Fillable Registration Package-f - Affidavit Of Registration Form

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Registration Package-f - Affidavit Of Registration Form

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COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS
COMMONWEALTH ELECTION COMMISSION
Hafa Adai and Tirow!
Enclosed you will find an Affidavit of Voter Registration Application, an Affidavit Questionnaire
and an Out of the CNMI Voters Instructions. These forms are necessary for us to determine your
eligibility to vote in the Commonwealth elections and to process your registration once your
eligibility has been determined and approved.
Please complete all portions of the Affidavit of Voter Registration and Questionnaire forms.
Ensure that you attach a copy of your picture identification form as part of your registration packet
and mail to us as soon as possible.
If you will be out of the CNMI during the election period, you will need to fill out an Application
for Absentee Voting no more than 75 days before or not less than 25 days before the election. The
application for Absentee Voting is necessary in order for an absentee ballot to be sent to you;
otherwise you will have to vote at the polling place here in the CNMI.
Respectfully,
KAYLA S. IGITOL
Executive Director
Instructions for Completing the Affidavit of Voter Registration Application
1 CMC §§ 6205 requires that you provide us with your last four digits of your social security
number, full legal name, place and date of birth and your residence in the Commonwealth of the
Northern Mariana Islands (CNMI), to include mailing address in the CNMI.
For Village, please include the village of your residence in the CNMI. Island should also include
the island of residence in the CNMI. A person who reside in Oleai Village should place Oleai
under Village and Saipan under Island. A person who reside in San Jose Village should place
Tinian as their Island of residence.
If you have registered before and have since had a change of name due to marriage, divorce or had
legal change of name, please register under your present name, and include your previous name
on item no. 10 in the Affidavit of Registration. Please include your legal document authenticating
your change of name.
If you are changing your election district, please complete your registration as you normally would,
except that you will indicate your new village (and island, if necessary) and will make the change
of election district. A person who are registering for the northern islands should place “Northern
Islands” under the village and island.
The Affidavit of Voter Registration Application, Affidavit Questionnaire and a copy of your
picture identification form must be mailed directly to the Commonwealth Election Commission,
P.O. Box 500470, Saipan, MP 96950-0470. Facsimile or other electronic means will not be
accepted. Election regulation requires that the mailing envelope be postmarked from the location
outside of the CNMI for registration for those residing outside of the CNMI.
If you are registered to vote in a jurisdiction outside of the CNMI, you must re-establish your
domiciliary and residency in the CNMI for a period of 120 days before an election as mandated
by Article VII, Section 1 of the CNMI Constitution.
Pursuant to 1 CMC §§ 6201, Voting: Eligibility:
a) Pursuant to Article VII, Section 1 of the Constitution of the Commonwealth of the Northern
Mariana Islands, a person is eligible to vote who, on the date of the election, is 18 years of
age or older, is domiciled in the Commonwealth, is a resident in the Commonwealth and
has resided in the Commonwealth for a period of time provided by law, is not serving a
sentence for a felony, has not been declared by a court to be of unsound mind, and is either
a citizen or national of the United States.
b) Pursuant to Article VII, Section 2 of the Commonwealth Constitution, a person shall not
be denied the right to vote because that person is unable to read or write.
c) Under the authority of Article VII, Section 1 of the Commonwealth Constitution, no person
shall be eligible to vote who has not resided in the Commonwealth at least 120 days prior
to the Election Day.
d) Consistent with Article VII, Section 1 of the Commonwealth Constitution, no person who
is confined to a mental institution shall be eligible to vote.
e) In accordance with Article VII, Section 1 of the Commonwealth Constitution, no person
serving a sentence for a felony, as defined by Section 6003(t) of this part, shall be eligible
to vote.
f) No person shall register or vote in any other precinct than that in which the person resides.
Instructions for Completing the Affidavit Questionnaire
The Affidavit Questionnaire is for the Commission’s as it will be used to determine your eligibility
to register to vote in the CNMI. Please keep in mind that you must be away from the CNMI for
numerous reasons, such as education, employment, medical, business, military, etc., but with
intention that the CNMI is your domiciliary and your residence outside the CNMI, no matter the
length of time, is temporary. On the Affidavit Questionnaire, you must include your residence
where you presently reside.
Other Information
The Application for Absentee Voting should be completed only when you are already registered
voter. Only registered voters could be issued an absentee ballot. Please ensure that the address you
provided in the absentee application is the address where you want your ballot mailed to. Again,
ensure that the address you placed on the application for absentee voting is the address where you
will be in the months leading to an election.
Finally, please ensure that your signature on your Affidavit of Voter Registration Application and
Affidavit Questionnaire, your Application for Absentee Voting are the same. The Commission, by
law, is required to compare the signature to ensure they match. Signatures that do not match may
be rejected and the ballots are either not issued or not counted.
Thank you and we hope your voting experience in the CNMI is enjoyable and meaningful. If you
