Vote By Mail List and/or Early Voting, Grace Period, UOCAVA and Vote By Mail Data Request

Early Voting list is limited to State or local political committees only.

Are You Affiliated With a State or Local Political Committee?

Are You Affiliated With a State or Local Political Committee? Yes No
Name of Committee:

Political committee must be registered with the Illinois State Board of Elections and in an active status.
Name of Requestor: Name of Requestor: First Last
Address of Requestor: Address of Requestor:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell Phone of Requestor: Cell Phone of Requestor: - ### - ### ####
Email of Requestor:
Certification:

I, the undersigned, am aware that only those state or local political committees registered pursuant to the Illinois Campaign Finance Act or the Federal Campaign Act are qualified to receive voter data. I hereby verify that the information shall be used only for bona fide political purposes. I also verify that this data shall not be used under any circumstances for purposes of commercial solicitation or other business purposes, and that to do so may result in substantial penalty, including, but not limited to, conviction of a class 4 felony. (10 ILCS 5/4-8, 5-7, and 6-35)
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.