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Alabama Online Election Complaint Form

I.  Complainant's Information
(PERSON MAKING COMPLAINT)

Your complaint will not be made public. Your complaint may be referred to law enforcement authorities.
* = required  
Name:*
Title First Name Last Name
   
Address:*  
City:*   
Zip:*  
Primary Phone:*
(xxx-xxx-xxxx)
Secondary Phone:*
(xxx-xxx-xxxx)
E-Mail Address:*  
Fax:
(xxx-xxx-xxxx)
Note: Please list only one (1) person per complaint form.
Please use a new form for each additional person making a complaint.
II.  Person or Entity Against Whom Complaint is Brought

Name(s):
Entity (if any):
Address:
City:
Zip:
Primary Phone:
(xxx-xxx-xxxx)
Secondary Phone:
(xxx-xxx-xxxx)
Email Address:
Date Incident Occurred: / /  
(MM / DD / YYYY)
Location of Occurrence:
Have you submitted information about this complaint to your District Attorney and/or Attorney General's office?

Have you submitted information about this complaint to the Alabama Ethics Commission?

  If known, please state the provision or section of election law(s) that you believe was violated.
(255 Characters Maximum)



  Explain the basis for your complaint. Please provide a detailed listing of facts, circumstances, witnesses, procedures, occurrences, and other information including the names of persons you believe have information about the alleged violation(s) by the person(s) or entity named in paragraph II.*
(5000 Characters Maximum)

III.  Sworn Statement of the Complainant
(PERSON MAKING COMPLAINT)

By entering my name in this box, I swear or affirm that all statements made in this complaint are accurate, true, and correct.*
 

 
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P.O. Box 5616
Montgomery, AL 36103-5616
1-800-274-VOTE (8683)
Fax:  (334) 242-4993
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