Voter Registration Form - The US Election Assistance Commission

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1 Register To Vote In Your State By Using This Postcard Form and Guide For U.S. Citizens

2 General Instructions Who Can Use this Application How to Submit Your Application If you are a U.S. citizen who lives or has an address Mail your application to the address listed under within the United States, you can use the application in your State in the State Instructions. Or, deliver the this booklet to: applicationinpersontoyourlocalvoterregistration RegistertovoteinyourState, office.TheStatesthatarerequiredtoacceptthe Reportachangeofnametoyourvoterregistration nationalformwillacceptcopiesoftheapplication office, printedfromthecomputerimageonregularpaper Reportachangeofaddresstoyourvoter stock,signedbytheapplicant,andmailedinan registrationoffice,or envelopewiththecorrectpostage. Registerwithapoliticalparty. First Time Voters Who Register by Mail Exceptions Ifyouareregisteringtovoteforthefirsttimein Please do not use this application if you live outside yourjurisdictionandaremailingthisregistration theUnitedStatesanditsterritoriesandhavenohome application,Federallawrequiresyoutoshowproof (legal)addressinthiscountry,or if you are in the ofidentificationthefirsttimeyouvote.Proofof militarystationedawayfromhome.UsetheFederal identificationincludes: PostcardApplicationavailabletoyoufrommilitary Acurrentandvalidphotoidentificationor bases,Americanembassies,orconsularoffices. Acurrentutilitybill,bankstatement,government check,paycheckorgovernmentdocumentthat New Hampshire town and city clerks will accept this showsyournameandaddress. application only as a request for their own absentee Votersmaybeexemptfromthisrequirementifthey votermailinregistrationform. submitaCOPYofthisidentificationwiththeirmailin North Dakotadoesnothavevoterregistration. voterregistrationform.IfyouwishtosubmitaCOPY, Wyominglawdoesnotpermitmailregistration. pleasekeepthefollowinginmind: Yourstatemayhaveadditionalidentification How to Find Out If You Are Eligible to Register to requirementswhichmaymandateyoushow Vote in Your State identificationatthepollingplaceevenifyoumeet EachStatehasitsownlawsaboutwhomayregisterand theFederalproofofidentification. vote.ChecktheinformationunderyourStateinthe State Instructions. All States require that you be a United Donotsubmitoriginaldocumentswiththis Statescitizenbybirthornaturalizationtoregistertovote application, only COPIES. infederalandStateelections.Federallawmakesitillegal tofalselyclaimU.S.citizenshiptoregistertovoteinany If You Were Given this Application in a State federal, State, or local election. You cannotberegistered Agency or Public Office tovoteinmorethanoneplaceatatime. IfyouhavebeengiventhisapplicationinaState How to Fill Out this Application agencyorpublicoffice,itisyourchoicetousethe Use both the Application Instructions and State application. If you decide to use this application to Instructionstoguideyouinfillingouttheapplication. registertovote,youcanfillitoutandleaveitwith First,readtheApplicationInstructions.These theStateagencyorpublicoffice.Theapplication instructionswillgiveyouimportantinformation willbesubmittedforyou.Or,youcantakeitwith thatappliestoeveryoneusingthisapplication. youtomailtotheaddresslistedunderyourState intheStateInstructions.Youalsomaytakeit Next,findyourStateundertheStateInstructions. with you to deliver in person to your local voter UsetheseinstructionstofilloutBoxes6,7,and8. registrationoffice. Alsorefertotheseinstructionsforinformationabout Note:ThenameandlocationoftheStateagency votereligibilityandanyoathrequiredforBox9. or public office where you received the application When to Register to Vote willremainconfidential.Itwillnotappearonyour EachStatehasitsowndeadlineforregisteringtovote. application. Also, if you decide not to use this CheckthedeadlineforyourStateonthelastpageof applicationtoregistertovote,thatdecisionwill this booklet. remainconfidential.Itwillnotaffecttheserviceyou receivefromtheagencyoroffice. 1 Revised 03/01/2006

3 Application Instructions Beforefillingoutthebodyoftheform,pleaseanswerthequestionsonthetopoftheformastowhetheryouarea UnitedStatescitizenandwhetheryouwillbe18yearsoldonorbeforeElectionDay.Ifyouanswernotoeitherofthese questions,youmaynotusethisformtoregistertovote.However,statespecificinstructionsmayprovideadditional informationoneligibilitytoregistertovotepriortoage18. Box 1 Name Box 7 Choice of Party PutinthisboxyourfullnameinthisorderLast, InsomeStates,youmustregisterwithapartyifyou First,Middle.Donotusenicknamesorinitials. wanttotakepartinthatpartysprimaryelection, Note:Ifthisapplicationisforachangeofname,please caucus,orconvention.TofindoutifyourStaterequires tell us in Box A (on the bottom half of the form) your this,seeitem7intheinstructionsunderyourState. fullnamebeforeyouchangedit. Ifyouwanttoregisterwithaparty,printintheboxthe Box 2 Home Address fullnameofthepartyofyourchoice. Putinthisboxyourhomeaddress(legaladdress).Do notputyourmailingaddresshereifitisdifferentfrom If you do notwanttoregisterwithaparty,writeno yourhomeaddress.Donotuseapostofficeboxor partyorleavetheboxblank.Donot write in the word ruralroutewithoutaboxnumber.Refertostatespecific independentifyoumeannoparty,becausethis instructionsforrulesregardinguseofroutenumbers. mightbeconfusedwiththenameofapoliticalpartyin your State. Note:Ifyouwereregisteredbeforebutthisisthefirst Note: Ifyoudonotregisterwithaparty,youcanstill timeyouareregisteringfromtheaddressinBox2, voteingeneralelectionsandnonpartisan(nonparty) please tell us in BoxB (on the bottom half of the form) primaryelections. theaddresswhereyouwereregisteredbefore.Please giveusasmuchoftheaddressasyoucanremember. Box 8 Race or Ethnic Group AfewStatesaskforyourraceorethnicgroup,inorder Also Note: If you live in a rural area but do not have a toadministertheFederalVotingRightsAct.Tofind street address, or if you have no address, please show outifyourStateasksforthisinformation,seeitem8 whereyouliveusingthemapinBox C (at the bottom intheinstructionsunderyourState.Ifso,putinBox8 of the form). thechoicethatbestdescribesyoufromthelistbelow: AmericanIndianorAlaskanNative Box 3 Mailing Address AsianorPacificIslander Ifyougetyourmailatanaddressthatisdifferentfrom Black,not of HispanicOrigin theaddressinBox2,putyourmailingaddressinthis box.IfyouhavenoaddressinBox2,youmust write in Hispanic Box3anaddresswhereyoucanbereachedbymail. Multiracial White,not ofHispanicOrigin Box 4 Date of Birth Other Putinthisboxyourdateofbirthinthisorder Month,Day,Year.Be careful not to use todays date! Box 9 Signature Reviewtheinformationinitem9intheinstructions Box 5 Telephone Number underyourState.Beforeyousignormakeyourmark, MostStatesaskforyourtelephonenumberincase makesurethat: there are questions about your application. However, you do nothavetofillinthisbox. (1)YoumeetyourStatesrequirements,and (2)YouunderstandallofBox9. Box 6 ID Number Federallawrequiresthatstatescollectfromeach Finally,signyourfullnameormakeyourmark,and registrantanidentificationnumber.Youmustreferto printtodaysdateinthisorderMonth,Day,Year. yourstate'sspecificinstructionsforitem6regarding Iftheapplicantisunabletosign,putinBox D the informationonwhatnumberisacceptableforyour name,address,andtelephonenumber(optional)ofthe state. If you have neither a drivers license nor a social person who helped the applicant. securitynumber,pleaseindicatethisontheformanda numberwillbeassignedtoyoubyyourstate. 2 Revised 03/01/2006

4 Voter Registration Application Before completing this form, review the General, Application, and State specific instructions. Are you a citizen of the United States of America? Yes No This space for office use only. Will you be 18 years old on or before election day? Yes No If you checked "No" in response to either of these questions, do not complete form. (Please see state-specific instructions for rules regarding eligibility to register prior to age 18.) Mr. Miss Last Name First Name Middle Name(s) Jr II 1 Mrs. Ms. III Sr IV Home Address Apt. or Lot # City/Town State Zip Code 2 Address Where You Get Your Mail If Different From Above City/Town State Zip Code 3 Date of Birth Telephone Number (optional) ID Number - (See item 6 in the instructions for your state) 4 5 Month Day Year 6 Choice of Party Race or Ethnic Group (see item 7 in the instructions for your State) (see item 8 in the instructions for your State) 7 8 I have reviewed my state's instructions and I swear/affirm that: I am a United States citizen I meet the eligibility requirements of my state and subscribe to any oath required. 9 The information I have provided is true to the best of my Please sign full name (or put mark) knowledge under penalty of perjury. If I have provided false information, I may be fined, imprisoned, or (if not a U.S. Date: citizen) deported from or refused entry to the United States. Month Day Year If you are registering to vote for the first time: please refer to the application instructions for information on submitting copies of valid identification documents with this form. Please fill out the sections below if they apply to you. If this application is for a change of name, what was your name before you changed it? Mr. Miss Last Name First Name Middle Name(s) Jr II A Mrs. Ms. Sr III IV If you were registered before but this is the first time you are registering from the address in Box 2, what was your address where you were registered before? Street (or route and box number) Apt. or Lot # City/Town/County State Zip Code B If you live in a rural area but do not have a street number, or if you have no address, please show on the map where you live. Write in the names of the crossroads (or streets) nearest to where you live. NORTH Draw an X to show where you live. Use a dot to show any schools, churches, stores, or other landmarks near where you live, and write the name of the landmark. Example C Route #2 Grocery Store Woodchuck Road Public School X If the applicant is unable to sign, who helped the applicant fill out this application? Give name, address and phone number (phone number optional). D Mail this application to the address provided for your State.


