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Fillable Printable National Voter Registration Form - The U. S. Election Assistance Commission

Fillable Printable National Voter Registration Form - The U. S. Election Assistance Commission

National Voter Registration Form - The U. S. Election Assistance Commission

National Voter Registration Form - The U. S. Election Assistance Commission

Register To Vote In Your State
By Using This
Postcard Form and Guide
For U.S. Citizens
General Instructions
Who Can Use this Application
If you are a U.S. citizen who lives or has an address
within the United States, you can use the application in
this booklet to:
•
•
•
•
RegistertovoteinyourState,
Reportachangeofnametoyourvoterregistration
oce,
Reportachangeofaddresstoyourvoter
registrationoce,or
Registerwithapoliticalparty.
Exceptions
Please do not use this application if you live outside
theUnitedStatesanditsterritoriesandhavenohome
(legal)addressinthiscountry,or if you are in the
militarystationedawayfromhome.UsetheFederal
PostcardApplicationavailabletoyoufrommilitary
bases,Americanembassies,orconsularoces.
New Hampshire town and city clerks will accept this
application only as a request for their own absentee
votermail‑inregistrationform.
North Dakotadoesnothavevoterregistration.
Wyominglawdoesnotpermitmailregistration.
How to Find Out If You Are Eligible to Register to
Vote in Your State
EachStatehasitsownlawsaboutwhomayregisterand
vote.ChecktheinformationunderyourStateinthe
State Instructions. All States require that you be a United
Statescitizenbybirthornaturalizationtoregistertovote
infederalandStateelections.Federallawmakesitillegal
tofalselyclaimU.S.citizenshiptoregistertovoteinany
federal, State, or local election. You cannotberegistered
tovoteinmorethanoneplaceatatime.
How to Fill Out this Application
Use both the Application Instructions and State
Instructionstoguideyouinllingouttheapplication.
•
•
First,readtheApplicationInstructions.ese
instructionswillgiveyouimportantinformation
thatappliestoeveryoneusingthisapplication.
Next,ndyourStateundertheStateInstructions.
UsetheseinstructionstolloutBoxes6,7,and8.
Alsorefertotheseinstructionsforinformationabout
votereligibilityandanyoathrequiredforBox9.
When to Register to Vote
EachStatehasitsowndeadlineforregisteringtovote.
CheckthedeadlineforyourStateonthelastpageof
this booklet.
How to Submit Your Application
Mail your application to the address listed under
your State in the State Instructions. Or, deliver the
applicationinpersontoyourlocalvoterregistration
oce.eStatesthatarerequiredtoacceptthe
nationalformwillacceptcopiesoftheapplication
printedfromthecomputerimageonregularpaper
stock,signedbytheapplicant,andmailedinan
envelopewiththecorrectpostage.
First Time Voters Who Register by Mail
Ifyouareregisteringtovoteforthersttimein
yourjurisdictionandaremailingthisregistration
application,Federallawrequiresyoutoshowproof
ofidenticationthersttimeyouvote.Proofof
identicationincludes:
•
•
Acurrentandvalidphotoidenticationor
Acurrentutilitybill,bankstatement,government
check,paycheckorgovernmentdocumentthat
showsyournameandaddress.
Votersmaybeexemptfromthisrequirementifthey
submitaCOPYofthisidenticationwiththeirmailin
voterregistrationform.IfyouwishtosubmitaCOPY,
pleasekeepthefollowinginmind:
•
•
Yourstatemayhaveadditionalidentication
requirementswhichmaymandateyoushow
identicationatthepollingplaceevenifyoumeet
theFederalproofofidentication.
Donotsubmitoriginaldocumentswiththis
application, only COPIES.
If You Were Given this Application in a State
Agency or Public Oce
IfyouhavebeengiventhisapplicationinaState
agencyorpublicoce,itisyourchoicetousethe
application. If you decide to use this application to
registertovote,youcanllitoutandleaveitwith
theStateagencyorpublicoce.eapplication
willbesubmittedforyou.Or,youcantakeitwith
youtomailtotheaddresslistedunderyourState
intheStateInstructions.Youalsomaytakeit
with you to deliver in person to your local voter
registrationoce.
Note:enameandlocationoftheStateagency
or public oce where you received the application
willremaincondential.Itwillnotappearonyour
application. Also, if you decide not to use this
applicationtoregistertovote,thatdecisionwill
remaincondential.Itwillnotaecttheserviceyou
receivefromtheagencyoroce.
