Delaware Elections  
 Monday, January 16, 2017 4:42 PM    
      
 
Voter Registration Cancellation Request
 
Voter Registration Cancellation Request - Close Relative
 
* - required
1. Your name (Required) (Name of requestor)
 
 * *
 
2. Cancellation reason  (Required)
  I am the                        of the below named registrant. Please cancel his/her voter registration because:
 

      Please specify your reason*:
 
3. Registrant name (Required) (Name of registered voter whose registration will be canceled.)
 
 * *
 
4. Identification (Required)
 
  *
 
 
5. Contact information (How we contact the registrant if we have a question.)
 
(Include international prefixes. No DSN number.)
)
 
6. Delaware registration address   (Required) (Address where registered in Delaware.)
 
* *
* * State *
DE
 
8. Validation
 
 
Office of the State Election Commissioner |  Tel No: 302.739.4277 |  Fax No: 302.739.6794 |  Email: coe_vote@state.de.us