6 Voter Registration Application Before completing this form, review the General, Application, and State specific instructions. Are you a citizen of the United States of America? Yes No This space for office use only. Will you be 18 years old on or before election day? Yes No If you checked "No" in response to either of these questions, do not complete form. (Please see state-specific instructions for rules regarding eligibility to register prior to age 18.) Mr. Miss Last Name First Name Middle Name(s) Jr II 1 Mrs. Ms. III Sr IV Home Address Apt. or Lot # City/Town State Zip Code 2 Address Where You Get Your Mail If Different From Above City/Town State Zip Code 3 Date of Birth Telephone Number (optional) ID Number - (See item 6 in the instructions for your state) 4 5 Month Day Year 6 Choice of Party Race or Ethnic Group (see item 7 in the instructions for your State) (see item 8 in the instructions for your State) 7 8 I have reviewed my state's instructions and I swear/affirm that: Q I am a United States citizen Q I meet the eligibility requirements of my state and subscribe to any oath required. 9 Q The information I have provided is true to the best of my Please sign full name (or put mark) knowledge under penalty of perjury. If I have provided false information, I may be fined, imprisoned, or (if not a U.S. Date: citizen) deported from or refused entry to the United States. Month Day Year If you are registering to vote for the first time: please refer to the application instructions for information on submitting copies of valid identification documents with this form. Please fill out the sections below if they apply to you. If this application is for a change of name, what was your name before you changed it? Mr. Miss Last Name First Name Middle Name(s) Jr II A III Mrs. Ms. Sr IV If you were registered before but this is the first time you are registering from the address in Box 2, what was your address where you were registered before? Street (or route and box number) Apt. or Lot # City/Town/County State Zip Code B If you live in a rural area but do not have a street number, or if you have no address, please show on the map where you live. QWrite in the names of the crossroads (or streets) nearest to where you live. NORTH QDraw an X to show where you live. QUse a dot to show any schools, churches, stores, or other landmarks near where you live, and write the name of the landmark. Example C Route #2 OGrocery Store Woodchuck Road Public School O X If the applicant is unable to sign, who helped the applicant fill out this application? Give name, address and phone number (phone number optional). D Mail this application to the address provided for your State.


8 State Instructions andthattheinformationcontained ballotfromtheballotsavailable. Alabama hereinistrue,sohelpmeGod 8. Race or Ethnic Group.Leave Updated: 03-01-2006 blank. Mailing address: 9. Signature. ToregisterinAlaska Registration Deadline Voter Office of the Secretary of State youmust: registrationisclosedduringthe P.O.Box5616 beacitizenoftheUnitedStates tendaysprecedinganelection. Montgomery,AL361035616 beatleast18yearsoldwithin90 Applicationsmustbepostmarked daysofcompletingthisregistration or delivered by the eleventh day bearesidentofAlaska prior to the election. Alaska notbeaconvictedfelon(unless unconditionallydischarged) Updated: 03-01-2006 notberegisteredtovotein 6. ID Number. Your social security numberisrequested(byauthority another State Registration Deadline 30 days oftheAlabamaSupremeCourt, before the election. 174122). Mailing address: 7. Choice of Party. Optional: You DivisionofElections 6. ID Number. Youmustprovide State of Alaska donothavetoregisterwithaparty oneofthefollowingidentification if you want to take part in that POBox110017 numbers;AlaskaDriver'sLicense Juneau,AK998110017 partysprimaryelection,caucus, orAlaskaStateIdentificationCard or convention. Number.Ifyoudonothavean 8. Race or Ethnic Group. You AlaskaDriver'sLicenseorAlaska arerequiredtofillinthisbox; Arizona StateIdentificationCard,youmust however, your application will providethelastfourdigitsofyour Updated: 03-01-2006 not be rejected if you fail to do so. SocialSecurityNumber.Ifyoudo See the list of choices under the nothaveanyoftheseidentification Registration Deadline 29days ApplicationInstructionsforBox8 numbers,pleasewrite"NONE" before the election. (onpage2). ontheform.Auniqueidentifying 9. Signature.Toregisterin numberwillbeassignedtoyoufor 6. ID Number.Yourcompleted Alabamayoumust: voterregistrationpurposes.This voterregistrationformmust beacitizenoftheUnitedStates informationiskeptconfidential. containthenumberofyour bearesidentofAlabama Havingthisinformationassists Arizona driver license, or andyourcountyatthetimeof inmaintainingyourvoterrecord nonoperatingidentification registration andmayassistinverifyingyour license issued pursuant to A.R.S. be18yearsoldbeforeanyelection identity(Title15oftheAlaska 283165,ifthelicenseiscurrent nothavebeenconvictedofafelony Statutes). and valid. If you do not have punishablebyimprisonmentinthe 7. Choice of Party. You do not a current and valid Arizona penitentiary (or have had your civil have to declare a party affiliation driverlicenseornonoperating andpoliticalrightsrestored) whenregisteringtovote.Ifyou identificationlicense,youmust notcurrentlybedeclared do not choose a party, you will includethelastfourdigitsof mentallyincompetentthrougha beregisteredasUndeclared. yoursocialsecuritynumberif competencyhearing Alaskahasaclosedprimary one has been issued to you. If you swearoraffirmtosupportand electionsystem.Eachrecognized do not have a current and valid defend the Constitution of the political party has a separate ballot driverlicenseornonoperating U.S.andtheStateofAlabama listingonlycandidatesfromthat identificationlicenseorasocial and further disavow any belief or politicalparty.Votersregistered securitynumber,pleasewrite affiliationwithanygroupwhich asamemberofapoliticalparty NONEontheform.Aunique advocates the overthrow of the mayonlyvotethatparty'sballot. identifyingnumberwillbe governmentsoftheU.S.ortheState Votersregisteredasundeclared assignedbytheSecretaryofState. ofAlabamabyunlawfulmeans ornonpartisanmaychooseone 3

9 State Instructions 7. Choice of Party. If you are ofyoursocialsecuritynumber.If IDcard,youmustprovidethe registeredinapoliticalpartywhich you do not have a driver's license lastfourdigitsofyourSocial hasqualifiedforballotrecognition, oranonoperatingidentification SecurityNumber(SSN).Ifyou youwillbepermittedtovotethe orasocialsecuritynumber,please donotincludethisinformation, primaryelectionballotforthat write"NONE"ontheform.A you will be required to provide party.Ifyouareregisteredasan uniqueidentifyingnumberwillbe identificationwhenyouvote. independent, no party preference assignedbytheState. 7. Choice of Party. Please enter orasamemberofapartywhichis 7. Choice of Party. Optional. You thenameofthepoliticalpartywith notqualifiedforballotrecognition, donothavetoregisterwithaparty whichyouwishtoregister.Ifyou youmayselectandvoteone if you want to take part in that donotwishtoregisterwithany primaryelectionballotforoneof partysprimaryelection,caucus,or party,enterDeclinetoStatein therecognizedpoliticalparties. convention. the space provided. 8. Race or Ethnic Group.Leave 8. Race or Ethnic Group.Leave California law allows voters who blank. blank. declinetostateanaffiliationwith 9. Signature.Toregisterin 9. Signature.Toregisterin aqualifiedpoliticalpartyorwho Arizonayoumust: Arkansasyoumust: affiliatewithanonqualifiedpolitical beacitizenoftheUnitedStates beacitizenoftheUnitedStates partytovoteintheprimaryelection bearesidentofArizonaandyour liveinArkansasattheaddressin ofanyqualifiedpoliticalpartythat countyatleast29dayspreceding Box2ontheapplication filesanoticewiththeSecretary thenextelection beatleast18yearsoldbeforethe ofStateallowingthemtodoso. be18yearsoldonorbeforethe nextelection Youcancall1800345VOTE nextgeneralelection notbeaconvictedfelon(or or visit to learn nothavebeenconvictedof havecompletelydischargedyour whichpoliticalpartiesareallowing treason or a felony (or have had sentenceorbeenpardoned) nonaffiliated voters to participate in yourcivilrightsrestored) notclaimtherighttovoteinany theirprimaryelection. notcurrentlybedeclaredan other jurisdiction 8. Race or Ethnic Group.Leave incapacitated person by a court notpreviouslybeadjudged blank. of law mentallyincompetentbyacourtof 9. Signature. Toregisterin competentjurisdiction Californiayoumust: Mailing address: beacitizenoftheUnitedStates Secretary of State/Elections Mailing address: bearesidentofCalifornia 1700W.Washington,7thFloor Secretary of State beatleast18yearsofageatthe Phoenix,AZ850072888 Voter Services timeofthenextelection P.O.Box8111 notbeimprisonedoronparole LittleRock,AR722038111 for the conviction of a felony Arkansas notcurrentlybejudgedmentally incompetentbyacourtoflaw Updated: 03-01-2006 California Signatureisrequired.Ifyou Updated: 03-01-2006 meettherequirementslisted Registration Deadline 30 days above,pleasesignanddatethe before the election. registrationcardinthespace Registration Deadline 15days before the election. provided. 6. ID Number. Yourcompleted voterregistrationformmust Mailing address: contain your state issued driver's 6. ID Number. Whenyouregister tovote,youmustprovideyour Secretary of State licensenumberornonoperating ElectionsDivision identificationnumber.Ifyou California drivers license or Californiaidentificationcard 150011thStreet do not have a driver's license or Sacramento,CA95814 nonoperatingidentification,you number,ifyouhaveone.Ifyou mustincludethelastfourdigits do not have a drivers license or 4

