Section 216.10  Applicability

 

a)         This Part implements the National Voter Registration Act of 1993 (42 U.S.C. Sections 1973gg et seq.) and the order of the Circuit Court of Cook County entered May 1, 1996 in Or, et al., v. Edgar, et al. 95 CO 246 and 95 CO 248 (Consolidated).

 

b)         The requirements and procedures contained in this Part apply to election authorities accepting or transmitting Voter Registration Applications under the provisions of the National Voter Registration Act of 1993 and/or maintaining voter registration records under the provisions of Articles 4, 5, 6, and 6A of the Election Code.

 

c)         The provisions of this Part are additional to any other method or provision for registration to vote contained in the Illinois Election Code [10 ILCS 5].

 

d)         Unless a provision to the contrary is made by this Part, the requirements of the  Election Code remain applicable to voter registration cards and to Voter Registration Applications.

 

Section 216.20  Definitions

 

            "Applicant" – An applicant for purposes of this Part is a person who:

 

            appears in person to request the Secretary of State of Illinois to issue a driver's license, including renewals and change of address or an identification card;

 

            appears in person to sign a request to receive public assistance or to renew a request for public assistance, or certify that he or she remains eligible for public assistance from a township government in counties under township organization, or from the county commissioners of a county not under township organization;

 

            meets the definition of an applicant under the statutes or rules which govern the administration of certain social services programs administered by designated agencies of the State of Illinois; or

 

            submits directly to an election authority a Voter Registration Application designed by the Illinois State Board of Elections or the National Mail Voter Registration Booklet designed by the United States Federal Election Commission.

 

            "Application" or "Voter Registration Application" – An application or Voter Registration Application for the purposes of this Part is an Illinois Voter Registration Application designed by the Illinois State Board of Elections or the National Mail Voter Registration Booklet designed by the United States Federal Election Commission or a document with identical purpose and conforming to the requirements of the National Voter Registration Act of 1993 and this Part generated by the Illinois Secretary of State, a designated agency, or an election authority.

 

            "Deputy registrar" – A deputy registrar is a person appointed by an election authority for the limited and particular purpose of registering persons to vote in all elections in Illinois by use of the triplicate registration card.  For purposes of this Part deputy registrar does not include an employee or contractor of the Secretary of State, designated agency, or township supervisor or county commissioner who accepts Voter Registration Applications but who is not so appointed, or any armed forces personnel designated by the United States Department of Defense to accept Voter Registration Applications not so appointed.

 

            "Designated agency" – A designated agency is an agency of the State of Illinois or its contractors selected by the Governor of the State of Illinois to provide an  opportunity to its clients to register to vote at the time the client applies for, reapplies for, or is recertified for services from one or more programs administered by the agency.

 

            "Election authority" – An election authority is a city board of elections commissioners, a county board of elections commissioners, or a county clerk in counties not under the management of a county board of elections commissioners.

 

            "Federal election" – For purposes of voter registration and voting by voters on inactive status, a federal election is a general or special election, including primary elections, for any federal office and a presidential preference primary election.  For purposes of maintaining on inactive status voters who have registered to vote  once transferred to inactive status and for keeping statistics required by Section 216.80 of this Part with respect to Voter Registration Applications, a federal election is a general election, excluding the general primary election.

 

            "Federal office" – Federal office includes electors to elect the President and Vice-President of the United States, United States Senators and Members of the United States Congress.

 

            "Inactive voter" – An inactive voter is a person who, having once submitted a Voter Registration Application subsequently acknowledged by the election authority having jurisdiction over the voter's place of residence, or a registration card, has not responded to a notice to confirm his or her address, but whose authority to vote has not yet been canceled.

 

            "Non-discriminatory" – Non-discriminatory means without intentionally differing treatment of an individual by reason of his or her racial, religious, ethnic, political party, gender, or linguistic characteristics, or without intentional or unintentional disparate impact upon a group of persons identified by racial, religious, ethnic, political party, gender or linguistic characteristics.

 

            "Record" – A record is a Voter Registration Application which has been accepted and acknowledged by an election authority.  Record includes Voter Registration Applications which have been placed in a file of inactive voters, but does not include rejected or unacknowledged Voter Registration Applications.

 

            "Secretary of State" – Secretary of State means the Division of Driver Services of the Office of the Illinois Secretary of State.

 

            "Voter Registration Card" – A Voter Registration Card is a voter registration card authorized by the Illinois Election Code and used by election authorities to enroll voters to vote prior to the enactment of the National Voter Registration Act of 1993 and presently.

