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Voter Registration
Voter Registration
• You must be a U.S. citizen by birth or naturalization. The location where you received this
• You must register to vote only in the county in where you live. form will remain confidential and will
• You must be at least 18 years old by general election day OR you may preregister if you are at least 16 be used only for voter registration
years old and understand that you must be 18 years of age on or before election day to vote. purposes. If you choose not to register
• You must not have been convicted of a felony, or if so, you have completed your sentence (including any to vote, your choice not to register will
probation, post-release supervision, or parole). also remain confidential.
Are you at least 16 years of age and understand that you must be 18 years of age on or before election day to vote? Yes No
Note: If you checked “No” in response to both questions, DO NOT submit this form. You must be at least 18 years old to register to vote or at least 16 years old to preregister to vote.
WILLIAMS-SHOCKLEY 09/13/1965
Legal First Name NC Driver License or NC DMV ID Number Last Four Digits of Social Security Number
RAMONA
Middle Name Suffix
000035294694 3785
CARRIE
4 Your Residential Address - where you physically live 5 Your Mailing Address (optional) – where you receive mail
DO NOT enter a P.O. Box or a mail drop location. If you do not receive mail where you live, please provide a mailing address.
Residential Address Mailing Address
Address Where You Were Last Registered County or State of Last Registration
Phone Number
I am declining voter registration services. I do not wish to register or preregister to vote at this time. I understand that
the fact I declined these services will remain confidential, except for administrative purposes related to voter
registration.
FRAUDULENTLY OR FALSELY COMPLETING THIS FORM IS A CLASS I FELONY UNDER CHAPTER 163 OF THE NC GENERAL STATUTES.
2023.09.15 14.00.54
Signature Date
NCSBOE 2023.04