Disabled Voter Ballot Request

If you have a Utah Driver's License or State ID and authorize the clerk to use your signature on your ID, you can submit the application electronically. If you do not authorize use of your ID, you will have to print, sign and email or mail in the application.

Submit this application electronically:
  • Complete the contact informaton below.
  • Select Yes.
  • Enter your Utah Driver's License or State ID number or the last four digits of your Social Security Number.
  • Press Submit.
Submit this application through email or mail:
  • Select No.
  • Download the PDF version of the Disabled Voter Ballot Request.
  • Print off, complete, and sign the form.
  • Scan and email the form to elections@utahcounty.gov or mail the form to Utah County Elections at 100 E Center St. Room 3100 Provo, UT 84606.
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I authorize the county clerk's office to use my driver's license, identification card, or voter registration application signature for the disabled voter ballot request purposes.

Must select Yes or No.