City of Portland

Candidate Filing Personal Contact Exemption

This public records exemption request must be based on a candidate’s personal safety concerns. If approved, certain personal contact information will be redacted from public disclosure in records and in public postings of candidate information. A written request for a public record exemption must include all of the following:


  • The name or description of the public record sufficient enough to identify the record. (Include name and date of birth of victim, location of incident, and date of incident.)
  • The mailing address for the requestor.
  • Evidence that sufficiently establishes that any disclosure of the requestor's home address, personal telephone number, or electronic mail address would constitute a danger to the personal safety of the requestor or a family member residing with the requestor.
  • This evidence may include any or all of the following documents: affidavits; declarations; court records; police reports or report numbers; restraining orders; or stalking protective orders.


More information can be found on the City of Portland's Safety Exemptions Website.


If you have any questions or concerns, please email elections@portlandoregon.gov or call at (503) 823-4022


I request that the following information that I am providing on this form and any attachment(s) be kept confidential:

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This can only include family members who reside with you.


To withhold family member information date of birth must be included for each person.

This is the email we will use to communicate with you regarding your request.



NOTE: If this is the same as a personal email address you are seeking to withhold from disclosure you must include it both here AND in the Personal Email field below.

I am requesting you withhold the following information and keep it confidential

Personal electronic mail addresses sought to be kept confidential. Business, work, government, and other public accounts are not eligible for this exemption.

Residential address sought to be kept confidential

Phone number sought to be kept confidential.

You are required to provide the name or description of the record(s) you want withheld

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To be eligible for this exemption you must provide evidence sufficient to establish how disclosure of your home address, personal telephone number, or personal electronic mail address would constitute a danger to your personal safety or that of a family member residing with you.


Use this section to describe your circumstances and attach any documentary evidence below. If you do not have evidence to attach then list any police report numbers, court orders, criminal/civil legal proceedings, or contacts with whom the City of Portland can independently verify your statements.

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