--- Requestor Information ---

Entity Name

Your Name

Email

Phone Number

--- Selection Criteria ---

Voter Group Status

District

Municipality

Or list your desired Precinct(s), CDD(s), or combination of any:

Party

Or list your desired party or parties if not listed above:

Race*

* Since many voters have chosen not to identify their race, limiting your list to a specific race will exclude those unidentified voters.

Gender

Do you want to limit results based on Voting History?

If you chose YES in the menu above - please list the election(s) and election year(s) you want to limit Voter History to on the line below:

--- File Output Section ---

Select the order you would like your list sorted by:

Sort Order

Media Format

** Printed lists incur a charge of $0.15/page (after the first 25 pages for free) for single-sided copies. Mailing labels incur a fee of $9.00 per 1,000 and a processing fee of $7.00.

Payments can be made upon collection of materials, but must be remitted in advance of printing if the amount exceeds $10.00.

PLEASE NOTE: An outstanding balance will prevent any further requests from being fulfilled until payment is remitted in full.

--- Pickup Options ---

Pickup Location

Or we can mail you the printed materials at an additional cost of at least $7.50. If you would prefer we mail it to you, please enter your desired mailing address in the line below:

Mailing Address

--- Extra Notes ---

If you have any special criteria or important notes that were not addressed in the form, you can mention them in the space below:

Special Criteria or Comments

NOTE: Clicking "Submit" signifies your agreement to the fee structure and delivery method for your request. Custom data requests will be fulfilled as soon as possible in the order in which they are received.