Runoff Election Ballot Form

Runoff Election Ballot Form
Submit your runoff election ballot details for the current election. Use the exact title consistently throughout the form.
Voter Identification
Full Legal Name
First NameMiddle NameLast Name
Voter Registration Number / Voter ID
Residential Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Ballot Selection
Runoff Race or Contest
Candidate Choice
Write-in
Voting Confirmation and Submission Details
Election Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Voting Method
Ballot Declaration
Comments or Notes
Should be Empty: