Signee Information

* indicates a required field

First Name:*

Last Name:*

Address:*

Address 2:

Zip Code:*

Email address:*

If you wish to receive an email confirmation of your submission please include an email address above.

Share My Contact Information*

Yes

Do you own this property?*

Yes

Phone Number:

Ballot Unique ID:*

Unique ballot ID is located in the bottom right corner of the ballot mailer.

Do you support the traffic safety measures outlined in the statement below?*

YES, I support the traffic safety measures

NO, I do not support the traffic safety measures

Attestation
Support Statement

By signing this ballot, I understand that traffic calming measures are being considered for installation on my street and in my neighborhood, as shown on the provided Concept Plan.
Check the results of the application and view the proposed Concept Plan here.

I certify the information I provided on and in connection with this form is true and correct to the best of my knowledge.

Knoxville's Neighborhood Street Traffic Safety Online Ballot

Signee Information