Address Confirmation Request

You were mailed an Address Confirmation Request so that the Supervisor of Elections can verify that we have your correct address. Please complete the form below.

If you have changed your name, please click here to be taken to the FL Voter Registration Form. This form must be completed and returned to our office in order to process a name change.

MOVED OUT OF FLORIDA?

If you no longer live in Florida and wish to cancel your Florida Voter Registration, please STOP HERE! Complete the request to remove your name from the voter file. This form may be faxed or emailed to our office.

Please use this form if you received an Address Confirmation Request, Address Change Notice or Address Confirmation Final Notice from our office to confirm your address within the State of Florida.

You can use this form if the following two statements are true.

* Your name is correct on the notice
* You continue with your legal residence in this county

Otherwise, if you have changed your name or moved to another place within the state of Florida, you may use the Florida Voter Registration Application to update your voter registration information.

Finally, if you moved your legal residence outside the state of Florida and wish to cancel your Florida Voter Registration, please complete the Elector's Removal Request Form.

Fields marked with a red asterisk are required.

First Name

Middle Name or Initial

Last Name

Date of Birth

Florida Voter Registration Number (if known)

Phone Number

E-mail Address

No permenent address?

Check here if you do not have a permanent address in this county and are living outside the county but intend to remain a permanent resident of this county. Leave the Current Residence Address (next field) blank.

Current County Residence Address

Previous County Residence Address

Mailing Address

Previous Mailing Address

Additional Comments