HB 183 - AS AMENDED BY THE HOUSE
6Jan2016... 3030h
2015 SESSION
\t15-0124
\t03/05
HOUSE BILL\t\t183
AN ACT\trelative to voter registration forms.
COMMITTEE:\tElection Law
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ANALYSIS
\tThis bill modifies the content of voter registration forms.
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Explanation:\tMatter added to current law appears in bold italics.
\t\tMatter removed from current law appears [in brackets and struckthrough.]
\t\tMatter which is either (a) all new or (b) repealed and reenacted appears in regular type.
6Jan2016... 3030h\t15-0124
\t03/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Fifteen
AN ACT\trelative to voter registration forms.
Be it Enacted by the Senate and House of Representatives in General Court convened:
\t1 Voter Registration Form. Amend RSA 654:7, IV to read as follows:
\t\tIV.(a) A standard registration application form shall be used throughout the state. The registration form shall be no larger than 8 1/2 inches by 11 inches.
\t\t\t(b) The secretary of state shall prescribe the form of the voter registration form to be used for voter registrations other than those at the polling place on the date of a state general election, which shall be in substantially the following form:
\tDate _________________
VOTER REGISTRATION FORM
\t(Please print or type)
1. Name _________________________________________________________________________
\t\t\t\tLast\t\t(suffix) First\t\t\tFull Middle Name
2. Domicile Address _______________________________________________________________
\t\t\t\t\t\t\t\tStreet \t\t\t\tWard Number
__________________________________________________________________________________
\t\t\t\tTown or City\t\t\t\t\t\tZip Code
3. Mailing Address if different than in 2 ____________________________________________
\t\t\t\t\t\t\t\t\t\t\tStreet
__________________________________________________________________________________
\t\t\t\tTown or City \t\t\t\t\t\tZip Code
4. Place and Date of Birth _________________________________________________________
\t\t\t\t\t\t\t\tTown or City\t\t\tState
\tDate_________________
5. Are you a citizen of the United States? Yes _____ No _____
If a naturalized citizen, give name of court where and date when naturalized __________________________________________________________________________________
6. Place last registered to vote _____________________________________________________
\t\t\t\t\t\t\t\t\tStreet\t\t\tWard Number
7. Name under which previously registered, if different from above
\t_______________________________________________________________________________
8. Party Affiliation (if any) ______________________________________________________
9. Driver’s License Number __________________________State ______________________
\tIf you do not have a valid driver’s license, provide the last four digits of your social security number ____________
My name is ____________________. I am today registering to vote in the city/town of ____________________, New Hampshire.
\tI understand that to vote in this city/town, I must be at least 18 years of age, I must be a United States citizen, and I must be domiciled in this city/town.
\tI understand that a person can claim only one state and one city/town as his or her domicile at a time. A domicile is that place, to which upon temporary absence, a person has the intention of returning. By registering or voting today, I am acknowledging that I am not domiciled or voting in any other state or any other city/town.
\t[In declaring New Hampshire as my domicile, I am subject to the laws of the state of New Hampshire which apply to all residents, including laws requiring a driver to register a motor vehicle and apply for a New Hampshire’s driver’s license within 60 days of becoming a resident.]
\tIn declaring New Hampshire as my domicile, I realize that I am not qualified to vote in the state or federal elections in another state.
\tIf I have any questions as to whether I am entitled to vote in this city/town, I am aware that a supervisor of the checklist is available to address my questions or concerns.
\tI acknowledge that I have read and understand the above qualifications for voting and do hereby swear, under the penalties for voting fraud set forth below, that I am qualified to vote in the above-stated city/town, and, if registering on election day, that I have not voted and will not vote at any other polling place this election.
____________________ ___________________________________________________
\t\tDate\t\t\t\t\tSignature of Applicant
\tIn accordance with RSA 659:34, the penalty for knowingly or purposefully providing false information when registering to vote or voting is a class A misdemeanor with a maximum sentence of imprisonment not to exceed one year and a fine not to exceed $2,000. Fraudulently registering to vote or voting is subject to a civil penalty not to exceed $5,000.
