§ Ind. Code § 3-11-4-5.1Application form; contents

(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