10 State Instructions 6. ID Number.Yourcompleted Colorado Connecticut voterregistrationformmust Updated: 03-28-2008 Updated: 03-01-2006 contain your state issued driver's licensenumberornonoperating Registration Deadline 29 Registration Deadline 14days identificationnumber.Ifyou days before the election. If the before the election. do not have a driver's license or applicationisreceivedinthemails nonoperatingidentification,you withoutapostmark,itmustbe 6. ID Number. Connecticut mustincludethelastfourdigits receivedwithin5daysoftheclose Driver'sLicenseNumber,orif ofyoursocialsecuritynumber.If ofregistration. none,thelastfourdigitsofyour you do not have a driver's license SocialSecurityNumber. oranonoperatingidentification 6. ID Number. Yourcompleted 7. Choice of Party.Thisis orasocialsecuritynumber,please voterregistrationformmustcontain optional,butyoumustregister write"NONE"ontheform.A your state issued driver's license with a party if you want to take uniqueidentifyingnumberwillbe numberoridentificationnumber. partinthatpartysprimary assignedbytheState. If you do not have a driver's license election, caucus, or convention. 7. Choice of Party.Youmust orstateissuedidentification,you 8. Race or Ethnic Group.Leave registerwithapartyifyouwantto mustincludethelastfourdigits blank. takepartinthatpartysprimary ofyoursocialsecuritynumber.If 9. Signature.Toregisterin election, caucus, or convention. you do not have a driver's license Connecticutyoumust: 8. Race or Ethnic Group.Leave orastateissuedidentificationora beacitizenoftheUnitedStates blank. socialsecuritynumber,pleasewrite bearesidentofConnecticut 9. Signature. Toregisterin "NONE"ontheform.Aunique and of the town in which you wish Delawareyoumust: identifyingnumberwillbeassigned to vote beacitizenoftheUnitedStates by the State. be17yearsold.Youcanvote beapermanentresidentof 7. Choice of Party.Youmust whenyouturn18 Delaware registerwithapartyifyouwantto havecompletedconfinementand beatleast18yearsoldonthe takepartinthatpartysprimary parole if previously convicted of a dateofthenextgeneralelection election, caucus, or convention. felony,andhavehadyourvoting felonsareeligibletovoteif 8. Race or Ethnic Group.Leave rightsrestoredbyRegistrarsofVoters. certainrequirementsaremet: blank. notcurrentlybedeclaredmentally finesandsentencecompletedat 9. Signature.Toregisterin incompetenttovotebyacourtoflaw leastfiveyearspriortoapplication Coloradoyoumust: date;felonyconvictionscannotbe beacitizenoftheUnitedStates Mailing address: disqualifyingfelonies,whichare bearesidentofColorado30days Secretary of State murder,sexualoffenses,orcrimes prior to the election ElectionsDivision againstpublicadministration be18yearsoldonorbefore 30 Trinity Street involvingbriberyorimproper election day Hartford, CT 06106 influence or abuse of office. notbeconfinedasaprisoner notbementallyincompetent orservinganypartofasentence undermandate Delaware Mailing address: StateofDelaware Updated: 02-07-2012 Office of the State Election Mailing address: Colorado Secretary of State Commissioner Registration Deadline The 905S.GovernorsAve.,Suite170 1700Broadway,Suite270 4thSaturdaybeforeaprimary Denver,Colorado80290 Dover,DE19904 orgeneralelection,and10days before a special election. 5

11 State Instructions driver'slicensenumberorFlorida District of Columbia identificationcardnumber.Ifyoudo Georgia Updated: 10-29-2003 nothaveaFloridadriver'slicenseor Updated: 03-28-2008 identificationcard,youmustprovide Registration Deadline 30 days thelastfourdigitsofyoursocial Registration Deadline The before the election. securitynumber.Ifyouhavenot fifthMondaybeforeanygeneral beenissuedanyofthesenumbers, primary,generalelection,or 6. ID Number.Federallawnow youmustwritethewordNONE. presidentialpreferenceprimary,or requiresthatallvoterregistration 7. Choice of Party.Youmust regularlyscheduledspecialelection applicationsmustincludeeither registerwithapartyifyouwantto pursuanttotheGeorgiaElection the applicants drivers license takepartinthatpartysprimary Code. In the event that a special numberorthelastfourdigits election, caucus, or convention. election is scheduled on a date of the applicants social security 8. Race or Ethnic Group. You are other that those dates prescribed numberinordertobeprocessed. requested,butnotrequired,tofill bytheGeorgiaElectionCode, 7. Choice of Party.Youmust inthisbox.Seethelistofchoices registrationwouldcloseonthe5th registerwithapartyifyouwantto under the Application Instructions dayafterthecall. takepartinthatpartysprimary forBox8(onpage2). election, caucus, or convention. 9. Signature.ToregisterinFlorida 6. ID Number.Federallawrequires 8. Race or Ethnic Group.Leave youmust: youtoprovideyourfullGADrivers blank. beacitizenoftheUnitedStates LicensenumberorGAStateissued 9. Signature.Toregisterinthe bealegalresidentofboththe IDnumber.IfyoudonothaveaGA DistrictofColumbiayoumust: StateofFloridaandofthecountyin DriversLicenseorGAIDyoumust beacitizenoftheUnitedStates whichyouseektoberegistered providethelast4digitsofyour beaDistrictofColumbia be18yearsold(youmay SocialSecuritynumber.Providing residentatleast30dayspreceding preregisterifyouareatleast16) yourfullSocialSecuritynumber thenextelection notbeadjudicatedmentally is optional. Your Social Security beatleast18yearsoldonor incapacitatedwithrespecttovoting numberwillbekeptconfidential precedingthenextelection inFloridaoranyotherState,orif andmaybeusedforcomparison notbeinjailforafelonyconviction youhave,youmustfirsthaveyour withotherstateagencydatabases nothavebeenjudgedmentally votingrightsrestored. forvoterregistrationidentification incompetentbyacourtoflaw notbeaconvictedfelon,orifyou purposes. If you do not possess notclaimtherighttovote are,youmustfirsthaveyourcivil aGADriversLicenseorSocial anywhereoutsideD.C. rightsrestorediftheyweretakenaway. Securitynumber,auniqueidentifier swearoraffirmthefollowing: will be provided for you. Mailing address: Iwillprotectanddefendthe 7. Choice of Party. You do not DistrictofColumbiaBoardof Constitution of the United States havetoregisterwithapartytotake Elections & Ethics and the Constitution of the State partinthatpartysprimary,caucus 4414thStreet,NW,Suite250 ofFlorida,thatIamqualifiedto or convention. Washington,DC200012745 registerasanelectorunderthe 8. Race or Ethnic Group. You Constitution and laws of the State of arerequestedtofillinthisbox. Florida,andthatallinformationin See the list of choices under the Florida this application is true. ApplicationInstructionsforBox8 (onpage2). Updated: 11-30-2011 Mailing address: 9. Signature.Toregisterin StateofFlorida Georgiayoumust: Registration Deadline 29days DepartmentofState beacitizenoftheUnitedStates before the election. DivisionofElections bealegalresidentofGeorgiaand TheR.A.GrayBuilding of the county in which you want 6. ID Number. If you have one, 500SouthBronoughSt,Rm316 to vote youmustprovideyourFlorida Tallahassee,Florida323990250 6