Revised 03/01/2006
1
Application Instructions
Beforellingoutthebodyoftheform,pleaseanswerthequestionsonthetopoftheformastowhetheryouarea
UnitedStatescitizenandwhetheryouwillbe18yearsoldonorbeforeElectionDay.Ifyouanswernotoeitherofthese
questions,youmaynotusethisformtoregistertovote.However,statespecicinstructionsmayprovideadditional
informationoneligibilitytoregistertovotepriortoage18.
Box 1 — Name
Putinthisboxyourfullnameinthisorder—Last,
First,Middle.Donotusenicknamesorinitials.
Note:Ifthisapplicationisforachangeofname,please
tell us in Box A (on the bottom half of the form) your
fullnamebeforeyouchangedit.
Box 2 — Home Address
Putinthisboxyourhomeaddress(legaladdress).Do
notputyourmailingaddresshereifitisdierentfrom
yourhomeaddress.Donotuseapostoceboxor
ruralroutewithoutaboxnumber.Refertostate‑specic
instructionsforrulesregardinguseofroutenumbers.
Note:Ifyouwereregisteredbeforebutthisistherst
timeyouareregisteringfromtheaddressinBox2,
please tell us in BoxB (on the bottom half of the form)
theaddresswhereyouwereregisteredbefore.Please
giveusasmuchoftheaddressasyoucanremember.
Also Note: If you live in a rural area but do not have a
street address, or if you have no address, please show
whereyouliveusingthemapinBox C (at the bottom
of the form).
Box 3 — Mailing Address
Ifyougetyourmailatanaddressthatisdierentfrom
theaddressinBox2,putyourmailingaddressinthis
box.IfyouhavenoaddressinBox2,youmust write in
Box3anaddresswhereyoucanbereachedbymail.
Box 4 — Date of Birth
Putinthisboxyourdateofbirthinthisorder—
Month,Day,Year.Be careful not to use today’s date!
Box 5 — Telephone Number
MostStatesaskforyourtelephonenumberincase
there are questions about your application. However,
you do nothavetollinthisbox.
Box 6 — ID Number
Federallawrequiresthatstatescollectfromeach
registrantanidenticationnumber.Youmustreferto
yourstate'sspecicinstructionsforitem6regarding
informationonwhatnumberisacceptableforyour
state. If you have neither a drivers license nor a social
securitynumber,pleaseindicatethisontheformanda
numberwillbeassignedtoyoubyyourstate.
Box 7 — Choice of Party
InsomeStates,youmustregisterwithapartyifyou
wanttotakepartinthatparty’sprimaryelection,
caucus,orconvention.TondoutifyourStaterequires
this,seeitem7intheinstructionsunderyourState.
Ifyouwanttoregisterwithaparty,printintheboxthe
fullnameofthepartyofyourchoice.
If you do notwanttoregisterwithaparty,write“no
party”orleavetheboxblank.Donot write in the word
“independent”ifyoumean“noparty,”becausethis
mightbeconfusedwiththenameofapoliticalpartyin
your State.
Note: Ifyoudonotregisterwithaparty,youcanstill
voteingeneralelectionsandnonpartisan(nonparty)
primaryelections.
Box 8 — Race or Ethnic Group
AfewStatesaskforyourraceorethnicgroup,inorder
toadministertheFederalVotingRightsAct.Tond
outifyourStateasksforthisinformation,seeitem8
intheinstructionsunderyourState.Ifso,putinBox8
thechoicethatbestdescribesyoufromthelistbelow:
•
•
•
•
•
•
•
AmericanIndianorAlaskanNative
AsianorPacicIslander
Black,not of HispanicOrigin
Hispanic
Multi‑racial
White,not ofHispanicOrigin
Other
Box 9 — Signature
Reviewtheinformationinitem9intheinstructions
underyourState.Beforeyousignormakeyourmark,
makesurethat:
(1)YoumeetyourState’srequirements,and
(2)YouunderstandallofBox9.
Finally,signyourfullnameormakeyourmark,and
printtoday’sdateinthisorder—Month,Day,Year.
Iftheapplicantisunabletosign,putinBox D the
name,address,andtelephonenumber(optional)ofthe
person who helped the applicant.
