VRA-English.pdf

There are three ways to register to vote

1. Register online

Maryland Voter Registration

2. Mail in a voter registration application You can also go online to register to vote.

Go to: vote.md.gov/VoterApply or scan the QR code Mail-in applications available in español, français, 中文 and 한국어.

What can I use this form for?

• To register to vote in federal, state, county, and municipal elections in Maryland.

• To change your name, address, or party affiliation.

WARNING

Giving false information on an application for voter registration is perjury, punishable by imprisonment for up to 10 years, and a violation of the election laws, punishable by a fine of up to $1,000, or by imprisonment for up to 5 years, or both.

Large type Voter Registration Applications are available upon request to your County Board of Elections or State Board of Elections.

Go to an early voting center in the county where you live during early voting, or go to your assigned election day polling place and bring a document that proves where you live.

3. Register to vote during early voting or on election day.

Confidentiality

• Except for items specified as confidential, voter registration records are generally available to the public.

• If you decide not to register to vote, that choice stays confidential. This information is only used for voter registration purposes.

• If you do register, the name of the office where you turned in your application will stay confidential.

Maryland’s Safe at Home Address Confidentiality Program can help protect the addresses of survivors of domestic violence and human trafficking. For details, call 1-800-633-9657, ext. 3875.

State Board of Elections Confidentiality Program can help protect the contact information of voters at risk in select scenarios.

To apply, visit https://elections.maryland.gov/forms/voter.html

This form collects personal information for voter registration purposes.

If you do not provide the required information, you cannot register or vote in Maryland.

• You can update your voter registration anytime through your County Board of Elections or by visiting vote.md.gov/Register.

• Most voter registration records are public and may be shared with jury commissioners/clerks or other government agencies, as allowed by law.

• Voter registration records cannot be used for commercial solicitation purposes.

Maryland voter registration form instructions How do I complete this form?

1. Complete Sections 1–8 of the Voter Registration Application,

2. If you need to submit a name change or address change also complete Section 10.

3. Sign and date Section 9.

This form must be completed in black ink.

How do I submit this form?

Am I eligible to vote?

To register to vote you must be:

• a U.S. citizen

• a Maryland resident

• at least 16 years old You are not eligible to vote if you:

• are under guardianship for mental disability, or if you are, have not been found by a court to be unable to communicate a desire to vote

• have been convicted of buying or selling votes

• are currently serving a sentence of imprisonment for a felony conviction

• You only need to choose a party if you want to vote in that party’s primary, caucus, or convention.

• If you do, check one box only. Questions?

Visit the State Board of Elections website at www.elections.

maryland.gov to verify your registration, find your polling place, and find out other important information.

If you have any questions, call your County Board of Elections or the State Board of Elections at the numbers listed on the back of the application.

Use of your information

What is the deadline to mail in my application?

To be eligible to vote in the next election, you must mail your application at least 21 days before election day.

What can I expect after I submit my application?

If your application is complete and you qualify, you will get a Voter Notification Card in the mail.

Do I need to pick a political party?

What information is necessary to confirm I can register to vote?

• If you have a current, valid Maryland driver’s license, learner’s permit or MVA ID card, use that ID number.

• If you don’t, you must write the last 4 digits of your Social Security number (Election Law § 3-202). This number is only used for registration and other administrative purposes and will be kept confidential.

What if I’m already registered to vote in another county or state?

• You must fill out Previous registration information (Section 10) if you are already registered in another Maryland county or in another state. We will then notify the appropriate voter registration agency.

1.Tear off this panel at the dotted line

2. Mail your completed application to your County Board of

Elections. The mailing addresses are listed on the back panel.

• Do not fax or email the form because it requires an original signature.

• Submitting the Statewide VRA to an individual other than an official, employee, or agent of a local board does not assure that the form will be filed or filed timely

Reason Required 2

Party affiliation Check one box only.

Maryland Voter Registration Form Please compete in BLACK INK. Detach form and fold where indicated to mail.

Are you a U.S. Citizen? 1Eligibility Required

Verification Required Confidential See instructions

If you answer “No” in response to either of these questions, do not complete this form.

Residence address Required

Yes No

Mailing address

Voter information Required 3

Are you are least 16 years old?

MD Driver’s License (DL) #, MD Learner’s Permit # or MD Non-Driver ID #

Last 4 digits of your SSN

9 Voter, sign here (power of attorney not allowed)

X

I swear or affirm under penalty of perjury that:

and belief.

Signature Required

Yes No

Gender

Contact information

You must register with a political party if you want to take part in that political party’s primary election, caucus, or convention. Check one box only. If you do not choose a party, you will automatically be registered as unaffiliated.

I do not have either a current, valid Maryland driver’s license / MVA ID card or a Social Security Number

Democratic

Birthdate (Not today’s date)

YearMonth Day Today’s Date

Check boxes that apply and complete sections 3–9.

New registration Name change Party affiliation change Address change

Male Female Unspecified or Other

If different from your address in section 5.

Republican

Green Other — Specify

Working Class Unaffiliated (independent of any party)

Month Day Year

Previous registration information (If applicable)

Last name First name Middle name Suffix

Last name First name Middle name Suffix

Apt or Lot # Zip CodeAddress where you live City or Town State

(No PO boxes)

Apt or Lot # Zip CodeAddress where you receive mail City or Town State

Apt or Lot # Zip CodeFormer address City or Town State

Email address Phone number

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