12 State Instructions be18yearsoldwithinsixmonths notbeincarceratedforafelony afterthedayofregistration,andbe conviction Illinois 18yearsoldtovote notbeadjudicatedbyacourtas Updated: 08-14-2012 notbeservingasentencefor noncomposmentis havingbeenconvictedofafelony Registration Deadline 28days nothavebeenjudicially Mailing address: prior to each election. determinedtobementally Office of Elections incompetent,unlessthedisability State of Hawaii 6. ID Number. Your drivers hasbeenremoved 802LehuaAvenue licensenumberisrequiredto PearlCity,HI96782 registertovote.Ifyoudonothave Mailing address: a drivers license, at least the last ElectionsDivision fourdigitsofyoursocialsecurity Office of the Secretary of State Idaho numberarerequired.Ifyouhave 1104WestTower neither,pleasewriteNONEon 2MartinLutherKing,Jr.Dr.SE Updated: 03-01-2006 theform.Auniqueidentifierwill Atlanta,GA303341505 beassignedtoyoubytheState. Registration Deadline 25days before the election. 7. Choice of Party.Partyregistration 6. ID Number. Enter your driver's or preference is not required for Hawaii voterregistration.However,when licensenumber.Ifyouhaveno Updated: 03-01-2006 driver'slicense,enterthelast4digits youapplyforaprimaryballot,you ofyoursocialsecuritynumber. mustindicateyourpartypreference Registration Deadline 30 days 7. Choice of Party. You do not have for that election. before the election. toregisterwithapartyifyouwant 8. Race or Ethnic Group.Leave totakepartinthatpartysprimary blank. 6. ID Number. Your full social election, caucus, or convention. 9. Signature.Asignatureis securitynumberisrequired.It 8. Race or Ethnic Group.Leave required.Ifsignatureismissing is used to prevent fraudulent blank. fromregistrationform,youwill registrationandvoting.Failure 9. Signature.ToregisterinIdaho benotifiedyourregistrationis tofurnishthisinformation youmust: incomplete. will prevent acceptance of this beacitizenoftheUnitedStates ToregisterinIllinoisyoumust: application (Hawaii Revised haveresidedinIdahoandinthe beacitizenoftheUnitedStates Statutes,Section1115). county for 30 days prior to the day bearesidentofIllinoisandof 7. Choice of Party.Achoiceof of election your election precinct at least 30 party is not required for voter beatleast18yearsold daysbeforethenextelection registration. nothavebeenconvictedof beatleast18yearsoldonor 8. Race or Ethnic Group. Race or afelony,andwithouthaving beforethenextelection ethnicgroupinformationisnot beenrestoredtotherightsof notbeinjailforafelony requiredforvoterregistration. citizenship,orconfinedinprison conviction 9. Signature.ToregisterinHawaii onconvictionofacriminaloffense notclaimtherighttovote youmust: anywhere else beacitizenoftheUnitedStates Mailing address: bearesidentoftheStateof Secretary of State Mailing address: Hawaii P.O.Box83720 StateBoardofElections beatleast16yearsold(youmust StateCapitolBldg. 2329S.MacArthurBoulevard be18yearsoldbyelectiondayin Boise,ID837200080 Springfield,IL62704 ordertovote) 7

13 State Instructions *Ifyoufailtomeetthevoter Indiana registrationdeadlinesaboveyou Kansas Updated: 03-01-2006 canregisterandvotebyfollowing Updated: 03-01-2006 theguidelinesforelectionday Registration Deadline 29days registration.Youcanfindthese Registration Deadline before the election. on the Iowa Secretary of States Postmarkedordelivered15days website: before the election. 6. ID Number.YourstatevoterID elections/EDRbrochure.pdf. numberisyourtendigitIndiana 6. ID Number.Yourcompleted issueddriver'slicensenumber.Ifyou 6. ID Number.YourIDnumberis voterregistrationformmust do not possess an Indiana driver's yourIowadriver'slicensenumber contain your state issued driver's license then provide the last four (orIowanondriveridentification licensenumberornondriver's digitsofyoursocialsecuritynumber. number)ifyouhaveone,ifnot identificationcardnumber.Ifyou Pleaseindicatewhichnumberwas thenthelastfourdigitsofyour do not have a driver's license or provided.(IndianaCode371313) socialsecuritynumber.TheID nondriver'sidentificationcard, you 7. Choice of Party.Leaveblank. numberyouprovidewillbe mustincludethelastfourdigits 8. Race or Ethnic Group.Leave verifiedwiththeIowaDepartment ofyoursocialsecuritynumber.If blank. of Transportation or the Social you do not have a driver's license 9. Signature.ToregisterinIndiana SecurityAdministration. or a nondriver'sidentificationcard youmust: 7. Choice of Party.Youmay,but orsocialsecuritynumber,please beacitizenoftheUnitedStates donothaveto,registerwithaparty write"NONE"ontheform.A haveresidedintheprecinctatleast in advance if you want to take part uniqueidentifyingnumberwillbe 30daysbeforethenextelection inthatpartysprimaryelection. assignedbytheState.Thenumber beatleast18yearsofageonthe Youmaychangeordeclareaparty you provide will be used for dayofthenextgeneralelection affiliationatthepollsonprimary administrativepurposesonlyand notcurrentlybeinjailfora election day. will not be disclosed to the public. criminalconviction 8. Race or Ethnic Group.Leave (KSA252309). blank. 7. Choice of Party.Youmust Mailing address: 9. Signature.ToregisterinIowa registerwithapartyifyouwantto ElectionDivision youmust: takepartinthatpartysprimary Office of the Secretary of State beacitizenoftheUnitedStates election, caucus, or convention. 302WestWashingtonStreet, bearesidentofIowa 8. Race or Ethnic Group.Leave RoomE204 beatleast171/2yearsold(you blank. Indianapolis,IN462042743 mustbe18tovote) 9. Signature.ToregisterinKansas nothavebeenconvictedofa youmust: felony(orhavehadyourrights beacitizenoftheUnitedStates Iowa restored) bearesidentofKansas notcurrentlybejudgedbya be18bythenextelection Updated: 03-28-2008 courttobe"incompetenttovote" havecompletedthetermsofyour notclaimtherighttovotein sentenceifconvictedofafelony; Registration Deadline Must be morethanoneplace apersonservingasentencefora deliveredby5p.m.10daysbefore giveupyourrighttovoteinany felonyconvictionisineligibletovote theelection,ifitisastateprimary other place notclaimtherighttovoteinany orgeneralelection;11daysbefore other location or under any other allothers.*Registrationforms Mailing address: name whicharepostmarked15or ElectionsDivision notbeexcludedfromvotingfor moredaysbeforeanelectionare Office of the Secretary of State mentalincompetencebyacourtof consideredontimeevenifreceived LucasBuilding1stFloor competentjurisdiction afterthedeadline. 321 E. 12th Street DesMoines,IA50319 8

14 State Instructions Mailing address: 9. Signature.Toregisterin Secretary of State Louisiana Louisianayoumust: 1stFloor,MemorialHall Updated: 08-14-2012 beacitizenoftheUnitedStates 120SW10thAve. bearesidentofLouisiana Topeka,KS666121594 Registration Deadline 30 days (Residenceaddressmustbeaddress before the election. whereyouclaimhomestead exemption,ifany,exceptfora Kentucky 6. ID Number. Youmustprovide residentinanursinghomeor yourLouisianadriverslicense veteranshomewhomayselect Updated: 03-01-2006 tousetheaddressofthenursing numberorLouisianaspecial identificationcardnumber,if homeorveteranshomeorthe Registration Deadline 29days homewherehehasahomestead before the election. issued.Ifnotissued,youmust provideatleastthelastfourdigits exemption.Acollegestudentmay ofyoursocialsecuritynumber, electtousehishomeaddressorhis 6. ID Number. Your full social addresswhileawayatschool.) securitynumberisrequired.Itis ifissued.Thefullsocialsecurity numbermaybeprovidedona beatleast17yearsold,andbe18 usedforadministrativepurposes yearsoldpriortothenextelection only and is not released to the voluntary basis. If the applicant hasneitheraLouisianadrivers to vote public(KRS116.155).Noperson notcurrentlybeunderanorder shallbedeniedtherighttoregister license,aLouisianaspecial identificationcard,orasocial ofimprisonmentforconvictionof because of failure to include social a felony securitynumber. securitynumber,theapplicant shallattachoneofthefollowing notcurrentlybeundera 7. Choice of Party. Youmust judgmentofinterdictionfor registerwithapartyifyouwantto itemstohisapplication:(a)a copy of a current and valid photo mentalincompetence takepartinthatpartysprimary election, caucus, or convention. identification;or(b)acopyofa currentutilitybill,bankstatement, Mailing address: 8. Race or Ethnic Group.Leave Secretary of State blank. governmentcheck,paycheck,or othergovernmentdocumentthat Attention:VoterRegistration 9. Signature.Toregisterin P.O.Box94125 Kentuckyyoumust: showsthenameandaddressof applicant.Neithertheregistrar BatonRouge,LA708049125 beacitizenoftheUnitedStates bearesidentofKentucky northeDepartmentofState bearesidentofthecountyforat shall disclose the social security numberofaregisteredvoter Maine least28dayspriortotheelectiondate be18yearsofageonorbefore or circulate the social security Updated: 08-14-2012 thenextgeneralelection numbersofregisteredvoterson notbeaconvictedfelonorifyou commerciallists(R.S.18:104and Registration Deadline Delivered have been convicted of a felony, 154;42U.S.C.405). 21 business days before the election yourcivilrightsmusthavebeen 7. Choice of Party. If you do not (oravotermayregisterin-person up restoredbyexecutivepardon list a party affiliation, you cannot toandincludingelectionday). nothavebeenjudgedmentally vote in the Presidential Preference incompetentinacourtoflaw Primaryandpartycommittee 6. ID Number. Youmustlist notclaimtherighttovote elections. Political party affiliation your valid Maine driver's license anywhere outside Kentucky is not required for any other number.Ifyoudon'thaveavalid election. Maine driver's license, then you Mailing address: 8. Race or Ethnic Group. You mustprovidethelastfourdigits StateBoardofElections arerequestedtofillinthisbox. ofyourSocialSecurityNumber. 140WalnutStreet See the list of choices under the Voters who don't have either of Frankfort,KY406013240 ApplicationInstructionsforBox8 theseformsofIDmustwrite (onpage2). "NONE"inthisspace. 9

