TO REGISTER TO VOTE IN MICHIGAN YOU MUST BE:
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1 State of Michigan Voter Registration Application and Michigan Driver License / Personal Identification Card Address Change Form -- Instructions and Special Notices -- TO REGISTER TO VOTE IN MICHIGAN YOU MUST BE: A resident of Michigan and the city or township where you are applying to register to vote. A citizen of the United States of America. At least 18 years of age (by election day). Not serving a sentence in jail or prison. YOU CAN USE THIS FORM TO: Register to vote in Michigan. Change your name or address on your voter registration NOTICE: VOTER REGISTRATION ADDRESS AND DRIVER LICENSE ADDRESS MUST BE THE SAME. Michigan law requires that the same address be used for voter registration and driver license purposes. Therefore, if the residence address you provide on this form differs from the address shown on a driver license or personal identification card issued by the State of Michigan, the Secretary of State will automatically change your driver license or personal identification card address to match the residence address entered on this form. If an address change is made, the Secretary of State will mail you an address update sticker for your driver license or personal identification card. Find your local clerk s office at Page 1 of 10
2 IDENTIFYING YOUR CITY OR TOWNSHIP OF RESIDENCE: Every person residing in Michigan lives in either a city or a township. If you do not know the name of your city or township, please describe your location in the space provided for If no house number or street address. Providing cross streets/roads and landmarks will help the clerk correctly identify your city or township. MAIL OR HAND DELIVER THIS FORM TO YOUR CITY OR TOWNSHIP CLERK. MAILING INSTRUCTIONS: If you live within the city limits of one of the cities listed in this packet, mail the application directly to the clerk of that city. If you do not live within one of the listed cities but you know or can locate the address of your city or township clerk, address and mail application directly to that clerk. Otherwise, mail the application to your county clerk (The addresses of Michigan s 83 county clerks are also listed in this packet.) The county clerk will forward it to your city or township clerk. Completed applications must be received or postmarked by the close of registration for an election in order to be effective for that election. IDENTIFICATION REQUIREMENT FOR NEW MICHIGAN REGISTRANTS: If you have never voted in Michigan and choose to submit this form by mail, place this form in an envelope and enclose one of the following forms of identification: (1) COPY of a current and valid photo identification (such as a driver license or personal ID card) or (2) COPY of a paycheck stub, utility bill, bank statement or a government document which lists your name and address. DO NOT SEND ORIGINAL ID DOCUMENTS BY MAIL. If identification is needed but not provided with this form, an Find your local clerk s office at Page 2 of 10
3 acceptable form of identification will be requested before you vote at the next federal election. The submission of an acceptable form of identification is not required if (1) you are updating your voter registration to show a move within the state (2) you submit this form in person or (3) another individual personally submits this form on your behalf. CONTACT YOUR CITY OR TOWNSHIP CLERK IF YOU HAVE ANY QUESTIONS. Your application is not valid until accepted by the clerk of the city or township in which you reside. If you do not receive a voter I.D. card within three weeks, contact your clerk. Find your local clerk s office at Page 3 of 10
4 Mail your application directly to your city or township clerk. If you do not live within one of the listed cities, you can locate the address of your city or township clerk by visiting mi/gov/vote and clicking on Find Your Clerk. Otherwise, mail this form to your county clerk, who will forward it. SELECTED CITY CLERKS ADDRESSES Ann Arbor 301 E Huron St, Ann Arbor Battle Creek 10 N Division St, Room 111, Battle Creek Bay City 301 Washington Ave, Bay City Dearborn Michigan Ave, Ste 11, Dearborn Detroit 2978 W Grand Blvd, Detroit Dearborn Heights 6045 Fenton, Dearborn Heights East Lansing 410 Abbott Rd, East Lansing Farmington Hills Eleven Mile Rd, Farmington Hills Flint 1101 S Saginaw, Flint Grand Rapids 300 Monroe Ave NW, Grand Rapids Hamtramck 3401 Evaline St, Hamtramck Kalamazoo 241 W South St, Kalamazoo Lansing 124 W Michigan, Lansing Lincoln Park 1355 Southfield Rd, Lincoln Park Livonia Civic Center Dr, Livonia Pontiac Woodward Ave, Pontiac Roseville PO Box 290, Roseville Royal Oak 211 Williams St, Royal Oak Saginaw 1315 S Washington, Saginaw St. Clair Shores Jefferson Cr Dr, St. Clair Shores Southfield Evergreen Rd, Southfield Sterling Heights Utica Rd, Sterling Heights Taylor Goddard, Taylor Troy 500 W Big Beaver, Troy Find your local clerk s office at Page 4 of 10
