MN Election Integrity Incident Report

Election Incident Report

To report an incident, please provide the following information
Full Name*

First NameLast Name
Email*
Phone Number
Address

Street Address

Street Address Line 2

CityState

Zip Code
Date and time when incident occurred:*

MonthDayYear
Date
Hour MinutesAM/PM Option
County where incident occurred*
Location (Please provide specific details - Precinct, Drop Box Location, etc.) *
Incident details*
Was this reported to any authority/authorities (for example Head Election Judge, Police, Sheriff's Department)?*

NoYes
Please give details of your report to authorities:*
Please provide details (who, what, where, when).
Upload any supporting documents or photos

Cancelof
Certify your statement*

I certify that the above information is true and correct.
Should be Empty:

Election Incident Report