Voter Certificate Request Form

Voter Certificate Request Form

Please fill out this form completely to request a certificate of your voter record.
Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState

Zip Code
I will provide the following identification:
Last Four Digits of Social Security Number
Utah Driver License or Utah ID Card Number
Email
We'll send your voter certificate to this email.
Signature
Contact Us

www.slco.vote | vote@saltlakecounty.gov | (385) 468-7400
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