2
Revised 03/01/2006
Voter Registration Application
Before completing this form, review the General, Application, and State specic instructions.
Are you a citizen of the United States of America?
Yes No
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-specic instructions for rules regarding eligibility to register prior to age 18.)
This space for oce use only.
1
Mr.
Mrs.
Miss
Ms.
Last Name First Name Middle Name(s)
Jr
Sr
II
III
IV
2
Home Address Apt. or Lot # City/Town State Zip Code
3
Address Where You Get Your Mail If Dierent From Above
City/Town State Zip Code
4
Date of Birth
Month Day Year
5
Telephone Number (optional)
6
ID Number - (See item 6 in the instructions for your state)
7
Choice of Party
(see item 7 in the instructions for your State)
8
Race or Ethnic Group
(see item 8 in the instructions for your State)
■
■
■
●
●
■
■
■
9
I have reviewed my state's instructions and I swear/arm that:
I am a United States citizen
I meet the elig ibility requirements of my state and
subscribe to any oath required.
The information I have provided is true to the best of my
knowledge under penalty of perjury. If I have provided false
information, I may be ned, imprisoned, or (if not a U.S.
citizen) deported from or refused entry to the United States.
Please sign full name (or put mark)
Date:
Month Day Year
If you are registering to vote for the rst time: please refer to the application instructions for information on submitting
copies of valid identication documents with this form.
Please ll 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?
A
Mr.
Mrs.
Miss
Ms.
Last Name First Name Middle Name(s)
Jr
Sr
II
III
IV
If you were registered before but this is the rst time you are registering from the address in Box 2, what was your address where you were registered before?
B
Street (or route and box number) Apt. or Lot # City/Town/County State Zip Code
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.
C
Write in the names of the crossroads (or streets) nearest to where you live.
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
Woodchuck Road
Route #2
Public School
Grocery Store
X
NORTH
If the applicant is unable to sign, who helped the applicant ll out this application? Give name, address and phone number (phone number optional).
D
Mail this application to the address provided for your State.
FOR OFFICIAL USE ONLY
FIRST CLASS
STAMP
NECESSARY
FOR
MAILING
Voter Registration Application
Before completing this form, review the General, Application, and State specic instructions.
Are you a citizen of the United States of America?
Yes No
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-specic instructions for rules regarding eligibility to register prior to age 18.)
This space for oce use only.
1
Mr.
Mrs.
Miss
Ms.
Last Name First Name Middle Name(s)
Jr
Sr
II
III
IV
2
Home Address Apt. or Lot # City/Town State Zip Code
3
Address Where You Get Your Mail If Dierent From Above
City/Town State Zip Code
4
Date of Birth
Month Day Year
5
Telephone Number (optional)
6
ID Number - (See item 6 in the instructions for your state)
7 8
Race or Ethnic Group
(see item 8 in the instructions for your State)
Q
Q
Q
O
O
½
Q
Q
Q
9
I have reviewed my state's instructions and I swear/arm that:
I am a United States citizen
I meet the elig ibility requirements of my state and
subscribe to any oath required.
The information I have provided is true to the best of my
knowledge under penalty of perjury. If I have provided false
information, I may be ned, imprisoned, or (if not a U.S.
citizen) deported from or refused entry to the United States.
Please sign full name (or put mark)
Date:
Month Day Year
If you are registering to vote for the rst time: please refer to the application instructions for information on submitting
copies of valid identication documents with this form.
Please ll 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?
A
Mr.
Mrs.
Miss
Ms.
Last Name First Name Middle Name(s)
Jr
Sr
II
III
IV
If you were registered before but this is the rst time you are registering from the address in Box 2, what was your address where you were registered before?
B
Street (or route and box number) Apt. or Lot # City/Town/County State Zip Code
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.
C
Write in the names of the crossroads (or streets) nearest to where you live.
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
Woodchuck Road
Route #2
Public School
Grocery Store
X
NORTH
If the applicant is unable to sign, who helped the applicant ll out this application? Give name, address and phone number (phone number optional).
D
Mail this application to the address provided for your State.
Choice of Party
(see item 7 in the instructions for your State)
FOR OFFICIAL USE ONLY
FIRST CLASS
STAMP
NECESSARY
FOR
MAILING
•
•
•
•
•
 
State Instructions
Alabama
Updated: 03-01-2006
Registration Deadline — Voter
registration is closed during the
ten days preceding an election.
