Voter Registration Cancellation Request - Registrant
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1State of Delaware
Department of Elections
Voter Registration Cancellation Request - Registrant
I request the cancelation of my Voter Registration in the State of Delaware for the following reason:
I no longer live in Delaware.
Cancelation
1
I no longer wish to vote in Delaware Elections.
reason
Other reasons.
Please specify your reason:
Last name
Suffix
Legal name
2
First name
Middle name
Voter ID (if known)
Identification
3
Birth date
Contact
Telephone
4
information
Email
Street Address (
)
Apt. #
Delaware
not P.O. Box
registration
5
City/Town/Village
address
County
State
Zip Code
Affirmation (REQUIRED)
I hereby swear or affirm, under penalty of perjury, that:
:
My signature and date herein indicate when I completed this document.
Signature
Print this form, sign, and send in.
The information on this form is true and complete to the best of my knowledge.
I understand that a material misstatement of fact in completion of this document
Today’s date
may constitute grounds for conviction of perjury.
Instructions
1. Make sure that the information on the form is correct and that all items are completed.
2. Save the form to your computer.
3. Print the form, then sign and date it.
4. Return the form by email, FAX or mail to the office in the County in which you are registered.
Kent County Office
New Castle County Office
Sussex County Office
votencc@state.de.us
email:
votekc@state.de.us
email:
votesc@state.de.us
email:
(302) 739-4515
(302) 577-6545
(302) 856-5082
FAX:
FAX:
FAX:
Department of Elections
Department of Elections
Department of Elections
mail:
mail:
mail:
New Castle County Office
Kent County Office
Sussex County Office
PO Box 699
PO Box 7079
PO Box 457
Dover DE 19903-0699
Wilmington DE 19803-0079
Georgetown DE 19947-0457
FOR OFFICE USE ONLY
In Person
Mail
Email
FAX
Other:__________
Received by: ____________________ Date: __________
Processed by: ____________________ Date: __________
This information is for official use only. Any unauthorized release may be punishable by law.
VRFM002 V1.0 2015-04-08
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Parent category: Legal