Voter Registration Application
En Español
Important: You must know your county of residence in order to fill out the form which begins on this screen.
Are you a United States Citizen?YesNo
Will you be 18 years of age on or before election day?YesNo
Application Type:NewChangeReplacementAre you interested in serving as an election worker?YesNoApplicant Information
First Name: | Middle Name (if any): | Last Name (Include suffix if any (Jr, Sr, III)): | Former Name: (if any) |
Date of Birth: (mm/dd/yyyy) | Gender (optional)
Select... Male Female | Telephone Number, Include Area Code: (Optional) | |
Texas Driver's License No. or Texas Personal I.D. No. (Issued by the Department of Public Safety): | | | |
If no Texas Driver's License or Texas 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 | | | |
Residence Address: Street Address and Apartment Number. If none, describe where you live.(Do not include P.O. Box, Rural Rt. or Business Address)
County:
Select... ANDERSON ANDREWS ANGELINA ARANSAS ARCHER ARMSTRONG ATASCOSA AUSTIN BAILEY BANDERA BASTROP BAYLOR BEE BELL BEXAR BLANCO BORDEN BOSQUE BOWIE BRAZORIA BRAZOS BREWSTER BRISCOE BROOKS BROWN BURLESON BURNET CALDWELL CALHOUN CALLAHAN CAMERON CAMP CARSON CASS CASTRO CHAMBERS CHEROKEE CHILDRESS CLAY COCHRAN COKE COLEMAN COLLIN COLLINGSWORTH COLORADO COMAL COMANCHE CONCHO COOKE CORYELL COTTLE CRANE CROCKETT CROSBY CULBERSON DALLAM DALLAS DAWSON DEAF SMITH DELTA DENTON DEWITT DICKENS DIMMIT DONLEY DUVAL EASTLAND ECTOR EDWARDS EL PASO ELLIS ERATH FALLS FANNIN FAYETTE FISHER FLOYD FOARD FORT BEND FRANKLIN FREESTONE FRIO GAINES GALVESTON GARZA GILLESPIE GLASSCOCK GOLIAD GONZALES GRAY GRAYSON GREGG GRIMES GUADALUPE HALE HALL HAMILTON HANSFORD HARDEMAN HARDIN HARRIS HARRISON HARTLEY HASKELL HAYS HEMPHILL HENDERSON HIDALGO HILL HOCKLEY HOOD HOPKINS HOUSTON HOWARD HUDSPETH HUNT HUTCHINSON IRION JACK JACKSON JASPER JEFF DAVIS JEFFERSON JIM HOGG JIM WELLS JOHNSON JONES KARNES KAUFMAN KENDALL KENEDY KENT KERR KIMBLE KING KINNEY KLEBERG KNOX LAMAR LAMB LAMPASAS LASALLE LAVACA LEE LEON LIBERTY LIMESTONE LIPSCOMB LIVE OAK LLANO LOVING LUBBOCK LYNN MADISON MARION MARTIN MASON MATAGORDA MAVERICK MCCULLOCH MCLENNAN MCMULLEN MEDINA MENARD MIDLAND MILAM MILLS MITCHELL MONTAGUE MONTGOMERY MOORE MORRIS MOTLEY NACOGDOCHES NAVARRO NEWTON NOLAN NUECES OCHILTREE OLDHAM ORANGE PALOPINTO PANOLA PARKER PARMER PECOS POLK POTTER PRESIDIO RAINS RANDALL REAGAN REAL RED RIVER REEVES REFUGIO ROBERTS ROBERTSON ROCKWALL RUNNELS RUSK SABINE SAN AUGUSTINE SAN JACINTO SAN PATRICIO SAN SABA SCHLEICHER SCURRY SHACKELFORD SHELBY SHERMAN SMITH SOMERVELL STARR STEPHENS STERLING STONEWALL SUTTON SWISHER TARRANT TAYLOR TERRELL TERRY THROCKMORTON TITUS TOM GREEN TRAVIS TRINITY TYLER UPSHUR UPTON UVALDE VAL VERDE VAN ZANDT VICTORIA WALKER WALLER WARD WASHINGTON WEBB WHARTON WHEELER WICHITA WILBARGER WILLACY WILLIAMSON WILSON WINKLER WISE WOOD YOAKUM YOUNG ZAPATA ZAVALA | Address: | City: |
State: | Zip: | |
City and County of Former Residence in Texas: | | |
Mailing Address: Street Address and Apartment Number. (If mail cannot be delivered
to your residence address)
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 one year in jail, 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.
Please verify your data is correct before you "Submit."