Opt-Out Form

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Please correct the fields below:

Please correct the field(s) marked in red below:

To opt-out of all future mail-in ballots, please complete this form in its entirety.

Contact Information

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Contact Information

First Name

Last Name

Date of Birth

Email

Street Address

Municipality

Electronic Submission. Under penalties of perjury, I certify that I am the person accessing this web page and submitting the Opt-Out Form to the New Jersey Somerset County Clerk's Office.

By checking this box and typing my name, I certify that all information on this form is true and correct. I also agree that the checkbox and my name typed below are to be used as my electronic signature. I understand that I can be prosecuted if I provide false or misleading information.

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Electronic Submission. Under penalties of perjury, I certify that I am the person accessing this web page and submitting the Opt-Out Form to the New Jersey Somerset County Clerk's Office. By checking this box and typing my name, I certify that all information on this form is true and correct. I also agree that the checkbox and my name typed below are to be used as my electronic signature. I understand that I can be prosecuted if I provide false or misleading information.

I certify the above information is true and correct and I am the person requesting information.

Type Full Name for digital Signature

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Email Address