5 Warren One City Square, Suite 205, Warren Westland Warren Rd, Westland Wyoming th St SW, Wyoming Use if you cannot locate your city or township clerk. COUNTY CLERKS ADDRESSES Alcona th St, Harrisville Alger 101 Court St, Munising Allegan 113 Chestnut St, Allegan Alpena 720 Chisholm St, Alpena Antrim PO Box 520, Bellaire Arenac 120 N Grove, Standish Baraga 2 S Main St, Lanse Barry 220 W State St, Hastings Bay 515 Center St, Bay City Benzie 448 Court Place, Beulah Berrien 811 Port St, Saint Joseph Branch 31 Division St, Coldwater Calhoun 315 W Green St, Marshall Cass 120 N Broadway, Cassopolis Charlevoix 203 Antrim St, Charlevoix Cheboygan 870 S Main St, Cheboygan Chippewa 319 Court St, Sault Ste. Marie Clare 225 W Main St, Harrison Clinton 100 E. State St, Saint Johns Crawford 200 W Michigan, Grayling Delta 310 Ludington St, Escanaba Dickinson 705 S Stephenson, Iron Mountain Eaton 1045 Independence Blvd, Charlotte Emmet 200 Division St, Petoskey Genesee 900 S Saginaw St, Flint Find your local clerk s office at Page 5 of 10
6 Gladwin 401 W Cedar Ave, Gladwin Gogebic 200 N Moore, Bessemer Grand Traverse 400 Boardman Ave, Traverse City Gratiot 214 E Gratiot, Suite 16, Ithaca Hillsdale 29 N Howell St, Hillsdale Houghton 401 E Houghton Ave, Houghton Huron 250 E Huron Ave, Bad Axe Ingham PO Box 179, Mason Ionia 100 Main St, Ionia Iosco PO Box 838, Tawas City Iron 2 S 6th St, Crystal Falls Isabella 200 N Main St, Mt Pleasant Jackson 312 S Jackson St, Jackson Kalamazoo 201 W Kalamazoo Ave, Kalamazoo Kalkaska 605 N Birch St, Kalkaska Kent 300 Monroe NW, Grand Rapids Keweenaw th St, Eagle River Lake 800 Tenth St, Suite 200, Baldwin Lapeer 255 Clay St, Lapeer Leelanau 8527 E Government Ctr Dr, Suttons Bay Lenawee 425 N Main St, Adrian Livingston 200 E Grand River, Howell Luce 407 W Harrie St, Newberry Mackinac 100 S Marley St, Room 10, St. Ignace Macomb Elections Dept, 40 N Main St, Mt Clemens Manistee 415 3rd St, Manistee Marquette 234 W Baraga Ave, Marquette Mason 304 E Ludington Ave, Ludington Mecosta 400 Elm St, Big Rapids Menominee th Ave, Menominee Midland 220 W Ellsworth St, Midland Missaukee 111 S Canal St, Lake City Find your local clerk s office at Page 6 of 10
7 Monroe 106 E 1st St, Monroe Montcalm 211 W Main St, Stanton Montmorency M-32 W, Atlanta Muskegon 990 Terrace, Muskegon Newaygo 1087 Newell, White Cloud Oakland 1200 N Telegraph Bldg 12E, Pontiac Oceana 100 State St, Ste 1, Hart Ogemaw 806 W Houghton Ave, West Branch Ontonagon 725 Greenland Rd, Ontonagon Osceola 301 W Upton, Reed City Oscoda 311 Morenci Ave, Mio Otsego 225 W Main St, Gaylord Ottawa Fillmore St, West Olive Presque Isle PO Box 110, Rogers City Roscommon 500 Lake St, Roscommon Saginaw 111 S Michigan, Saginaw Sanilac 60 W Sanilac, Sandusky Schoolcraft 300 Walnut, Manistique Shiawassee 208 N Shiawassee, Corunna St. Clair 201 McMorran Blvd, Port Huron St. Joseph 125 W Main St, Centreville Tuscola 440 N State St, Caro Van Buren 212 Paw Paw, Paw Paw Washtenaw 200 N Main St, Ann Arbor Wayne 2 Woodward Ave, Room 502, Detroit Wexford 437 E Division, Cadillac Find your local clerk s office at Page 7 of 10
8 State of Michigan Voter Registration Application and Michigan Driver License/Personal Identification Card Address Change Form After completing application, sign and date in three spaces marked X. Additional signatures will be used for school or village records. BEFORE MAILING, REMOVE TAPE FROM OPPOSITE END OF FORM AND FOLD IN HALF TO SEAL CLOSED HERE. ANSWER FIRST Are you a citizen of the United States of America? Yes No Will you be 18 years of age on or before election day? Yes No If you checked No in response to either of these questions, do not complete this form. Last Name First Name Middle Name Address where you live - house number and street or road Apt. No./Lot No. Name of city or township where you live City Township of City MI Zip Code Name of county where you live If no house number or street address - describe location where you live - cross streets or roads, landmarks, etc. Find your local clerk s office at Page 8 of 10
9 Mailing Address (if different) For use on Driver License/Personal ID and Voter Registration For use on Voter Registration Only Date of Birth Sex / / M F ID Number Check applicable box and provide appropriate number. Check if you have a state issued driver license or personal ID card and enter your driver license or personal ID card number here: Check if you do not have a state issued driver license or personal ID card and enter the last four digits of your Social Security Number here: Check if you do not have a state issued driver license, a state issued personal ID card or a Social Security Number. (An ID number will be assigned to you for voter registration purposes.) Telephone Number (optional) School District (if known) ( ) Previous Address Are you still registered to vote at your last address? Yes No Don t Know Find your local clerk s office at Page 9 of 10
10 If you checked YES or DON T KNOW, enter last address below. Registered under name of (if different than above) Previous Street Address State Zip Code City Township Name of City or Township County Voter Declaration - Read and Sign Below. I certify that: - I am a citizen of the United States. - I am a resident of the State of Michigan and will be at least a 30 day resident of my city or township by election day. - I authorize cancellation of any previous registration. - The information I have provided is true to the best of my knowledge under penalty of perjury. If I have provided false information, I may be subject to a fine or imprisonment or both under federal or state laws. X / / Signature of Applicant Date Find your local clerk s office at Page 10 of 10
TO REGISTER TO VOTE IN MICHIGAN YOU MUST BE:
State of Michigan Voter Registration Application and Michigan Driver License / Personal Identification Card Address Change Form -- Instructions and Special Notices -- TO REGISTER TO VOTE IN MICHIGAN YOU
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