15 State Instructions 7. Choice of Party.Youmust beusedonlyforregistrationand 7. Choice of Party. If you do registerwithapartyifyouwantto otheradministrativepurposes.It notdesignateapartyofpolitical takepartinthatpartysprimary willbekeptconfidential. designationinthisbox,you election, caucus, or convention 7. Choice of Party.Youmust willberegisteredasunenrolled. (unlessotherwisepermittedbya registerwithapartyifyouwantto Unenrolledvotersmayparticipate politicalparty). takepartinthatpartysprimary inpartyprimaries.However,an 8. Race or Ethnic Group.Leave election. unenrolledvotermustenrollina blank. 8. Race or Ethnic Group.Leave party on the day of the Presidential 9. Signature.ToregisterinMaine blank. PreferencePrimaryinorderto youmust: 9. Signature.Toregisterin participateinthatprimary. beacitizenoftheUnitedStates Marylandyoumust: 8. Race or Ethnic Group.Leave bearesidentofMaineandthe beaU.S.citizen blank. municipalityinwhichyouwant beaMarylandresident 9. Signature.Toregisterin to vote beatleast18yearsoldbythe Massachusettsyoumust: beatleast17yearsold(youmust nextgeneralelection beacitizenoftheUnitedStates be18yearsoldtovote) notbeunderguardianshipfor bearesidentofMassachusetts mentaldisability be18yearsoldonorbeforethe Mailing address: nothavebeenconvictedof nextelection ElectionsDivision buyingorsellingvotes nothavebeenconvictedof BureauofCorporations, nothavebeenconvictedofa corrupt practices in respect to ElectionsandCommissions felony, or if you have, you have elections 101 State House Station completedservingacourtordered notbeunderguardianshipwith Augusta,ME043330101 sentenceofimprisonment, respecttovoting includinganytermofparoleor notbecurrentlyincarceratedfor Maryland probation for the conviction. a felony conviction Updated: 06-26-2008 Mailing address: Mailing address: StateBoardofElections SecretaryoftheCommonwealth Registration Deadline 9:00 P.O.Box6486 ElectionsDivision,Room1705 p.m.21daysbeforetheelection. Annapolis,MD214010486 One Ashburton Place Boston,MA02108 6. ID Number. If you have a current, valid Maryland drivers Massachusetts license or a Motor Vehicle Michigan Administrationidentificationcard, Updated: 03-01-2006 youmustenterthedriverslicense Updated: 03-01-2006 oridentificationnumber.Ifyoudo Registration Deadline 20 days not have a current, valid Maryland before the election. Registration Deadline 30 days drivers license or Motor Vehicle before the election. Administrationidentification 6. ID Number.Federallawrequires card,youmustenteratleastthe that you provide your drivers 6. ID Number. Yourcompleted last4digitsofyoursocialsecurity licensenumbertoregistertovote. voterregistrationformmust number.However,pleasenote, If you do not have a current and contain your state issued driver's the disclosure of your full Social valid Massachusetts drivers license licensenumberorstateissued Securitynumberisvoluntary.The thenyoumustprovidethelastfour personalidentificationcard statutoryauthorityallowingelection (4)digitsofyoursocialsecurity number.Ifyoudonothavea officials to request your full Social number.Ifyouhaveneither,you driver's license or state issued SecuritynumberisElectionLaw mustwriteNONEintheboxand personalidentificationcard,you Article,Section3202,Annotated auniqueidentifyingnumberwillbe mustincludethelastfourdigitsof CodeofMaryland.Thenumberwill assignedtoyou. yoursocialsecuritynumber.Ifyou 10

16 State Instructions do not have a driver's license or a Mailing address: Mailing address: stateissuedpersonalidentification MichiganDepartmentofState Secretary of State cardorasocialsecuritynumber, BureauofElections 60EmpireDrive,Suite100 pleasewrite"NONE"ontheform. P.O.Box20126 St.Paul,MN551031855 Auniqueidentifyingnumberwill Lansing,MI489010726 beassignedbytheState. 7. Choice of Party. A"choiceof Mississippi party"isnotrequiredforvoter Minnesota Updated: 05-07-2010 registration. Updated: 12-31-2008 8. Race or Ethnic Group.Leave Registration Deadline 30 days blank. Registration Deadline before the election. 9. Signature.Toregisterin Deliveredby5:00p.m.21days Michiganyoumust: before the election (there is also 6. ID Number. You are required beacitizenoftheUnitedStates electiondayregistrationatpolling to provide your current and valid be18yearsoldbythenext places). driver'slicensenumberor,ifyou election donthaveone,thelastfourdigits bearesidentofMichiganandat 6. ID Number. You are required ofyoursocialsecuritynumber. least a 30 day resident of your city to provide your Minnesota drivers 7. Choice of Party. Mississippi or township by election day licenseorstateIDnumberto doesnothavepartyregistration. notbeconfinedinajailafter registertoVote.Ifyoudonothave Therefore,youdonothaveto beingconvictedandsentenced a Minnesota drivers license or state registerwithapartyifyouwantto IDthenyouwillhavetoprovide takepartinthatpartysprimary Notice: Michiganlawrequiresthat thelastfourdigitsofyoursocial election, caucus, or convention. thesameaddressbeusedforvoter securitynumber.Ifyouhaveneither, 8. Race or Ethnic Group.Leave registrationanddriverlicense pleasewritenoneontheform. blank. purposes.Therefore,iftheresidence 7. Choice of Party. Leaveblank. 9. Signature. Toregisterin addressyouprovideonthisform 8. Race or Ethnic Group. Leave Mississippiyoumust: differsfromtheaddressshown blank. beacitizenoftheUnitedStates on a driver license or personal 9. Signature. Toregisterin havelivedinMississippiandin identificationcardissuedbythe Minnesotayoumust: yourcounty(andcity,ifapplicable) StateofMichigan,theSecretary beacitizenoftheUnitedStates 30 days before the election in ofStatewillautomaticallychange bearesidentofMinnesotafor20 which you want to vote your driver license or personal daysbeforethenextelection be18yearsoldbythetimeofthe identificationcardaddresstomatch maintainresidenceattheaddress generalelectioninwhichyouwant the residence address entered on givenontheregistrationform to vote thisform.Ifanaddresschangeis beatleast18yearsoldon havenotbeenconvictedof made,theSecretaryofStatewill election day murder,rape,bribery,theft,arson, mailyouanaddressupdatesticker ifpreviouslyconvictedofafelony, obtainingmoneyorgoodsunder for your driver license or personal yourfelonysentencehasexpiredor falsepretense,perjury,forgery, identificationcard. beencompleted,oryouhavebeen embezzlement,armedrobbery, Caution:Ifyouregisterbymail, dischargedfromthesentence extortion,felonybadcheck,felony youmustvoteinpersonatyour notbeunderacourtordered shoplifting,larceny,receiving assignedprecinctthefirsttimeyou guardianshipinwhichtherightto stolenproperty,robbery,timber vote, unless you are: vote has been revoked larceny,unlawfultakingofamotor notbefoundbyacourttobe vehicle,statutoryrape,carjacking, disabledasdefinedbystatelaw; legallyincompetenttovote. orbigamy,orhavehadyourrights 60yearsofageorolder;or restored as required by law temporarilyresidingoverseas. nothavebeendeclaredmentally incompetentbyacourt 11

