___ NEW REGISTRATION I am not registered to vote in New Hampshire |
___ TRANSFER I am registered to vote in New Hampshire and have moved my voting domicile to a new town or ward in New Hampshire |
___ NAME CHANGE/ADDRESS UPDATE I am registered to vote in this town/ward and have changed my name/address |
Date ____________________ |
VOTER REGISTRATION FORM |
(Please print or type) | |
1. Name | |
Last (suffix) First Full Middle Name | |
2. Domicile Address | |
Street Ward Number | |
Town or City Zip Code | |
3. Mailing Address if different than in 2 | |
Street | |
Town or City Zip Code | |
4. Place and Date of Birth |
Town or City State |
Date____________________ | |
5. Are you a citizen of the United States? Yes _____ No _____ | |
If a naturalized citizen, give name of court where and date when naturalized | |
6. Place last registered to vote |
Street Ward Number |
I am not currently registered to vote elsewhere (initial here __________), or I request that my name be removed as a registered voter in ______________________________ (fill in your address where previously registered, street, city/town, state, and zip code) |
7. Name under which previously registered, if different from above | |
8. Party Affiliation (if any) | |
9. Driver's License Number _________________________ State |
Date | Signature of Applicant |
___ NEW REGISTRATION I am not registered to vote in New Hampshire |
___ TRANSFER I am registered to vote in New Hampshire and have moved my voting domicile to a new town or ward in New Hampshire |
___ NAME CHANGE/ADDRESS UPDATE I am registered to vote in this town/ward and have changed my name/address |
Date registration form is submitted _______________ |
Date applicant moved to the address listed below as the voter's domicile __________ |
VOTER REGISTRATION FORM |
FOR USE STARTING 30 DAYS BEFORE AN ELECTION AND AT THE POLLING PLACE ON ELECTION DAY |
(Please print or type) |
1. Name | |
Last (suffix) First Full Middle Name | |
2. Domicile Address |
Street Ward Number |
Town or City Zip Code | |
3. Mailing Address if different than in 2 |
Street |
Town or City Zip Code | |
4. Place and Date of Birth |
Town or City State |
Date____________________ | |
5. Are you a citizen of the United States? Yes _____ No _____ | |
If a naturalized citizen, give name of court where and date when naturalized | |
6. Place last registered to vote |
Street Ward Number |
I am not currently registered to vote elsewhere (initial here __________), or I request that my name be removed as a registered voter in ______________________________ (fill in your address where previously registered, street, city/town, state, and zip code) |
7. Name under which previously registered, if different from above | |
8. Party Affiliation (if any) | |
9. Driver's License Number _________________________ State |
Date | Signature of Applicant |
Identity yes/no _____ | ||
(initials) | ||
Citizenship yes/no _____ | ||
(initials) | ||
Age yes/no _____ | ||
(initials) | ||
Applicant | Election Official | |
Notary Public/Justice of the Peace/Official Authorized by RSA 659:30 |
Name | |
Last (suffix) First Full Middle Name | |
Domicile Address | |
Street Ward Number | |
Town or City Zip Code |
Date | Signature of Applicant |
Date | Signature of Clerk |
End of Document | © 2024 Thomson Reuters. No claim to original U.S. Government Works. |