Ill. Admin. Code tit. 26, § 216.EXHIBIT – E...Voter Identification Card

			VOTERS CERTIFICATE OF REGISTRATION
	Polling Place		(DISPOSITION OF REGISTRATION)

CONG.

LEG.

REP.

CO. BD.

I hereby certify that the person whose name and address appears

City/Village

below is a registered voter.

PCT.

WARD

TWP.

Elem. Sch. Dist.

County Clerk/Exec. Director

Jurisdiction

High Sch. Dist.

Twp.

Pct/Ward

Comm. Coll. Dist.

Name

Sanitary Dist.

Street No.

Street Name

Fire Dist.

Apt. No.

Park Dist.

City

State

Zip

Cem. Dist.

Date Issued

Judicial District

Judicial Circuit

(DO NOT DETACH)

(RETAIN THIS CARD)

(See reverse side)