Form Mv-232 - Address Change Page 2

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ADDRESS CHANGE
PAGE 2 OF 2
Change your address online at dmv.ny.gov
MV-232 (8/17)
PART 1 - Complete this section to CHANGE YOUR ADDRESS
Provide the information in Part 1 that applies to the type of document that you want to update. Mark the box for each type of document that you have and
that must be changed to show your new address.
State (not Enhanced) License/Permit/Non-Driver ID Card
Enhanced License/Permit/non-Driver ID Card
Registration
IMPORTANT:
If you are registered to vote, your voter registration record will be updated when you complete and submit this form. If you do NOT want your new address
on your voter registration record, mark this box
. If you do not mark the box, your new address will be sent to the Board of Elections of your county of residence.
TELEPHONE NUMBER
(
)
LICENSE/PERMIT/NON-DRIVER ID CARD:
DATE OF BIRTH
GENDER
Year Document Expires
Enter the ID number as it is printed on the front
of your license, permit or non-driver ID card
M
F
NAME (Print your name - Last, First, MI)
NEW ADDRESS - WHERE YOU GET YOUR MAIL (Required - Include Street No. and Name, Rural Delivery, Apt. No., and/or P.O. Box No. Also fill in residence address below.)
STATE
ZIP CODE
COUNTY
CITY OR TOWN
NEW ADDRESS – WHERE YOU LIVE (Required - Include Street No. and name, and Apt. No.)
STATE
ZIP CODE
COUNTY
CITY OR TOWN
PREVIOUS NYS ADDRESS (Include Street No. and Name, Rural Delivery, Apt. No., and/or Box No.) CITY OR TOWN
COUNTY
REGISTRATION: Provide the information below for each registration in your name.
License Plate No.
Type of Registration (Mark One)
Passenger
Commercial
Snowmobile
Boat
Other (Specify)
Passenger
Commercial
Snowmobile
Boat
Other (Specify)
Passenger
Commercial
Snowmobile
Boat
Other (Specify)
Passenger
Commercial
Snowmobile
Boat
Other (Specify)
CERTIFICATION: I certify that I am the individual named above and that the information provided is true to the best of my knowledge.
x
:
Sign Here
Sign Name in Full
Date
WARNING! Knowingly providing false information on this form is a misdemeanor and will result in penalties authorized by law.
Mark the box for each type of document that you currently have and want to update to show your new address. Then, write a check that has the
account holder’s name pre-printed or a money order payable to “Commissioner of Motor Vehicles” for the total fee.
PART 3 NEW YORK STATE VOTER REGISTRATION APPLICATION
Complete this application if you want to register to vote or update your voter registration information with the Board of Elections.
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
Yes
No
has changed:
County was:
Your address was
What Year?
skip if this has not changed or
you have not voted before.
Political Party
AFFIDAVIT: I swear or affirm that
I wish to enroll in a political party:
I am a citizen of the United States.
Democratic party
Political party
I will have lived in the county, city, or village for at least 30 days before the election.
enrollment is optional
Republican party
but that, in order to
I meet all requirements to register to vote in New York State.
Conservative party
vote in a primary
This is my signature or mark on the line below.
Green party
election of a political
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
Working Families party
party, a voter must
jailed for up to four years.
Independence party
enroll in that political
Women’s Equality party
party unless state
Reform party
party rules allow
Other
otherwise.
I do not wish to enroll in a political party
X
Sign
Date
No party
reset/clear
reset/clear

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