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Warren Slocum - San Mateo County Chief Election Officer & Assessor-County Clerk-Recorder

  
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 spacer Voter Registration

Application for Voter Registration Materials (Election Code Sections 2188, 2194, and 2157.2)
 

 

Information on your voter registration affidavit is used by elections officials to send you official information on the voting process, such as the location of your polling place and the issues and candidates that will appear on the ballot.  Commercial use of voter registration information is prohibited by law and a misdemeanor.

Voter registration information may be provided to:

  • a candidate for office
  • a ballot measure committee
  • or to persons or groups for election, scholarly, journalistic, political, or governmental purposes as determined by the Secretary of State.

Driver's license, social security numbers and/or your signature as shown on your voter registration card cannot be released for these purposes.

All legitimate requests to view, purchase, or use voter registration information must be accompanied by a written application.  Simply complete the form below and:

  1. Mail or fax the form to us at the address/fax number listed below. (Mail orders need to be accompanied by your notarized signature on the form and a photocopy of your driver's license) or
  2. Bring the completed form to the address listed below. (You will need to bring your driver's license with you.)

The Registrar of Voters
Elections Office
40 Tower Road
San Mateo, CA 94402
Fax (650) 312-5348

The fees for voter data are as follows:

Upload to FTP and email - FREE
CD-ROM (pick-up) - $1.00
CD-ROM (mailed) - $2.00
Printed List of Voters - $0.50 per 1000 voters
Statement of Vote book - $25.00 - $50.00

Inquiries regarding voter data files should be directed to Steve Dennison, Elections Information Services at 650.312.5370 or SDennison@smcare.org.

 

 
Name  
 
Home Address  
 
City  
 
State  
 
Zip  
 
Phone Number  
 
Email Address  
 
Business Address  
 
City  
 
State  
 
Zip  
 
Phone Number  
 
Email Address  
 
Driver's License Number  
 
Driver's License Expiration Date  
 
State of Driver's License  
 
If this application is in behalf of any person or persons other than the applicant, this section must be completed.

 

Name of person or group requesting voter information:
 
Name  
 
Home Address  
 
City  
 
State  
 
Zip  
 

Name of person authorizing or requesting voter information.
 
THIS SECTION MUST BE COMPLETED
 
Specific information requested:  
 
Intended use of voter registration information:  
 
The aforementioned voter registration information set forth in affidavits of registration or derived from computer terminals, electronic data processing tapes or disks, printed labels, and/or computer-printed listings will be used only for election, scholarly, journalistic, political, or governmental purposes as determined by the Secretary of State. The information (or a portion or copy thereof) will not be sold, leased, or given to any person, organization or agency without first receiving written authorization to do so from the Secretary of State or the county elections official. I certify under penalty of perjury, that all information on this form is true and correct under the laws of the State of California.
 
Signature  
 
Date  
 

 

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