N.H. Rev. Stat. Ann. § 657:7
Prior to any state election, the secretary of state shall prepare the following forms in such quantity as he deems necessary:
II. Affidavit envelopes of sufficient size to contain the ballots on which shall be printed the following:
YOUR COMPLETED ABSENTEE BALLOT MUST BE SEALED IN THIS ENVELOPE
I do hereby certify under the penalties for voting fraud set forth below that:
I am a voter in the city or town of ____________________ , New Hampshire.
One of the following applies to me:
1) I will be absent on election day. Absence includes:
a) I will be out-of-town on election day.
b) I will be unable to vote in person because I will be working.
c) I will be unable to vote in person because I will be caring for children or infirm adults, with or without compensation.
d) I am voting absentee on the Monday immediately before the election, the National Weather Service has issued a winter storm warning, blizzard warning, or ice storm warning that applies to my town/ward, and I have concerns for traveling in the storm.
2) I am unable to vote in person due to disability.
3) I am unable to vote in person due to observance of a religious commitment, which prevents me from voting in person.
4) I am confined to a penal institution for a misdemeanor or while awaiting trial.
I have carefully read or had read to me the absentee voting instructions. I personally marked the absentee ballot enclosed in this envelope or, due to a disability, I had assistance in marking the absentee ballot.
| Voter Signature_ | |
| Printed Name_ | |
| Voter Address_ |
A person assisting a voter with a disability shall sign this statement on this envelope acknowledging the assistance.
I attest that I assisted (print voter name) ____________________ because the voter is a person with a disability. I marked the ballot and/or this form as instructed by the voter.
In accordance with RSA 659:34, the penalty for knowingly or purposefully providing false information when registering to vote or voting is a class A misdemeanor with a maximum sentence of imprisonment not to exceed one year and a fine not to exceed $2,000. Fraudulently registering to vote or voting is subject to a civil penalty not to exceed $5,000.
Source. 1979, 308:5; 436:1. 1983, 220:1. 2003, 289:37. 2006, 136:2, eff. July 21, 2006. 2016, 130:3, eff. May 27, 2016. 2017, 216:7, eff. July 10, 2017. 2018, 329:5, eff. Jan. 1, 2019. 2021, 96:3, eff. Aug. 30, 2021; 175:3, eff. Sept. 28, 2021. 2025, 298:4, eff. Sept. 30, 2025.