Form Mv-44 - Application For Driver License Or Non-Driver Id Card Page 3

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NEW YORK STATE VOTER REGISTRATION APPLICATION INFORMATION
OFFICE USE ONLY
MV-44 (8/13)
(Please read before you complete application on the other side.)
Use the NYS Voter Registration Application to Register to Vote in NYS Elections, and/or:
change the name or address on your voter registration
become a member of a political party
change your party membership
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To Register You Must:
be a U.S. citizen;
be 18 years old by the end of this year;
not be in prison or on parole for a felony conviction;
not claim the right to vote elsewhere
If you decline to register, your decision will remain confidential. If you believe that someone has interfered with your right to register or decline to register to vote,
your right to privacy in deciding whether to register or in applying to register to vote, or your right to choose your own political party or other political preference,
you may file a complaint with the NYS Board of Elections, 40 Steuben Street, Albany, NY 12207-2109 (phone: 1-800-469-6872).
Your completed application will be sent to the Board of Elections and you will be notified by your County Board of Elections when your application has been
processed. If you have any questions about filling out the voter registration application or registering to vote, you should call your County Board of Elections or call
1-800-FOR-VOTE (TDD/TTY Dial 711) (only for voter registration questions). If you live in New York City, you should call 1-866-VOTE-NYC. You may also find
answers or tools at the NYS Board of Elections website:
NEW YORK STATE VOTER REGISTRATION APPLICATION
Only fill this out if you want to register to vote or change your address or other information with the Board of Elections.
If you register to vote, your completed voter registration application will be sent directly to the Board of Elections. If you decline to register, your decision will
remain confidential. You will be notified by your County Board of Elections when your voter registration application has been processed.
o
o
o
o
Telephone Number (optional)
Are you a citizen of the U.S.?
Yes
No
Will you be 18 years of age or older on or before election day?
Yes
No
If you answer NO, you cannot register to vote unless you will be 18 by the end of the year.
If you answer NO, you cannot register to vote
Have you voted before?
Voting information that
Your name was
Your state or NYS
o
o
Yes
No
has changed:
County was:
What Year?
skip if this has not changed or
Your address was
you have not voted before.
Political Party
AFFIDAVIT: I swear or affirm that
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I am a citizen of the United States.
Democratic party
You must make 1 selection
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I will have lived in the county, city, or village for at least 30 days before the election.
Republican party
To vote in a primary
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I meet all requirements to register to vote in New York State.
election, you must be
Conservative party
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This is my signature or mark on the line below.
enrolled in one of these
Working Families party
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The above information is true, I understand that if it is not true, I can be convicted and fined up to $5,000 and/or
listed parties - except the
Independence party
o
Independence Party, which
jailed for up to four years.
Green party
permits non-enrolled voters
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______________
Other (write in)
to participate in certain
o
I do not wish to enroll in a party
primary elections.
X
Sign
Date
MV-44 (8/13)
reset/clear

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