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=======================Notice of Rights====================
Help: If you would like help in filling out your voter registration application, we will help you. The decision whether to seek or
accept help is yours. You may fill out the voter registration application in private.
Benefits: If you are applying for public assistance from this agency, applying to register, or declining to register to vote will not
affect the amount of assistance you will be provided by this agency.
Privacy: Your decision not to register or update your record and the location where you applied to register or update your voter
registration record is confidential and may only be used for voter registration purposes.
Formal Complaint: If you believe someone has interfered with either your right to apply to register or to decline to register to
vote, your right to privacy in deciding whether to apply to register to vote, or your right to choose your own political party or other
political preference, you may file a complaint with: Florida Secretary of State, Division of Elections, NVRA Administrator, R.A.
Gray Building, 500 S. Bronough Street, Tallahassee, Florida 32399-0250. Forms for filing a complaint are available at
http://election.dos.state.fl.us/nvra/index.shtml or call 1-850-245-6200.
[Authority: National Voter Registration Act (42 U.S.C. 1973gg); sections 97.023, 97.058, and 97.0585, F.S.]
To Register to Vote in Florida, You Must:
Be a U.S. citizen (a lawful permanent resident cannot register or vote)
Be at least 18 years old (you may pre-register if you are at least 16 years old although you cannot vote
until you are 18 years old)
Be a Florida resident
Have had your right to vote restored if you have ever been convicted of a felony
Have had your right to vote restored if a court has ever declared you to be mentally incapacitated as to
your right to vote.
If you do not meet these requirements, you are not eligible to register.
------------------------------------------------------------------------------------------------------------
You Can Register to Vote at:
Any Supervisor of Elections’ office
Any driver’s license office or tax collector’s office that issues driver’s licenses
Any voter registration agency (that is, any public assistance office, any office that provides services for
persons with disabilities, any center for independent living, any armed forces recruitment office or any
public library)
The Division of Elections (Florida Department of State)
----------------------------------------------------------------------------------------------------------
You Can Hand-in or Mail a Completed Application to
Any of the Locations Listed Above
If mailing, mail with sufficient postage to:
Division of Elections
R.A. Gray Building
500 S. Bronough Street
Tallahassee, Florida 32399-0250
(contact information: 850-245-6200; http://election.dos.state.fl.us)
Your Supervisor of Elections will contact you if your application is incomplete, denied, or a duplicate.
Once you are registered, you will receive a voter information card.
***************************Turn Page Over for Registration Application*********************
Client’s preference (check the box only in 1. or 2.)
If you do not check any box, it will be considered that you chose not to
register or update your voter registration at this time.
1. If you are not registered to vote where you live now,
would you like to apply to register to vote today?
Yes No, I decline.
2. If you are registered to vote where you live now, would you
like to update your voter registration record?
Yes No, I decline.
CLIENT:
Name or identification number Date
OFFICIAL USE ONLY (check all that apply)
[Note: Only a client who is eligible can decline or accept an
opportunity to register or update a record on his or her behalf]
1. Client applied for:
New services/assistance
Renewal of services/assistance Address change
2. How client applied:
In person By phone
At home Online/web service
3. Client:
Submitted registration application.
Was sent form/application on ___/___/___(date).
Did not complete application/took form/application.
Preference form must be retained by agency for two years from dated
form (DS-DE 77-ENG; rev. 11-2011)
Application to Register in Florida Part 1 - Instructions
To Register in Florida, you must: Be a
U.S. citizen, be a Florida resident and at
least 18 years old (y ou may also pr e-
register if you are 16 or 17 years old but you
cannot vote until you are 18).
If you have ever been convicted of a felony
or if a court has ever found you to be
mentally incapacitated as to your right to
vote, your right to vote has to be restored
before you can register.
If you do not meet any one of these
requirements, you are not eligible to
register.
Where to Register: You can register to
vote in-person or by mailing or hand-
delivering your application to any supervisor
of elections’ office, any office that issues
driver’s licenses, a ny voter registration
agency (for example, any public assistance
office, assisted living facility, office serving
persons with disabilities, pub lic library, or
armed forces recruitment office) or t he
Division of Elections. If mailing application,
be sure to add sufficient postage.
Deadline to Register: The deadline to
register to vote is 29 d ays before an
upcoming election. You can update your
registration record at any time, but to
change your political party for a primary
election, you must make the change by the
registration deadline. For a new application,
you will be contacted if your application is
incomplete, denied or a duplicate of an
existing registration. If y ou receive a v oter
information card, that means you are
registered to vote.
Identification (ID) Requirements: If you are a
new applicant, state and federal law require you
to provide a current and valid Florida driver’s
license number (FL DL#) or Florida identification
card number (FL ID#). If you have not been
issued a FL DL# or FL ID#, you must then
provide the last four digits of your Social
Security Number (SSN). If y ou have not been
issued any of these ID numbers, check “None”
on the application. I f you do not provide any
number or do not c heck “None,” your
registration may be denied. See s.303, HAVA
and section 97.053(6), Fla. Stat.
Special ID requirements: If you are registering
by mail, have never voted in Florida, and have
never been issued one of the ID numbers
above, you must include with your application,
or at a later time before you vote, one o f the
following:
A copy of an ID that shows your name and
photo (acceptable IDs)--U.S. Passport, debit
or credit card, military ID, stude nt ID,
retirement center ID, neighborhood
association ID, or public assistance ID; or
A copy of an ID that shows your name and
current residence address (acceptable
documents)--utility bill, bank statement,
government check, paycheck, or oth er
government document.
You do n ot have to p rovide the special ID to
register if you are 65 or older, have a temporary
or permanent physical disability, are a member
of the active uniformed services or merchant
marine who is absent from the county for active
duty, or a family member t hereof, or are
currently living outside the U.S. but eligible to
vote in Florida.
Political Party Affiliation: Florida is a clo sed primary election
state. That means voters registered with a po litical party can
only vote for that party’s candidates in a partisan race on a
primary election ballot. However, regardless of the political party
with which you registered, you can still vote in the primary
election on any issue, any nonpartisan race or any race where
the candidate will face no opposition in the general election.
Indicate the political party with which you wish to be registered.
If you leave the political party affiliation box blank or w rite
“None,” you will be registered without any party affiliation. For a
list of political parties registered in Florida, go to the Division of
Elections’ website under the heading For the Voters at:
http://election.dos.state.fl.us/
Race/Ethnicity: You are not required to list your race or
ethnicity. However, if you choose to do so, please choose only
one of the following: American Indian/Alaskan Native,
Asian/Pacific Islander, Black (Not Hispanic) Hispanic, Multi-
racial, White (Not Hispanic), or Other.
Public Record Notice: This application becomes a public
record when filed. However, the following information is not
available to th e public and is used only for v oter registration
purposes: your FL DL#, FL ID# and SSN, where you registered
to vote, and whether you declined to r egister or update your
voter registration record when asked by a voter registration
agency. Your signature can be viewed but not c opied. (Section
97.0585, Fla. Stat.)
Criminal Offense: It is a 3rd d egree felony to submit f alse
information. Penalties include fines up to $5,000 and/or up to 5
years of prison.
Questions: For more information, contact your local supervisor
of elections, or refer to the Division of Elections’ website at:
http://election.dos.state.fl.us..
Información en español Sirvase llamar a la oficina del
supervisor de elecciones de su condado si le interesa obtener
este formulario en español.
Application To Register in Florida Part 2 - Form (national mail-in application)
Yes
Yes
No
No