 

Section 216.30  Receipt of Voter Registration Applications

 

a)         This Section implements Sections 4, 5, 6, and 7 of the National Voter Registration Act of 1993 (42 U.S.C. Sections 1973gg-2, gg-3, gg-4, and gg-5) and the order of the Circuit Court of Cook County entered May 1, 1996 in Or, et al., v. Edgar, et al. 95 CO 246 and 95 CO 248 (Consolidated).

 

b)         Each election authority is authorized and directed to accept Voter Registration Applications tendered to it under circumstances complying with the provisions of the National Voter Registration Act of 1993, by the Secretary of State, designated agencies, county clerks and Board of Election Authorities and their employees and deputy registrars, township supervisors, county commissioners of counties not under township organization, recruitment offices of the United States Department of Defense and individual applicants using the United States Postal Service.

 

c)         Each Voter Registration Application  so accepted shall be processed by the election authority according to the provisions of the National Voter Registration Act of 1993, and each Voter Registration Application  acknowledged by an election authority shall entitle the applicant to vote in all elections conducted in the State of Illinois under the Illinois Election Code.

 

d)         Each election authority shall acknowledge every Voter Registration Application and Voter Registration Card  which conforms to the requirements of the National Voter Registration Act of 1993 and this Part submitted by qualified voters as defined by 10 ILCS 5/3-1.  Voter Registration Applications and Voter Registration Cards not conforming to the requirements of the National Voter Registration Act of 1993 shall be processed according to this Part.

 

Section 216.40  Maintaining Voter Records

 

a)         This Section implements Section 8 of the National Voter Registration Act of 1993 (42 U.S.C. Sections 1973gg-5 and gg-6) and the order of the Circuit Court of Cook County entered May 1, 1996 in Orr, et al. v. Edgar, et al., 95-CO-246 and 95-CO-248 (Consolidated).

 

b)         Each election authority shall enter any Voter Registration Application it acknowledges into its master file of registered voters.

 

c)         Each election authority shall make a copy of each Voter Registration Application it acknowledges and place such copy in the precinct binder of the precinct in which the applicant resides, or, where voter registration data is kept by signature digitization systems, enter such data into the signature digitization system.

 

d)         At each election it conducts, each election authority shall send to each precinct polling place in its jurisdiction the precinct binder for that precinct or such list of eligible voters prepared by a signature digitization system as may be allowed by statute and rule of the State Board of Elections.

 

e)         Beginning January 1, 1998, each election authority shall, at each election it conducts, prepare for each precinct polling place in its jurisdiction, a list or file of all Voter Registration Applications and Voter Registration Cards that have been transferred to inactive status in that precinct. Such list shall either, in the discretion of the election authority, include or be entirely composed of a computer-generated list of the electronically stored Voter Registration Applications and Voter Registration Cards of that precinct. The information to be included in the computer stored data shall be the name, address, date of birth, last four digits of the social security number and a computer-generated duplicate of the signature of the applicant.  Such list, to the extent that it is not composed of a list generated from electronically stored data, shall consist of copies of Voter Registration Applications and duplicate Voter Registration Cards.

 

f)         Each election authority shall keep all records concerning the implementation of programs and activities conducted to maintain the accuracy and currency of voter registration files for at least two years.  Such records shall be made available to the public for inspection and where facilities permit, copies shall be provided at reasonable cost.  However, nothing in this Section or any other to the contrary withstanding, information that relates to a voter's declination to register or identifies the agency through which a voter registered shall remain confidential.

 

g)         Election authorities shall maintain a list of all voters to whom a forwardable confirmation of address notice has been sent.  Such list shall note whether the voter has responded to the notice.  The list shall be made available to the public and be current as of the date the request for public inspection is made.

 

h)         Not earlier than February 1 and not later than March 1 of each odd-numbered year, each election authority shall report to the State Board of Elections the number of forwardable confirmation of address notices mailed and the number of responses received between the two previous federal elections.

 

i)          After April 1, 1999 no election authority shall employ any electronic data storage or processing system for registration records which will not operate correctly after January 1, 2000.

 

(Source:  Amended at 23 Ill. Reg. 3948, effective March 19, 1999)

 

Section 216.50  Canceling Voter Registrations

 

a)         This Section implements Section 8 of the National Voter Registration Act of 1993 (42 U.S.C Sections 1973gg-5 and gg-6) and the order of the Circuit Court of Cook County entered May 1, 1996 in Or, et al., v. Edgar, et al. 95 CO 246 and 95 CO 248 (Consolidated).

