TITLE 26: ELECTIONS
CHAPTER I: STATE BOARD OF ELECTIONS
PART 216 REGISTRATION OF VOTERS
SECTION 216.EXHIBIT F CONFIRMATION OF ADDRESS

 

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

 

back of SBE No. R-26

 

 

 

 

 

Preprinted FIMB If Postage Paid

 

 

 

Without Bar Code

 

 

 

Preprinted Address

 

Preprinted FIMC If Postage Paid

 

 

 

 

 

and Bar Code is Applied

 

 

 

 

 

 

 

 

 

 

ELECTION OFFICIAL

 

 

 

 

 

ELECTION OFFICE

 

 

 

 

 

Method of

OUTGOING

 

STREET ADDRESS OR PO BOX

 

FIRST CLASS MAIL

 

Postage at

FIRST CLASS

 

CITY, ST 00000-0000

 

U.S. POSTAGE PAID

 

Discretion  of

POSTCARD

 

 

 

 

ANYTOWN, STATE

 

Election Authority

 

 

 

 

PERMIT NO. 0000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICIAL ELECTION MATERIAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Optional Line)

 

 

NON-ADDRESS DATA

 

 

 

(Top Line)

 

 

NAME OF RECIPIENT

 

 

 

(Optional Line)

 

 

INFORMATION/ATTENTION LINE

 

4 x 6

 

(Line Above Last)

 

 

DELIVERY ADDRESS

 

 

 

 

 

 

POST OFFICE (CITY) STATE ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

Bar Code Area

If automatically

applied

 

 

 

 

 

 

 

 

 

 

 

 

perforated fold

 

PLEASE CHECK ONE

□  NEW ADDRESS

□  SAME ADDRESS

 

perforated fold

 

 

PRINT FULL NAME

 

 

 

 

 

 

(Include Middle Name)

 

 

 

 

DATE OF BIRTH

 

 

 

 

 

 

SOCIAL SECURITY NUMBER

 

 

 

4 x 6

 

 

(Last four numbers only)

 

 

REPLY

 

TELEPHONE NUMBER (Optional)

 

 

 

 

POSTCARD

 

MY ADDRESS IS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Signature)

 

 

 

 

 

 

 

 

 

 

 

 

 

(Date)

 

 

 

 

 

 

 

 

 

*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 2 to 5 years.