Upon completion of the Registrar’s Affirmation, the registrar shall issue a receipt to the voter confirming that the voter has qualified as a confidential voter. The registrar will also provide the individual a copy of 950 C.M.R. 49.00. The receipt shall be substantially as follows:

CONFIDENTIAL VOTER REGISTRATION RECEIPT

City or Town Date

You have provided the registrar with proof which qualifies you as a confidential voter. You have been assigned confidential voter number ______. You will be sent a certificate of Confidential Registration prior to the next election. Please be aware that you must bring the certificate of Confidential Registration with you to the polls in order for you to vote.

__________________ Registrar’s Signature

NOTE TO CERTIFICATE HOLDER: Please be aware that your confidential voter registration may expire if certain conditions are not met. If you have received confidential registration because:

° you have a court order granting protection, it will expire 60 days from the date when the court order expires, unless you provide the registrar with proof that the court order has been extended; ° you are a resident in a shelter, it will expire one year and 60 days from the date on the shelter director’s letter confirming residency, unless you provide the registrar with a new letter from the director of the shelter.