Applications must be postmarked
or delivered by the eleventh day
prior to the election.
6. ID Number. Your social security
number is requested (by authority
of the Alabama Supreme Court,
17‑4‑122).
7. Choice of Party. Optional: You
do not have to register with a party
if you want to take part in that
party’s primary election, caucus,
or convention.
8. Race or Ethnic Group. You
are required to ll in this box;
however, your application will
not be rejected if you fail to do so.
See the list of choices under the
Application Instructions for Box 8
(on page 2).
9. Signature. To register in
Alabama you must:
be a citizen of the United States
be a resident of Alabama
and your county at the time of
registration
be 18 years old before any election
not have been convicted of a felony
punishable by imprisonment in the
penitentiary (or have had your civil
and political rights restored)
not currently be declared
mentally incompetent through a
competency hearing
swear or arm to “support and
defend the Constitution of the
U.S. and the State of Alabama
and further disavow any belief or
aliation with any group which
advocates the overthrow of the
governments of the U.S. or the State
of Alabama by unlawful means
and that the information contained
herein is true, so help me God”
•
Mailing address:
Oce of the Secretary of State
P.O. Box 5616
Montgomery, AL 36103‑5616
Alaska
Updated: 03-01-2006
Registration Deadline — 30 days
before the election.
6. ID Number. You must provide
one of the following identication
numbers; Alaska Driver's License
or Alaska State Identication Card
Number. If you do not have an
Alaska Driver's License or Alaska
State Identication Card, you must
provide the last four digits of your
Social Security Number. If you do
not have any of these identication
numbers, please write "NONE"
on the form. A unique identifying
number will be assigned to you for
voter registration purposes. is
information is kept condential.
Having this information assists
in maintaining your voter record
and may assist in verifying your
identity (Title 15 of the Alaska
Statutes).
7. Choice of Party. You do not
have to declare a party aliation
when registering to vote. If you
do not choose a party, you will
be registered as Undeclared.
Alaska has a closed primary
election system. Each recognized
political party has a separate ballot
listing only candidates from that
political party. Voters registered
as a member of a political party
may only vote that party's ballot.
Voters registered as undeclared
or non‑partisan may choose one
ballot from the ballots available.
8. Race or Ethnic Group. Leave
blank.
9. Signature. To register in Alaska
you must:
be a citizen of the United States
be at least 18 years old within 90
days of completing this registration
be a resident of Alaska
not be a convicted felon (unless
unconditionally discharged)
not be registered to vote in
another State
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Mailing address:
Division of Elections
State of Alaska
PO Box 110017
Juneau, AK 99811‑0017
Arizona
Updated: 03-01-2006
Registration Deadline — 29 days
before the election.
6. ID Number. Your completed
voter registration form must
contain the number of your
Arizona driver license, or
non‑operating identication
license issued pursuant to A.R.S.
§ 28‑3165, if the license is current
and valid. If you do not have
a current and valid Arizona
driver license or non‑operating
identication license, you must
include the last four digits of
your social security number if
one has been issued to you. If you
do not have a current and valid
driver license or non‑operating
identication license or a social
security number, please write
“NONE” on the form. A unique
identifying number will be
assigned by the Secretary of State.
3
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State Instructions
7. Choice of Party. If you are
registered in a political party which
has qualied for ballot recognition,
you will be permitted to vote the
primary election ballot for that
party. If you are registered as an
independent, no party preference
or as a member of a party which is
not qualied for ballot recognition,
you may select and vote one
primary election ballot for one of
the recognized political parties.
8. Race or Ethnic Group. Leave
blank.
9. Signature. To register in
Arizona you must:
be a citizen of the United States
be a resident of Arizona and your
county at least 29 days preceding
the next election
be 18 years old on or before the
next general election
not have been convicted of
treason or a felony (or have had
your civil rights restored)
not currently be declared an
incapacitated person by a court
of law
Mailing address:
•
Secretary of State/Elections
1700 W. Washington, 7th Floor
Phoenix, AZ 85007‑2888
Arkansas
Updated: 03-01-2006
Registration Deadline — 30 days
before the election.
6. ID Number. Your completed
voter registration form must
contain your state issued driver's
license number or nonoperating
identication number. If you
do not have a driver's license or
nonoperating identication, you
must include the last four digits
of your social security number. If
you do not have a driver's license
or a nonoperating identication
or a social security number, please
write "NONE" on the form. A
unique identifying number will be
assigned by the State.