 

b)         No voter registration may be canceled without following the procedures and providing the notice of suspension or cancellation required by Section 8(a) through (d) of the National Voter Registration Act of 1993.  The Voter Registration Application or the Voter Registration Card of an inactive voter who has not voted in two consecutive general federal elections shall be canceled at the completion of procedures set forth in Section 8(d) of the National Voter Registration Act of 1993, provided that while such procedures are pending, the voter has taken no action specified in the National Voter Registration Act of 1993 to restore his or her name to active voter status.

 

c)         An election authority shall cancel the Voter Registration Application or Voter Registration Card of a voter upon receipt of a request in writing from the voter to do so.  A written acknowledgment by the voter that he or she has changed residence to a place beyond the jurisdiction of the election authority or an attempt to register in another jurisdiction shall be deemed a request to cancel the voter registration.

 

d)         A voter's registration shall be canceled upon the election authority's receipt of:

 

1)         a notice from the State Board of Elections that the voter has been incarcerated in a United States correctional facility by reason of conviction;

 

2)         a certified notice from the a state department of corrections or a sheriff of a county in the United States that the voter has been incarcerated in a state or county correctional facility, as the case may be, if:

 

A)        the certified notice states on its face that the incarceration is a result of a criminal conviction and the crime of which the voter has been convicted, or

 

B)        the certified notice is accompanied by a certified judgment of conviction or equivalent document issued by the court in which the conviction was obtained;

 

3)         a certified copy of a judgment of conviction from a court of record that the voter has been convicted of a crime in which it was found that the voter lacked the requisite qualifications to be a voter in Illinois either at the time of conviction or at the time application was made to become a voter, whether or not the voter was incarcerated as a result of such conviction;

 

4)         a certified copy of a final judgment order of a court of record or a certified copy of the final determination of an administrative tribunal having jurisdiction in which it was found that the voter lacked the requisite qualifications to be a voter in Illinois either at the time of entry of the judgment or determination, or at the time application was made to become a voter; or

 

5)         a certified copy of the voter's death certificate or equivalent document issued by a department of vital records, wherever situated.

 

Section 216.60  Forms

 

a)         This Section implements Sections 5, 6, 7 and 8 of the National Voter Registration Act of 1993 (42 U.S.C. Sections 1973gg-3, gg-4, gg-5 and gg-6) and the order of the Circuit Court of Cook County entered May 1, 1996 in Or, et al., v. Edgar, et al. 95 CO 246 and 95 CO 248 (Consolidated).

 

b)         Township supervisors and county commissioners in counties not under township organization shall, and the Illinois Secretary of State and designated agencies of the State of Illinois may, use the forms prescribed in Exhibits A, B, and C of this Part in taking and transmitting the Voter Registration Applications of applicants who choose to submit Voter Registration Applications, or in recording the decision of the applicants who decline to submit Voter Registration Applications if such agencies do not otherwise provide forms of their own design meeting the requirements of the National Voter Registration Act of 1993.

 

c)         Election authorities shall use the forms prescribed in Exhibits D, E, F, G, and H in providing notice of decisions taken with respect to Voter Registration Applications and Voter Registration Cards.

 

d)         The State Board of Elections shall supply to each election authority a quantity of the National Mail Voter Registration Booklets  designed by the United States Federal Election Commission on an as-needed basis. Each election authority shall make a copy of the National Mail Voter Registration Booklet available to any person over 18 years of age in its jurisdiction who seeks to register to vote in another state, or refer a request from such person for a National Mail Voter Registration Booklet to the Illinois State Board of Elections in accord with subsection (h) of this Section.

 

e)         Each election authority shall make a copy of the Illinois Voter Registration Application  available to any person over 18 years of age in its jurisdiction who seeks to register to vote in Illinois.  Each Voter Registration Application supplied to an individual shall be accompanied by instructions for completing the forms and returning it to the appropriate address. Such instructions may be oral where the form is supplied by a designated agency to an applicant.

 

f)         Election authorities, the Secretary of State, and designated agencies shall obtain the Illinois Voter Registration Application for their own purposes and, in the case of election authorities, in sufficient quantities for distribution to the public.  Each Voter Registration Application so produced shall conform to the measurements, paper weight, color and layout,  and shall reproduce verbatim the text set forth in Exhibit A of this Part.

