An elector shall provide all of the following information on the voter registration application form:

1. (1) The elector’s full name, including first and last name.
2. (2) The elector’s complete address, including street, number and municipality.
3. (3) The elector’s date of birth.
4. (4) The elector’s driver’s license number or, if the elector has not been issued a valid and current driver’s license but has a department of transportation issued identification card, the transportation identification card number, or the last four digits of the elector’s social security number. If the elector has not been issued a valid and current driver’s license and does not have a social security number, the elector shall indicate that the elector has neither of those documents.
5. (5) An indication of the elector’s age.
6. (6) An indication of the elector’s citizenship.
7. (7) An indication that the elector is not disqualified from voting because the elector has not completed the terms of a sentence resulting from a felony conviction.
8. (8) If the elector was registered at a different location, the complete address including street, number and municipality of the previous address.
9. (9) If the elector was registered under a different name; the elector’s former name, including first and last name.
10. (10) The signature of the elector certifying that the elector is qualified to vote in this state.

History

History: Emerg. cr. eff. 7-1-76; cr. Register, August, 1976, No. 248, eff. 9-1-76; CR 07-059: r. and recr. Register January 2008 No. 625, eff. 2-1-08.