Privacy Notice: Voter registration records contain standard data that is available to the public, such as your name, residential and mailing address, party affiliation, and age range.

A few items remain strictly confidential and are only available to authorized government entities: your social security number, Utah Driver's License or ID number, full date of birth, and your signature. Your email address and phone number are also kept confidential unless you explicitly consent to disclose them to your affiliated political party.

What does this request do? This form allows certain individuals to request that their voter registration record is classified as at-risk. Personally identifiable information will not be publicly released. Submitting this request limits the disclosure of your voter registration record after this form has been processed by the election official.

Important Notes:

• Submitting this form does not remove or prevent the disclosure of your personal information that may be located in other government or commercial databases.

• If you sign a political petition (such as an initiative or referendum), your voter identification number and the date you signed may be publicly disclosed.

• If your record was previously classified as "private" or "withheld" without a specific reason under old laws, you must submit this new form and required proof by May 6, 2026, or your record will become public.

Who can apply for designation as an at-risk voter? Utah law only allows certain categories of individuals to withhold their voter registration records from disclosure. You may apply for designation as an at-risk voter if you are, or if you reside with:

• An individual who is a victim of, or who is threatened with, domestic violence or dating violence.

• A law enforcement officer.

• A public figure. (Under Utah Code 20A-1-102(62), this now includes elected officials or government employees who have received threats of harm to person or property).

• A member of the armed forces.

• An individual protected by a protective or protection order.

How do I submit this form? You must provide a statement that explains why you meet the category you indicated. This section is not required if you are a victim of domestic violence or dating violence, or if you reside with one. Your election official may require you to provide additional documentation to verify that you meet the category that you indicated.

Submit this completed form to the county clerk's office. You may submit this form by mail, email (clerk@daviscountyutah.gov), or in person.

Download