Form Mv-44 - Application For Permit, Driver License Or Non-Driver Id Card - New York Dmv Page 3

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OFFICE USE ONLY

NEW YORK STATE VOTER REGISTRATION APPLICATION INFORMATION

MV-44 (8/17)

OFFICE USE ONLY

(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

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

Información en español: si le interse obtener

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

este formulario de re-gistro del votante en

español, llame al 1-800-367-8683

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

西班牙语信息：如果您有兴趣获得西班牙语的这

스페인어로 된 정보 :이 유권자 등록 양식을 스페인

种选民登记表，请致电1-800-367-8683

어로 얻으려면 1-800-367-8683으로 전화하십시오.

If you do not complete the NYS Voter Registration Application, you will be considered to have declined to register to vote. If you decline to register to vote, the fact that

you have declined to register will remain confidential and will be used only for voter registration purposes. If you do register to vote, the office at which you submit a voter

registration application will remain confidential and will only be used for voter registration purposes. If you believe that someone has interfered with your right to register or

registration application will remain confidential and will only be used for voter registration purposes. If you believe that someone has interfered with your right to register

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

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 enter 711) (only for voter registration questions). If you reside in New York City, you should call 1-866-VOTE-NYC or visit 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.

Telephone Number (optional)

Are you a citizen of the U.S.?

Yes

Will you be 18 years of age or older on or before election day?

Yes

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