 

g)         Voter Registration Applications made available to the general public to be returned by mail to the election authority shall be placed in holders or dispensers bearing the uniform logo designed for the purpose by the State Board of Elections.  Control numbers assigned by the election authority may be added to Voter Registration Applications distributed to the general public, but no such control number shall be assigned to any Voter Registration Application supplied by the election authority to a designated registration agency, a township supervisor, or a county commissioner.  Voter Registration Applications offered to the general public to be returned by mail must bear the mailing address of the election authority having jurisdiction over the place where the form dispenser is located.  Whenever an election authority receives  a Voter Registration Application for an applicant who does not reside in the election authority's jurisdiction, the election authority shall forward, within three days after its receipt, the Voter Registration Application  to the election authority for the place where the applicant resides.  The election authority shall include with the forwarding a transmittal notice of the kind identified in Appendix C of this Part.  The election authority receiving such a transmitted application shall treat the application as if it had been originally filed with the receiving election authority.  The postmark on  the application or date of the application's receipt by the transmitting election authority shall determine the voter's eligibility to vote in the next ensuing election.

 

h)         Election authorities shall limit the number of the National Mail Voter Registration Booklets supplied to an organization conducting a voter registration drive to 50.  Requests for the National Mail Voter Registration Booklet in quantities exceeding 50 shall be referred to the State Board of Elections, which shall, prior to filling the request, require the organization making such a request to submit in writing a copy of its plan to distribute the booklets, including the states in which the organization intends to distribute the booklet and the quantities to be distributed in each state.  The State Board of Elections shall deny the request if such a written plan is not submitted, and shall substitute the Voter Registration Application for any quantities of the National Mail Voter Registration Booklet intended for distribution in Illinois.  The State Board of Elections shall charge the requesting party the actual cost of reproducing the National Mail Voter Registration Booklet for any quantities requested over 200.

 

Section 216.70  Processing Voter Registration Applications

 

a)         The State Board of Elections shall, and all persons accepting from applicants Voter Registration Applications are encouraged to, transmit executed applications to the election authority:

 

1)         not more than ten days after execution, if executed five days or more prior to the date upon which voter registration closes, or

 

2)         not more than five days after execution, if executed less than five days prior to the date upon which registration closes but prior to the close of registration.

 

b)         Applications arriving prior to the close of registration at an election authority unaccompanied by a Voter Registration Application Transmittal shall, for the purpose of first time voting only, be deemed to be applications received by mail, and all applicants whose applications are so transmitted shall be advised that they will be required to vote in person at the first election in which they vote.

 

c)         A Voter Registration Application may be executed while voter registration is closed, but in such case such application shall not entitle the applicant to vote at any election held before registration reopens.  Applications bearing no postmark arriving by mail not later than five days after the close of registration shall be deemed to have been filed prior to the close of registration.  Applications arriving by mail after the close of registration, but bearing a postmark earlier than the day upon which registration closed shall be deemed to have been filed prior to the close of registration no matter when actually received. Applications which arrive by mail bearing a postmark later than the day upon which registration closed shall not be deemed to have been filed prior to the close of registration no matter when actually received.

 

d)         The State Board of Elections shall assign to each township supervisor, county commissioner in counties not under township organization, and designated agency a block of document control numbers, the identity of which block shall be confidential, which such entities may use on each Voter Registration Application Transmittal accompanying batches of applications sent to election authorities.

 

e)         Every Voter Registration Application Transmittal shall note on its face how many applications are being transmitted, a document control number from the block assigned to the entity submitting the Voter Registration Application Transmittal, identified in subsection (d) of this Section, and the date of transmittal.

 

f)         Every application received by an election authority shall be examined to determine if the information contained on the application is sufficient on its face to cause the applicant to be listed among the voters of the jurisdiction, or if the application duplicates a record or Voter Registration Card already on file with the election authority.

 

1)         If the application duplicates a record already on file with the election authority, the applicant shall be sent a forwardable Disposition of Registration notice advising the voter that he or she is already registered to vote.

 

2)         If the information is insufficient, the election authority shall send the applicant a forwardable Disposition of Registration notice informing the applicant:

 

A)        that his or her application has been rejected, identifying the reason for rejection, and

 

B)        that he or she will not be entitled to vote until a new and sufficient application has been received by the election authority.

