NEBRASKA VOTER REGISTRATION APPLICATION
1. Are you a citizen of the United States of America?
2. Are you at least 18 years of age, or will you be 18 years of age on or before
the 1st Tuesday following the 1st Monday in November of this year?
If you marked NO to either of the questions above, STOP.
Do not complete this application.
Print your full and complete Legal Name to avoid errors and duplicate registrations
Nebraska Secretary of State's
Official Voter Registration Application
First Middle Initial Last Suffix or Previous Last Name
Date of Birth (MM/DD/YYYY)
Place of Birth
Nebraska Driver’s License Number
Last 4 digits SSN, if no Neb. DL#