Replacement Ballot Request

To request a replacement vote-by-mail ballot, please enter your information below and click submit to access your voter record.

Note: Replacement ballot requests can only be made by registered voters that have not returned a ballot or already voted.

First Name *

Last Name *

House Number *

Birth Date *

Zip Code *

To continue with your ballot application request for the April 8, 2025, First Supervisorial District, Special Primary Election, please review your voter information shown below and supply any missing information:

First Name *

Middle Name

Last Name *

Birthday (MM/DD/YYYY)

Residence Address *

City *

Zip Code *

Mailing Address

Phone (enter using format ###-###-####) *

Email Address

Party *

New/One-Time Mailing Address Line 1 (Optional)

New/One-Time Mailing Address Line 2 (Optional)

New/One-Time Mailing City (Optional)

New/One-Time Mailing State (Optional)

New/One-Time Mailing Zip (Optional)

New/One-Time Mailing Country (Optional)

To complete your ballot request, please read and acknowledge the voter attestation section below and submit your request.

Voter Attestation:

By checking this box, I understand that only the registered voter themself may request a replacement ballot. A request for a replacement ballot that is made by any person other than the registered voter is a criminal offense.

Click on the submit button below to complete your request.