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Get Voter Action Request Form

N Santa Clara County to use this form. 2. Please print clearly. 3. If requesting a name or party change, you must re-register. 4. If requesting an action for another voter, provide their information in the VOTER INFORMATION box. VOTER INFORMATION All information must be provided to complete your request. Name: Birth Date: / / Registered Address: Signature: Date: Sample Ballot & Voter Information Pamphlet (Opt-In/Out): I want to use the on-line Sample Ballot & Voter I.

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