SBE: INCIDENT SUBMISSION FORM (PUBLIC)
This form was created by the State Board of Elections to allow organizations and members of the public to report information regarding incidents witnessed during elections in North Carolina. Staff at the State Board will review submissions and work to resolve incidents, though an individual response is not guaranteed.

SUBMISSIONS ARE PUBLIC RECORD. Please do not disclose confidential information (birth dates, Social Security numbers, driver license numbers, etc.) This form is provided as a portal for informal complaints. All official complaints and elections protests must be filed in the manner consistent with the laws governing those proceedings.
Name of Person Completing this Form *
Telephone Number *
Email Address *
Date/Time of Incident *
MM
/
DD
/
YYYY
County *
Early Voting / Precinct Location *
Type of Incident *
Required
General Nature of Incident *
Required
Description of Incident *
Requested Action: *
Witness *
Required
If you did not personally witness this incident, please provide the contact information for the person who did:
Submit
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