have any questions, please do not hesitate to contact our office at (670)235-8683 (VOTE) or email
us at administrative@votecnmi.gov.mp.
0000
8
C O M M O N W E A L T H O F T H E N O R T H E R N M A R I A N A I S L A N D S
A F F I D A V I T O F V O T E R R E G I S T R A T I O N A P P L I C A T I O N
COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS
Island of Saipan – Election District: _______
Island of Tinian – Election District 6
Island of Rota – Election District 7
FAILURE TO COMPLETE ALL
ITEMS MAY PREVENT
ACCEPTANCE OF THIS
CEC OFFICE USE ONLY:
Affidavit No:
_______________-______________
I HEREBY SWEAR (OR AFFIRM) THAT THE FOLLOWING INFORMATION IS TRUE AND CORRECT:
Last Four (4) Digits of Social Security Number
XXX-XX- ___ ___ ___ ___
1
Gender (Circle One)
M a l e F e ma le
2
Date of Birth
___ ___ /___ ___ /___ ___ ___ __ _
3
4
Full Legal Last Name
Middle
First Name
Established CNMI Residency Since
Telephone Contact Information Place of Birth
7
9
5
Physical Residence Address-CNMI (Must be completed. P.O. Box or General Delivery is not acceptable)
Island
ZIP Code
I was last registered to vote under (If applicable) (Give previous legal last name, first name and middle name)
10
Island
ZIP Code
6
Mailing Address-CNMI (Street Address, P.O. Box or General Delivery)
Island
ZIP Code
Warning A person who signs an affidavit of registration knowing that they do not qualify to vote, or who knowingly registers
with intent to vote more than once, or who registers in an election district in which they do not reside, may be fined not more than $2,000 or
imprisoned for not more than 2 years. 1 CMC § 6704.
Notice: The office at which a person registers to vote is confidential. A person’s declination to register to vote is also confidential and is used for voter registration
purposes only as mandated by the National Voter Registration Act of 1993.
Witness Signature (required only if applicant makes a mark as signature)
13
Date
Witness Address/Contact Information
12
I hereby swear (or affirm) that:
a. I am a citizen or national of the United States of America Yes No
(If no, do not continue completing this form)
b. I am at least 18 years of age by the date of the election. Yes No
(If no, do not continue completing this form)
c. Yes No I am a resident of the Commonwealth of the Northern Mariana
islands as indicated above for at least 120 days prior to the election.
The residency stated in this affidavit is not simply because of my presence in the CNMI, but that the residence was
acquired to make the CNMI my legal residence with all the accompanying obligations therein.
Signature _____________________________________________ Date: __________________
Are you currently registered to vote in another state or U.S. jurisdiction? Yes No
If “Yes”, please complete the following: I was registered to vote in: ____________________________________ in the State of ______________, __________, __________
Last Registered Address County/City State Zip Code
and hereby authorize cancellation of my previous voter registration.
11
(This portion must be completed)
Commonwealth of the Northern Mariana Islands
Previous Voter Registration Information (Cancellation)
No, I have never registered to vote in the past. (If no, stop and skip this box.)
Yes, I am registered to vote in another jurisdiction. (If yes, the information below must be completed.)
Full Legal Name ______________________________________________________ Date of Birth __________________________
Address at which you were Last 4 digits of your
previously registered to vote _______________________________________ Social Security Number _______________________
City/Count/Town ___________________________________________ State ________________ Zip Code __________________
This cancellation information will be sent to the city/county/state entered above that you previously registered.
14
For the Election Commission to determine your eligibility to vote in Commonwealth elections, you must furnish us with additio
nal information by completing and
returning this document, together with your Affidavit of Registration.
F
ailure to complete
all items will prevent acceptance of registration
.
PRINT CLEARLY IN BLACK INK.
C O M M O N W E A L T H E L E C T I O N C O M M I S S I O N
AFFIDAVIT QUESTIONNAIRE
I hereby
affirm
that: 1) I am the person named above;
and
2)
A
ll information furnished on this
application is true and
correct.
DateSignature or Mark of Applicant (Only signature or mark of applicant is acceptable):
Witness Name & Signature (required only if applicant makes a mark) Date
Mailing Address (Witness) Contact No. (Witness)
8
Are any of your dependents presently in school/medical care in the US?
(Circle One)
YES
NO
9
Are you a dependent of anyone in military/school/medical care in the US?
(Circle One)
YES
NO
Are you currently employed in the US? (Circle One) If yes, length of employment:
YES NO
7
When was the last time you were in the CNMI
and length of stay?
6
State reason of absence from the Commonwealth:
5
10
Have you ever registered to vote in the CNMI? (Circle One) If yes, indicate when and under what full legal name?
YES NO
Do you have a current CNMI Driver’s License? If yes, issued date?
(Circle One)
YES
NO
11 12
If not, have you ever had a CNMI Driver’s License? If yes, issued date?
YES NO
When was the last time you filed your 1040 tax report in the CNMI?
13 14
Have you ever had the intention never to reside in the CNMI? (Circle One)
YES NO
15
What jurisdiction do you consider your permanent home?
DATE OF BIRTH
___ ___ / ___ ___ - ___ ___ ___ ___
Month Day Year
2 3
PLACE OF BIRTH
____________________________________ _____________________
CITY
STATE
1
LAST NAME FIRST NAME MIDDLE INITIAL
4
CNMI RESIDENCE
/VILLAGE
(
P.O. Box or General Delivery
is
not acceptable)
ZIP CODE
ISLAND
OFFICE USE ONLY
AFFIDAVIT NO: ____________ --- ____________
Revised 6/14/2021)
Saipan
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Registration Package-f - Affidavit Of Registration Form

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