 

Section 216.80  Documenting Transactions

 

a)         Each election authority shall generate and keep the following information from the registration activities it conducts:

 

1)         the total number of Voter Registration Applications and Voter Registration Cards received, from whatever source, between the two immediately past federal elections, excepting those Voter Registration Applications and Voter Registration Cards which are deemed duplicates, are rejected or report only changes of address;

 

2)         the total number of Voter Registration Applications received from the Secretary of State between the two immediate past federal elections, and the total number of these applications which are duplicates of already existing registrations;

 

3)         the total number of Voter Registration Applications received by mail between the two immediately past federal elections, and the total number of these applications which are duplicates of already existing registrations;

 

4)         the total number of Voter Registration Applications received from each office of a designated agency, township supervisor or county commissioner between the two immediately past federal elections, and the total number of these applications which are duplicates of already existing registrations;

 

5)         the total number of Voter Registration Applications received from each office of armed forces personnel registering voters between the two immediately past federal elections, and the total number of these applications which are duplicates of already existing registrations;

 

6)         the total number of Voter Registration Applications and Voter Registration Cards received from any other source not specifically enumerated in subsections (a)(2) through (5) of this Section, by source, between the two immediately past federal elections, and the total number of these applications and registration cards which are duplicates of already existing registrations;

 

7)         the total number of Voter Registration Applications canceled, for whatever reason, between the two immediately past federal elections;

 

8)         the number of name and address confirmation forms mailed out between the two immediately past federal elections, and the number of responses thereto; and

 

9)         the postal costs incurred between the two immediately past federal elections for all mailings required to satisfy requirements of 42 U.S.C. 1973gg et seq.

 

b)         "By mail", for purposes of this Section, excludes those applications transmitted by the Secretary of State, designated agencies, township supervisors and county commissioners, and armed forces personnel registering voters, even though applications arrive by means of the United States Postal Service.

 

c)         The data required to be kept by this Section may be kept in electronic or paper copy format.

 

Section 216.90  Voting

 

a)         Voters shall vote at the polling place for the precinct where they reside, except that:

 

1)         a voter who moves without notice to the election authority to a different residence still within the same election jurisdiction (territory under the control, for voting and registration purposes, of an election authority) as the place from which he or she moved shall vote for the first time he or she offers to vote after changing residence in the polling place for the residence from which the voter most recently registered, and thereafter in the polling place for the voter's present residence;

 

2)         such voters are entitled by this Part to vote for federal offices only (However, those persons may be entitled by the Election Code to vote for other offices; see, for example, 10 ILCS 5/6-27 and 6-53.); and

 

3)         subject to the requirements of subsection (d) (c) of this Section, any voter otherwise qualified to vote an absentee ballot may vote  by absentee ballot.

 

b)         In jurisdictions employing an electronic system which utilizes ballot cards:

 

1)         the ballot card for voters described in subsection (a)(2) shall be of stock of any color, provided that there shall be printed on the back of such cards, both on the stub and on the ballot card itself, the words "FEDERAL OFFICES ONLY" in type of no less than 15 pt., and may, at the option of the election authority, also bear the number of the Congressional district of the voters of the precinct.  If, in a split precinct, no distinction in color is made between the ballot cards for differing Congressional districts, such ballots must also bear the number of the Congressional district for which they are to be used.

 

2)         the number of federal office only ballot cards supplied to any polling place shall not exceed 10% of the number of registered voters assigned to the polling place.

 

c)         The election authority shall transfer the record or registration card, as the case may be, of each voter described in subsection (a)(1) of this Section to the binder for the precinct encompassing the voter's new place of residence immediately after the first election at which the voter offers to vote after changing residence, making such notations on the record as are necessary to bring the information contained on it current, and thereafter the voter shall vote in the precinct polling place for the new residence.

 

d)         An applicant who has submitted a Voter Registration Application by mail must vote in person at the first election at which he or she votes after his or her application is acknowledged unless the voter is entitled to cast an absentee ballot under the provisions of Article 20 of the Illinois Election Code or is eligible to vote an absentee ballot by any pertinent federal statute or law. Voting in person includes in-person absentee voting, nursing home voting and hospitalized voters voting under the provision of Section 19-13 of the Election Code [10 ILCS 5/19-13].

 

e)         An absentee voter voting under the provisions of subsections (a) (1) through (3) of this Section shall also complete an Address Correction for Fail Safe Voters.  A Fail Safe Voter is a voter who votes under the provisions of subsection (a)(1) of this Section.

 

(Source:  Amended at 22 Ill. Reg. 19330, effective October 15, 1998)

 

Section 216.100  Designation of Chief State Election Official

 

a)         This Section implements Section 10 of the National Voter Registration Act of 1993 (42 U.S.C. Section 1973gg-8).