17 State Instructions Note:Statelawchangedbyfederal 8. Race or Ethnic Group. Leave 9. Signature.Toregisterin courtorderin1998andbystate blank. Montanayoumust: legislationin2000.Wenowaccept 9. Signature. To vote in Missouri beacitizenoftheUnitedStates theformasregistrationforvoting youmust: beatleast18yearsoldonor for all state and federal offices. beacitizenoftheUnitedStates before the election bearesidentofMissouri bearesidentofMontanaandof Mailing address: beatleast171/2yearsofage the county in which you want to Secretary of State (youmustbe18tovote) vote for at least 30 days before the P.O.Box136 notbeonprobationorparole nextelection Jackson,MS392050136 afterconvictionofafelony,until notbeinapenalinstitutionfora finallydischargedfromsuch felony conviction Local county addresses: probation or parole notcurrentlybedeterminedbya Youalsomayreturncompleted notbeconvictedofafelonyor courttobeofunsoundmind applications to the county circuit misdemeanorconnectedwiththe meetthesequalificationsbythe clerk/registrarwhereyoureside. rightofsuffrage nextelectiondayifyoudonot Acompletelistofcountycircuit notbeadjudgedincapacitatedby currentlymeetthem clerk/registrarsisavailableon any court of law Mississippis website at www.sos. notbeconfinedunderasentence Mailing address: ofimprisonment Secretary of States Office P.O.Box202801 Missouri Mailing address: State Capitol Secretary of State Helena,MT596202801 Updated: 09-12-2006 P.O.Box1767 JeffersonCity,MO651021767 Registration Deadline 28days Nebraska before the election. Montana Updated: 03-01-2006 6. ID Number. Yourcompleted Updated: 03-01-2006 Registration Deadline The voterregistrationformmust thirdFridaybeforetheelection contain your state issued driver's Registration Deadline 30 days (ordeliveredby6p.m.onthe licensenumber.Yourcompleted before the election. secondFridaybeforetheelection). voterregistrationformmust alsoincludethelastfourdigits 6. ID Number. Youmustprovide 6. ID Number. Youmustprovide ofyoursocialsecuritynumber. your Montana driver's license yourNebraskadriver'slicense (Section115.155,RSMo).Ifyou number.Ifyoudo not have a number.Ifyoudo not have a do not have a driver's license or Montanadriver'slicensenumber Nebraskadriver'slicensenumber asocialsecuritynumber,please thenyoumustlisttheLASTFOUR thenyoumustlistthelastfour write"NONE"ontheform.A DIGITSOFYOURSOCIAL digitsofyoursocialsecurity uniqueidentifyingnumberwill SECURITYNUMBER.Ifyou number. beassignedbytheState.Any have neither a driver's license, nor 7. Choice of Party. Youmust electronicmedia,printoutsor asocialsecuritynumber,please registerwithapartyifyouwantto mailinglabelsprovidedunderthis writeNONEontheform.The takepartinthatpartysprimary section shall not include telephone stateofMontanawillassigntoyou election, caucus, or convention. numbersandsocialsecurity auniqueidentifyingnumber. 8. Race or Ethnic Group.Leave numbersofvoters.(Section 7. Choice of Party. Montana does blank. 115.157,RSMo). notrequirepartyregistrationto 9. Signature. Toregisterin 7. Choice of Party. You do not have participate in any election. Nebraskayoumust: toregisterwithapartyifyouwant 8. Race or Ethnic Group.Leave beacitizenoftheUnitedStates totakepartinthatpartysprimary blank. bearesidentofNebraska election, caucus, or convention. 12

18 State Instructions beatleast18yearsofageorwill aNonpartisanBallotforthe be18yearsofageonorbeforethe PrimaryElection. New Hampshire firstTuesdayafterthefirstMonday 8. Race or Ethnic Group.Leave Updated: 03-01-2006 ofNovember blank. nothavebeenconvictedofa 9. Signature.ToregisterinNevada Registration Deadline New felony, or if convicted, have had youmust: Hampshiretownandcityclerks yourcivilrightsrestored beacitizenoftheUnitedStates will accept this application only as nothavebeenofficiallyfoundto haveattainedtheageof18years a request for their own absentee bementallyincompetent onthedateofthenextelection votermailinregistrationform, havecontinuouslyresidedinthe whichmustbereceivedbyyour Mailing address: StateofNevada,inyourcounty,at city or town clerk by 10 days before NebraskaSecretaryofState least 30 days and in your precinct the election. Suite2300,StateCapitolBldg. atleast10daysbeforethenext Lincoln,NE685094608 election NewHampshiretownandcityclerks haveyourcivilrightsrestoredif will accept this application only as a Nevada you were convicted of a felony request for their own absentee voter notbedeterminedbyacourtof mailinregistrationform.Youneed Updated: 05-07-2010 lawtobementallyincompetent tofillinonlyBox1andBox2or3. claimnootherplaceasyourlegal Registration Deadline The residence Theapplicationshouldbemailed deadlineformailinregistration to your town or city clerk at your isthefifthSaturdaybeforeany Mailing address: zipcode.Theseaddressesare primaryorgeneralelection. Secretary of State listed on the Secretary of State Inpersonregistrationremains ElectionsDivision web site at availableuntil9:00p.m.onthe 101NorthCarsonStreet clerks.htm thirdTuesdayprecedingany Suite 3 primaryorgeneralelection.You CarsonCity,NV897014786 Itshouldbemailedinplentyof mayregistertovoteinpersononly timeforyourtownorcityclerkto byappearingattheofficeofthe Applicationsmaybereturnedto mailyoutheirownformandfor CountyClerk/RegistrarofVoters. the Secretary of States office at youtoreturnthatformtothemby the address above, but to avoid 10 days before the election. 6. ID Number. You must supply a possible delays, you are advised NevadasDriversLicenseNumber toreturnyourcompletedvoter orNevadaIDCardNumberif you registrationapplicationsdirectlyto New Jersey have been issued one. If you do not your local county election official. haveaDriversLicenseNumber Updated: 03-28-2008 orNevadaIDCardNumber,you Local county addresses: mustsupplythelastfourdigitsof Tomeetregistrationdeadlines, Registration Deadline 21 days yourSocialSecurityNumber.If especiallyduringthetwoweeks before the election. you do not have a Social Security beforethecloseofthemailin Number,pleasecontactyour registrationdeadline,return 6. ID Number. Thelastfourdigits CountyClerk/RegistrarofVoters completedapplicationsto ofyourSocialSecuritynumberOR tobeassignedauniqueidentifier. your respective County Clerk/ yourNewJerseyDriver'sLicense 7. Choice of Party.Youmust RegistrarofVoters.Acomplete numberisrequiredforvoter registerwithapartyifyou listofCountyClerk/Registrarof registration.Ifyoudonotpossess want to take part in that partys Votersandregistrationdeadlines eitheroftheseidentifications, primaryelection,caucus,or isavailableonNevadaswebsite: pleasewrite"NONE"ontheform. convention.Ifyouregisterwith TheStatewillassignanumberthat aminorpoliticalparty,orasa will serve to identify you for voter Nonpartisanyouwillreceive registrationpurposes. 13

19 State Instructions 7. Choice of Party. NewJersey's 6. ID Number. Your full social voterregistrationformdoesnot securitynumberisrequired. New York provideacheckoffforpolitical Thisregistrationcardcontaining Updated: 03-01-2006 partyaffiliation.Anewlyregistered yoursocialsecuritynumberwill voter or voter who has never voted becomepartofthepermanentvoter Registration Deadline 25days inapoliticalpartyprimaryelection registrationrecordsofyourlocality, before the election. can declare party affiliation at which are open to inspection thepollingplaceonthedayofa by the public in the office of the 6. ID Number. Federallawrequires primaryelection.InNewJersey,a county clerk. However, your social that you provide your drivers primaryelectionisonlyheldfor securitynumberanddateofbirth licensenumbertoregistertovote. theDemocraticandRepublican willremainconfidentialandwill If you do not have a drivers license parties.Avotermayalsofilea not be disclosed to the public. then you will have to provide at least politicalpartydeclarationformto Computerizedlistingsoflimited thelastfourdigitsofyoursocial becomeamemberofapolitical voterregistrationinformation securitynumber.Ifyouhaveneither, party. If a declared voter wished (withoutsocialsecuritynumber pleasewriteNONEontheform. tochangepartyaffiliationheor orbirthdate)areavailabletothe Auniqueidentifyingnumberwillbe shemustfileadeclarationform50 generalpublic,andarefurnished assignedtoyoubyyourState. daysbeforetheprimaryelection, uponrequesttoincumbentelection 7. Choice of Party. Youmust in order to vote. officeholders, candidates, political enroll with a party if you want 8. Race or Ethnic Group.Leave parties,courtsandnonprofit tovoteinthatpartysprimary blank. organizationspromotingvoter election or caucus. 9. Signature.ToregisterinNew participationandregistration,for 8. Race or Ethnic Group. Leave Jerseyyoumust: politicalpurposesonly(1519B, blank. beacitizenoftheUnitedStates NMSA1978). 9. Signature.ToregisterinNew beatleast18yearsofagebythe 7. Choice of Party. Youmust Yorkyoumust: timeofthenextelection registerwithapartyifyouwantto beacitizenoftheUnitedStates bearesidentofthisStateand takepartinthatpartysprimary bearesidentofthecounty,orof county at your address at least 30 election, caucus, or convention. theCityofNewYork,atleast30 daysbeforethenextelection 8. Race or Ethnic Group. Leave days before an election notbeservingasentenceoron blank. be18yearsoldbyDecember31of parole or probation as the result 9. Signature.ToregisterinNew theyearinwhichyoufilethisform of a conviction of any indictable Mexicoyoumust: (Note:Youmustbe18yearsoldbythe offenseunderthelawsofthisor beacitizenoftheUnitedStates dateofthegeneral,primary,orother another state or of the United States bearesidentoftheStateofNew electioninwhichyouwanttovote) Mexico notbeinjailoronparolefora Mailing address: be18yearsofageatthetimeof felony conviction NewJerseyDepartmentofLaw thenextelection notcurrentlybejudged and Public Safety nothavebeendeniedtheright incompetentbyorderofacourtof DivisionofElections to vote by a court of law by reason competentjudicialauthority POBOX304 ofmentalincapacityand,ifI notclaimtherighttovote Trenton,NJ086250304 have been convicted of a felony, I elsewhere havecompletedallconditionsof probation or parole, served the Mailing address: New Mexico entirety of a sentence or have been NYSBoardofElections Updated: 03-01-2006 grantedapardonbytheGovernor. 40SteubenStreet Albany,NY122072108 Registration Deadline 28days Mailing address: before the election. BureauofElections 325DonGaspar,Suite300 SantaFe,NM87503 14

