ACCEPTAB LE PROOF OF RESIDENCE DOCUMENTS All Wisconsin voters must provide proof of residence - PDF document

��ACCEPTABLE PROOF OF RESIDENCE DOCUMENTS All Wisconsin voters must provide proof of residence when registering to vote. Any document used as a proof of residence MUST include: Your current and complete nameYour current and complete residential addressA visible account or document number (if applicable) AND A current and valid Wisconsin driver’s licenseor identification card. Example:a WI license or ID card that has the voter’s current name and address.Any other official identification card or license issued by a Wisconsin governmental body or unit. Example: Example: A workplace photo ID that includes the employee name and residential address. A residential lease which is effective for a period that includes registration date (cannot be used if registering by mail) Example: A Marquette student ID a copy of tuition receipt from the Bursar’s office.Please note that a public university or college student (such as UW-Milwaukee or MATC) can provide any document from that school with name and current address under the “GOVDOC” category. An affidavit for homeless voters Example By marking this circle and signing this form, I certify that I am a qualified elector: I am a United States citizen I will be at least 18 years old on the day of or before the next election I am not currently serving a sentence, including probation, parole, or extended supervision, for a felony conviction I will have lived at my address for at least 10 consecutive days before the next election with no present intent to move I am not otherwise disqualified from voting If you do not meet EACH of these qualifications, you are not qualified to register. Do NOT complete this form. Please Select: New WI Voter Address Change Name Change Other If you have never been issued a WI driver license or WI DOT-issued ID, you MUST provide the last four digits of your Social Security number (SSN). Date of Birth (Month/Date/Year): ___ ___ / ___ ___ / ___ ___ ___ ___ WDL OR ID #: ___ ___ ___ ___- ___ ___ ___ ___-___ ___ ___ ___-___ ___ Expiration Date: ______/______/______ SSN: XXX - XX - ___ ___ ___ ___ Check this circle if you have never been issued a WI Driver's License, WI ID or a Social Security Number. Please PRINT your NAME exactly as it appears on your identification listed above - WDL/ID or SSN: Last Name: Circle: Jr., Sr., II, III, IV First Name: Middle Name/Initial: Current Address: Apt./Unit Number: City of Milwaukee, WI Zip Code: Email Address: Phone Number: ( ) A postcard verifying your address will be mailed to the address above unless you maintain and provide a separate mailing address. Mailing Address (if different): Apt./Unit Number: City: State: Zip Code: Previous Information Last Name: First Name: Middle: Address: Apt./Unit Number: City: State: Zip Code: __________________________________________________ _______________________________ VOTER SIGNATURE Date (Month/Day/Year) I would like information on serving as a City of Milwaukee election worker. 1.) Circle POR Type: WDL DOTID GOVID EMPID LSE TAX UTIL BNK PYCK GOVDOC FEE/STU ID HME 2.) Issuing Entity (AT&T, DMV, US Bank, Medicare, etc.): 3.) Document Number (LAST 4 #s ONLY; last 2 #s if # is less than 7#s) 4.) Election Official Signature: Voter unable to sign form. Assistant Signature: Assistant Address: OFFICE USE ONLY District: _____ Ward: _____ NV____ AC____ NC____ DUP____ Confidential Voter ID# __ __ __ __ __ - __ __ __ SVRS ID# ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ Init / Date: ______________ 414-286-3491 If I have provided false information I may be subject to fine or imprisonment under State and Federal laws. Return completed forms to: City of Milwaukee Election Commission 200 E. Wells St., Room 501 Milwaukee, WI 53202 CITY OF MILWAUKEE ELECTION COMMISSION VOTER REGISTRATION APPLICATION IDENTIFICATION MAILING CURRENT FOR OFFICE USE ONLY PREVIOUS ***If registering by mail, please include a copy of your proof of residence document with your application.*** If you have been issued a WI driver license or WI DOT-issued ID that is current and valid , you MUST provide the number and expiration date. If you are unsure of the number, please call DMV at 608-266-2261. If you have been issued a WI driver license that is currently revoked, suspended or expired; or have been issued a WI DOT-issued ID that is expired, you MUST provide the last 4 digits of your Social Security number (SSN). WDL or ID number is optional. Last revised 1/6/17 I hereby certify to the best of my knowledge that I am a qualified elector and that all statements on this form are true and correct.