Texas Voter Registration Information

Languages

If you have any questions about how to fill out this application, please call your local voter registrar.

These Questions Must Be Completed Before Proceeding (check one)

New Application

Change of Address, Name, or Other Information

Request for a Replacement Card

Are you a United States Citizen?

Yes

Will you be 18 years of age on or before election day?

Yes

If you checked "No" in response to either of the above, do not complete this form.

Are you interested in serving as an election worker?

Yes

Personal Information

Last Name

First Name

Suffix

Middle Name (if any)

Former First Name (if any)

Former Last Name (if any)

Residence Address Information

House Number

Street If none, describe where you live. (Do not include P.O. Box, Rural Rt. or Business Address)

Unit Type

Unit Number

City

State TEXAS

Zip Code

County TRAVIS

Mailing Address Information

Address Street Address and Apartment Number. (if mail cannot be delivered to your residence address.)

City

State

Zip Code

City and County of Former Residence in Texas

City

County

Date of Birth

Month

Day

Year

Gender (optional)

Male

Female

Telephone Number (optional)

Texas Driver's License No. or Texas Personal I.D. No.(Issued by the Deparetment of Public Safety)

If no Texas Driver's License or Personal Identification, give last 4 digits of your Social Security Number

XXX-XX-

I have not been issued a Texas Driver's License/Personal Identification Number or Social Security Number

Check if true

Confirmation I understand that giving false information to procure a voter registration is perjury, and a crime under state and federal law. Conviction of this crime may result in imprisonment up to 1 year, a fine up to $4,000, or both. Please read all three statements to affirm before signing.

I am a resident of this county and a U.S. Citizen
I have not been finally convicted of a felony, or if a felon, I have completed all of my punishment including any term of incarceration, parole, supervision, period of probation, or I have been pardoned; and
I have not been determined by a final judgment of a court exercising probate jurisdiction to be totally mentally incapacitated or partially mentally incapacitated without the right to vote.