ELECTION INTEGRITY - INCIDENT FORM - Take California Back

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- EVENTS
- VOLUNTEER
2020 ELECTIONS
- CALIFORNIA GENERAL ELECTION NOVEMBER 2020
- MARCH 2020 PRIMARY
  - CALIFORNIA MARCH 2020 RESULTS – FINAL
  - CALIFORNIA MARCH 2020 CANDIDATES
ELECTION INTEGRITY
- COUNTY ELECTION OFFICIALS
RESOURCES
- ADDITIONAL RESOURCES
- DOWNLOADS
CONTACT US

HOME
- EVENTS
- VOLUNTEER
2020 ELECTIONS
- CALIFORNIA GENERAL ELECTION NOVEMBER 2020
- MARCH 2020 PRIMARY
  - CALIFORNIA MARCH 2020 RESULTS – FINAL
  - CALIFORNIA MARCH 2020 CANDIDATES
ELECTION INTEGRITY
- COUNTY ELECTION OFFICIALS
RESOURCES
- ADDITIONAL RESOURCES
- DOWNLOADS
CONTACT US

ELECTION INTEGRITY – INCIDENT FORM

First Name*

Last Name*

Address*

City*

Zip Code*

County*

Email*

Phone

*Take California Back, Election Integrity Project-California or it's legal representative may contact you to discuss your submission

Registration (select all that apply)

Party Preference Changed De-Registered Other

Vote By Mail (select all that apply)

Received Wrong Party Ballot Received More Than One Ballot Did Not Receive Ballot Other

Voter Center (select all that apply)

Voter Center Not Open Correct Ballot Not Available Not Allowed to Vote Vote Center Location

Primary Election General Election

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

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