ACLU: American Civil Liberties Union of Ohio
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Voter Complaint Form  

This form is designed to assist the ACLU in the evaluation of your voting problem. Please be as specific and detailed as possible. If we need further information, we have your address and/or telephone number and can request any documents necessary. We will not use your name without your permission. Your report will be grouped with other complaints to help us analyze the performance of boards of elections. Thank you.

Although we keep our files confidential, submitting cases via e-mail is not a secure means of transmission. If you do not wish to submit your form via e-mail, you may fill out the form, print it and mail it to:

ACLU of Ohio - Voter Complaints
4506 Chester Ave.
Cleveland, OH 44103

    Basic information
* First name
* Last name
* Address 1
Address 2
* City
* State
* Zip code
* Daytime telephone
Evening telephone
Email

     Complaint Information
Location
Precinct
City
(or Community, Twp.)
County
Date of Complaint

    What is the nature of your complaint?
  Registration (Were forms returned? Other problems?)
  Absentee Ballots (Were forms returned? When did you mail or deliver the forms to the BOE?)
  Long Lines (How long was the wait? Were you able to vote?)
  Machine Malfunction (What kind of machine and what went wrong?)
  Voter Challenge (Were you required to show ID? Were you asked to show anything else?)
  Provisional ballot problem (please specify)
  Other (please specify)
     Were there witnesses to the incident?
     Have you filed this complaint with any other agencies?
     If yes, please describe in the following space and include dates.
     Are you represented by an attorney in this matter?
Yes No
If so, please fill in the following:
Attorney's name
Agency
Address
City
State
Zip code
County
Telephone

    
     I understand that by accepting this complaint, the ACLU is not undertaking legal representation of me, and that the ACLU is not responsible for ensuring that any statute of limitations requirement is met in my case. I hereby authorize the ACLU to use this information in any manner it deems necessary.

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