7. Choice of Party. Optional. You
do not have to register with a party
if you want to take part in that
party’s primary election, caucus, or
convention.
8. Race or Ethnic Group. Leave
blank.
9. Signature. To register in
Arkansas you must:
be a citizen of the United States
live in Arkansas at the address in
Box 2 on the application
be at least 18 years old before the
next election
not be a convicted felon (or
have completely discharged your
sentence or been pardoned)
not claim the right to vote in any
other jurisdiction
not previously be adjudged
mentally incompetent by a court of
competent jurisdiction
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Mailing address:
Secretary of State
Voter Services
P.O. Box 8111
Little Rock, AR 72203‑8111
California
Updated: 03-01-2006
Registration Deadline — 15 days
before the election.
6. ID Number. When you register
to vote, you must provide your
California driver’s license or
California identication card
number, if you have one. If you
do not have a driver’s license or
ID card, you must provide the
last four digits of your Social
Security Number (SSN). If you
do not include this information,
you will be required to provide
identication when you vote.
7. Choice of Party. Please enter
the name of the political party with
which you wish to register. If you
do not wish to register with any
party, enter “Decline to State” in
the space provided.
California law allows voters who
“decline to state” an aliation with
a qualied political party or who
aliate with a nonqualied political
party to vote in the primary election
of any qualied political party that
les a notice with the Secretary
of State allowing them to do so.
You can call 1‑800‑345‑VOTE
or visit www.sos.ca.gov to learn
which political parties are allowing
nonaliated voters to participate in
their primary election.
8. Race or Ethnic Group. Leave
blank.
9. Signature. To register in
California you must:
be a citizen of the United States
be a resident of California
be at least 18 years of age at the
time of the next election
not be imprisoned or on parole
for the conviction of a felony
not currently be judged mentally
incompetent by a court of law
Signature is required. If you
meet the requirements listed
above, please sign and date the
registration card in the space
provided.
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Mailing address:
Secretary of State
Elections Division
1500 11th Street
Sacramento, CA 95814
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State Instructions
Colorado
Updated: 03-28-2008
Registration Deadline — 29
days before the election. If the
application is received in the mails
without a postmark, it must be
received within 5 days of the close
of registration.
6. ID Number. Your completed
voter registration form must contain
your state issued driver's license
number or identication number.
If you do not have a driver's license
or state issued identication, you
must include the last four digits
of your social security number. If
you do not have a driver's license
or a state issued identication or a
social security number, please write
"NONE" on the form. A unique
identifying number will be assigned
by the State.
7. Choice of Party. You must
register with a party if you want to
take part in that party’s primary
election, caucus, or convention.
8. Race or Ethnic Group. Leave
blank.
9. Signature. To register in
Colorado you must:
be a citizen of the United States
be a resident of Colorado 30 days
prior to the election
be 18 years old on or before
election day
not be conned as a prisoner
or serving any part of a sentence
under mandate
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Mailing address:
Colorado Secretary of State
1700 Broadway, Suite 270
Denver, Colorado 80290
Connecticut
Updated: 03-01-2006
Registration Deadline — 14 days
before the election.
6. ID Number. Connecticut
Driver's License Number, or if
none, the last four digits of your
Social Security Number.
7. Choice of Party. is is
optional, but you must register
with a party if you want to take
part in that party’s primary
election, caucus, or convention.
8. Race or Ethnic Group. Leave
blank.
9. Signature. To register in
Connecticut you must:
be a citizen of the United States
be a resident of Connecticut
and of the town in which you wish
to vote
be 17 years old. You can vote
when you turn 18
have completed connement and
parole if previously convicted of a
felony, and have had your voting
rights restored by Registrars of Voters.
not currently be declared mentally
incompetent to vote by a court of law
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Mailing address:
Secretary of State
Elections Division
30 Trinity Street
Hartford, CT 06106
Delaware
Updated: 02-07-2012
Registration Deadline — e
4th Saturday before a primary
or general election, and 10 days
before a special election.
6. ID Number. Your completed
voter registration form must
contain your state issued driver's
license number or nonoperating
identication number. If you
do not have a driver's license or
nonoperating identication, you
must include the last four digits
of your social security number. If
you do not have a driver's license
or a nonoperating identication
or a social security number, please
write "NONE" on the form. A
unique identifying number will be
assigned by the State.
