PUBLIC INFORMATION REQUEST FORM DETAILS AND INSTRUCTIONS
Send Order to: Send Statement to:
____________________________ _______________________________
____________________________ _______________________________
____________________________ _______________________________
Telephone (___) ______________ Telephone (___) _________________
Below are the procedures for filling out the attached Public Information Request form. Failure to
adequately complete the form may cause incorrect information or could delay the processing of
your order.
1. Media Selection: CD-ROM or FTP. If selecting an FTP please provide FTP site, login
and password information.
2. Format: Voter registration list (individual records) in zipped fixed width text file(s). See
the attached record layout.
3. Extracts & Data Reduction- Options may be selected to select a limited group of voters.
Additional extract requests may result in data manipulation, which would result in
additional charges. Section 552.231 of the Texas Government Code requires that
agencies send a written statement about the cost of potentially manipulating data to any
requestor. Should it be determined that your request will require data manipulation, then
a statement of the estimated cost of providing the information in the requested form will
be supplied to you within the timeframe outlined in section 552.231.
4. In the area for county name(s) or District Number(s), please note the following: If the
entire state is requested, mark the space provided. If a district or county is
requested, list the district number or county (write “All” by the county name to indicate
all precincts). Otherwise, for partial district, county or other requests, please list the
county names and applicable precinct numbers.
5. The attached affidavit must be signed before a notary public. A $75.00 deposit must
accompany each request. If the request is from a Member of the House or Senate, the
Member must submit the request through the appropriate business office for approval of
funds before
submitting it to this office, unless the request is being paid for out of
personal funds. CD-ROM will not be released and/or files will not be uploaded to the
FTP until full payment is received. A complete address (No P. O. Box) must be provided
along with a telephone number. The Secretary of State will furnish information not later
than the 15
th
day after the date the request is received. (Texas Election Code, Section
18.066).
Please retain a copy of this form for your records. Please include a $75.00 deposit fee with your
request, made payable to the Secretary of State’s Office. The Secretary of State will furnish the
information not later than the 15th day after the date the request is received. Your order will not
be released until full payment is received. The attached affidavit must be signed before a notary
public and accompany all requests.
If you have any questions, please contact Elections Division at (512) 463-5650 or toll free at 1-
800-252-VOTE (8683).