Board of Elections Data Request Form "*" indicates required fields Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* What type of data are you looking for?* Voter Registration Report Voter History Report Statistics Report Campaign Finance Report Jurisdiction Maps Other Select AllWhich of the following fields would you like included in your report?*NOTE: Number of fields will affect the font size of the printout Voter Registration Number Name Status Party Affiliation Registration Date Gender Ethnicity Race Age Residential Address Mailing Address Telephone Precinct Municipality School Board District Select AllHow would you like your report grouped/sorted?* Sort Alphabetically by last name Sort by Precinct Other (specify in comment field below) In what format would you like to receive your data?* Printout ($.25 for first page + $.05 for each additional page) Compact Disc ($25.00) Email (Free—specify format in comment field below) Labels ($.50 per page) CommentsPhoneThis field is for validation purposes and should be left unchanged.