 

b)         The Executive Director of the Illinois State Board of Elections is designated as the Chief State Election Official for the purposes of the National Voter Registration Act of 1993.

 

c)         The Executive Director of the State Board of Elections may issue such opinions or directions as he or she deems necessary to insure that the National Voter Registration Act of 1993, the order of the Circuit Court of Cook County issued May 1, 1996 in Or, et al., v. Edgar, et al. and this Part are implemented uniformly throughout Illinois.

 

Section 216.EXHIBIT A   Voter Registration Application-Illinois

 

ILLINOIS VOTER REGISTRATION APPLICATION

 

FOR U.S. CITIZENS ONLY		YOU CAN USE THIS FORM TO:
(If you are not a citizen, do not continue)		˜	apply to register to vote in the State of Illinois
TO REGISTER YOU MUST:		˜	change your address on your voter registration card
˜	be a United States citizen	˜	change your name (change due to marriage, etc.)
˜	be at least 18 years old on or before the next election
˜	live in your election precinct at least 30 days before the next election	TO COMPLETE THIS FORM:
		˜	Box 1 – If you do not have a middle name, print "none"
˜	not be convicted and in jail	˜	Box 3: – If you have never registered before, print “none”. If you do not remember your former address, print "unsure". If you have not changed your name, print "same".
˜	not claim the right to vote anywhere else
DEADLINE INFORMATION:
˜	Mail or deliver this form no later than 29 days before the next election.	˜	Box 8 – Read, date and personally sign your name or
			make your mark in the box.
˜	If you do not receive a Notice within 2 weeks of mailing or delivering this form, call the County Clerk or Board of Election Commissioners named on the front of this card.	IF YOU HAVE NO STREET ADDRESS, describe your home:  list the name of subdivisions; cross streets; roads; landmarks, mileage and/or neighbor's names.
IMPORTANT INFORMATION:
˜	if you register by mail, the first time you vote must be in person	N
		W						E
˜	if you register at a public service agency, any information regarding the agency which assisted you will remain confidential as will any decision not to register
					S

 

FOLD LINE

PRINT CLEARLY OR TYPE IN BLACK OR BLUE INK

Office Use

1.  Last NAME

First Name

Middle Name or Initial

Suffix (Circle One)

JR. SR. II III IV

2.  Address where you live (do not give P.O. address) House No.         Street Name

City/Village/Town

Township

Apt. No./P.O. Box

County

Zip Code

3.  Former Registration Address: (include City and State)

County

Former Name: (if changed)

4. Date of Birth:

5. Sex (Circle One)

6. Telephone Number (optional)

7.  Full Social Security No. Or last 4 digits only

Month  Day  Year

M               F

 

8.

Voter Affidavit – Read all statements and sign within

˜

This is my signature or mark in the space below.

the box to the right.  I swear or affirm that

˜

I am a citizen of the United States:

˜

I will be at least 18 years old on or before the next election;

é

ů

˜

I will have lived in the State of Illinois and in my election precinct 30 days as of the date of the next election.

˜

All of the above information is true.  I understand that if it is not true, I can be convicted of perjury and fined up to $5,000 and/or jailed for 2 to 5 years.

ë

ű

Date:

9.

If you cannot sign your name, ask the person who helped you fill in this form to print their name, address and telephone number.

Name

Full Address

Telephone No.

FOLD ON DOTED LINES, PEEL OFF TAPE, SEAL AND MAIL

*Mandated Oct. 1996

 

YOUR ADDRESS

back of SBE No. R-19

PUT

FIRST

CLASS

STAMP

HERE

MAIL TO:

CHANGE OF ADDRESS

PCT

WARD

CODE

ADDRESS

CITY

ZIP

COUNTY

DATE

CLERK

SUSPENSION, CANCELLATION AND REINSTATEMENT

DATE

EXPLAIN

CLERK

DATE

EXPLAIN

CLERK

To Election Judges:

Voting Record

95  96  97  98  99  01  02  03  04  05  06  07  08  09  10  11  12  13  14  15  16  17  18  19  20

For Primary, mark

Primary

D for Democrat

General

R for Republican

NonPartisan

for all other

Special

elections, markV

 

 

 

*Mandated: Oct. 1996

SBE No. R-19A

 

Office Use

1.  Last Name             First Name                 Middle Name or Initial

Suffix (Circle One) JR. SR. II III IV

2.  Address where you live (do not give P.O. address)    House No.    Street Name

City/Village/Town

Township

Apt. No./P.O. Box

County

Zip Code

3.  Former Registration Address: (include City and State)

County

Former Name: (if changed)

4.  Date of Birth: Month    Day    Year

5.  Sex (Circle One) M          F

6.  Telephone Number (optional)

7.  Full Social Security No. Or last 4 digits only

8.

