Check boxes that apply
A person applying for voter registration for the first time in Florida should indicate by placing an “X’ in the New Registration box. The form may also be used to update a voter’s address or signature, change name or party, or to request a new voter information card.

Are you a citizen of the United States of America ? (Required)
In order to register to vote, one must be a U.S. citizen.

I affirm I am not a convicted felon, or if I am, my rights relating to voting have been restored (Required)
An applicant who has been convicted of a felony and has not had his/her civil rights with respect to voting restored, is not eligible to register.

I affirm I have not been adjudicated mentally incapacitated with respect to voting or, if I have, my competency has been restored (Required)
An applicant who has been found by a court of law to be mentally incapacitated with respect to voting and who has not had his/her competency restored, is not eligible to register.

Date of Birth (Required)
This information determines whether a person is old enough to register and vote One must be 18 years old to vote. However, you may pre-register to vote on or after your 17 th birthday.

Florida driver license or Florida ID card number or last four digits of Social Security number (Required)
If Applicant has a current and valid Florida driver license number or Florida ID card number, it must be provided. If applicant has neither, he/she must provide last four digits of Social Security number. If applicant has not been issued a Fl driver license, Fl ID card, or SSN, he/she should write “NONE” in the space provided.

Line 7

Last Name, Suffix, First Name, Middle Name/Initial (Required)
An applicant should use his/her full legal name on the applications. Nicknames should not be used.

Address Where You Live (Legal Residence) Do Not Give P.O. Box (Required)
An applicant must indicate his/her current residential address so that he/she can be placed in the proper voting precinct. Be sure to include the city and five digit zip code. The Sarasota County supervisor of elections will forward applications from non-Sarasota residents to the proper jurisdiction for processing.

Mailing Address if Different from Above
An applicant who wishes to receive mail at a P.O. Box or address other than his/her residence, may list it here.

Address Last Registered to Vote
An applicant who previously has been registered to vote should complete this section. The supervisor of elections will notify the prior jurisdiction to cancel the previous registration. A voter may not be registered in more than one jurisdiction at any time.

Former Name if Making Name Change & Day Phone Number
A person who is already registered in Florida and needs to change his/her name, should complete this section. (Voter should sign new name on line 16).

Party Affiliation (Check only one)
An applicant should indicate his/her party preference. This is important to determine whether a person will be eligible to vote in a party primary election. Note: Florida is a closed primary state, which means a person must be affiliated with one of the major political parties (Republican or Democrat) to vote in that party’s primary. A person may also affiliate with a minor party or choose no party affiliation.

Race/Ethnicity (Check only one)

• American Indian/Alaskan Native
• Asian/Pacific Islander
• Black, not Hispanic
• Hispanic
• White, not Hispanic

Sex – Check appropriate box

Do you need voting assistance at the polls? – Refers to the physical act of casting a ballot. An individual who is unable to read or write, or who, because of some disability, needs assistance in voting should mark “Yes.”

Are you interested in being a poll worker? – A person who selects “Yes” will be contacted by the SOE poll worker coordinator.

 State or Country of Birth – Applicant should indicate state or country of birth

Are You Active Duty Military/Merchant Marine, Dependent of Active Duty Military/Merchant Marine, U.S. Citizen Currently Residing Outside the U.S.
Check appropriate box.

Oath and Signature (Required)
Applicant should sign his/her name inside the blue box after reading the oath. By signing the form, the applicant affirms that all information on the form is true. If the information is not true, applicant could be convicted of a felony of the third degree and fined up to $5,000 and/or imprisoned for up to five years.