2025 Primary Election Ballot Cure Form

2025 Primary Election Ballot Cure Form

votebymail@saltlakecounty.gov | (385) 468-7400 | slco.vote
Voter ID number provided on Cure Letter Notice*
Name*

First NameLast Name
Email (optional)
example@example.com
Phone Number (optional)
Format: (000) 000-0000.
Date of Birth*

MonthDayYear
Date
Utah State Driver License NumberLast 4 digits of my Social Security Number
Utah Driver License Number*
Last 4 digits of Social Security Number*
YesNo (by selecting no, your ballot will not be counted)
I am a voter with a qualifying disability under the Americans with Disabilities Act that impacts my ability to sign my name consistently. I can provide appropriate documentation upon request.
I understand that by signing this affidavit, I authorize the Lieutenant Governor's and County Clerk's offices the use of my signature on the affidavit for voter identification purposes.
By signing I affirm that the information provided is true and correct and that I have personally voted the ballot provided to me. I do solemnly swear that I am a qualified resident voter and that I am entitled to vote in this election. I am not a convicted felon currently incarcerated for commission of a felony.
Signature*

Clear
It is illegal to forge a signature or cast another person’s ballot. Attempting to vote when not qualified, attempting to vote more than once, or falsely signing this oath is a felony punishable by a maximum imprisonment of five years, a maximum fine of $10,000, or both.
Should be Empty: