NC Voting Anomaly Report

Canvasser Section

This form is to be completed if you have an anomaly or questionable voting irregularities that would require a sworn affidavit on behalf of the canvasser of an address.
Canvasser Full Name (Person doing the work)

First NameLast Name
Canvasser Email
example@example.com
Canvasser county
Canvasser Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Voter Anomaly Found
Type of canvasing
County being canvased
Person being canvased

First NameMiddle NameLast Name
Voter's Party
Voter's Gender
Voter's Race
Walk Book ID:
leave blank if no walk book
Voter's NCID
Voter's 2nd NCID
If voter has multiple NCID's enter second NCID
Voter's Registered Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Anomaly at Address
Enter anomaly found at this address for this voters record
Votes Registered
If the voter did not agree with the voting method, please choose the correct voting method stated by the voter.
If registered and voted in multiple counties

(exact name in both counties)
Voted in county 1
Voting method in county 1
Voted on date County 1

MonthDayYear
Date
Voted in county 2
Voting method in county 2
Voted on date County 2

MonthDayYear
Date
Voted in county 3
Voting method in county 3
Voted on date County 3

MonthDayYear
Date
Other anomaly
(any other anomaly that is not captured in previous questions)
Supporting Images

(Upload the images from Voter Search and/or other photos to support this anomaly)
Cancelof
Affidavits are needed…

When registered VOTERs did not live at the residence on or before 10/04/2020, or are deceased prior to 11/03/2020. -- When the method by which the resident says he/she voted does not match the record (someone voted for me, different voting method, vote got lost).-- When address is a vacant lot, campground, church, hotel, business, PO Box, virtual mailbox… -- Reminder-an affidavit is a sworn statement based on what you hear and observe
Affidavit Upload

(If you have a completed and notarized affidavit upload the scanned file or images here before you submit this form)
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Status of affidavit
Send these INSTRUCTIONS to your FAMILY, FRIENDS, CHURCH Members, etc.

Ask them to check their street and look up their personal voter information. IF the official NC Board of Elections record does not match their voting actions in 2020, INCLUDING THEIR VOTING METHOD
Should be Empty:

Canvasser Section

Voter Anomaly Found

If registered and voted in multiple counties

Affidavits are needed…

Send these INSTRUCTIONS to your FAMILY, FRIENDS, CHURCH Members, etc.