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Application to Vote by Sealed Ballot

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NORTH CAROLINA INDUSTRIAL COMMISSION

IC Form MSC4 (rev. 10/2017)

I.C. File No.

Carrier No.

County

FILE VIA ELECTRONIC DOCUMENT FILING PORTAL

HTTP://WWW.IC.NC.GOV/DOCFILING.HTML

NCIC-Mediation Section

mediation@ic.nc.gov

1236 Mail Service Center

Raleigh, NC 27699-1236

Plaintiff

V.

Defendant

DESIGNATION OF MEDIATOR

Appearances

Carrier

Plaintiff's Attorney

Telephone

Address

Fax

Defendant's Attorney

Telephone

Address

Fax

THIS FORM IS TO BE COMPLETED BY EITHER THE PLAINTIFF OR THE DEFENDANT WITHIN THE TIME SPECIFIED IN THE COMMISSION'S ORDERS AND THE ICMSC RULES.

Pursuant to the Order entered in the above captioned case, referring it to a mediated settlement conference, the parties have selected the DRC certified mediator named below, who has agreed to serve.

Mediator's name

Telephone

Address

Fax

The mediation conference is scheduled to convene on the following date:

(within 120 days of mediation order).

This the day of , .

Signature of Plaintiff / Defendant or Representative

Enter text

What the Application to Vote by Sealed Ballot Is

The Application to Vote by Sealed Ballot is a formal request used by eligible voters to receive or cast a ballot that will be returned in a sealed envelope for secure processing by election officials. Typically used when voters cannot appear in person or require confidentiality, the form captures identity, residence, reason for sealed ballot, and delivery preferences. Completed applications are reviewed against voter rolls and identification requirements before a sealed ballot is issued. State and local rules determine eligibility, deadlines, witness or notarization needs, and acceptable submission channels.

Why a Sealed-Ballot Application Matters

The application ensures a secure, auditable path for voters who need confidentiality or remote options, aligning ballot issuance with state election law. It helps reduce rejection risk by documenting eligibility and required proofs, while preserving chain-of-custody for election integrity.

Why a Sealed-Ballot Application Matters

Who Prepares and Uses This Application

Common users include voters needing absentee or privacy protections, election officials, and community organizations assisting with voter access.

  • Eligible absentee voters: people out of precincts, temporarily away, or with disability-related needs.
  • Election administrators: verify applications, confirm voter records, and manage sealed ballot issuance.
  • Nonprofit and legal aid groups: assist with application completion and document submission.

Use the application when local rules permit sealed ballots and before published filing deadlines to avoid disqualification.

Core Elements Included in a Professional Application

Core elements ensure identity verification, voter eligibility, secure delivery, chain-of-custody documentation, and clear instructions for enclosed sealed ballot handling by election staff.

Voter Information

Full legal name, residential address, date of birth, and voter registration number where required. Accurate entries prevent mismatches with voter rolls that can delay or reject sealed ballot issuance.

Reason for Request

Specify why a sealed ballot is needed (e.g., absence, disability, safety). Some states require a specific statutory reason; include supporting documentation if requested. Provide concise facts and dates to support the request.

Delivery Options

Indicate whether the sealed ballot should be mailed, held for pickup, or returned via secure drop box. Provide mailing address and contact phone or email for tracking.

Authentication

Include required identification details, witness names, or notarization as mandated. Remote online notarization may be allowed where state law permits; follow state-specific identity-proofing rules exactly.

Chain of Custody

Form should document who handled the sealed ballot, timestamps for receipt and transmission, and tracking numbers. This preserves audit trails for ballot integrity and dispute resolution.

Instructions & Notices

Provide clear signing instructions, deadlines, privacy notices, and ESIGN/UETA consumer disclosures when applicable. State-specific disclaimers about eligibility and penalties should be included, along with contact information for the election office.

Step-by-Step: Completing and Submitting the Application

Follow a clear sequence to complete, verify, and submit the application before local deadlines to ensure timely sealed ballot issuance.

  • 01
    Step 1: Fill all required fields and attach supporting documents.
  • 02
    Step 2: Include ID number or notarization if required.
  • 03
    Step 3: Choose mail, pickup, or secure drop-off per local options.
  • 04
    Step 4: Send via approved channel and retain proof of filing.

Digital Workflow Configuration for Electronic Completion

Configure electronic form fields, verification checks, and routing rules to match state requirements for sealed ballot applications.

Field Configuration
Applicant Name Field Required text field with exact-name validation.
Date Field MM/DD/YYYY format enforced with calendar picker.
ID Upload Accept PDF or image; store audit metadata.
Submission Routing Email and system routing to local clerk; confirmation generated.

How Application Processing Typically Works

A typical processing flow moves from application intake through verification, sealed ballot issuance, return tracking, and final tabulation under election rules.

  • Intake: Election office records application and logs submission.
  • Verification: Match applicant to voter rolls and ID.
  • Ballot Issuance: Issue sealed ballot with tracking number.
  • Return & Tabulation: Receipt logged; chain-of-custody preserved for counting.

Technical Requirements for eSubmission and Storage

Use secure electronic channels that comply with state rules and preserve audit trails during eSubmission or physical delivery.

  • Formats: PDF, DOCX accepted; maintain original file fidelity.
  • Authentication: Email link, SMS code, or stronger KBA/2FA.
  • Integrations: Connect to voter databases and document storage.

Typical Timelines and Deadlines to Watch

Timelines vary by state; submit applications well before local cutoffs to allow verification and sealed ballot delivery before election day.

Application Submission Deadline:

Often 7–30 days before election; some states allow later.

Ballot Request Processing Time:

Clerks may need several days to verify and send ballots.

Return Deadline:

Ballot must be received by election office by close of polls or by postmark rule.

Notarization or Witness Deadline:

If required, complete notarization before submission; notary scheduling may add days.

Confirmation and Tracking:

Retain proof of application and seek confirmation number for follow-up.

Common Preparation Pitfalls to Avoid

  • Incomplete or inconsistent entries are a leading cause of rejection; missing signatures, wrong dates, or mismatched names commonly require resubmission and prolong processing.
  • Failure to attach required identification or proof of eligibility often triggers manual review and may lead to denial if deadlines prevent remedial submission.
  • Submitting an application at or after the cutoff can disqualify issuance of a sealed ballot; postal delays and notary scheduling compound timing risk.
  • Using improper witness counts, incorrect notarization methods, or unaware RON procedures causes rejection; verify state-specific witness and notary rules in advance.

Consequences of Errors or Fraud on the Application

Application Rejection: Ballot not issued
Delayed Ballot: Risk of missing election
Criminal Penalty: Fraudulent claims subject to criminal prosecution
Civil Penalties: Fines or administrative sanctions possible
Loss of Voting Rights: Depends on jurisdiction and offense
Record Retention: Applications may be public records

Typical eSignature Vendor Comparison for Sealed-Ballot Workflows

Vendor feature comparison for eSignature platforms typically used to process sealed-ballot applications; signNow is listed first for reference.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Free trial available Free trial available Free trial available Free trial available
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently Asked Questions about the Application

Common questions about completing, submitting, and validating an Application to Vote by Sealed Ballot, including identity verification and timelines.


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