Johnston County Elections | Data Request Form

Data Request Form

First Name:

Last Name:

Middle Name:

Street Address:

City:

State:

Zip:

Phone:

Email:

How would you like the data you are requesting? (Check one or more)

Print-out (Computer Report)

$.15 / sheet

Copies

$.15 / sheet

Labels (Peel-off)

$.40 / sheet

USB

$10.00 each:

E-mail

Free

How would you like the data organized?

List order: (Specify):

Type of Request:

Payment Type:

Cash (exact amount please)

Check or Money Order (made payable to 'Johnston County Board of Elections')

Acknowledgement of receipt of data:

Printed Signature:

Date Signed:

Security Question:

Notice: In an effort to prevent Spam form submissions, you will need to type the word 'drf2022' in the field below, without any quotation marks, in order to submit your application.

Thank you for your Submission.

Page last updated: October 12, 2022

Data Request Form

How would you like the data you are requesting? (Check one or more)

How would you like the data organized?

Type of Request:

What district or precinct information are you looking for?

Information can include or be limited to any of the following:

Additional comments or requests (if applicable)

What district or precinct information are you looking for?

For Voter History Only (Check Election Type Needed)

Information can include or be limited to any of the following:

What district or precinct information are you looking for?

Information can include or be limited to any of the following:

Payment Type:

Acknowledgement of receipt of data:

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