Florida Voter Registration Application–Part 1 – Instructions
How to Register: You can submit an online application at www.registertovoteflorida.gov,or if you print an
application, you can sign, mail or deliver the completed application to any supervisor of elections’ office, office
that issues driver’s licenses, or voter registration agency (public assistance office, center for independent living,
office serving persons with disabilities, public library, or armed forces recruitment office) or the Division of
Elections. The application form is available in English and Spanish. Mailing addresses are on back side of this
form.
Deadline to Register: The deadline to register to vote is 29 days before any election. You can update your
registration record at any time, but for a Primary Election, party changes must be completed 29 days before that
election. You will be contacted if your new application is incomplete, denied or a duplicate of an existing
registration. Your Voter Information Card will be mailed to you once you are registered.
Identification (ID) Requirements: New applicants must provide a current and valid Florida driver’s license
number (FL DL#) or Florida identification card number (FL ID#). If you do not have a FL DL# or FL ID#, then you
must provide the last four digits of your Social Security number (SSN). If you do not have any of these numbers,
check “None.” If you leave the field and box blank, your new registration may be denied. See section 97.053(6),
Fla.Stat. Special ID requirements: If you are registering by mail, have never voted in Florida, and have never
been issued one of the ID numbers above, include one of the following with your application, or at a later time
before you vote: 1) A copy of an ID that shows your name and photo (acceptable IDs--U.S. Passport, debit or
credit card, military ID, student ID, retirement center ID, neighborhood association ID, or public assistance ID);
or 2) A copy of an ID that shows your name and current residence address (acceptable documents--utility bill,
bank statement, government check, paycheck, or other government document). The special ID is not required if
you are 65 or older, have a temporary or permanent physical disability, are a member of the active uniformed
services or merchant marine who is absent from the county for active duty, or a spouse or dependent thereof, or
are currently living outside the U.S. but otherwise eligible to vote in Florida.
Political Party Affiliation: Florida is a closed primary election state. In primary elections, registered voters can
only vote for their registered party’s candidates in a partisan race on the ballot. In a primary election, all registered
voters, regardless of party affiliation, can vote on any issue, nonpartisan race, and race where a candidate faces
no opposition in the General Election. If you do not indicate your party affiliation, you will be registered with no
party affiliation. For a list of political parties, visit the Division of Elections’ website at: dos.myflorida.com/elections/
Race/Ethnicity: It is optional to list your race or ethnicity.
Boxes: Please check boxes () where applicable.
To Register in Florida, you must be:
a U.S. citizen,
a Florida resident,
at least 18 years old (you may pre-register at 16 or 17, but
cannot vote until you are 18).
If you have been convicted of a felony, or if a court has found you
to be mentally incapacitated as to your right to vote, you cannot
register until your right to vote is restored pursuant to law.
If you do not meet any ONE of these requirements, you are
not eligible to register.
Questions?
Contact the Supervisor of Elections in your county:
dos.elections.myflorida.com/supervisors/
Visit the Florida Division of Elections’ website at:
dos.myflorida.com/elections/
CRIMINAL OFFENSE: It is a 3rd degree felony to submit false
information. Maximum penalties are $5,000 and/or 5 years in
prison.
PUBLIC RECORD: Voter registration records, including phone
number and email addresses, are public record in Florida.
However, the following information can only be used for voter
registration purposes: information you check or provide in rows 2
and 5, pre-registration information for 16 and 17 year olds,
information as to where you registered to vote, and whether you
declined to register or update your voter registration record. Your
signature can be viewed but not copied. For other applicable
exemptions, contact your supervisor of elections.
Numbered rows 1 through 7 and 12 (signature) must be completed for a new registration.
Florida Voter Registration Application
Part 2 – Form (DS-DE #39, R1S-2.040, F.A.C.)(eff. XX/XXX)
Form available online at registertovoteflorida.gov
Formulario disponible en línea en: registertovoteflorida.gov
New Registration Record Update/Change (e.g., Address, Party Affiliation, Name, Signature) Request to Replace Voter Information Card
Are you a citizen of the United States of America? YES NO
Official Use
Only
FVRS No:
I affirm I have never been convicted of a felony.
If I have been convicted of a felony, I affirm my voting rights have been restored by the Board of Executive Clemency.
If I have been convicted of a felony, I affirm my voting rights have been restored pursuant to s. 4 , Art. VI of the State
Constitution upon the completion of all terms of my sentence, including parole or probation.
If I have been convicted of a felony, I affirm my rights have been restored pursuant to federal law or the laws of another
state.
I affirm that I have not been adjudicated mentally incapacitated with respect to voting or, if I have, my right to vote has been restored.
Date of Birth (MM-DD-YYYY)
Florida Driver License (FL DL) or Florida identification (FL ID) Card Number
If no FL
DL or FL
ID, then
provide
Last 4 digits of Social
Security Number
I have
NONE of
these
numbers.
Name Suffix
(Jr., Sr., I, II, etc.)
Address Where You Live (legal residence-no P.O. Box)
Mailing Address (if different from above address)
Address Where You Were Last Registered to Vote
Former Name (if name is changed)
State or Country of Birth
Telephone No. (optional)
( )
Email me SAMPLE BALLOTS
if option is available in my county.
Email address
(See Public Record Notice above)
Party Affiliation
(Check only one. If left blank, you will
be registered without a party
affiliation”)
Florida Democratic Party
Republican Party of Florida
No party affiliation
Minor party (print party name):
Race/Ethnicity (Check only one)
American Indian/Alaskan
Native
Asian/Pacific Islander
Black, not of Hispanic Origin
Hispanic
White, not of Hispanic Origin
Multi-racial
Other:
Military/Overseas (Check if applicable)
I am an active duty Uniformed
Services or Merchant Marine member.
I am a spouse or a dependent of an
active duty uniformed services or
merchant marine member.
I am a U.S. citizen residing outside
the U.S.
Spanish
Preference
I would like
voting materials
in Spanish.
I will need
assistance
with voting.
I am
interested in
becoming a
poll worker.
Oath: I do solemnly swear (or affirm) that I will protect
and defend the Constitution of the United States and
the Constitution of the State of Florida, that I am
qualified to register as an elector under the
Constitution and laws of the State of Florida, and that
all information provided in this application is true.
