Vote By Mail Ballot Application Replacement Request

Every registered voter will receive a Vote By Mail ballot starting 29 days before Election Day. Complete the Vote by Mail Ballot Application Replacement Request Form available below if you need a replacement ballot. Last day to request a Vote by Mail Ballot Replacement by mail: .

Application Reason

Failed to Receive Ballot

Lost My Original Ballot

Destroyed My Original Ballot

Election

First Name

Middle Name

Last Name

Drivers License or ID

Social Security Number (Last 4 Digits)

Birthdate

Residence Address

Residence City

Residence State

Residence Zip

Mailing Address

Mailing City

Mailing State

Mailing Zip

Day Phone Number (Optional)

Evening Phone Number (Optional)