Last Name (some last names might need extra spaces, example..McCarthy, enter Mc Carthy)
Date of Birth:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
Last 4 digits of Social Security
Or
Drivers License Number
Format: X11122223333 - do not include dashes
*Required fields: House Number, Street Name, City
House Number
Format: '1776' or '1N234'
Street Name
Omit direction(N., W. etc) and suffix (St., Ave, Dr. etc.)
Direction
N
E
S
W
Suffix
Ave
Blvd
Cir
Cove
Cr
Crse
Ct
Ctr
Cv
Dr
Hwy
Ln
Loop
Pass
Path
Pkwy
Pl
Plz
Pt
Rd
Rdg
Run
Sq
St
Ter
Terr
Trl
Walk
Way
Xing
City
Addison
Aurora
Bartlett
Batavia
Bensenville
Bloomingdale
Bolingbrook
Burr Ridge
Carol Stream
Clarendon Hills
Darien
Downers Grove
Elgin
Elmhurst
Eola
Glen Ellyn
Glendale Hts
Hanover Park
Hinsdale
Itasca
Keeneyville
Lemont
Lisle
Lombard
Medinah
Naperville
Northwoods
Oak Brook
Oakbrook Ter
Roselle
St Charles
Villa Park
Warrenville
Wayne
West Chicago
Westmont
Wheaton
Willowbrook
Winfield
Wood Dale
Woodridge
District Type
-Select District Type-
City
Community College
Congressional
County
County Board
Educational Service Region
Federal
Fire Protection
Forest Preserve
Grade School
High School
Judicial
Legislative
Library
Miscellaneous
Park
Representative
State
Township
Unit School
Water Commission
District
-Select District-
Information Type
Polling Location
Precinct
Precinct Committeemen
Sample Ballot