Fillable Form C03 - State Of Alaska Voter Registration Application (Page 2 of 2) in pdf

State of Alaska - Division of Elections

Voter Registration Application

To register to vote in Alaska you must be a U.S. Citizen, a resident of Alaska, and at least 18 years old or will be

18 years old within 90 days of completing this application.

Initial registration or registration changes must be made at least 30 days prior to an election. Once your application is

processed, a notice will be mailed to you within 3 to 4 weeks.

1. When Completing This Application You MUST Provide:

Alaska Residence Address Where You Claim Residency – A complete physical residence address in Alaska must



be included on your application. The residence address you provide will be used to assign your voter record to a voting

district and precinct. Your application will be denied if you do not provide an Alaska residence address or you provide a

PO Box, HC No. and Box, PSC Box, Rural Route No., Commercial Address or Mail Stop Address or a residence address

outside of Alaska on Line 4 of the application.

If your residence has been assigned a street name and house number, provide this information or indicate exactly

where you live such as, highway name and milepost number, boat harbor, pier and slip number, subdivision name with

lot and block or trailer park name and space number. If you live in rural Alaska, you may provide the community name

as your residence address.

If you have a different mailing address than your residence address, you may choose to keep your residence address

confidential. Confidential addresses are not released to the general public, but may be released to government

agencies or during election processes as set out in state law.

If you are temporarily out of state and have intent to return, you may maintain your Alaska residence as it appears on

your current record. If you provide a new residence address, it must be within Alaska. Active military and military

spouses are exempt from intent requirement.

Proof of Identity – Your identity must be verified. If you have been issued a Social Security number, Alaska Driver’s



License, or Alaska State ID card, you MUST provide at least one number on Line 10 of the application. If you have

never been issued one of the identification numbers, please indicate so by checking the box on Line 10.

Date of Birth – You MUST provide your date of birth.



2. Are you submitting this application by mail, by fax, or email? If so, and if you are not already registered to vote

in Alaska, your identity must be verified either at the time you register or the first time you vote. If you would like to

ensure that your identity is verified at the time you register, submit a copy of one of the below:

 Current and valid photo identification

 Passport

 Birth certificate

 Driver’s license

 State identification card

 Hunting and Fishing license

3. Are you registering from outside the State of Alaska? If so, you must provide proof of Alaska residency, such as a

copy of your current Alaska driver's license/ID, current Alaska hunting or fishing license, student loan or college tuition

documents showing Alaska as state of residence, proof of employment in Alaska that indicates the date on which you

were employed, military leave and earnings statement that identifies Alaska as the state of legal residence or other

documentation that supports your claim as an Alaska resident. If you do not provide proof of Alaska residency, your

application will not be processed.

4. Have you been convicted of a felony? If so, you may register to vote only if you have been unconditionally

discharged. Provide a copy of your discharge papers with this application if available.

5. Political Affiliation. Write your political affiliation. Recognized political parties are parties who have gained recognized

political party status under Alaska Statute. Political groups are parties who have applied for recognized political party

status but have not met the qualifications. Alaska political affiliations are as follows:

Recognized Political Parties:

Political Groups:

Other:

 Alaska Democratic Party

 Nonpartisan (not affiliated

 Alaska Constitution Party

 Progressive Party of Alaska

with a political party or

 Alaska Libertarian Party



Green Party of Alaska

 Twelve Visions Party of Alaska

group)

 Alaska Republican Party

Moderate Party of Alaska



 UCES’ Clowns Party

 Undeclared (do not wish to

 Alaskan Independence Party

 Patriot’s Party of Alaska

 Veterans Party of Alaska

declare a political affiliation)

Mail, fax or email (as a PDF, TIFF or JPEG attachment) your completed application to one of the offices listed below:

Region I Elections Office

Region II Elections Office

Region III Elections Office

Region IV Elections Office

PO Box 110018

Anchorage Office

675 7

Ave Ste H3

PO Box 577

Juneau, AK 99811-0018

2525 Gambell St Ste 100

Fairbanks, AK 99701-4542

Nome, AK 99762-0577

(907) 465-3021 – Telephone

Anchorage, AK 99503-2838

(907) 451-2835 – Telephone

(907) 443-5285 – Telephone

(907) 465-2289 – Fax

(907) 522-8683 – Telephone

(907) 451-2832 – Fax

(907) 443-2973 – Fax

Toll Free 1-866-948-8683

(907) 522-2341 – Fax

Toll Free 1-866-959-8683

Toll Free 1-866-953-8683

electionsr1@alaska.gov

Toll Free 1-866-958-8683

electionsr3@alaska.gov

electionsr4@alaska.gov

electionsr2a@alaska.gov

Matanuska-Susitna Office

Native Language Assistance

North Fork Professional Building

Toll Free 1-866-954-8683

1700 E Bogard Rd Ste B102

Wasilla AK 99654-6565

(907) 373-8952 – Telephone

(907) 373-8953 - Fax

electionsr2m@alaska.gov

Visit our website at:

Form C03 - State Of Alaska Voter Registration Application Page 2

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