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I do not wish to recieve a Vote by Mail Ballot for all future elections. 
 
 
Voter’s Name (Print)______________________________________________
 
Voter’s Signature ________________________________________________
 
Address ________________________________________________
 
City ________________________________________________
 
Phone Number(optional) ________________________________________________
 
 
 
You can send this form by mail to the below address, fax to the below number, or email to middlesexvotes@co.middlesex.nj.us
 
Please be advised you may always re-apply for a Vote by Mail Ballot after requesting to be removed.
 
 
 
75 Bayard Street, PO Box 1110
NEW BRUNSWICK, NJ 08903
Phone: 732-745-2170 | FAX: 732-745-2170
www.middlesexcountynj.com
 
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