OKLAHOMA VOTER REGISTRATION APPLICATION

You may use this form to: ● Register to vote for the first time in Oklahoma. ● Change your address for voter registration within Oklahoma. ● Change your name. ● Change your . ● Change your mailing address.

IMPORTANT INFORMATION PLEASE READ CAREFULLY WARNING All answers on this application must be true. It is a felony to submit false information on this form. You can be prosecuted if you do. If you are convicted, you can be imprisoned for not more than five years, fined not more than $50,000, or both.

Voter registration is closed for 24 days before an . If you apply when registration is closed, your application will be processed when registration reopens after the election. ● If you mail this application, it must be postmarked no later than the 25th day before the election in which you wish to vote. ● You cannot vote until your application is approved by your local county election board. When it is approved, you will receive a voter identification card in the mail. ● If you do not receive a voter identification card within 30 days, contact your local county election board or check the State Election Board’s website at https://elections.ok.gov. ● If you have questions about registering to vote, call your local county election board or visit the State Election Board’s website at https://elections.ok.gov. ● Voter registration records are subject to public disclosure under the Oklahoma Open Records Act, Title 51 O.S. 2011, §§ 24A.1-29. OKLAHOMA VOTER REGISTRATION APPLICATION

USE BLUE OR BLACK INK. After you complete this RESIDENCE ADDRESS, MAILING SECTION 5 application, tear off the instructions page and mail the ADDRESS, AND COUNTY OF RESIDENCE application to: ● You must register to vote at your address of residence. Oklahoma State Election Board If you have a street address or 911 address, this is P.O. Box 528800 your address of residence. Oklahoma City, OK 73152-8800 ● A rural route or a post office box is NOT an acceptable You may also drop off the form at your county election address of residence. board or at the State Election Board. ● If you do not have a street address or 911 address, you may write directions to your home or provide the INSTRUCTIONSINSTRUCTIONS legal description (section, township, range) of the location of your home. SECTION 1 NAME SECTION 6 HAVE YOU BEEN REGISTERED BEFORE?

Provide your full legal name on your voter registration ● If you have been registered before, enter information application. about the place you were last registered. If you have never been registered before, leave this space blank. SECTION 2 DATE OF BIRTH ● Enter your former name if it has changed since you Provide your full date of birth (MM/DD/YYYY). last registered. SECTION 3 IDENTIFICATION NUMBER SECTION 7 OATH ● Read the Oath carefully. By signing the Oath, you Your registration cannot be completed without an confirm that you have read, understand, and agree identification number. Your options include: to each statement. Sign and date it in ink. If you ● Your Oklahoma driver’s license or identification card cannot sign your name, make your mark, and, in the number. appropriate box below the signature, the person who helped you must give his or her name. ● The last four digits of your Social Security number, if you do not have a driver’s license. ● Who can register — You can register to vote if you are a citizen of the , a resident of the State ● Mark box C only if you do not have an Oklahoma of Oklahoma, and 18 years old or older. You can pre- driver’s license number or identification card and you register to vote in Oklahoma if you are at least 17½, have never been issued a Social Security number. but your registration will not become valid and you SECTION 4 POLITICAL PARTY cannot vote until you are 18 years old.

● Persons convicted of a felony — A person convicted of ● If you register in a political party recognized in a felony may register to vote when he or she has fully Oklahoma, you may vote only in that party’s primary served his or her sentence of court-mandated calendar Applicant: Please detach this page before you mail your application. elections. days, including any term of incarceration, parole, or ● All registered voters may vote in general elections, supervision being fully served, or a period of probation regardless of their party affiliation. completed as ordered by any court. ● No party (independent) voters generally may not vote ● Persons judged incapacitated — Persons judged in party primaries. However, every two years, political incapacitated by a court may not register to vote. parties may opt to allow no party (independent) voters to vote in primary elections during the following two years. Visit the State Election Board’s website (https:// www.ok.gov/elections/Election_Info/Political_Party_ info.html) to find out if any parties allow no party (independent) voters in their primaries at this time. ● If you write in a political party not recognized in Oklahoma or if you leave your political affiliation blank, you will be registered as a no party (independent) voter. ● You may be unable to change your political party at certain times in even-numbered years. OKLAHOMA VOTER REGISTRATION APPLICATION

VRA/MLA office use only Stamp received date here OK93140-605-W

MLA use only

Enter MLA ID number: ______

Are you a citizen of the United States of America? Will you be 18 years of age or older on election day? ¨Yes ¨No ¨Yes ¨No If you check NO in response to either of these questions, DO NOT sign or submit this form.

1. Last name (print) First name (print) Middle name (print) Suffix (print) Jr. Sr. II, etc.

2. Birth date 3. Identification number (See instructions.) MM/DD/YYYY a. Oklahoma driver’s license b. Last four digits of Social c. ¨ I do not have a driver’s number (required) Security number (required if license or a Social Security no driver’s license) number.

4. Political party ¨ Democratic Party ¨ Libertarian Party ¨ Republican Party ¨ No party ¨ Other (See instructions.)

5. Street or 911 address or directions to your home City State ZIP code (Do not use a rural route or P.O. box. See instructions.)

Mailing address (if different from above) City State ZIP code County of residence

6. Please complete the sections below if: 7. Oath (See instructions.) I swear or affirm that: • You were previously registered in another • I am a citizen of the United States and I am a resident of the State of county or state, or Oklahoma.

Applicant: Please detach this page before you mail your application. • You wish to change the name or address • I am 18 years old or older, or I am at least 17½ years old and I on your current registration. understand that I cannot vote in any election before I am 18 years old. • I have not been convicted of a felony, or if having been convicted, I Previous name am now eligible to register to vote as I have fully served my sentence of court-mandated calendar days, including any term of incarceration, parole, or supervision, or completed a period of probation as ordered Previous residence address by any court. • I am not now under judgement as an incapacitated person. I am not under judgement as a partially incapacitated person prohibited from Previous county/state . • The information I have given is true. I reside at the address given. I understand that submitting false information on this form is a felony If someone helped you fill out this application, punishable by not more than five years in prison, by a fine of not more the helper should write his or her name and than $50,000, or both. address here. X Signature or mark of applicant Date CEB use only Voter ID Precinct Activation date

Applicant: Fold this page and tape it closed to mail it. If you received this application form in a public assistance office or a tag agency, it is your choice to use the form. If you want to use this form to register to vote, you can fill it out and leave it with the public assistance office or tag agency. The application form will be submitted to election officials for you. Or, you can take it with you and put a stamp on it to mail to the State Election Board. You also may take it with you and deliver it in person to your local county election board office. Note: The name and location of the public assistance office or tag agency where you got the application form will remain confidential. It will not appear in your voter registration information. Also, if you decide not to use this form to register to vote, your decision not to register will remain confidential. It will not affect the service you receive from the public assistance office or tag agency where you got the form.

11/01/19

Applicant name and address Postage required.

Post Office will not deliver without proper postage.

OKLAHOMA STATE ELECTION BOARD P.O. BOX 528800 OKLAHOMA CITY, OK 73152-8800