Electronic Virginia Petition of Qualified Voters

Electronic form to petition for candidates to be on the ballot in the Virginia Democratic Primary, June 8, 2021.
Frequently Asked Questions

Your Information

Your full name is required.
The last four digits of your SSN are required to be able to electronically sign this form.
Your Full Residential Address
Please enter your residential address.
Please enter your city
Please provide a valid state.
Zip code required.
You must select your locality.

Candidate Information

Select the candidates below for which you would like to sign petitions. Signing a candidate's petition does not indicate support for that candidate or that you will vote for the candidate.

Governor

Lieutenant Governor

Attorney General

House of Delegates

Enter your address above.

Petition Signer Statement

I, the qualified voters of the district in which the above candidate seeks nomination or election, and of signed herunder, do hereby petition the above named individual(s) to become a candidate for the office stated above in the Democratic Primary to be held on the 8th day of June, 2021, and we do further petition that his/her name be printed upon the official ballots to be used at the election.

Note to Petition Signer

  • Your signature on this petition must be your own and does not signify an intent to vote for the candidate.
  • You may sign petitions for more than one candidate.
  • Privacy notice:
    • This information provided will be checked against the official voter registration roll.
    • This form is available for public inspection, but your SSN, or any part thereof, will not be provided.
  • Fraud notice: Any willfully false material statement or entry made on this form by any person shall constitute the crime of election fraud and be punishable as a Class 5 Felony.

Your Signature

I affirm the information provided is true, and I affirm I am a resident of my jurisdiction and of the address provided below.

I authorize this electronic signature to be applied to electronic petition forms submitted to the campaign of each candidate I have selected above.

Please enter your full name again, as your signature.
Please enter a date.

Email Copy

Enter your email address below if you would like a copy of the submitted petitions sent to you. Your email address will only be used for this purpose, and will not be otherwise stored or collected unless authorized.

Please enter a valid email address to receive a copy of this submission.

Your information is used to submit this petition request only. It will not be retained or collected for any other purpose, unless you authorize the sharing of your email address.

I acknowledge that the Virginia Department of Elections requires that such petitions contain personal information and that the Fairfax County Democratic Committee makes no additional representations or warranties regarding the usage, storage, or security of the personal information contained on this petition on behalf of the campaigns.