Maryland State Board of Elections SBE 03-202-1 Rev 02/24 VRA
TO REGISTER, YOU MUST
n Be a U.S. citizen;
n Be a Maryland resident;
n Be at least 16 years old*;
n Not be under guardianship for mental disability or
if you are, you have not been found by a court to be
unable to communicate a desire to vote;
n Not have been convicted of buying or selling votes;
n Not be currently serving a sentence of imprisonment
for a felony conviction.
*You may register to vote if you are at least 16 years old
but cannot vote unless you will be at least 18 years old by
the next general election.
DEADLINE INFORMATION
n This application must be postmarked no later than 21
days before an election.
n If your application is complete and you are found to
be qualied, a Voter Notication Card will be mailed to
you.
n The submission of this form to an individual other
than an ocial, employee, or agent of a County Board
of Elections does not assure that the form will be
submitted or led in a timely manner.
YOU CAN USE THIS FORM TO
n Register to vote in federal, state, county, and municipal
elections in Maryland.
n Change your name, address, or party aliation.
INSTRUCTIONS
n If you do not have a current, valid Maryland driver’s
license, Learner’s Permit or MVA ID card, you must
enter the last 4 digits of your social security number.
The statutory authority allowing ocials to request the
last 4 digits of your social security number is Election
Law Article, § 3-202. The number will only be used for
registration and other administrative purposes. It will
be kept condential.
n Complete Items 1–11 in Voter Registration Application.
Sign and date Item 12. If you are registered to vote in
another Maryland county or another state, you must
complete Items A–B in Last Voter Registration.
n You must register with a party if you want to take part
in that party’s primary election, caucus or convention.
Check one box only.
n Detach this panel at the perforation.
n Address and mail the application to your County Board
of Elections, using the list on the back panel.
WARNING
Giving false information on an application for voter
registration is perjury, punishable by imprisonment
for up to 10 years, and a violation of the election laws,
punishable by a ne of up to $1,000, or by imprisonment
for up to 5 years, or both.
PERSONAL RECORDS NOTICE/CONFIDENTIALITY
This form collects personal information for voter
registration purposes. If you are not registered to vote
and you refuse to provide this information, you will not
be allowed to vote in Maryland. You may update your
voter registration at any time at your County Board of
Elections. Except for items specied as condential,
voter registration records are generally available for
public inspection; they may also be shared with jury
commissioners/clerks or other government agencies
as provided by law. The law prohibits use of voter
registration records for commercial solicitation purposes.
If you decline to register to vote, that fact will remain
condential and will be used only for voter registration
purposes.
If you register to vote, the identity of the oce at which
the application is submitted will remain condential and
will be used only for voter registration purposes.
The Maryland Safe at Home Address Condentiality
Program (ACP) is administered by the Oce of the
Secretary of State and provides an important service to
victims of domestic violence and human tracking. For
more information about this Program please call 1-800-
633-9657, ext. 3875.
QUESTIONS
Visit the State Board of Elections website at www.
elections.maryland.gov to verify your registration,
nd your polling place, and nd out other important
information. If you have any questions, call your County
Board of Elections or the State Board of Elections at the
numbers listed on the back of the application.
MARYLAND VOTER REGISTRATION APPLICATION
AFTER THIS FORM IS FILLED OUT, YOU MUST SIGN AND MAIL IT TO YOUR
COUNTY BOARD OF ELECTIONS. IT CANNOT BE PROCESSED IF IT IS FAXED
OR E-MAILED, BECAUSE IT REQUIRES AN ORIGINAL SIGNATURE.
!
Large type Voter Registration
Applications available upon
request to your County Board
of Elections or the State
Board of Elections.
!
Detach this panel before mailing.
1
Are you at least 16 years old? l Yes l No
ARE YOU A U.S. CITIZEN? l Yes l No
If you answer NO to either question, do not complete this form.
2
Check boxes that apply and complete Items 3–12.
l New Registration l Name Change l Party Aliation Change l Address Change
3
Last Name First Name Middle Sux
4
Gender: l Male l Female l Unspecied or Other
5
Month Date Year
Birth Date:
6a
MARYLAND Driver’s License, Learner’s Permit or MVA ID Number MANDATORY (If you have neither see instructions)
6b
Social Security Number (last 4 digits)
6c
l Check here if you do not have either a current, valid Maryland
driver’s license, Learner’s Permit, MVA ID card or a Social Security Number
7
Maryland Street Number Street Name Apt. No. City or Town Zip Code County
Residence
Address:
8
Mailing Address (if dierent from Item 7)
9
You must register with a political party if you want to take part in the political party’s primary election, caucus, or convention. Check one box only.