Voter Affidavit – Read all statements and sign within

˜

This is my signature or mark in the space below.

the box to the right.  I swear or affirm that

˜

I am a citizen of the United States;

˜

I will be at least 18 years old on or before the next

election;

é

ů

˜

I will have lived in the State of Illinois and in my

election precinct 30 days as of the date of the next

election.

˜

All of the above information is true.  I understand

ë

ű

that if it is not true, I can be convicted of perjury and

fined up to $5,000 and/or jailed for 2 to 5 years.

Date:

9.

If you cannot sign your name, ask the person who helped you fill in this form to print their name, address and telephone number.

Name

Full Address

Telephone No.

back of SBE No. R-19A

CHANGE OF ADDRESS

PCT

WARD

CODE

ADDRESS

CITY

ZIP

COUNTY

DATE

CLERK

SUSPENSION, CANCELLATION AND REINSTATEMENT

DATE

EXPLAIN

CLERK

DATE

EXPLAIN

CLERK

To Election Judges:

Voting Record

95  96  97  98  99  01  02  03  04  05  06  07  08  09  10  11  12  13  14  15  16  17  18  19 20

For Primary, mark

Primary

D for Democrat

General

R for Republican

NonPartisan

for all other

Special

elections, markV

STOCK 110 lb. CARD OR COMPARABLE STOCK

 

 

COLOR                                 WHITE

 

SIZE                                       5" x 8"

 

TYPEFACE                          SIMPLE SANS SERIF, 7 AND 8 PT.

 

 

AS MANDATED BY PUBLIC LAW 103-31, THE FOLLOWING INFORMATION MUST BE PRINTED IN THE SAME TYPEFACE (ONLY THIS MATERIAL, WILL BE PRINTED IN THE 8 PT. TYPEFACE): THE BULLETED INFORMATION IN THE INSTRUCTIONS SECTION ENTITLED "TO REGISTER YOU MUST" AND "IMPORTANT INFORMATION" AND THE INFORMATION ON THE REGISTRATION FORM #8 "VOTER AFFIDAVIT"

 

SEAL                                     PULL OFF ADHESIVE TAPE

(bottom edge)

 

 

 

Section 216.EXHIBIT B  Voter Registration Information

 

Mandated

July, 1995

SBE No. R-24

 

VOTER  REGISTRATION  INFORMATION

 

"If you are not registered to vote where you live now, would you like to apply to register here today?"

IMPORTANT!

 

(Public assistance agencies include the following: "Applying to register or declining to register to vote will not affect the amount of assistance that you will be provided by this agency.")

If you would like help filling out the voter registration application form, we will help you.  The decision whether to seek or accept help is yours. You may fill out the application in private.

 

IF YOU DO NOT CHECK EITHER BOX, YOU WILL BE CONSIDERED TO HAVE DECIDED NOT TO REGISTER TO VOTE AT THIS TIME.          □YES                □NO __________________________________________ Signature	All information will remain confidential and will be used only for voter registration purposes.  Anyone not choosing to register to vote and/or information regarding the office to which the application was submitted will remain confidential, to be used only for voter registration purposes.     ___________________________________ Please Print Full Name
month                                day                                        year   ____________________________________________________ Date

 

 

(Half 8 ˝" x 11" sheet)

 

 

Section 216.EXHIBIT C  Voter Registration Application Transmittal

 

Suggested

July, 1995

SBE No. R-25

 

VOTER  REGISTRATION  APPLICATION

TRANSMITTAL

 

To:        _________________________________                      _____________________

                                  Election Office                                                                                Date

 

From:    _________________________________

                     Agency Office Number or Designation

 

Number of Voter Registration Applications Enclosed:  _________________________

 

Comments:  _____________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

 

(To be completed by Election Authority)

 

Date Received:  _________________

 

Number of Applications Received:__________________________________________

 

Number of Duplicate Registrations in Group:_________________________________

 

Number of Incomplete Applications:   _______________________________________

 

Problems or Other Comments:   ____________________________________________

 ________________________________________________________________________

 

________________________________________________________________________

 

 

 

White Copy – Election Authority                                        Yellow Copy – Agency

 

 

Section 216.EXHIBIT D  Disposition of Registration

 

 

Mandated July, 1995 SBE No. R-23

DISPOSITION OF REGISTRATION

(Application Rejected)

BACK

YOUR APPLICATION TO REGISTER TO VOTE HAS BEEN REFUSED FOR THE REASON(S) INDICATED BELOW.  YOU MUST REAPPLY TO BE ENTITLED TO VOTE.

