Request a Replacement Vote by Mail Ballot

Application

General Information

Address Information

Submit

Confirmation

General Information

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

Check this box if you: previously requested a Vote by Mail ballot and have not received it, or made a mistake, damaged or lost your ballot and want to request a new one.

Name (as you are registered to vote)

For a single name, use the Last Name field For a single name, use the Last Name field

First Name

Middle Name

*Last Name

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

Contact

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

Phone

Request a Crossover Ballot

If you’re registered to vote with No Party Preference you may crossover into the American Independent Party, Democratic Party and Libertarian Party and request their Presidential Primary ballot.

Check this box to request a crossover ballot.

Please select a party

Notice: If you’re registered with No Party Preference and want to receive a Vote by Mail ballot for the Green, Peace & Freedom or Republican party, you must change your party affiliation by completing a new voter registration, click here.