This form is for reporting a bug or error in IDOA's Executive Branch Lobbyist Registration application.

Required Field
First Name: First Name is required
Last Name: Last Name is required
Phone Number: Phone Number is required
E-mail: Name is required Email address is invalid.
Application Username: Username is required
Are you a lobbyist or delegate? User Type is required
Name of Lobbyist: (if you are a delegate)
Are you trying to register or file? Register or File is required
Year of Registration/Filing: Year is required
Date When You Tried to Register/File (mm/dd/yyyy): Date is required
Description of Your Issue: Description of Issue is required
Error Message if You Received One:

Every effort is made to resolve each ticket within 3 days.