1. Each voter registration form shall provide space for the registrant to provide the following information:
a. The county where the registrant resides.
b. The registrant's name.
c. The address at which the registrant resides and claims as the registrant's residence for voting purposes.
d. The registrant's mailing address if it is different from the residence address.
e. Social security number of the registrant (optional to provide).
f. Date of birth.
h. Residential telephone number (optional to provide).
i. Political party registration.
j. The name and address appearing on the registrant's previous voter registration.
k. A space for a rural resident to provide township and section number, and such additional information as may be necessary to describe the location of the rural resident's home.
l. A space for a registrant who is homeless or who has no established residence to provide such information as may be necessary to describe a place to which the person often returns.
m. A statement that lists each eligibility requirement, contains an attestation that the registrant meets all of the requirements, and requires the signature of the registrant under penalty of perjury.
n. A space for the registrant's signature and the date signed.
2. The voter registration form shall include, in print that is identical to the attestation portion of the form, the following:
a. Each voter eligibility requirement.
b. The penalty provided by law for submission of a false voter registration form, which shall be the penalty for perjury as provided by section 902.9, subsection 4.
3. Voter registration forms used by voter registration agencies under section 48A.19 shall include the following statements:
a. If a person declines to register to vote, the fact that the person has declined to register will remain confidential and will be used only for voter registration purposes.
b. If a person does register to vote, the office at which the registrant submits a voter registration form will remain confidential and the information will be used only for voter registration purposes.
4. Voter registration forms may be on paper or electronic media.
5. All forms for voter registration shall be prescribed by rule adopted by the state voter registration commission.
94 Acts, ch 1169, §12
Referred to in § 47.7
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© 1999 Cornell College and League of Women Voters of Iowa
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