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You are non registered until you:
Print, sign, stamp, and mail complete forge.
INSTRUCTIONS
1 Print and Sign the form. You mustiness sign
the voter enrolment form before you
mail it.
2 Make a mailer by f sure-enough(a)ing the address sheet
in half. Make sure the address is visible on the
outside. fleck registration form in mailer and
fold. Tape or staple the folded form at the
bottom to create the mailer. Alternately,
place your form in an envelope and hand
address it to the Secretary of State.
Mail to the future(a) address:
NYS Board of Elections
40 Steuben Street
Albany, NY 12207-2108
REGISTRATION DEADLINE:
25 eld before the election
HO W TO MAKE
A MAILER
3 opinion it. Place a first class stamp on your
new envelope.
4 Mail it. Put your voter registration form
in the mail.
5 Vote. On Election Day, go to the canvas and
vote.
See the accompanying page for full
operating instructions on complemental your voter
registration application.
Voter Registration Application
Before completing this form, palingenesis the General, Application, and State specific instructions.
Are you a citizen of the United States of the States?
No
X Yes
Will you be 18 years old on or before election day?
No
X Yes
If you checked No in response to either of these questions, do not complete form.
This space for office use only.
(Please match state-specific instructions for rules regarding eligibility to register prior to age 18.)
1
2
3
(Circle one)
Last Name
head start Name
Mr. Mrs. Miss Ms.
Pallotta
Stephen
Home grapple
9 Shereen Lane
State
Zip Code
Latham
NY
12110
State
Zip Code
bid Number (optional)
Day
ID Number - (See item 6 in the instructions for your state)
5 9143460418
8/27/94
Month
9
City/Town
City/Town
Address Where You Get Your Mail If Different From Above
4
(Circle one)
Jr Sr II tercet IV
Apt. or Lot #
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