Form Mv-44cr - Restricted Use Or Conditional Driver License Application Page 3
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3NEW YORK STATE VOTER REGISTRATION APPLICATION INFORMATION
OFFICE USE ONLY
MV-44CR (09/17)
(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
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become a member of a political party
change your party membership
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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
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 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 dial 711) (only for voter registration questions). If you live in New York City, you should call 1-866-VOTE-NYC. You may also find
answers or tools at 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.
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o
o
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Telephone Number (optional)
Are you a citizen of the U.S.?
Yes
No
Will you be 18 years of age or older on or before election day?
Yes
No
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
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o
has changed:
Yes
No
County was:
skip if this has not changed or
What Year?
Your address was
you have not voted before.
Political Party
I wish to enroll in a political party:
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AFFIDAVIT: I swear or affirm that
You
must
make
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Democratic party
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I am a citizen of the United States.
selection. Political party
Republican party
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enrollment is optional
I will have lived in the county, city, or village for at least 30 days before the election.
Conservative party
o
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but that, in order to
I meet all requirements to register to vote in New York State.
Green party
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vote
in
a
primary
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This is my signature or mark on the line below.
Working Families party
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election of a political
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The above information is true. I understand that if it is not true, I can be convicted and fined up to $5,000 and/or
Independence party
party, a voter must
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jailed for up to four years.
Women’s Equality party
enroll in that political
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Reform party
party unless state party
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_________________
Other
rules allow otherwise.
I do not wish to enroll in a political party
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X
Sign
No party
PAGE 3 OF 3
MV-44CR (09/17)
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