1. (1) The following application is to be used by Alabama voters who need a free birth or marriage certificate to obtain a free Alabama Photo Voter Identification Card.
2. (2) The birth or marriage certificate will be provided electronically to the processing or issuing agent and is for voting purposes only. The voter will not be given a copy of these free birth or marriage certificates. The processing or issuing agent is to transmit both sides of the application to the state office of the Alabama Department of Public Heath using the contact information provided by the Secretary of State.

3. (3) The processing or issuing agent transmitting the application for free Alabama birth or marriage certificate must include a transmittal form identifying the office that is transmitting the form to the Alabama Department of Public Health.

   1. 1. a valid Alabama driver’s license or a valid Alabama nondriver identification card which was properly issued by the appropriate state or county department or agency;
      2. a valid Alabama photo voter identification card;
      3. a valid identification card issued by a branch, department, agency, or entity of the State of Alabama, any other state, or the United States authorized by law to issue personal identification, provided that such identification card contains a photograph of the elector;
      4. a valid U.S. passport;
      5. a valid employee identification card containing the photograph of the elector and issued by any branch, department, agency, or entity of the U.S. government, the State of Alabama, or any county, municipality, board, authority, or other entity of this state;
      6. a valid student or employee identification card issued by a public or private college, university, or postgraduate technical or professional school located within the State of Alabama, provided that such identification card contains a photograph of the elector;
      7. a valid U.S. military identification card, provided that such identification card contains a photograph of the elector; or
      8. a valid tribal identification card containing a photograph of the elector.

      I, _________________________________, a registered voter in the State of Alabama, do hereby swear or affirm that I do not possess any of the forms of photo ID listed above. I further swear or affirm that the information contained on this form (Side A and Side B) is true and correct. I understand that the free birth or marriage certificate will be issued electronically to the processing or issuing agent and that said free certification cannot be used for any purpose other than obtaining a free Alabama photo voter ID card. Signature of Alabama registered voter______________________
      Date__________

      SIDE B

      APPLICATION FOR ISSUANCE OF A FREE ALABAMA BIRTH OR MARRIAGE CERTIFICATION TO OBTAIN FREE ALABAMA PHOTO VOTER ID CARD

      SIDE A MUST BE COMPLETED BEFORE COMPLETING SIDE B OF THIS FORM

      USE ONLY FOR A VITAL EVENT WHICH OCCURRED IN ALABAMA

      

   SIDE A

   OFFICE OF THE SECRETARY OF STATE APPLICATION FOR ISSUANCE OF FREE ALABAMA BIRTH OR MARRIAGE CERTIFICATION TO OBTAIN FREE ALABAMA PHOTO VOTER ID CARD

   Print Your Name:________________________________________________ Address: _______________________________________________________ City: __________________________ State:_________________________ Zip:_________________ Daytime Phone:(______)____________________

   DO NOT COMPLETE THIS FORM IF YOU HAVE ANY OF THE FOLLOWING:

Author: Jean Brown, William Sutton

Statutory Authority: Code of Alabama, section 17-9-30 (2011).

History: New Rule: Filed October 9, 2014; effective November 13, 2014.