Electronic Vote By Mail Ballot Application

Application

General Information

Mailing Address

Submit

Confirmation

General Information

Enter your information below. Fields with an (*) are required.

Name (as you are registered to vote)

*First Name

*Last Name

*Date of Birth (Ex: mm/dd/yyyy)

*House Number

*Zip Code

Contact

Your phone number will be used if we have a question about your vote by mail ballot.

*Phone

*By submitting your phone number or email, you authorize us to update your voter registration record. If you do not wish to provide this information, please call (800) 815-2666, option 2 to complete your request.

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Request a Replacement Ballot

General Information

Name (as you are registered to vote)

Contact