Return by Fax: Received by 8
by October 21, 2024 PM, November 5, 2024

By Mail: Postmarked by Return by Mail: Postmarked

General Election November October 21, 2024 Received by by** November 5, 2024
5, 2024 By Online or Fax: Received October 29, 2024 Return by Fax: Received by 8
by October 21, 2024 PM, November 5, 2024

Recommended Mailing Dates for Voted Ballots in 2024

From Iraq, Afghanistan, Deployed Naval
4 weeks before the election
Vessels
From Other Overseas Military Installations 3 weeks before the election
4 weeks before the election (depending on foreign mail
From Other Overseas locations
service)
From Within the United States 1 week before the election
Federal Write-In Absentee Ballot 4 weeks before the election
 Please do not send this page

Instructions for California

Thank you for using the FVAP online assistant. Please review, print, sign and submit your completed PDF package
to your local election official at the address provided below.

Sign and date. No witness signature required.

Step 1: Review your personalized FPCA PDF package before printing.

Step 2: Print and Sign your FPCA.

Step 3: Select and download the envelope template (Standard U.S. (#10 envelope 4 1/8in. by 9 1/2in.) or European
standard C4 (229mm by 324mm), depending on your envelope printer setting).

Step 4: Send your election materials: This PDF package includes items to send to your election official as well as
reference material. Please send your FPCA and the documents marked for sending.

Where to Send
Mail your FPCA: Once your FPCA is complete, sign and date the form. Mail your FPCA directly to your election
official.

Mail the absentee ballot request form to your local election official at the following address:
Alameda Registrar of Voters
1225 Fallon St, Rm G-1
Oakland, CA 94612-4229 USA

If you need to contact your election office by telephone, the number is (510) 272-6973

Email your FPCA: Once your FPCA is complete, sign and date the form. Scan the signed FPCA into your computer.
Be sure to also include the "Transmission Cover Sheet". Email this package directly to your election official.

Email to VBM_Overseas@acgov.org

Fax your FPCA: Once your FPCA is complete, sign and date the form. Fax your FPCA directly to your election
official. Be sure to also include the "Transmission Cover Sheet". You may use the DoD Fax Service to fax your FPCA
if you do not have access to a fax machine to fax your election official directly. Instructions for the DoD Fax Service
are in the "Important Information" section or online at FVAP.gov.

Fax the ballot request form to: (510) 470-7995

If you are using the FPCA to register to vote, you must mail or fax the form. If you are already registered
and are using the FPCA to request an absentee ballot or to update your registration information, you
can mail, email or fax your signed form to your election official.

To find out the status of your FPCA, contact your election official. Your election official will contact you if your FPCA
is not accepted.

If you do not receive your requested ballot at least thirty days prior to the election, you should use the Federal
Write-In Absentee Ballot (FWAB).
 Send this page

Official Election Materials - Cover Sheet (FPCA)

Transmission (Cover) Sheet from Absentee Voter to Election Official

To:
City/County Board of Elections: Alameda Registrar of Voters
State: California
LEO Email: VBM_Overseas@acgov.org
Fax Number: (510) 470-7995

From:
Last Name: Patyal
First Name: Anjaneya
Middle Name: Singh
Telephone Number: +918264596588
Fax Number:
Email Address: AnjanSinghP@gmail.com

Additional Information:

If a VOTED BALLOT is being faxed or emailed, sign below:

"I understand that by faxing or emailing my voted ballot I am voluntarily waiving my right to a secret ballot"

Signature:_______________________________________________________ Date:____________________

Number of pages being transmitted, including this sheet: ________

Not all forms can be sent electronically. Please check the FVAP.gov website or the
Voting Assistance Guide to verify what forms can be electronically sent to your Local Election Official.

Fax: Send directly to your Election Official. If you are unable and need fax assistance send to: 703-693-5527/DSN 223-
5527 or 1-800-368-8683 or check FVAP.gov for international fax numbers. If you need to fax and do not have access
to a fax machine you can email your forms to fax@fvap.gov.

Email: If your forms can be emailed, DO NOT USE FAX@FVAP.GOV.

Email them directly to your election official. Email addresses for your election official can be found at FVAP.gov.
Voter Registration and This form is for absent Uniformed Service members,
their families, and citizens residing outside the United
Absentee Ballot Request States. It is used to register to vote, request an
absentee ballot, and update your contact information.
Federal Post Card Application (FPCA)
See your state’s guidelines at FVAP.gov.
Print clearly in blue or black ink, please see back for instructions.
1. Who are you? Pick one.
I request an absentee I on active duty in the Uniformed Services or Merchant Marine -OR-
am I am an eligible spouse or dependent.
ballot for all elections ✘ I am
a U.S. citizen living outside the country, and I intend to return.
in which I am eligible I am
a U.S. citizen living outside the country, and my intent to return is uncertain.
to vote AND: I am
a U.S. citizen living outside the country, I have never lived in the United States.
✘ Mr. Miss
Last name Patyal Suffix (Jr., II)
Mrs. Ms.
First name Anjaneya Previous names (if applicable)

Middle name Singh Birth date (MM/DD/YYYY) 07/04/2004

Social Security Number 9312 Driver's license or State ID#

2. What is your address in the U.S. state or territory where you are registering to vote and requesting an absentee ballot?
Your voting materials will not be sent to this address. See instructions on the other side of form.

Street address 119 MARTINGALE DR Apt #

City, town, village FREMONT State CA

County Alameda ZIP 94539
3. Where are you now? You MUST give your CURRENT address to receive your voting materials.
Your mailing address. (Different from above) Your mail forwarding address. (If different from mailing address)

K1-604, Emaar, The Views

Sector 105
Mohali, Punjab, PIN CODE 140306
INDIA
4. What is your contact information? This is so election officials can reach you about your request.
Provide the country code and area code with your phone and fax number. Do not use a Defense Switched Network (DSN) number.

Email: AnjanSinghP@gmail.com Phone: +918264596588

Alternate email: Fax:

5. What are your preferences for upcoming elections?

A. How do you want to receive Mail
B. What is your political party
voting materials from your ✘ Email or online No Party Preference
for primary elections?
election office? (Select One) Fax
6. What additional information must you provide?
Puerto Rico and Vermont require more information, see back for instructions. Additional state guidelines may be found at FVAP.gov. You
may also use this space to clarify your voter information.

Receive Ballot For: All elections for which I am eligible.

7. You must read and sign this statement.

I swear or affirm, under penalty of perjury, that:
■ The information on this form is true, accurate, and complete to the best of my knowledge. I understand that a material misstatement of fact in
completion of this document may constitute grounds for conviction of perjury.
■ I am a U.S. citizen, at least 18 years of age (or will be by the day of the election), eligible to vote in the requested jurisdiction, and
■ I am not disqualified to vote due to having been convicted of a felony or other disqualifying offense, nor have I been adjudicated mentally
incompetent; or if so, my voting rights have been reinstated; and
■ I am not registering, requesting a ballot, or voting in any other jurisdiction in the United States, except the jurisdiction cited in this voting form.

Sign here X Today's date

(MM/DD/YYYY)
This information is for official use only. Any unauthorized release may be punishable by law. Previous editions are obsolete. Standard Form 76 (Rev.09-2021), OMB No. 0704-0503, NSN 7540-00-643-5053