Fillable NOTIFICATION OF DECEASED VOTER Department of Registration and (Fulton County Government)

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NOTIFICATION OF DECEASED VOTER Department of Registration and (Fulton County Government)

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NOTIFICATION OF DECEASED VOTER
Department of Registration and Elections
130 Peachtree Street, SW, Suite # 2186, Atlanta, GA 30303
(404) 612-7020
elections.voterregistration@fultoncountyga.gov
Suffix:
Last 4 digits of SSN:
Decea
sed Voter Info
rmation
Last Name:
First Name:
Middle Name:
Date of Birth: Gender:
GA. Driver’s License or ID Number:
Address As Registered:
Last Known Address:
Date of Death:
State of Death:
Person Providing Deceased Voter Information:
Full Name:
Relationship to Voter: Address:
City:
State: Zip Code:
Spou
se
Sibling
Child
Parent
Grandchild
In-Law of any of the above
Legal Guardian
Representative of the Estate
Supporting Documentation:
De
ath Certificate
Obituary
Other:
Date
:
S
ignature:
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NOTIFICATION OF DECEASED VOTER Department of Registration and (Fulton County Government)

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Completed 17 July 2020

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