I. Any person registering to vote shall be:
(a) At least 18 years of age on the day of the next election; and
(b) A United States citizen; and
(c) Domiciled in the town or city in which the applicant is registering to vote and not otherwise disqualified to vote.
II. The applicant shall be required to produce appropriate proof of qualifications as provided in RSA 654:12 and fill out the form as prescribed in paragraph III.
III. (a) Standard registration application forms shall be used throughout the state. The registration forms shall be no larger than 8 1/2 inches by 11 inches.
(b) The secretary of state shall prescribe the form of the voter registration form to be used for voter registrations, transfers, or updates, which shall be in substantially the following form:
_____ NEW REGISTRATION I am not registered to vote in New Hampshire
_____ TRANSFER I am registered to vote in New Hampshire and have moved my voting domicile to a new town or ward in New Hampshire
_____ NAME CHANGE/ADDRESS UPDATE I am registered to vote in this town/ward and have changed my name/address
Date ____________________
VOTER REGISTRATION FORM
(Please print or type)
1. Name
Last (suffix) First Full Middle Name
2. Domicile Address
Street Ward Number
Town or City Zip Code
3. Mailing Address if different than in 2
Street
Town or City Zip Code
4. Place and Date of Birth
Town or City State
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
Street Ward Number
I am not currently registered to vote elsewhere (initial here __________ ), or I request that my name be removed as a registered voter in ____________________ (fill in your address where previously registered, street, city/town, state, and zip code)
7. Name under which previously registered, if different from above
8. Party Affiliation (if any)
9. Driver's License Number
____________________
State
If 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. If a city, ward number _____ .
I understand that to vote in this ward/town, I must be at least 18 years of age, I must be a United States citizen, and I must be domiciled in this ward/town.
I understand that a person can claim only one state and one city/town as his or her domicile at a time. I understand that my domicile for voting is that one place from which I participate in democratic self-government and that I have acted to carry out that intent. By registering or voting today, I am acknowledging that I am not domiciled or voting in any other state or any other city/town.
In declaring New Hampshire as my domicile, I realize that I am not qualified to vote in the state or federal elections in another state.
If 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.
I 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.
Date Signature of Applicant
In accordance with RSA 659:34, the penalty for knowingly or purposely 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.