(a) The affidavit of registration shall show: (1) The facts necessary to establish the affiant as an elector. (2) The affiantâs name at length, including the personâs given name, and a middle name or initial, or if the initial of the given name is customarily used, then the initial and middle name. The affiantâs given name may be preceded, at the affiantâs option, by the designation of âMiss,â âMs.,â âMrs.,â or âMr.â A person shall not be denied the right to register because of that personâs failure to mark a prefix to the given name and shall be so advised on the voter registration card. This subdivision shall not be construed as requiring the printing of prefixes on an affidavit of registration. (3) The affiantâs place of residence, residence telephone number, if furnished, and email address, if furnished. A person shall not be denied the right to register because of the personâs failure to furnish a telephone number or email address, and shall be so advised on the voter registration card. (4) The affiantâs mailing address, if different from the place of residence. (5) The affiantâs date of birth to establish that the affiant will be at least 18 years of age on or before the date of the next election. In the case of an affidavit of registration submitted pursuant to subdivision (d) of Section 2102, the affiantâs date of birth to establish that the affiant is at least 16 years of age. (6) The state or country of the affiantâs birth. (7) (A) In the case of an affiant who has been issued a current and valid driverâs license, the affiantâs driverâs license number. (B) In the case of any other affiant, other than an affiant to whom subparagraph (C) applies, the last four digits of the affiantâs social security number. (C) If a voter registration affiant has not been issued a current and valid driverâs license or a social security number, the state shall assign the affiant a number that will serve to identify the affiant for voter registration purposes. If the state has a computerized list in effect under this paragraph and the list assigns unique identifying numbers to registrants, the number assigned under this subparagraph shall be the unique identifying number assigned under the list. (8) The affiantâs political party preference. (9) That the affiant is currently not imprisoned for the conviction of a felony. (10) A prior registration portion indicating whether the affiant has been registered at another address, under another name, or as preferring another party. If the affiant has been so registered, the affiant shall give an additional statement giving that address, name, or party. (b) The affiant shall certify the content of the affidavit of registration as to its truthfulness and correctness, under penalty of perjury, with the signature of the affiantâs name and the date of signing. If the affiant is unable to write, the affiant shall sign with a mark or cross. An affiant who is an individual with a disability may complete the affidavit with reasonable accommodations as needed. (c) The affidavit of registration shall also contain a space that would enable the affiant to state the affiantâs ethnicity or race, or both. An affiant shall not be denied the ability to register because the affiant declines to state the affiantâs ethnicity or race. (d) If a person assists the affiant in completing the affidavit of registration, that person shall sign and date the affidavit below the signature of the affiant. (e) The Secretary of State may continue to supply existing affidavits of registration to county elections officials before printing new or revised forms that reflect the changes made to this section by Chapter 508 of the Statutes of 2007.
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