Party (check one): l Democratic Party l Republican Party l Unaliated (independent of any party) l Libertarian Party
Party (c l No Labels Maryland Party l Other – Specify ___________________________________________
10
CONTACT INFORMATION
Daytime Phone: Email (optional):
11
l Check here if you need help voting.
l Check here if you would like to be an election judge.
12
Under penalty of perjury, I hereby swear or arm: I am a U.S. citizen. n I am a Maryland resident. n I am at least 16 years old. n I have not been convicted of buying or selling votes.
n I am not currently serving a sentence of imprisonment for a felony conviction. The information in this application is true to the best of my knowledge, information and belief.
l Check here if you reside in Baltimore City.
Signature (required)
X
Date
VOTER REGISTRATION APPLICATION
PLEASE COMPLETE IN BLACK INK – DETACH FORM AND FOLD WHERE INDICATED TO MAIL
A
Name Last Name Title (Jr., Sr., etc.) First Name Middle Name Date of Birth
on Last
Registration:
B
Address Street Number Street Name Apt. No. City or Town Zip Code State
on Last
Registration:
LAST VOTER REGISTRATION INFORMATION (if applicable)
Maryland State Board of Elections SBE 03-202-1 Rev 02/24 VRA
State Board of Elections • P.O. Box 6486 • Annapolis, MD 21401-0486 • elections.maryland.gov • 800-222-8683 • MD Relay Service (800) 735-2258
Applicant’s Return Address
County Board of Elections
Place
Stamp
Here
Fold here and close with adhesive strip to mail.
County Board of Elections
To:
OPEN HERE OPEN HERE
Maryland State Board of Elections SBE 03-202-1 Rev 02/24 VRA
Allegany County
701 Kelly Road, Suite 231
Cumberland, MD 21502-2887
301-777-5931
Anne Arundel County
P.O. Box 490
Glen Burnie, MD 21060-0490
410-222-6600
Baltimore City
Charles L. Benton Bldg.
417 E. Fayette Street, Rm. 129
Baltimore, MD 21202-3432
410-396-5550
Baltimore County
5 Crossing Way
Owings Mills, MD 21117
410-887-5700
Calvert County
P.O. Box 798
Prince Frederick, MD 20678-0798
410-535-2214
Caroline County
Health & Public Services Bldg.
403 S. Seventh Street, Suite 247
Denton, MD 21629-1378
410-479-8145
Carroll County
P.O. Box 3191
Westminster, MD 21158
410-386-2080
Cecil County
200 Chesapeake Blvd.
Suite 1900
Elkton, MD 21921-6395
410-996-5310
Charles County
P.O. Box 908
La Plata, MD 20646-0908
301-934-8972
301-870-3167
Dorchester County
1000 Goodwill Ave.
P.O. Box 414
Cambridge, MD 21613-0414
410-228-2560
Frederick County
8490 Progress Drive
Suite 300
Frederick, MD 21701
301-600-VOTE (8683)
Garrett County
Public Service Center
2008 Maryland Highway, Suite 1
Mountain Lake Park, MD 21550-6349
301-334-6985
Harford County
133 Industry Lane
Forest Hill, MD 21050-1621
410-638-3565
Howard County
9770 Patuxent Woods Drive, Suite 200
Columbia, MD 21046
410-313-5820
Kent County
135 Dixon Drive
Chestertown, MD 21620-1141
410-778-0038
Montgomery County
P.O. Box 4333
Rockville, MD 20849-4333
240-777-VOTE (8683)
TDD 800-735-2258
Prince George’s County
1100 Mercantile Lane, Suite 115A
Largo, MD 20774
301-341-7300
Queen Anne’s County
110 Vincit St, Suite 102
Centreville, MD 21617-0274
410-758-0832
St. Mary’s County
P.O. Box 197
Leonardtown, MD 20650-0197
301-475-4200 ext. 1625
Somerset County
P.O. Box 96
Princess Anne, MD 21853-0096
410-651-0767
Talbot County
P.O. Box 353
Easton, MD 21601-0353
410-770-8099
Washington County
17718 Virginia Avenue
Hagerstown, MD 21740-7084
240-313-2050
Wicomico County
P.O. Box 4091
Salisbury, MD 21803-4091
410-548-4830
Worcester County
201 Belt Street
Suite C
Snow Hill, MD 21863-1367
410-632-1320
County Board of Elections
State Board of Elections • P.O. Box 6486 • Annapolis, MD 21401-0486 • elections.maryland.gov • 800-222-8683 • MD Relay Service (800) 735-2258