4 X 6

Address could not be verified.

Application incomplete.

Application rejected because

Other

For questions about this notice call

County Clerk or

Board of Election Commissioners

Date

Phone No.

 

 

ELECTION OFFICIAL

ELECTION OFFICE

FIRST CLASS MAIL

STREET ADDRESS OF PO BOX

U.S. POSTAGE

CITY, ST. 00000-0000

ANYTOWN, STATE

FRONT

PERMIT NO. 0000

4 X 6

OFFICIAL ELECTION MATERIAL

Non-Address Data

Name of Recipient

Information Attention Line

Delivery Address

Post Office (City) State Zip Code

 

 

Section 216.EXHIBIT E...Voter Identification Card

 

10 ILCS 5/4-15, 5-21, 6-57	Suggested
	Revised July, 1995
	SBE No. R-15
SUGGESTED VOTER I.D. 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)

 

Section 216.EXHIBIT F  Confirmation of Address

 

SIDE A (top) Second Notice (Bottom) Addressee Side-Reply Card   (6 x 8" duo-fold Postcards)

Suggested Revised, Jan. 1997 SBE No. R-26

CONFIRMATION OF ADDRESS   □     OUR RECORDS INDICATE THAT YOU HAVE MOVED TO ______________________________.   •      To confirm this information complete and return the postcard at the bottom, not later than              _________________________________________ .     •      This new address has been added to your voter registration record.  Your new precinct is ______.   □     WE HAVE NOT BEEN ABLE TO CONFIRM YOUR ADDRESS.     •      Please complete and return the postcard at the bottom, not later than _____________________.     •      If this card is not returned, you may be required to confirm your address before being permitted to vote in a Federal election.  If this card is not returned and you fail to vote during the period beginning on the date of this notice and ending on the date of the second general election that occurs after the date of the notice, your registration will be cancelled.   □      IF YOU HAVE MOVED TO AN ADDRESS OUTSIDE OF ________________________________

4 x 6

OUTGOING

POSTCARD

(jurisdiction)

•  You will have to register with the County Clerk or Board of Election Commissioners where you live.  (Consult your telephone directory.)

(tear here)

perforated

perforated

fold

fold

NO POSTAGE

NECESSARY

IF MAILED

BUSINESS REPLY MAIL

IN THE

FIRST CLASS MAIL PERMIT NO 0000 ANYTOWN, STATE

UNITED STATES

preprinted FIMC

POSTAGE WILL BE PAID BY ADDRESSEE

OFFICIAL ELECTION MATERIAL

4 x 6

PREPAID

REPLY

ELECTION OFFICIAL

ELECTION OFFICE

STREET ADDRESS OR PO BOX

CITY, ST 00000-0000

 

	Preprinted Address	Preprinted Bar Code
	With Zip + 4	Corresponding to Zip + 4

 

Section 216.EXHIBIT G  Registration Deadline Notice

 

Suggested

July, 1995

SBE No. R-28

 

 

 

 

 

 

 

FRONT

4 x 6

postcard

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BACK

 

 

Section 216.EXHIBIT H  Address Correction for Fail Safe Voter

 

Mandated

December, 1995

SBE No. C-6

 

 

ADDRESS CORRECTION FOR FAIL-SAFE VOTER

 

□    FEDERAL  BALLOT  ONLY

 

·                     Voters who change residence to another address within Election Authority's jurisdiction.

 

·                     Voting in former residence polling place or when applying for absentee ballot.

 

 

 

Social Security Number (last four numbers:  ______________________________

 

Date of Birth:  ________________________

 

Voter's Full Name (Please Print):

 

__________________________________________________________________

 

Current Address:

 

__________________________________________________________________

 

City/Village ___________________________       Zip Code _________________

 

Former Address:

 

__________________________________________________________________

 

City/Village ___________________________       Zip Code _________________

 

 

 

 

__________________                                      _____________________________

Date                                                                   Signature of Voter or Mark