Request to Inspect Sealed Election Materials for a Post-Election Audit

Use this form when your locality wants to conduct a post-election audit as required by Va. Code §
24.2-671.2.

Pursuant to Va. Code § 24.2-669, you must receive permission from the Department of Elections to
unseal ballots cast on Election Day for a post-election audit. You must fill out and submit this form
to the Department of Elections prior to conducting an audit for your locality.

If ELECT provides permission to unseal election materials for a post-election audit, you must provide
the form, which will be sent to the email address entered below, to the Clerk of the Circuit Court of your locality.

Election Date: * +

Election Type: *

Date of Request: * +

Name of Requester *

Position *

If EB or Other, Title *

Email Address *

Confirm Email Address *

Phone Number *

Locality *

Precinct Name *

Precinct #: *

Specific Envelope which needs to be inspected: *

The Envelope needs to be inspected to determine: *