7. Choice of Party. You must
register with a party if you want to
take part in that party’s primary
election, caucus, or convention.
8. Race or Ethnic Group. Leave
blank.
9. Signature. To register in
Delaware you must:
be a citizen of the United States
be a permanent resident of
Delaware
be at least 18 years old on the
date of the next general election
felons are eligible to vote if
certain requirements are met:
nes and sentence completed at
least ve years prior to application
date; felony convictions can not be
disqualifying felonies, which are
murder, sexual oenses, or crimes
against public administration
involving bribery or improper
inuence or abuse of oce.
not be mentally incompetent
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Mailing address:
State of Delaware
Oce of the State Election
Commissioner
905 S. Governors Ave., Suite 170
Dover, DE 19904
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State Instructions
District of Columbia
Updated: 10-29-2003
Registration Deadline — 30 days
before the election.
6. ID Number. Federal law now
requires that all voter registration
applications must include either
the applicant’s driver’s license
number or the last four digits
of the applicant’s social security
number in order to be processed.
7. Choice of Party. You must
register with a party if you want to
take part in that party’s primary
election, caucus, or convention.
8. Race or Ethnic Group. Leave
blank.
9. Signature. To register in the
District of Columbia you must:
be a citizen of the United States
be a District of Columbia
resident at least 30 days preceding
the next election
be at least 18 years old on or
preceding the next election
not be in jail for a felony conviction
not have been judged “mentally
incompetent” by a court of law
not claim the right to vote
anywhere outside D.C.
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Mailing address:
District of Columbia Board of
Elections & Ethics
441 4th Street, NW, Suite 250
Washington, DC 20001‑2745
Florida
Updated: 11-30-2011
Registration Deadline — 29 days
before the election.
6. ID Number. If you have one,
you must provide your Florida
driver's license number or Florida
identication card number. If you do
not have a Florida driver's license or
identication card, you must provide
the last four digits of your social
security number. If you have not
been issued any of these numbers,
you must write the word “NONE.”
7. Choice of Party. You must
register with a party if you want to
take part in that party’s primary
election, caucus, or convention.
8. Race or Ethnic Group. You are
requested, but not required, to ll
in this box. See the list of choices
under the Application Instructions
for Box 8 (on page 2).
9. Signature. To register in Florida
you must:
be a citizen of the United States
be a legal resident of both the
State of Florida and of the county in
which you seek to be registered
be 18 years old (you may
pre‑register if you are at least 16)
not be adjudicated mentally
incapacitated with respect to voting
in Florida or any other State, or if
you have, you must rst have your
voting rights restored.
not be a convicted felon, or if you
are, you must rst have your civil
rights restored if they were taken away.
swear or arm the following:
“I will protect and defend the
Constitution of the United States
and the Constitution of the State
of Florida, that I am qualied to
register as an elector under the
Constitution and laws of the State of
Florida, and that all information in
this application is true.
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Mailing address:
State of Florida
Department of State
Division of Elections
e R.A. Gray Building
500 South Bronough St, Rm 316
Tallahassee, Florida 32399‑0250
Georgia
Updated: 03-28-2008
Registration Deadline — e
h Monday before any general
primary, general election, or
presidential preference primary, or
regularly scheduled special election
pursuant to the Georgia Election
Code. In the event that a special
election is scheduled on a date
other that those dates prescribed
by the Georgia Election Code,
registration would close on the 5th
day aer the call.
6. ID Number. Federal law requires
you to provide your full GA Drivers
License number or GA State issued
ID number. If you do not have a GA
Drivers License or GA ID you must
provide the last 4 digits of your
Social Security number. Providing
your full Social Security number
is optional. Your Social Security
number will be kept condential
and may be used for comparison
with other state agency databases
for voter registration identication
purposes. If you do not possess
a GA Drivers License or Social
Security number, a unique identier
will be provided for you.
7. Choice of Party. You do not
have to register with a party to take
part in that party’s primary, caucus
or convention.
8. Race or Ethnic Group. You
are requested to ll in this box.
See the list of choices under the
Application Instructions for Box 8
(on page 2).
9. Signature. To register in
Georgia you must:
be a citizen of the United States
be a legal resident of Georgia and
of the county in which you want
to vote
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