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 www.michigan.gov/vote Page 1 of 10
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 www.michigan.gov/vote Page 2 of 10
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 www.michigan.gov/vote Page 3 of 10
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 48107 Battle Creek 10 N Division St, Room 111, Battle Creek 49014 Bay City 301 Washington Ave, Bay City 48708 Dearborn 16901 Michigan Ave, Ste 11, Dearborn 48126 Detroit 2978 W Grand Blvd, Detroit 48202 Dearborn Heights 6045 Fenton, Dearborn Heights 48127 East Lansing 410 Abbott Rd, East Lansing 48823 Farmington Hills 31555 Eleven Mile Rd, Farmington Hills 48336 Flint 1101 S Saginaw, Flint 48502 Grand Rapids 300 Monroe Ave NW, Grand Rapids 49503 Hamtramck 3401 Evaline St, Hamtramck 48212 Kalamazoo 241 W South St, Kalamazoo 49007 Lansing 124 W Michigan, Lansing 48933 Lincoln Park 1355 Southfield Rd, Lincoln Park 48146 Livonia 33000 Civic Center Dr, Livonia 48154 Pontiac 47450 Woodward Ave, Pontiac 48342 Roseville PO Box 290, Roseville 48066 Royal Oak 211 Williams St, Royal Oak 48067 Saginaw 1315 S Washington, Saginaw 48601 St. Clair Shores 27600 Jefferson Cr Dr, St. Clair Shores 48081 Southfield 26000 Evergreen Rd, Southfield 48037 Sterling Heights 40555 Utica Rd, Sterling Heights 48311 Taylor 23555 Goddard, Taylor 48180 Troy 500 W Big Beaver, Troy 48084 Find your local clerk s office at www.michigan.gov/vote Page 4 of 10
Warren One City Square, Suite 205, Warren 48093 Westland 36300 Warren Rd, Westland 48185 Wyoming 1155 28 th St SW, Wyoming 49509 Use if you cannot locate your city or township clerk. COUNTY CLERKS ADDRESSES Alcona 106 5 th St, Harrisville 48740 Alger 101 Court St, Munising 49862 Allegan 113 Chestnut St, Allegan 49010 Alpena 720 Chisholm St, Alpena 49707 Antrim PO Box 520, Bellaire 49615 Arenac 120 N Grove, Standish 48658 Baraga 2 S Main St, Lanse 49946 Barry 220 W State St, Hastings 49058 Bay 515 Center St, Bay City 48708 Benzie 448 Court Place, Beulah 49617 Berrien 811 Port St, Saint Joseph 49085 Branch 31 Division St, Coldwater 49036 Calhoun 315 W Green St, Marshall 49068 Cass 120 N Broadway, Cassopolis 49031 Charlevoix 203 Antrim St, Charlevoix 49720 Cheboygan 870 S Main St, Cheboygan 49721 Chippewa 319 Court St, Sault Ste. Marie 49783 Clare 225 W Main St, Harrison 48625 Clinton 100 E. State St, Saint Johns 48879 Crawford 200 W Michigan, Grayling 49738 Delta 310 Ludington St, Escanaba 49829 Dickinson 705 S Stephenson, Iron Mountain 49801 Eaton 1045 Independence Blvd, Charlotte 48813 Emmet 200 Division St, Petoskey 49770 Genesee 900 S Saginaw St, Flint 48502 Find your local clerk s office at www.michigan.gov/vote Page 5 of 10
Gladwin 401 W Cedar Ave, Gladwin 49624 Gogebic 200 N Moore, Bessemer 49911 Grand Traverse 400 Boardman Ave, Traverse City 49684 Gratiot 214 E Gratiot, Suite 16, Ithaca 48847 Hillsdale 29 N Howell St, Hillsdale 49242 Houghton 401 E Houghton Ave, Houghton 49931 Huron 250 E Huron Ave, Bad Axe 48413 Ingham PO Box 179, Mason 48854 Ionia 100 Main St, Ionia 48846 Iosco PO Box 838, Tawas City 48764 Iron 2 S 6th St, Crystal Falls 49920 Isabella 200 N Main St, Mt Pleasant 48858 Jackson 312 S Jackson St, Jackson 49201 Kalamazoo 201 W Kalamazoo Ave, Kalamazoo 49007 Kalkaska 605 N Birch St, Kalkaska 49646 Kent 300 Monroe NW, Grand Rapids 49503 Keweenaw 5095 4th St, Eagle River 49950 Lake 800 Tenth St, Suite 200, Baldwin 49304 Lapeer 255 Clay St, Lapeer 48446 Leelanau 8527 E Government Ctr Dr, Suttons Bay 49682 Lenawee 425 N Main St, Adrian 49221 Livingston 200 E Grand River, Howell 48843 Luce 407 W Harrie St, Newberry 49868 Mackinac 100 S Marley St, Room 10, St. Ignace 49781 Macomb Elections Dept, 40 N Main St, Mt Clemens 48043 Manistee 415 3rd St, Manistee 49660 Marquette 234 W Baraga Ave, Marquette 49855 Mason 304 E Ludington Ave, Ludington 49431 Mecosta 400 Elm St, Big Rapids 49307 Menominee 839 10th Ave, Menominee 49858 Midland 220 W Ellsworth St, Midland 48640 Missaukee 111 S Canal St, Lake City 49651 Find your local clerk s office at www.michigan.gov/vote Page 6 of 10
Monroe 106 E 1st St, Monroe 48161 Montcalm 211 W Main St, Stanton 48888 Montmorency 12265 M-32 W, Atlanta 49709 Muskegon 990 Terrace, Muskegon 49442 Newaygo 1087 Newell, White Cloud 49349 Oakland 1200 N Telegraph Bldg 12E, Pontiac 48341 Oceana 100 State St, Ste 1, Hart 49420 Ogemaw 806 W Houghton Ave, West Branch 48661 Ontonagon 725 Greenland Rd, Ontonagon 49953 Osceola 301 W Upton, Reed City 49677 Oscoda 311 Morenci Ave, Mio 48647 Otsego 225 W Main St, Gaylord 49735 Ottawa 12220 Fillmore St, West Olive 49460 Presque Isle PO Box 110, Rogers City 49779 Roscommon 500 Lake St, Roscommon 48653 Saginaw 111 S Michigan, Saginaw 48602 Sanilac 60 W Sanilac, Sandusky 48471 Schoolcraft 300 Walnut, Manistique 49854 Shiawassee 208 N Shiawassee, Corunna 48817 St. Clair 201 McMorran Blvd, Port Huron 48060 St. Joseph 125 W Main St, Centreville 49032 Tuscola 440 N State St, Caro 48723 Van Buren 212 Paw Paw, Paw Paw 49079 Washtenaw 200 N Main St, Ann Arbor 48104 Wayne 2 Woodward Ave, Room 502, Detroit 48226 Wexford 437 E Division, Cadillac 49601 Find your local clerk s office at www.michigan.gov/vote Page 7 of 10
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 www.michigan.gov/vote Page 8 of 10
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 www.michigan.gov/vote Page 9 of 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 www.michigan.gov/vote Page 10 of 10