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Voter Registration Application Form Instructions

Where can I register to vote? What do I need if I decide to mail in the application? At your local Clerk’s Office, by mail, or at the polls on If you are mailing the voter registration application in, you will Election Day. need:  To complete the form and sign the oath before an What documents do I need to bring with me to the oath-taking officer*; Clerk’s office?  To include a (scanned) paper copy of the identification Present a valid Wyoming driver's license. (If you do not have shown to the oath-taking officer; and your current valid driver's license with you, you must provide  Mail the form and printed copy of your identification the number along with additional acceptable identification as directly to your local County Clerk’s office. noted in the table below.) What are the deadlines to register? If you have not been issued a Wyoming driver's license or yours is expired, you must provide: Voter registration closes two weeks prior to an election.  A statement to that effect; However, you may still register and vote absentee at the same  The last four digits of your social security number; and time within that two week period or at the polls on Election  Acceptable identification as noted in the table below. Day.

If you have neither a valid Wyoming driver's license nor a social security number, please indicate this by checking the Still have questions? Please contact your local appropriate box on the Voter Registration Application form County Clerk’s Office at the phone number listed below. and contact your County Clerk.

Acceptable Identification** Provide any one of the following: OR Provide any two or more of the following:  U.S. Passport  ID Card issued by local, state, or  Certificate of US citizenship  Original or certified copy of  Out-of-State DL federal agency or naturalization; birth certificate  Military ID  WY Student ID  Draft record  Any other form of ID  Tribal ID  VR Card from out-of-state issued by official agency

Wyoming County Clerks Albany County Clerk Converse County Clerk Johnson County Clerk Park County Clerk Teton County Clerk 525 Grand Ave Ste. 202 107 N 5th St Ste. 114 76 N Main St 1002 Sheridan P.O. Box 1727 Laramie, WY 82070 Douglas, WY 82633 Buffalo, WY 82834 Cody, WY 82414-3589 Jackson, WY 83001-1727 (307) 721-2541 (307) 358-2244 (307) 684-7272 (307) 527-8600 (307) 733-4430 Big Horn County Clerk Crook County Clerk Laramie County Clerk Platte County Clerk Uinta County Clerk County Courthouse P.O. Box 37 P.O. Box 608 P.O. Drawer 728 P.O. Box 810 P.O. Box 31 Sundance, WY 82729 , WY 82003 Wheatland, WY 82201 Evanston, WY 82931 Basin, WY 82410-0031 (307) 283-1323 (307) 633-4242 (307) 322-2315 (307) 783-0306 (307) 568-2357 Lincoln County Clerk County Clerk Campbell County Clerk Fremont County Clerk Sheridan County Clerk 925 Sage Avenue 1001 Big Horn Avenue P.O. Box 3010 450 N 2nd St Rm 220 224 S Main St., Ste. B-17 Suite 101 P.O. Box 260 Gillette, WY 82717 Lander, WY 82520 Sheridan, WY 82801 Kemmerer, WY 83101 Worland, WY 82401 (307) 682-7285 (307) 332-2405 (307) 674-2515 (307) 877-9056 ext. 303 (307) 347-3131 Natrona County Clerk Carbon County Clerk Goshen County Clerk Sublette County Clerk Weston County Clerk 200 North Center St P.O. Box 6 P.O. Box 160 P.O. Box 250 1 West Main P.O. Box 863 Rawlins, WY 82301 Torrington, WY 82240 Pinedale, WY 82941-0250 Newcastle, WY 82701 Casper, WY 82601-0863 (307) 328-2668 (307) 532-4051 (307) 367-4372 (307) 746-4744 (307) 235-9217 Sweetwater County Clerk Hot Springs County Clerk Niobrara County Clerk 80 W. Flaming Gorge Way **Rules Chapter 2: * UOCAVA voters are exempt 415 Arapahoe P.O. Box 420 Suite 150 Thermopolis, WY 82443 Lusk, WY 82225-0420 Identification for Election from this requirement. Green River, WY 82935 (307) 864-3515 (307) 334-2211 Purposes W.S. 22-3-103(c) (307) 872-3732 Mail the application to your local County Clerk's office. Wyoming Voter Registration Application and Change Form ☐New Voter Application ☐ ☐Change to Current Registration VR#______District______Precinct______Split ______House ______Senate______School ______Municipality ______Ward______Eligibility I am a citizen of the . ☐True ☐False I will be at least eighteen (18) years of age on or before the next general election. ☐True ☐False 1 Felony status (please check one): ☐ I am not a convicted felon. ☐ I am a convicted felon and my voting rights have not been restored. ☐ I am a convicted felon and my voting rights have been restored. If you answered "False" to any of the above questions, or are a convicted felon and have not had your voting rights restored, do not complete this form. Name 2 ______Legal Last Name Legal First Name Legal Middle Name Suffix (Jr./Sr./II/III) Identification ☐ I have a valid Wyoming Driver’s License. Provide your birth date and ______Write that number here: ______‐ ______your identification MM DD YYYY ☐ I do not have a Wyoming Driver’s License. information. (Additional 3 identification documents Date of Birth Write the last four digits of your SSN here: XXX‐XX‐ ______may be required.) ☐ I do not have a Wyoming Driver’s License or a Social Security Number. (Other approved ID will be required) Additional ☐Male ☐Female ☐ I would like to be an election judge. ☐ I need assistance to vote. information 4 Providing this information (______) ______‐ ______is optional. Phone Number Email Address Wyoming address where you live ______Residential Address (no P.O. Boxes) Unit/Apt Number 5 ______City/ Zip Code ☐I have no fixed residence. This is a location I regularly return to. I have also provided a mailing address in Section 6, if I have one. Address where you ☐Same as above receive mail ______6 Mailing Address ______City/Town State Zip Code Political Affiliation Choose one of the following: 7 ☐Republican ☐Democratic ☐Libertarian ☐Constitution ☐Unaffiliated Updating a current ______Wyoming record? If so, you must provide your 8 Previous Residential Address City/Town/County Previous Legal Name previous information here. ______Previous Mailing Address City/Town State/Zip Code Previous Political Affiliation Previous State Withdrawal 9 ______Previous State’s Residential Address City/Town County State Zip Code Registration Oath I do solemnly swear (or affirm) that I am a citizen of the United States; that I am a bona fide resident of the (Required on all state of Wyoming and this county; that if registered in another county or state, I hereby request that my applications) registration be withdrawn; that I will be at least eighteen (18) years of age on or before the next election; that I 10 am not currently adjudicated a mentally incompetent person; that I have not been convicted of a felony, or if I have been convicted of a felony, I have had my civil or voting rights restored by a competent authority; and that the voter registration information contained herein is true and accurate to my best knowledge and belief. Sign your full ☐ I qualify under the Uniformed and legal name 11 Overseas Citizens Absentee Voting Act (UOCAVA). Therefore, the oath Proof of For County Clerk or use only is self‐ administered under penalty identification shown 12 of perjury and does not require the ______signature of an oath‐taking official Type of identification within section 13 below.

Registry Agent or Subscribed and affirmed or sworn to before me by ______on person authorized to ______, 20 ______. (Voter Name) administer oaths 13 ______, Title ______

3/2020