20 State Instructions Mailing address: North Carolina North Dakota Secretary of State of Ohio Updated: 03-01-2006 Updated: 03-01-2006 ElectionsDivision 180E.BroadStreet15thFloor Registration Deadline NorthDakotadoesnothavevoter Columbus,OH43215 Postmarked25daysbefore registration. the election or received in the Oklahoma electionsofficeordesignatedvoter registrationagencysiteby5:00p.m. Ohio Updated: 10-29-2003 25daysbeforetheelection. Updated: 03-01-2006 Registration Deadline 25days 6. ID Number. ProvideyourNorth Registration Deadline 30 days before the election. Carolinadriverslicensenumber, before the election. orNorthCarolinaDepartment 6. ID Number.Thelastfourdigits ofMotorVehiclesIDnumber.If 6. ID Number. Your social security ofyoursocialsecuritynumber you do not have a driver's license, numberisrequested.Providing arerequired.(OklahomaTitle26, thenlistthelastfourdigitsofyour thisnumberisvoluntary.This Section4112)Inaddition,your socialsecuritynumber. informationallowstheBoardof Oklahomadriverslicensenumber 7. Choice of Party.Youmust Electionstoverifyyourregistrationif is requested. registerwithapartytovoteinthat necessary(O.R.C.3503.14).[Federal 7. Choice of Party.Youmust partysprimaryunlessthatparty registerwithapartyifyouwantto law requires that you provide your allows unaffiliated voters to vote takepartinthatpartysprimary driverslicensenumbertoregister initsprimary.Ifyouindicatea election, caucus, or convention. to vote. If you do not have a drivers politicalpartythatisnotaqualified 8. Race or Ethnic Group.Leave license then you will have to provide party, or indicate no party, you will blank. atleastthelastfourdigitsofyour belistedasUnaffiliated. 9. Signature.Toregisterin socialsecuritynumber.Ifyoudont 8. Race or Ethnic Group. You are Oklahomayoumust: haveeithernumberyouwillhaveto requiredtofillinthisbox.However, beacitizenoftheUnitedStates writeNONEontheformandthe your application will not be rejected and a resident of the State of Statewillassignyouanumber.] if you fail to do so. See the list of Oklahoma 7. Choice of Party. You do not choices under the Application be18yearsoldonorbeforethe registerwithapartyifyouwantto InstructionsforBox8(onpage2). dateofthenextelection takepartinthatpartysprimary 9. Signature. ToregisterinNorth havenotbeenconvictedofa election. Party affiliation is established Carolinayoumust: felony,forwhichaperiodoftime byvotingataprimaryelection. beacitizenoftheUnitedStates equaltotheoriginalsentencehas 8. Race or Ethnic Group. Leave bearesidentofNorthCarolina notexpired,orforwhichyouhave and the county in which you live for blank. 9. Signature. ToregisterinOhio not been pardoned at least 30 days prior to the election notnowbeunderjudgmentasan be18yearsofagebythedayof youmust: beacitizenoftheUnitedStates incapacitated person, or a partially thenextgeneralelection incapacitated person prohibited haveyourrightsofcitizenship bearesidentofOhio be18yearsoldonorbefore fromregisteringtovote restored if you have been convicted of a felony electionday.Ifyouwillbe18on orbeforethedayofthegeneral Mailing address: notberegisteredorvoteinany OklahomaStateElectionBoard other county or state election,youmayvoteinthe primaryelectionforcandidatesonly. Box528800 notbeconvictedofafelonyand OklahomaCity,OK731528800 Mailing address: StateBoardofElections currently incarcerated P.O.Box27255 notbefoundincompetentbya Raleigh,NC276117255 courtforpurposesofvoting 15

21 State Instructions socialSecurityNumber.Ifyoudo 7. Choice of Party. In Rhode Island, Oregon nothaveaSocialSecurityNumber, apersonmustregisterwithaparty Updated: 03-01-2006 pleasewriteNONEinthebox. if he/she wishes to take part in that 7. Choice of Party.Youmustregister party'sprimaryelection.Aperson Registration Deadline 21 days with a party if you want to take part whofailstoregisterwithapartyat before the election. inthatpartysprimaryelection. thetimeofregistrationmay,ifhe/ 8. Race or Ethnic Group. You shechooses,registerwithaparty 6. ID Number. Federallawrequires arerequestedtofillinthisbox. onthedayofthatparty'sprimary that you provide your drivers See the list of choices under the andtakepartinthatparty'sprimary licensenumbertoregistertovote. ApplicationInstructionsforBox8 election. If a person does not If you do not have a drivers license (onpage2). registerwithaparty,he/shecanstill then you will have to provide at 9. Signature. Toregisterin voteingeneralelectionsandnon leastthelastfourdigitsofyour Pennsylvaniayoumust: partisanprimaryelections. socialsecuritynumber.Ifyouhave beacitizenoftheUnitedStates 8. Race or Ethnic Group. Leave neither, you will need to write atleastonemonthbeforethenext blank. NONEontheform.Aunique election 9. Signature. ToregisterinRhode identifyingnumberwillinsteadbe bearesidentofPennsylvaniaand Islandyoumust: assignedtoyoubyyourState. your election district at least 30 beacitizenoftheUnitedStates 7. Choice of Party. Youmust days before the election bearesidentofRhodeIslandfor registerwithapartyifyouwantto beatleast18yearsofageonthe 30daysprecedingthenextelection takepartinthatpartysprimary dayofthenextelection be18yearsoldbyelectionday election. notbecurrentlyincarceratedina 8. Race or Ethnic Group.Leave Mailing address: correctional facility due to a felony blank. Office of the Secretary of conviction 9. Signature.ToregisterinOregon theCommonwealth nothavebeenlawfullyjudgedto youmust: 210NorthOfficeBldg. bementallyincompetent beacitizenoftheUnitedStates Harrisburg,PA171200029 bearesidentofOregon Mailing address: beatleast18yearsoldby RhodeIslandStateBoardof Rhode Island Elections election day Updated: 03-28-2008 50BranchAve. Mailing address: Providence,RI029042790 Secretary of State Registration Deadline 30 days ElectionsDivision before the election. South Carolina 141StateCapitol Salem,OR973100722 6. ID Number.Theapplicant Updated: 03-01-2006 shall be required to provide his/ her Rhode Island driver's license Registration Deadline 30 days Pennsylvania numberiftheapplicanthasbeen before the election. Updated: 03-01-2006 issued a current and valid Rhode Island driver's license. In the case 6. ID Number. Your full social Registration Deadline 30 days of an applicant who has not been securitynumberisrequired.Itis beforeanelectionorprimary. issued a current and valid driver's required by the South Carolina licensehe/shemustprovidethe CodeofLawsandisusedfor 6. ID Number. Youmustsupply lastfour(4)digitsofhis/hersocial internal purposes only. Social aDriver'sLicenseNumber,ifyou securitynumber.Anapplicant, securitynumberdoesnotappear have one. If you do not have a whohasneither,willbeassigneda on any report produced by the Driver'sLicenseNumber,youmust uniqueidentifyingnumberbythe StateElectionCommissionnor supply the lastfourdigits of your State of Rhode Island. is it released to any unauthorized 16

