Board of Elections, Warren County Ohio

Voter Registration Application Form

I am
Citizenship and Age
Are you a U.S. citizen?  
Will you be at least 18 years of age on or before the next General Election?  
Voter Info
Last Name:
* Last Name Required
First Name:
* First Name Required
Middle Name or Initial:
Jr., II, Etc.:
House Number and Street:
* Residential Address Required
Apt. or Lot #:
City or Post Office:
* City or Post Office Required
Zip Code:
* Zip Code Required
Additional Rural or Mailing Address (if necessary):
County where you live:

BIRTHDATE:
 Month Day Year
     
Phone No. (Voluntary)
YOU MUST CHOOSE ONE OF THE TWO ITEMS LISTED
Drivers License No:  
Where is my Drivers License Number?
Last 4 Digits of SSN:  
 
ADDRESS CHANGE ONLY - PREVIOUS ADDRESS
Address:
City:
State:
County:


NAME CHANGE ONLY
Former Legal name:



 Please correct the following:
  • * Last Name Required
  • * First Name Required
  • * Residential Address Required
  • * City or Post Office Required
  • * Zip Code Required


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