SBE: INCIDENT SUBMISSION FORM (PUBLIC)
This form was created by the State Board of Elections and Ethics Enforcement to allow organizations and members of the public to report information regarding incidents witnessed during the 2018 General Election. 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 (birthdays, Social Security numbers, drivers license number, 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.

Applicable statutes may be found: http://dl.ncsbe.gov/sboe/ElectionLawIndex.pdf

Thank you for taking the time to submit your report.

Name of Person Completing this Form *
Your answer
Telephone Number *
Your answer
Email Address *
Your answer
Date/Time of Incident *
MM
/
DD
/
YYYY
County *
Early Voting / Precinct Location *
Your answer
Type of Incident *
Required
General Nature of Incident *
Required
Description of Incident *
Your answer
Requested Action: *
Your answer
Witness *
Required
If you did not personally witness this incident, please provide the contact information for the person who did:
Your answer
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