Form Va-Nvra-1 - Virginia Voter Registration Application (Page 2 of 2) in pdf

Virginia Voter Registration Application

With this form, you can register to vote in elections in Virginia. You can also use this form to change the information

on your Virginia voter registration.

If you are currently registered to vote, you do not have to use this form unless you have moved or changed your

Vote

name.

ATTENTION: Overseas citizens, uniformed service voters, qualifying spouses and dependents may register using the

Federal Post Card Application (FPCA), available at .

You may complete your voter registration application online at elections.virginia.gov/register . You may also check

Go Online

your voter registration status online at elections.virginia.gov/status .

You must provide a street address or description of your physical dwelling place as a residence address. If your

Your Address

residence address is not serviced by the U.S. Postal Service, or if you are homeless, you can list a mailing address in

Box 4. Overseas citizens, uniformed service members, qualifying spouses and dependents can list a mailing address

in Box 4. If you are a qualified protected voter, you must list a Virginia post office box to protect your residential

address from public disclosure in Box 4. No other applicant can list a mailing address.

Mail your completed application to your local registrar. Use the online address lookup tool if you do not know your

registrar’s address: elections.virginia.gov/localGR or mail your application to:

How to Mail

Virginia Department of Elections

1100 Bank Street

Richmond, VA 23219

Mailed applications must be postmarked at least 22 days before the next election in which you plan to vote. A

qualified active-duty uniformed services member, spouse or dependent is NOT subject to the mailing deadline if by

reason of active duty, you are normally absent from the locality in which you reside.

Questions?

Call your local voter registration office or call (800) 552-9745 • TTY 711.

When registering to vote, Article II, Section 2 of the Constitution of Virginia (1971) requires you to provide your social

security number, if you have one. If you do not provide your social security number, your application will be denied.

Voting officials use the social security number as a unique identifier to ensure that no voter is registered in more than

Privacy Act

one place.

Notice

Your application will only be open to inspection by the public if the social security number is removed. Your social

security number will appear on reports produced only for official use by voter registration and election officials, for

jury selection purposes by courts, and all lawful purposes. Your decision to decline to register to vote as well as the

office where you submit your application, if you choose to do so, are confidential and will only be used for voter

registration purposes.

All voters must show one acceptable, valid photo ID when voting in-person. For a complete list of acceptable forms

of photo identification visit: elections.virginia.gov/voterID . All acceptable forms of photo ID can be used up to a year

Photo ID

after the ID has expired.

Need more information? Go Online: elections.virginia.gov Or Call: (800) 552-9745 TTY: 711

WARNING: INTENTIONALLY VOTING MORE THAN ONCE IN AN ELECTION OR MAKING A MATERIALLY FALSE

STATEMENT ON THIS FORM CONSTITUTES THE CRIME OF ELECTION FRAUD, WHICH IS PUNISHABLE UNDER

VIRGINIA LAW AS A FELONY. VIOLATORS MAY BE SENTENCED TO UP TO 10 YEARS IN PRISON, OR

UP TO 12 MONTHS IN JAIL AND/OR FINED UP TO $2,500.

VA-NVRA-1 04/16

Form Va-Nvra-1 - Virginia Voter Registration Application Page 2

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