Fill - Free fillable State of Michigan Voter Registration Application PDF form

State of Michigan Voter Registration Application

and Michigan Driver’s License/State Identification Card Address Change Form Instructions

Track your registration status, find your city/township clerk, view your polling location, and more at Michigan.gov/Vote.

qualifications

To register to vote in Michigan you must be:

• A Michigan resident (at the time you

township for at least 30 days (when you

vote).

• A United States citizen.

• At least 18 years of age (when you vote).

• Not currently serving a sentence in jail or

prison.

residential & mailing address

You may only register to vote in one place. If

you have more than one place of residence,

you may register to vote in the place where

you are currently located or the place you

intend to return. For example, students

attending college may register in their

hometown or at their campus address, and

temporary in-patient residents of nursing

homes may register at their home address or

at the medical facility.

If you would prefer to receive mail related to

your voter registration or driver’s

license/state identification card at an address

other than your residential address (ex. PO

Box), you may provide a mailing address

where indicated on the form. If you provide a

mailing address, it won’t appear on your voter

information card or driver’s license/state

identification card.

criminal convictions and registering to vote

If you have a past criminal conviction and are

no longer in jail or prison, you can register

and vote. You also can register and vote if you

are in jail and awaiting trial or sentencing. If

you are currently serving a sentence in jail or

prison you can’t register or vote.

deliver to your city or township clerk

Mail or deliver this completed application

directly to your city or township clerk. Find

your city or township clerk’s address at

Michigan.gov/Vote.

registering by mail – special requirements for first-time voters

Are you registering to vote in Michigan for the first time?

If you have never voted in Michigan and choose to submit this form

by mail or through a voter registration drive, you must meet the

federal identification requirement as explained below.

federal requirement – provide identification

To comply with the identification requirement, you must:

(1) Enter your Michigan-issued driver’s license number

or Michigan-issued state ID card number where requested on

this form.

(2) If you do not have a Michigan-issued driver’s license or

Michigan-issued state ID card, provide the last four digits of

your Social Security number.

(3) Send one of the following forms of identification when mailing

this form to your county, city or township clerk: a COPY of a

current and valid photo identification (such as a driver’s license

or state ID card from any state) or a COPY of a paycheck stub,

utility bill, bank statement or a government document that lists

your name and address.

***DO NOT SEND ORIGINAL ID DOCUMENTS BY MAIL***

If this requirement applies to you and you don’t provide the

information identified above, you must provide an acceptable form

of identification before you vote in the first election in which you

wish to participate.

Note: The identification requirement doesn’t apply if you: (1)

personally hand-deliver this form to your county, city or township

clerk’s office instead of mailing this form or submitting it through a

voter registration drive, (2) are disabled or (3) are eligible to vote

under the federal Uniformed and Overseas Citizens Absentee Voting

Act.

questions?

Contact your city or township clerk if you have any questions.

Your application isn’t valid until accepted by your city or township

clerk. If your application is accepted, your clerk will mail you a voter

information card within 3 weeks. You can verify your voter

registration status by going to Michigan.gov/Vote.

ED-121 (1-2020)

instructions

If you have a Michigan driver’s license

or state ID card, you can register to

vote online. Start the process at

Michigan.gov/Vote.

Complete this form to register to vote

or update your registration

information

Please print all information

clearly using black or blue pen.

Sign the form.

Mail or drop off the form to

your city/township clerk.

Find your city/township clerk and more

information at Michigan.gov/Vote.

Phone number/email provided will be

used for official election purposes only.

Name changes must be completed at an

SOS branch office.

The voter registration

deadline is 15 days before

election day, IF you submit

this form through a voter

registration drive or deliver it

to a county clerk or secretary

of state office. If you mail the

form, it must be postmarked

at least 15 days before the

election.

You can register any time up

through Election Day by

going to your city or

township clerk office with

residency verification.

If you have a Michigan driver’s license

(DL) or state identification card (SID),

you must use the same address for

voter registration and DL/SID.

This form will also change your DL/SID

address. You’ll be mailed a sticker

with your new address to put on your

DL/SID.

If you have never voted in person in

Michigan and choose to submit this

form by mail or through a voter

registration drive, review the

instructions on page 1. You might

need to provide additional ID.

More instructions can be found on

page 1.

State of Michigan Voter Registration Application

and Michigan Driver’s License/State Identification Card Address Change Form

qualifications



yes



I am a United States citizen.

 yes

 no

I am at least 17.5 years old and will vote only after I turn 18.

If you are not a US citizen, DON’T complete this form

Michigan-issued driver’s license/Michigan-issued state ID card #

- -- -

If you don’t have a Michigan-issued driver’s license or Michigan-issued state ID

card, provide the last four digits of your Social Security number:

x x x – x x –

 I don’t have a valid Michigan-issued driver’s license, a Michigan-issued state ID card, or

a Social Security number.

personal information *required information

last name*

first*

middle

suffix

_ _

 male  female

date of birth*

address where you live – house number & street name*

apt/lot #

city*

zip

( )

phone

mailing address (if different than where you live) city

state

zip

Complete to join permanent

absent voter application list:



I want to vote absentee in all future elections.

Automatically send me an application for every election.

signature

I certify that:

• I am a United States citizen.

• I am a Michigan resident and will vote only

after I have lived in my city or township for

at least 30 days.

• I am at least 17.5 years old and will vote

only after I turn 18.

• I authorize the cancellation of any previous

registration.

The information I have provided is true to the best of my knowledge under penalty of perjury. If I

have provided false information, I may be subject to a fine or imprisonment or both under federal

or state laws.

signature date

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