New Jersey Voter Registration Application

1.) Check the box if you are a citizen of the United States.

Check the box if you are at least 17 years of age.

If either of the above is not true, do not fill out this form.

2.) Check all that apply:

New Registration
Address Change
Name Change
Signature Update
Change Political Party Affiliation
3.) First Name: Last Name: M: Suffix:

4.) DOB:

5.) Driver's License Number: (Do not include hyphens)

6.) If you do NOT have a driver's license, enter the last 4 digits of your Social Security Number:

If you have neither Social Security nor a driver's license, please check this box:

7.) Home Address: Apt: Municipality: Zip:
Mailing Address: Apt: Municipality: Zip:
Last Address Registered: Apt: Municipality: Zip:

8.) Enter former name if making name change:

9.) Do you wish to to declare a political party affiliation?:

Yes, the party name is:
No

10.) Gender
Male Female

Declaration- I swear or affirm that:

  • I am an U.S citizen
  • I live at the above address
  • I cannot vote until 18 years old of age
  • I am not on parole, or probation.
  • I understand that any fraudalent registration may subject to a fine of $15,000

    • Signature:
    _____________________________
    Important Instructions for steps 5, 6, and 9!
    5.) Registrants who are submitting this form by mail and are registering to vote for the first time: If you do not have any of the information required by section 5 or the information you provide cannot be verified, you will be asked to provide a COPY of a current and valid photo ID.
    6.) If you are homeless, you may complete section 6 by providing a contact point or the location where you spend most of your time.
    9.) You may declare a political party affiliation or you may declare to be unaffiliated, regardless of any prior party affiliation. If you are a previously affiliated voter who wants to change political party affiliation or become unaffiliated, you must file this form no later than 55 days before the primary election in order to vote in the primary election.

    Need more information? Check boxes below if you would like to recieve more important information about:

    Voting by mail Becoming a poll worker Polling place accessibillity Voting if you have a disability