Indiana Code § 3-7-14-11

Written acknowledgment of application; format
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Sec. 11. Whenever an applicant completes a voter registration application under section 4 of this chapter, the bureau of motor vehicles commission shall provide the applicant with a written acknowledgment that the applicant has completed a voter registration application at a license branch. The acknowledgment: (1) may be: (A) a detachable part; or (B) an electronic version; of the registration form prescribed under section 4 of this chapter; and (2) must set forth the name and residential address of the applicant and the date that the application was completed.

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