Fillable Oregon Voter Registration Card (Oregon)

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Oregon Voter Registration Card (Oregon)

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The Oregon Voter Registration Card (Oregon) form is 2 pages long and contains:

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  • 42 other fields

Country of origin: US
File type: PDF

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If you are not yet 18 years of age, you
will not receive a ballot until an election
occurs on or after your 18th birthday.
Only registered voters are
eligible to sign petitions.
The deadline to register to
vote is the 21st day before
an election.
You must provide your valid
Oregon Driver's License, Permit
or ID number. A suspended Driver's
License is valid, a revoked Driver's
License is not valid.
-or-
If you do not have valid Oregon ID,
provide the last four digits of your
Social Security number.
-or-
If you do not have valid Oregon ID or
Social Security number, provide a copy
of one of the following that shows your
name and current address.
acceptable identification
g
valid photo identification
g
a paycheck stub
g
a utility bill
g
a bank statement
g
a government document
g
proof of eligibility under the
Uniformed and Overseas Citizens
Absentee Voting Act (UOCAVA) or the
Voting Accessibility for the Elderly
and Handicapped Act (VAEH).
information disclosure
Information submitted on an Oregon Voter
Registration Card is public record. However,
information submitted in the Oregon Driver's
License section is, by law, held confidential.
assistance
If you need assistance registering to vote or
voting please contact your County Elections
Official. See reverse for contact info.
oregonvotes.gov
1 866 673 8683
se habla español
1 800 735 2900
for the hearing impaired
Print with a black or blue pen
to complete the form.
Sign the form.
Mail or drop off the form at
your County Elections Office.
Your County Elections Office will mail you
a Voter Notification Card to confirm your
registration.
you may use this form to
g register to vote
g update your information
Oregon Voter Registration Card
x x x - x x -
*5E8106*
registration updates Complete this section if you are updating your information.
previous registration name previous county and state
home address on previous registration
date of birth (month/day/year)
signature I swear or affirm that I am qualified to be an elector and I have told the truth on this registration.
sign here date today
If you sign this card and know it to be false, you can be fined up to $125,000 and/or imprisoned for up to 5 years.
political party
Not a member of a
party
Constitution
Democratic
Independent
Libertarian
Pacific Green
Progressive
Republican
Working Families
Other
I do not have a valid Oregon Driver's License/Permit/ID or a SSN.
I have attached a copy of acceptable identification.
I do not have a valid Oregon Driver's License/Permit/ID.
The last 4 digits of my Social Security Number (SSN) are:
Provide a valid Oregon Driver's License, Permit or ID:
Oregon Driver's License/ID number
last name* first* middle
Oregon residence address, city and zip code (include apt. or space number)*
date of birth (month/day/year)* county of residence
phone email
mailing address, including city
, state and zip code (required if different than residence)
personal information
*
required information
Are you a citizen of the United States of America? yes no
Are you at least 16 years of age?
yes no
If you mark no in response to either of these questions, do not complete this form.
qualifications
SEL 500LP rev 6/20
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Oregon Voter Registration Card (Oregon)

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Completed 2 August 2021

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