Submit a Temporary Mailing Address
Please complete the form below to submit a temporary mailing address for Election information and documents:
Name:

Permanent Address:

Permanent Address Line 2:

Permanent City (Mason):

State or Province (MI):

Zip or Postal Code (48854):

Phone:

Email:

Enter Start Date & End Date (date returning to Mason):
MM/DD/YYYY - MM/DD/YYYY
 
Enter Temporary Mailing Address: (Including Apt. # and c/o info, if applicable)

Please list other members of the same household who are also affected by this temporary address change:

  Check this box if you'd like an email confirmation that you've been added to the Temporary Mailing Address list.