Nebraska Voter Registration FormNebraska Voter Registration Form
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NEBRASKA VOTER REGISTRATION APPLICATION
1. Are you a citizen of the United States of America?

Yes

No

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?

Yes

No

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

www.sos.ne.gov

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#