22 State Instructions individual. (South Carolina Title 6. ID Number. Your drivers license 9. Signature.Toregisterin 75170) numberisrequested.Ifyoudonot Tennesseeyoumust: 7. Choice of Party. You do not have have a valid driver's license, you beacitizenoftheUnitedStates toregisterwithapartyifyouwant mustprovidethelastfourdigitsof bearesidentofTennessee totakepartinthatpartysprimary yoursocialsecuritynumber. beatleast18yearsoldonor election, caucus, or convention. 7. Choice of Party.Youmust beforethenextelection 8. Race or Ethnic Group. You are registerwithapartyifyouwantto nothavebeenconvictedofa requiredtofillinthisbox.Your takepartinthatpartysprimary felony, or if convicted, have had applicationmayberejectedifyou election, caucus, or convention. yourfullrightsofcitizenship fail to do so. See the list of choices 8. Race or Ethnic Group.Leave restored(orhavereceivedapardon) under the Application Instructions blank. notbeadjudicatedincompetent forBox8(onpage2). 9. Signature.ToregisterinSouth byacourtofcompetent 9. Signature.ToregisterinSouth Dakotayoumust: jurisdiction (or have been restored Carolinayoumust: beacitizenoftheUnitedStates tolegalcapacity) beacitizenoftheUnitedStates resideinSouthDakota beatleast18yearsoldonor be18yearsoldbythenext Mailing address: beforethenextelection election Coordinator of Elections bearesidentofSouthCarolina, notbecurrentlyservinga TennesseeTower,NinthFloor your county and precinct sentence for a felony conviction 312EighthAvenue,North notbeconfinedinanypublic whichincludedimprisonment, Nashville,TN37243 prisonresultingfromaconviction served or suspended, in an adult ofacrime penitentiarysystem neverhavebeenconvictedof nothavebeenadjudgedmentally Texas afelonyoroffenseagainstthe incompetentbyacourt Updated: 03-01-2006 election laws, or if previously convicted, have served your entire Mailing address: Registration Deadline 30 days sentence,includingprobationor Elections, Secretary of State before the election. parole, or have received a pardon 500E.Capitol for the conviction Pierre,SD575015070 6. ID Number.Youmustprovide notbeunderacourtorder yourdriverslicensenumberto declaringyoumentally registertovote.Ifyoudonothavea incompetent Tennessee drivers license then you will have to claimtheaddressonthe Updated: 03-01-2006 provideatleastthelastfourdigitsof applicationasyouronlylegalplace yoursocialsecuritynumber.Ifyou ofresidenceandclaimnoother Registration Deadline 30 days haveneither,pleasewriteNONE placeasyourlegalresidence before the election. ontheform.Auniqueidentifying numberwillinsteadbeassignedto Mailing address: 6. ID Number. Your full social you by your State. StateElectionCommission securitynumberisrequired.Social 7. Choice of Party. You do not have P.O.Box5987 securitynumber,ifany,isrequiredfor toregisterwithapartyifyouwant Columbia,SC292505987 purposesofidentificationandtoavoid totakepartinthatpartysprimary duplicateregistration(TCA2.2.116). election, caucus, or convention. South Dakota 7. Choice of Party. You do not 8. Race or Ethnic Group.Leave havetoregisterwithapartyifyou blank. Updated: 03-01-2006 want to take part in that partys 9. Signature.ToregisterinTexas primaryelection,caucus,or youmust: Registration Deadline Received convention. beacitizenoftheUnitedStates 15daysbeforetheelection. 8. Race or Ethnic Group. Optional. 17

23 State Instructions bearesidentofthecounty election law allows each political 7. Choice of Party.Vermontdoes in which the application for partytochoosewhomitwillallow notrequirepartyregistrationto registrationismade tovoteinitsprimaryelection.If participate in any election. beatleast17yearsand10months you do not affiliate with a party, 8. Race or Ethnic Group.Leave old(youmustbe18tovote) youmayberestrictedfromvoting blank. notbefinallyconvictedofa intheprimary. 9. Signature.Toregisterin felony, or if a convicted felon, 8. Race or Ethnic Group.Leave Vermontyoumust: youmusthavefullydischarged blank. beacitizenoftheUnitedStates yourpunishment,includingany 9. Signature. ToregisterinUtah bearesidentofVermont incarceration, parole, supervision, youmust: be18yearsofageonorbefore period of probation or be pardoned. beacitizenoftheUnitedStates election day havenotbeendeclaredmentally haveresidedinUtahfor30days havetakenthefollowingOath: incompetentbyfinaljudgmentofa immediatelybeforethenextelection Yousolemnlyswear(oraffirm) court of law beatleast18yearsoldonor thatwheneveryougiveyour beforethenextelection voteorsuffrage,touchingany Mailing address: notbeaconvictedfeloncurrently matterthatconcernsthestateof Office of the Secretary of State incarceratedforcommissionofa Vermont,youwilldoitsoasin ElectionsDivision felony yourconscienceyoushalljudge P.O.Box12060 notbeconvictedoftreason willmostconducetothebest Austin,TX787112060 orcrimeagainsttheelective goodofthesame,asestablishedby franchise, unless restored to civil the Constitution, without fear or rights favorofanyperson[VotersOath, Utah notbefoundtobementally VermontConstitution,ChapterII, Updated: 03-28-2008 incompetentbyacourtoflaw Section42] BysigninginBox9,youare Registration Deadline 30 days Mailing address: attestingthatyouhaveswornor beforetheelectionformailin OfficeoftheLieutenant affirmedtheVermontvotersoath applications;15daysbeforethe Governor as printed above. electionforwalkinregistrationsat P.O.Box142325 the county clerks office. SaltLakeCity,UT84114 Mailing address: Office of the Secretary of State 6. ID Number.Yourcompleted DirectorofElections Vermont 26 Terrace Street voterregistrationformmust contain your state issued driver's Updated: 07-29-2008 Montpelier,VT056091101 licensenumberornonoperating identificationnumber.Ifyou Registration Deadline Delivered Virginia do not have a driver's license or tothetownclerkbefore5:00PMon nonoperatingidentification,you theWednesdaybeforetheelection. Updated: 11-30-2011 mustincludethelastfourdigits ofyoursocialsecuritynumber.If 6. ID Number.Youmustprovide Registration Deadline Delivered you do not have a driver's license yourVermontDriver'slicense 22 days before the election. oranonoperatingidentification number,orifnone,thelast4digits orasocialsecuritynumber,please ofyourSocialSecuritynumber. 6. ID Number. Your full social write"NONE"ontheform.A IfyoudonothaveaVermont securitynumberisrequired.Your uniqueidentifyingnumberwillbe Driver'slicenseoraSocialSecurity socialsecuritynumberwillappear assignedbytheState. number,pleasewriteNONEon on reports produced only for 7. Choice of Party. Declaringa theform.TheSecretaryofState's officialusebyvoterregistration party is not required in order to officewillassignyouaunique and election officials and, for jury registertovote.However,Utah's identifyingnumber. selection purposes, by courts. 18

24 State Instructions Article II, 2, Constitution of 8. Race or Ethnic Group. Leave live in West Virginia at the above Virginia(1971). blank. address 7. Choice of Party. You do not 9. Signature. To register in be 18 years old, or to vote in havetoregisterwithapartyifyou Washington must: you the primary be 17 years old and want to take part in that partys beacitizen of the United States turning 18 before the general primaryelection,caucus,or be a legal resident of Washington election convention. your State, county and precinct for not be under conviction, 8. Race or Ethnic Group. Leave 30 days immediately preceding the probation, or parole for a felony, blank. in which election you want to vote orelection treason bribery 9. Signature. Toregisterin be at least 18 years old by election not have been judged mentally Virginiayoumust: day incompetent in a court of beacitizenoftheUnitedStates convicted not be of infamous competent jurisdiction bearesidentofVirginiaandofthe crime, unless restored to civil precinct in which you want to vote rights Mailing address: be18yearsoldbythenextMay orNovembergeneral election Secretary of State Mailing address: Building 1, Suite 157K nothavebeenconvictedofa Secretary of State 1900 Kanawha Blvd. East felony,orhavehadyourcivilrights Elections Division Charleston, WV 253050770 restored P.O. Box 40229 notcurrentlybedeclaredmentally Olympia, WA 985040229 incompetentbyacourtoflaw Wisconsin Mailing address: West Virginia Updated: 09-12-2006 VirginiaStateBoardofElections 1100BankStreet,1stfloor Updated: 09-12-2006 Registration Deadline Twenty Richmond,VA23219 (20) days before the election Registration Deadline 21 days (or completed in the local voter before the election. registration office up to 5:00 pm. 1 Washington day before the election, completed or 6. ID Number. your Enter driver's at the polling place on election day). Updated: -2-20 license number. If you donot have a drivers license number, enter the 6. ID Number. Provide Registration Deadline 29 days your driver's before the election (or delivered last four numbers of your social license number, if you have no security number. If you do not current inperson to the local voter and valid drivers license, the have a driver's license number last 4 digits registration office until 8 days of your social security or a social security an number, number or DOTissued ID card before the election). identification number will be number. , assigned to you. 7. Choice of Party. Not required. 6. ID Number. You must provide 7. Choice of Party. You must register 8. Race or Ethnic Group. Not your Washington drivers license or with a party if you want to take part required. state ID card number. If you do not in that partys primary election, 9. Signature. have a Washington driver's license, To register in caucus, or convention (unless you Wisconsin you or state ID card, you must provide must: request the ballot of a party which beacitizen of the the last four digits of your Social United States allows independents to vote) be a resident of Wisconsin for at Security Number. Failure to provide 8. Race or Ethnic Group. Leave least this information may prevent your 10 days blank. be 18 registration from being processed. years old 9. Signature. To register in West not have been convicted of 7. Choice of Party. You are not Virginia you must: treason, required to designate your party felony or bribery, or if you affiliation to register in Washington. be a citizen of the United States have, your civil rights have been restored 19

25 State Instructions nothavebeenfoundbyacourtto beincapableofunderstandingthe objective of the electoral process notmakeorbenefitfromabetor wagedependingontheresultofan election nothavevotedatanyotherlocation, ifregisteringonelectionday Mailing address: StateElectionsBoard 17WestMainStreet,Suite310 P.O.Box2973 Madison,WI537012973 Wyoming Updated: 03-01-2006 Wyomingbylaw,cannotaccept thisformunlessStatelawis changed. 20

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