N.Y. Election Law § 15-120
1. A qualified voter of a village may vote as an absentee voter under this section if during all the hours of voting on the day of a general or special village election he or she will be:
4. The application for an absentee ballot when filed must contain in each instance the following information:
(c) A statement, as appropriate, that on the day of such election the applicant expects in good faith to be in one of the following categories: