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  • S I O V R F: Qualifications

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    This document is an official voter registration form for the state of Iowa. It requests the registrant's name, date of birth, gender, address, political affiliation, and identification information. It also contains a warning that falsely signing the form could result in perjury charges and fines or jail time, as well as an affidavit for the registrant to sign confirming their eligibility to vote.

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    Vote App

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    This document is an official voter registration form for the state of Iowa. It requests the registrant's name, date of birth, gender, address, political affiliation, and identification information. It also contains a warning that falsely signing the form could result in perjury charges and fines or jail time, as well as an affidavit for the registrant to sign confirming their eligibility to vote.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    11 views1 page

    S I O V R F: Qualifications

    Uploaded by

    klumer_x
    This document is an official voter registration form for the state of Iowa. It requests the registrant's name, date of birth, gender, address, political affiliation, and identification information. It also contains a warning that falsely signing the form could result in perjury charges and fines or jail time, as well as an affidavit for the registrant to sign confirming their eligibility to vote.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    STATEOFIOWAOFFICIALVOTERREGISTRATIONFORM

    Revised 8/1/2013

    Qualifications

    1. AreyouacitizenoftheUnitedStates? 2. Willyoube18yearsofageonorbeforeElectionDay? Ifyouhavepreviouslybeenconvictedofafelony: 3. Haveyourrightsbeenrestored?

    Yes Yes Yes

    No No No

    IfyouansweredNotoanyofthequestions,donotcompletethisform.

    IDNumber nonoperatorID

    Youmust provideyour
    Iowadriverslicense,

    IAdriverslicense#: IAnonoperatorID#: Last4digitsofSocialSecuritynumber:XXXXX IdonothaveanIAdriverslicense,nonoperatorID,orSocialSecuritynumber. DateofBirth(month,day,year)//

    number,orthelast4

    digitsofyourSocial

    Securitynumberifyou haveone.

    Additional Information

    Dateofbirthand genderarerequired.

    Gender

    Male

    Female

    Phoneand/orEmail(optional) Last First Middle StreetAddress


    (includeapt.,lot,etc.)

    YourName

    Suffix

    Address WhereYou Live

    City

    Zip

    County

    Ifhomelessoryoudonothaveanestablishedresidence,describewhereyoureside: Address/P.O.Box City Yournamewas Youraddresswas Yourcityandstatewere PoliticalParties: NoParty Yourzipwas Democratic Green Republican Libertarian State Zip

    WhereYou ReceiveMail
    (ifdifferent)

    Previous

    Voter Registration Information

    Political Affiliation (checkonlyone)

    NonPartyPoliticalOrganizations:

    WARNING Ifyousignthis formandyou knowthe informationis nottrue,you maybe convictedof perjuryand finedupto $7,500 and/or jailedforupto 5years.

    RegistrantAffidavit

    Iswearoraffirmunderpenaltyofperjurythat: Iamthepersonnamedabove. IamacitizenoftheUnitedStates. Ihavenotbeenconvictedofafelony(orIhavereceivedarestorationofrights). Iamatleast17yearsold. Iliveattheaddresslistedabove. Iamnotcurrentlyjudgedbyacourttobeincompetenttovote. Idonotclaimtherighttovoteanywhereelse.

    Signature

    Date

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