Motor Vehicle Administration
6601 Ritchie Highway, N.E.
Glen Burnie, Maryland 21062
Application for Maryland Change of Address
UNITED STATES GOVERNMENT EMPLOYEES SHOULD USE FORM VR-102 TO CERTIFY A TEMPORARY OUT-OF-STATE ADDRESS.
Please complete in ink. All applicants must complete Section A. Complete Section B to apply to register to vote in Maryland. If you are already
registered to vote in Maryland, you can use Section B to indicate that you do not want your voter registration address updated or to change your
party affiliation. For additional instructions, see back of form.
Title (Jr., Sr., etc.):
Certification: I hereby certify, under penalty of perjury, that the statements made on this form are true and correct to the best of my knowledge, information, and belief.
If you are already registered to vote in Maryland, the information in Section A will automatically update your voter registration information.
Check here if you do not want your voter registration updated.
If you are already registered to vote in Maryland and you only want to change your party affiliation, complete Items 3, 9, 13, and 14.
If you are NOT registered to vote in Maryland, and you would like to apply to register to vote, complete Items 2 - 14. You Must be a U.S. Citizen.
Check boxes that apply and complete Items 4-14:
Are you at least 16 years old?
Party Affiliation Change
ARE YOU A U.S. CITIZEN?
If you answer NO to either question, do not complete this form.
Mailing address (if different
from residence address
above in section A):
Social Security Number:
(Voluntary. See Instructions in section D):
YOU MUST REGISTER WITH A POLITICAL PARTY
IF YOU WANT TO TAKE PART IN THAT POLITICAL
PARTY’S PRIMARY ELECTION, CAUCUS, OR
Unaffiliated (independent of any party)
Other – Specify:
CONVENTION. CHECK ONE BOX ONLY.
Check here if you need help voting.
Check here if you would like to be an election judge.
Under penalty of perjury, I hereby swear or affirm: I am a U.S. citizen • I am a Maryland resident • I am at least 16 years old • I have not been convicted of buying or
selling votes • I have not been convicted of a felony, or if I have, I have completed serving a court-ordered sentence of imprisonment. The information in Section B of
this application is true to the best of my knowledge, information, and belief.
Full Signature (required)
DO NOT WRITE IN SPACE BELOW
Address on Last
City or Town
For more information, please call: 410-768-7000 (to speak with a customer agent).
TTY for the hearing impaired: 1-800-492-4575. Visit our website at:
White Copy - Board of Elections
Canary Copy - MVA
Pink Copy - Customer