Colorado Department of State Data Request Form Office Use ...

Colorado Department of State Data Request Form

Complete and return this form to the Colorado Secretary of State. Please type or print legibly.

Contact Information

Requestor Name: Mailing Address City Phone E-mail Address

Company Name:

State Extension

Zip Code

Office Use Only: Received Date_______________ Processed By ________________ Sent Date___________________

Apt/Unit

Data Requested

$1000.00 Election Cycle Subscription Service

Subscription provides electronic download access to the listed data extracts for the 2021-2022 statewide election cycle including the Odd-year Coordinated Election, Primary Election, and General Election. The following reports are included with the subscription:

Statewide Registered Voter List (EX-003) updated monthly Master Voter History (EX-002) with updates following the primary, general, and odd-year elections Statewide Mail Ballots Returned (CE-018) for the primary, general, and odd-year elections - hourly after ballots are mailed Statewide In-Person Voting List (CE-019) for the primary, general, and odd-year elections - hourly after in-person voting begins Statewide UOCAVA Voter List (CE-036) for the primary, general and odd-year elections - one time after ballots are mailed Statewide Voter Service and Polling Center Locations List (VSPC) for the primary, general and odd-year elections - one time after ballots are mailed Public List of Voters with a Ballot (CE-068) for the primary, general, and odd-year elections - daily after ballots are mailed

Data Request on Data Disc for $50.00 per report Master Voter History List Export (EX-002) Statewide Registered Voter List (EX-003) Election Abstract (per two-year election cycle) *Available free online Rejected Cure Ballots (CE-077) Date(s) Requested

Statewide UOCAVA Voter List (CE-036) Voters with a Ballot (CE-068) Rejected Ballots (Daily, to one day after cure deadline)

Person picking up

Date picked up

Signature

Payment and Mailing Instructions Amount Enclosed: $

Number of Copies Requested

PLEASE ENCLOSE A CHECK OR MONEY ORDER PAYABLE TO THE COLORADO SECRETARY OF STATE

zRequests will be returned via first class mail within 72 hours depending on request. For Fed-ex, USPS Express Mail, or UPS please include a pre-paid mailer. zMail completed form to the address below:

Colorado Secretary of State Elections Division

1700 Broadway, Suite 550 Denver, Colorado 80290 Phone: (303) 894-2200

Fax: (303) 869-4861

Save & Print

Please contact us with any questions or concerns at

(303) 894-2200 or e-mail to:

elections@

Revised August 2021

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