Mississippi Affidavit Voting Report
Submit your details and select the reason you voted by affidavit, including any additional notes if needed.
Name
*
First Name
Last Name
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
County
*
Please Select
Adams
Alcorn
Amite
Attala
Benton
Bolivar
Calhoun
Carroll
Chickasaw
Choctaw
Claiborne
Clarke
Clay
Coahoma
Copiah
Covington
DeSoto
Forrest
Franklin
George
Greene
Grenada
Hancock
Harrison
石inds
Holmes
Humphreys
Issaquena
Itawamba
Jackson
Jasper
Jefferson
Jefferson Davis
Jones
Kemper
Lafayette
Lamar
Lauderdale
Lawrence
Leake
Lee
Leflore
Lincoln
Lowndes
Madison
Marion
Marshall
Monroe
Montgomery
Neshoba
Newton
Noxubee
Oktibbeha
Panola
Pearl River
Perry
Pike
Pontotoc
Prentiss
Quitman
Rankin
生aven
Scott
Sharkey
Simpson
Smith
Stone
と思all
Tallahatchie
Tate
Tippah
Tishomingo
Tunica
Union
Walthall
Warren
Washington
Wayne
Webster
Wilkinson
Winston
Yalobusha
Yazoo
Name of polling location (Optional)
Why did you vote by affidavit?
*
I didn’t have an acceptable photo ID
My name wasn’t on the voter list
I was told I was at the wrong polling place (including a moved or merged location)
I moved and my address wasn’t updated
I requested an absentee ballot
My vote was challenged at the polls
Not sure / they didn’t tell me
Other (please explain)
Submit
Should be Empty: