Wisconsin Voter Registration ApplicationWisconsin Voter Registration Application
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Wisconsin Voter Registration Application

(Official Use Only)

SVRS ID #

Confidential Elector ID#
(HINDI - sequential #) (Official Use Only)

Instructions

1

Submitted by Mail

(Official Use Only)

Instructions for completion are on the back of this form. Return this form to your municipal clerk, unless directed otherwise.
 Please use uppercase (CAPITAL) letters only. Fill in circles as appropriate.
 If you have not previously voted in WI and are submitting this form by mail, you must also provide a copy of your proof of residence (see reverse).
 NOTE: If this is a change of address, then upon completion of this application your voting rights will be cancelled at your previous residence.
New WI Voter
Name Change
Address Change

Town
Village
City

Municipality
County

Expiration Date

WI Driver License or WI DOT-issued ID
(DL # required if issued)
2
Social Security Number - Last Four Digits (if driver license not issued or not current
and valid)

XXX-XX-

Last Name

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