Your browser does not have javascript enabled. Make sure your contact information is correct before you submit the form. If you have any questions about the form, call Rickie Autrey at (254)933-5319.

Voter Information Order Form

Customer Information Name:?
Address:?
City:?
State:?
Zip:?
Phone Number:?
E-mail Address:?

Order Form Voter Information File preferred?

Current Information
Historical Information

Include Suspended Voters?

Yes
No

Precinct(s):?
City(s):?
School District(s):?

Election(s):?

Voter Party:?

Both
Democrat
Republican

Additional Information?

Output Specifications Sort Sequence?

Address
Name

Pick Up/Delivery Method?

In person
Via Mail or E-Mail

Medium preferred?

CD
ZIP and E-mailed
Laser Labels (30 per page)
Loose-Leaf

Digital format preferred?

Comma Separated Values (*.csv)
Microsoft Excel (*.xls)
Adobe PDF (*.pdf)
HTML (*.htm)
dBase (*.dbf)

One Voter Per Household?

Yes
No

Affidavit

I do solemnly swear that the provided customer information is correct and that the information obtained from the copy of the state master voter file will not be used to advertise or promote commercial products or services.

TEXAS ELECTION CODE Sec. 18.009.
Unlawful use of information on registration list
(a) A person commits an offense if the person uses information in connection with advertising or promoting commercial products or services that the person knows was obtained under Section 18.008.
(b) An offense under this section is a Class A Misdemeanor.

To submit this form, agreement to the above statement must be made.
I disagree. I agree.