1 Determining Qualifications of Applicant: Domicile. Amend RSA 654:12, I(c) to read as follows:

(c) DOMICILE. Any reasonable documentation which indicates that the applicant has a domicile and intends to maintain a domicile, as defined in this chapter, in the town, city, or ward in which he or she desires to vote, or,. When registering on election day as provided in RSA 654:7-a, if the applicant does not have reasonable documentation in his or her possession at the place and time of voter registration, a sworn statement on the general election day voter registration form, or he or she may execute an affidavit in the following form, which shall be retained in accordance with RSA 33-A:3-a:

DOMICILE AFFIDAVIT

Date: ________

First Name: _________

Middle Name: _________

Last Name: _________

Date of birth: __________

Place of birth: __________

Current Domicile Address: ________

Street Ward Number

Town or City Zip Code

Current Mailing Address (if different): ________

Street Ward Number

Town or City Zip Code

Telephone number (requested but optional) ________

Email address (requested but optional) _________

Date when current domicile was established: Month: _ Year: ___

Place and date of birth: ______

Owner's name for property designated as your current domicile address: _______

Applicant's relationship to property owner: ________

If renting, do you have a written rental/lease agreement? _____

Address of last previous domicile: ________

Street Ward Number

Town or City Zip Code

I hereby swear and affirm, under the penalties for voting fraud set forth below, that I am not currently in possession of necessary documents to prove my domicile and that my established domicile is at the current domicile address I have entered above. I 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 city/town, and that to the best of my knowledge and belief the information above is true and correct.

(Signature of applicant)

In 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.

On the date shown above, before me, ____ (print name of notary public, justice of the peace, election officer), appeared ______ (print name of person whose signature is being notarized), (known to me or satisfactorily proven (circle one)) to be the person whose name appears above, and he or she subscribed his or her name to the foregoing affidavit and swore that the facts contained in this affidavit are true to the best of his or her knowledge and belief.

Notary Public/Justice of the Peace/Official Authorized by RSA 659:30

2 Effective Date. This act shall take effect 60 days after its passage.

1 Determining Qualifications of Applicant: Domicile. Amend RSA 654:12, I(c) to read as follows:

(c) DOMICILE. Any reasonable documentation which indicates that the applicant has a domicile and intends to maintain a domicile, as defined in this chapter, in the town, city, or ward in which he or she desires to vote. When registering on election day as provided in RSA 654:7-a, if the applicant does not have reasonable documentation in his or her possession he or she may execute an affidavit in the following form, which shall be retained in accordance with RSA 33-A:3-a:

DOMICILE AFFIDAVIT

Date: ________

First Name: _________

Middle Name: _________

Last Name: _________

Date of birth: __________

Place of birth: __________

Current Domicile Address: ________

Street Ward Number

Town or City Zip Code

Current Mailing Address (if different): ________

Street Ward Number

Town or City Zip Code

Telephone number ________

Email address (requested but optional) _________

Date when current domicile was established: Month: _ Year: ___

Owner's name for property designated as your current domicile address: _______

Applicant's relationship to property owner: ________

If renting, do you have a written rental/lease agreement? _____

Address of last previous domicile: ________

Street Ward Number

Town or City Zip Code

I hereby swear and affirm, under the penalties for voting fraud set forth below, that I am not currently in possession of necessary documents to prove my domicile and that my established domicile is at the current domicile address I have entered above. I 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 city/town, and that to the best of my knowledge and belief the information above is true and correct.

(Signature of applicant)

In 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.

On the date shown above, before me, ____ (print name of notary public, justice of the peace, election officer), appeared ______ (print name of person whose signature is being notarized), and he or she subscribed his or her name to the foregoing affidavit and swore that the facts contained in this affidavit are true to the best of his or her knowledge and belief.

Notary Public/Justice of the Peace/Official Authorized by RSA 659:30

2 Effective Date. This act shall take effect 60 days after its passage.