Florida Voter Registration Application
Part 1 – Instructions (DS-DE #39, R1S-2.040, F.A.C. (eff. 01/2012)
Información en español: Sirvase llamar a la oficina del supervisor de
elecciones de su condado si le interesa obtener este formulario en español.
To Register in Florida, you must be:
A U.S. citizen,
A Florida resident, and
At least 18 years old (you may also pre-
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 must 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
any voter registration agency (for example, any
public assistance office,
center for independent
living,
office serving persons with disabilities,
public library, or armed forces recruitment
office) or the Division of Elections. If mailing
application, be sure to add sufficient postage.
Deadline to Register: The deadline to register
to vote is 29 days 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 you receive a voter 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 you
have not been issued any of these ID numbers,
check “None” on the application. If you do not
provide any number or do not check “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 of the following:
A copy of an ID that shows your name and photo
(acceptable IDs)--U.S. Passport, debit or credit
card, military ID, Student 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 other government document.
You do not have to provide 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 thereof, or are currently living outside the
U.S. but otherwise eligible to vote in Florida. If you
vote at the polls, you will still need to show a
photo/signature ID as is required of all voters.
Political Party Affiliation: Florida is a closed primary election state.
That means registered voters affiliated with a political 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 field blank, 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 from the list.
Public Record Notice: This application becomes a public record
when filed. However, the following information is not available to the
public and is used only for voter registration purposes: your FL DL#,
FL ID# and SSN, where you registered to vote, and whether you
declined to register or update your voter registration record when
asked by a voter registration agency. Your signature can be viewed
but not copied. (Section 97.0585, Fla. Stat.)
Criminal Offense: It is a 3rd degree felony to submit false
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
http://election.dos.state.fl.us/SOE/supervisor_elections.shtml
or refer to the Division of Elections’ website at:
http://election.dos.state.fl.us.
All shaded lettered boxes are
required for a new registration.
Florida Voter Registration Application
Part 2 – Form (DS-DE #39, R1S-2.040, F.A.C. (eff. 01/2012)
The downloadable/printable online form is available at:
http://election.dos.state.fl.us/pdf/webappform.pdf
This is: New Registration Record Update/Change (e.g., Address, Party Affiliation, Name, Signature) Request to Replace Voter Information Card
Are you a citizen of the United States of America? YES NO
OFFICIAL USE ONLY
FVRS No: _____________________________________
I affirm that I am not a convicted felon, or if I am, my right to vote has been restored.
I affirm that I have not been adjudicated mentally incapacitated with respect to
voting or, if I have, my right to vote has been restored.
Date of Birth (Enter in format MM-DD-YYYY)
Florida Driver’s License (FL DL) or Florida identification (FL ID) Card Number
If no FL DL
or FL ID,
then
provide
Last 4 digits of Social
Security Number
I have
NONE of
these
numbers.
Name Suffix
(Jr., Sr., I, II, etc.):
Address Where You Live (legal residence-no P.O. Box)
Mailing Address (if different from above address)
Address Where You Were Last Registered to Vote
Former Name (if name is changed)
State or Country of Birth
Telephone No. (optional)
( )
Party Affiliation
(Check only one. If left blank, you will
be registered without party affiliation)
Florida Democratic Party
Republican Party of Florida
No party affiliation
Minor political party (print name):
______________________
Race/Ethnicity (Check only one)
American Indian/Alaskan Native
Asian/Pacific Islander
Black, not of Hispanic Origin
Hispanic
White, not of Hispanic Origin
Other:________________
Multi-racial
Active Uniformed Services, Merchant Marine, or
Overseas U.S. Citizen
(Check only one if applicable)
Active duty uniformed services/merchant marine
Family member of active duty uniformed services or
merchant marine member
U.S. Citizen Residing Outside U.S.
I will need
assistance with
voting.
I am
interested in
becoming a poll
worker.
Oath: I do solemnly swear (or affirm) that I will
protect and defend the Constitution of the United
States and the Constitution of the State of Florida,
that I am qualified to register as an elector under the
Constitution and laws of the State of Florida, and that
all information provided in this application is true.
