Voter Registration Application And Michigan Driver License/ Personal Identification Card Address Change Form

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State of Michigan
Voter Registration Application and Michigan Driver License/
Personal Identification Card Address Change Form
1
You can use this form to:
Are you registering to vote in
Michigan for the first time?
Register to vote in Michigan.
Change your name or address on your voter registration.
If you have never voted in Michigan
and choose to submit this form by mail,
If you have never voted in Michigan and choose to submit this form by mail,
you must meet a new identification
you must appear in person to vote in the first election in which you
wish to participate. This requirement does not apply if (1) you personally
requirement provided under federal
hand deliver this form to your county, city or township clerk’s office instead
law. To comply with the identification
of mailing the form (2) you are 60 years of age or more (3) you are disabled
requirement, you must:
or (4) you are eligible to vote under the Uniformed and Overseas Citizens
(1) accurately enter your state issued
Absentee Voting Act.
driver license number or personal
ID card number where requested
2
To register to vote in Michigan you must be:
on this form.
– A resident of Michigan and the city or township where you are applying to
or
register to vote.
– A citizen of the United States of America.
(2) send one of the following forms of
– At least 18 years of age (by election day).
identification when mailing this form
– Not serving a sentence in jail or prison.
to your county, city or township
clerk: a COPY of a current and
3
Voter registration and driver license address must be the same
valid photo identification (such as a
driver license or personal ID card)
Michigan law states that the same address must be used for voter
or a COPY of a paycheck stub,
registration and driver license purposes. Therefore, if the residence
utility bill, bank statement or a
address you provide on this form differs from the address shown on a driver
government document which lists
license or personal identification card issued by the State of Michigan, the
your name and address.
Secretary of State will automatically change your driver license or personal
identification card address to match the residence address entered on this
DO NOT SEND ORIGINAL
form. If an address change is made, the Secretary of State will mail you an
DOCUMENTS BY MAIL.
address update sticker for your driver license or personal identification card.
If you are subject to the identification
requirement and do not meet the
4
Identifying the city or township where you live
requirement as explained above, an
Every person residing in Michigan lives in either a city or a township. If you
acceptable form of identification will be
do not know the name of your city or township, please describe your location
requested before you vote in the first
in the space provided for If no house or street address. Providing cross
election in which you wish to
streets/roads and landmarks will help the clerk correctly identify your city or
participate.
township.
Note: The identification requirement
5
Mailing address option provided
does not apply if (1) you personally
hand deliver this form to your county,
If you would prefer to receive mail related to your voter registration or driver
city or township clerk’s office instead of
license/personal identification card at an address other than your residential
mailing this form (2) you are disabled
address, provide a mailing address where indicated on the form. If you
or (3) you are eligible to vote under the
provide a mailing address, it will not appear on your voter I.D. card or driver
Uniformed and Overseas Citizens
license/personal identification card.
Absentee Voting Act.
6
Mail or hand deliver this form to your city or township clerk
Contact your city or township clerk
If you live within the city limits of one of the cities listed on the reverse side
if you have any questions
of this sheet, mail or hand deliver the application directly to the clerk of that
Your application is not valid until
city. If you do not live within one of the listed cities but you know or can
accepted by the clerk of the city or
locate the address of your city or township clerk, mail or hand deliver the
township in which you reside. If you do
application directly to that clerk. Otherwise, mail or hand deliver the
not receive a voter I.D. card within
application to your county clerk. (The addresses of Michigan’s 83 county
three weeks or have any questions,
clerks are also listed on the reverse side of this sheet.) The county clerk will
contact your clerk.
forward it to your city or township clerk. Completed applications must be
received or postmarked by the close of registration for an election in order to
ED-121 (Rev. 4-04)
be effective for that election.

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