Ballot Cure Form

We have received a ballot envelope with your name on it. However, we are unable to count the ballot because either your signature was not on the envelope, or the signature did not match our records. Utah law requires that we verify the signature and the ID numbers if provided on the ballot envelope before the ballot can be counted. We must receive your signed affidavit by 12:00pm on Monday, July 6th, 2026.

Please enter the following information for voter identification and authentication.

Voter ID

(The Voter ID is listed on the email/letter we sent to you)

Voter Date of Birth

Date

Voter Name

First NameLast Name

Email

example@example.com

Phone Number

Format: (000) 000-0000.

Last 4 digits of your Utah Issued Driver License or State Issued ID.

OR Last 4 digits of your Social Security Number

Please Provide one of the following for further authentication:

Last 4 digits of your Utah Driver's License/State IDDrivers License/State ID
Last 4 digits of your social security number Last 4 of SSN*

Did you return your voted ballot?

Contact Info

Voter Signature Affidavit:

By signing this affidavit, you are stating under penalty of law: you are a registered voter qualified to vote in the precinct in which you are registered, this ballot belongs to you, and you voted this ballot. The ballot will not be counted if the signature on the affidavit does not match the signature on file with the election's office of the individual to whom the ballot was sent. By signing this affidavit, you authorize the lieutenant governor's and county clerk's use of the signature on the affidavit for voter identification purposes.

Signature