Statewide Mail Ballot File Request

STATEWIDE MAIL BALLOT FILE REQUEST

The Pennsylvania Statewide Mail-Ballot File (SWMBF) contains point-in-time information about each mail-ballot application and mail-ballot recorded in the Statewide Uniform Registry of Electors (SURE) system. Sections 1309 and 1307-D of the Pennsylvania Election Code, 25 P.S. §§ 3146.9 and 3150.17, provide that “all information and lists [concerning absentee and mail-in ballots] are hereby designated and declared to be public records.” Sections 202 and 308 of the Pennsylvania Election Code, 25 P.S. §§ 2642 and 2648, provide that access to election-related records be limited to registered electors of the Commonwealth.

Information

Required fields are marked with an asterisk.(*)

Requestor’s First Name

Requestor’s Last Name

Requestor’s Email Address

Requestor’s Phone Number

Requesting information on behalf of

Requestor’s Registered Address

Address Line 1

Address Line 2

City

State

Zip Code

Requestor’s County of Registration

By submitting this form, I affirm the following:*

that any information obtained from the records requested from the Department of State will not be used for commercial or other purposes, except purposes related to elections, political activities and law enforcement, as required by 25 Pa.C.S. §§ 1207(b) & 1404(c)(2). I further affirm that I will not publish any of the data obtained through this request on the Internet.

that I am a registered elector of the Commonwealth of Pennsylvania; I give my permission to the Department of State and its agents and employees to verify my voter registration status; and, I understand that false statements made herein are subject to the penalties of 18 Pa.C.S. § 4904, relating to unsworn falsification to authorities.

I Affirm

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