Fillable Montana Voter Registration Application Form printable pdf download

MONTANA VOTER REGISTRATION APPLICATION

Fields marked with an asterisk (*) are required. If you do not provide all of the required information, your application to register

to vote will not be complete.

UNDER FEDERAL AND/OR STATE LAW ALL ELECTORS MUST PRESENT ID WHEN VOTING.

Please print clearly and use black or blue pen.

COMPLETE FORM AND SUBMIT TO COUNTY ELECTION OFFICE.

ELIGIBILITY REQUIREMENTS AND IDENTIFYING INFORMATION

NOTE: VOTER REGISTRATION REQUIRES U.S. CITIZENSHIP

Check all that apply:

New Registration

Name Change

Address Change

Signature Update

Other

*If you answer “No” to any of the following questions, do not complete this form.

Are you a citizen of the United States?*

Yes

Will you be at least 18 years of age on or before the next election?*

Yes

Will you be a Montana resident for at least 30 days before the next election?*

Yes

First Name*

Middle

Suffix

(Jr., Sr., III)

Last Name*

Select one of the following and provide the required information*

__ __ __ __ __ __ __ __ __ __ __ __ __

I have a Montana Driver’s License or Montana ID and that number is

__ __ __ __

I have not been issued a Montana Driver’s License or ID card. The last 4 digits of my SSN are

I have not been issued a Montana Driver’s License or ID card, or a Social Security Number. I have attached a copy

of a photo ID that shows my name or acceptable ID that shows my name and current address

(paycheck stub; utility bill;

bank statement; or government document).

City*

County*

Zip Code*

Montana Residence Address*

City

State

Zip Code

Mailing Address

(required if differs from residence address)

Contact Phone

Email Address

Date of Birth*

_______

month

day

year

If applicable, check one of the following:

Military Domestic (or military spouse or dependent) – only if on active duty and will be absent from place of registration

Military Overseas (or overseas military spouse or dependent)

U.S. Citizen Overseas

PREVIOUS REGISTRATION INFORMATION

REQUIRED IF NAME CHANGED OR IF PREVIOUSLY REGISTERED TO VOTE IN ANOTHER COUNTY OR STATE

Residence Address of Previous Registration

Previous Name

Previous City, County and State

OPTIONAL - CHECK ONE OF THE OPTIONS BELOW TO BE PLACED ON THE ANNUAL ABSENTEE LIST

Yes, I request an absentee ballot to be mailed to me for ALL elections in which I am eligible to vote this year as long as I

reside at the address listed on this application, and for subsequent years. I understand that in order to continue to receive an

absentee ballot, I must complete, sign, and return a confirmation notice mailed to me by the county election office each year.

Yes, I request an absentee ballot to be mailed to me for ONLY each federal election in which I am eligible to vote this

year as long as I reside at the address listed on this application, and for subsequent years. I understand that in order to

continue to receive an absentee ballot, I must complete, sign and return a confirmation notice mailed to me by the county

election office each year.

If your mailing address differs during certain times of the year, please visit

sos.mt.gov

or contact your county

election office for a separate absentee list application.

APPLICANT AFFIRMATION

I affirm under penalty of perjury that the information on this application is true, that I am qualified to be an elector in the State of

Montana, that I am not serving a felony conviction in a penal institution nor have I been found to be of unsound mind by a court. If I

have given false information on this application, I may be subject to a fine or imprisonment, or both under Federal and/or State law.

Signature*___________________________________________________________ Date*_________________________

For county use only

Date

Senate

House

Precinct / Split

Ward

School

Montana Voter Registration Application Form

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