Wufoo

Name * First Last
Email *
Phone Number * ### - ### - ####
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Which county are you registered in? *
Is this complaint regarding: *
Voter registration A polling location Voting by mail Other issue
If this complaint has to do with a polling location, where was it located?
Describe in detail the issue that you have had voting. Please include dates, places and names or positions of those directly involved. *
Were you given an explanation by election officials for why this happened? If so, what was the reason?
Did you try to resolve the issue with an election official? If so, please name the official and describe the result. *
Please state clearly what you would like the ACLU to do for you. *
I certify that I have read all of the information contained on this complaint form, and that all information I have given is accurate and complete to the best of my knowledge. I understand that by accepting this complaint, the ACLU of Utah is not undertaking my legal representation and is not responsible for ensuring that any statute of limitations restriction is met in my case. I authorize the ACLU of Utah to use this information in any manner that it deems necessary. *
Yes
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