Indiana Code § 3-7-18-12

Written acknowledgment of application; format
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Sec. 12. Whenever an applicant completes a voter registration application under this chapter, the office shall provide the applicant with a written acknowledgment that the applicant has completed a voter registration application at the office. The acknowledgment: (1) may be a detachable part of the registration form prescribed under section 3 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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