Public Record Exemption Request

​​​In certain circumstances, individuals can request the Secretary of State not to disclose their home address, personal phone numbers, and email addresses. You may fill out this form as a public record exemption request. The request for a Public Record Exemption MUST include a non-exempt mailing address for the requestor and enough evidence to warrant the request. 

You must submit enough evidence to show that any disclosure of the requestor's personal information would constitute a danger to the personal safety of the requestor or a family member residing with the requestor. The evidence may include affidavits, declarations, court records, police reports, restraining orders, or stalking protective orders. See Examples of Evidence that May Establish Danger​.​