CENTRAL COUNCIL
Tlingit and Haida Indian Tribes of Alaska
Program Compliance • Andrew P. Hope Building
320 West Willoughby Avenue, Suite 300 • Juneau, Alaska 99801
UPDATING ADDRESS OR VOTING RECORDS
First Name
Middle Name
Last Name
Suffix
Other Names (To change your name, please send in Court Decree, Driver’s License or State Photo ID)
Birth Date
Enrollment Number
Email Address
Address
Mailing
Resident
Both
City
State
Zip Code
Home Phone
Work Phone
Cell Phone
UPDATED VOTING COMMUNITY
Complete only if you live 100 miles outside of a voting community.
Anchorage
Hydaburg
Klawock
San Francisco
Yakutat
Angoon
Juneau
Klukwan
Saxman
Craig
Kake
Metlakatla
Seattle
Haines
Kasaan
Pelican
Sitka
Hoonah
Ketchikan
Petersburg
Wrangell
I certify that the information that I have provided on this document is true and correct.
CERTIFIED
Signature
Date
Check only one reason for your request:
I am temporarily away from my permanent residence because of college, military service, medical or
other reasons. The community listed is either my permanent or temporary residence.
Live Outside T&H Community