\t\t\t(c) The secretary of state shall prescribe the form of the voter registration form to be used only for voter registrations at the polling place on the date of a state general election, which shall be in substantially the following form:
Date _________________
VOTER REGISTRATION FORM
FOR USE AT THE POLLING PLACE ON THE DATE OF THE STATE GENERAL ELECTION
\t(Please print or type)
1. Name _________________________________________________________________________
\tLast\t(suffix) First\tFull Middle Name
2. Domicile Address _______________________________________________________________
\t\t\t\t\t\t\t\tStreet \t\t\t\tWard Number
__________________________________________________________________________________
\t\t\t\tTown or City\t\t\t\t\tZip Code
3. Mailing Address if different than in 2 ____________________________________________
\t\t\t\t\t\t\t\t\t\t\tStreet
__________________________________________________________________________________
\t\t\t\tTown or City \t\t\t\t\tZip Code
4. Place and Date of Birth _________________________________________________________
\t\t\t\t\t\t\t\tTown or City \t\t\t\tState
Date_________________
5. Are you a citizen of the United States? Yes _____ No _____
If a naturalized citizen, give name of court where and date when naturalized __________________________________________________________________________________
6. Place last registered to vote _____________________________________________________
\t\t\t\t\t\t\t\t\tStreet\t\t\tWard Number
7. Name under which previously registered, if different from above
________________________________________________________________________________
8. Party Affiliation (if any) ______________________________________________________
9. Driver’s License Number __________________________State ______________________
\tIf you do not have a valid driver’s license, provide the last four digits of your social security number ______________
My name is ____________________. I am today registering to vote in the city/town of ____________________, New Hampshire.
\tI understand that to vote in this city/town, I must be at least 18 years of age, I must be a United States citizen, and I must be domiciled in this city/town.
\tI understand that a person can claim only one state and one city/town as his or her domicile at a time. A domicile is that place, to which upon temporary absence, a person has the intention of returning. By registering or voting today, I am acknowledging that I am not domiciled or voting in any other state or any other city/town.
\t[In declaring New Hampshire as my domicile, I am subject to the laws of the state of New Hampshire which apply to all residents, including laws requiring a driver to register a motor vehicle and apply for a New Hampshire’s driver’s license within 60 days of becoming a resident.]
\tIn declaring New Hampshire as my domicile, I realize that I am not qualified to vote in the state or federal elections in another state.
\tIf I have any questions as to whether I am entitled to vote in this city/town, I am aware that a supervisor of the checklist is available to address my questions or concerns.
\tI acknowledge that I have read and understand the above qualifications for voting and do hereby swear, under the penalties for voting fraud set forth below, that I am qualified to vote in the above-stated city/town, and, if registering on election day, that I have not voted and will not vote at any other polling place this election.
____________________ ___________________________________________________
\t\tDate\t\t\t\t\tSignature of Applicant
If this form is used in place of proof of identity, age, citizenship, or domicile, I hereby swear that such information is true and accurate to the best of my knowledge.
\tThis form was executed for purposes of proving (applicant shall circle yes or no and initial each item):
\tIdentity\t\t\tyes/no\t_____
\t\t\t\t\t\t\t(initials)
\tCitizenship\t\t\tyes/no\t_____
\t\t\t\t\t\t\t(initials)
\tAge\t\t\t\t\tyes/no\t_____
\t\t\t\t\t\t\t(initials)
\tDomicile\t\t\tyes/no\t_____
\t\t\t\t\t\t\t(initials)
______________________________________\t\t\t____________________________
\t\t\tApplicant\t\t\t\t\t\t\tElection Official
________________________________
Notary Public/Justice of the Peace/Official Authorized by RSA 659:30
\tIn accordance with RSA 659:34, the penalty for knowingly or purposefully providing false information when registering to vote or voting is a class A misdemeanor with a maximum sentence of imprisonment not to exceed one year and a fine not to exceed $2,000. Fraudulently registering to vote or voting is subject to a civil penalty not to exceed $5,000.
\t2 Effective Date. This act shall take effect 60 days after its passage.