Section 2150 Of Article 4. Forms From California Elections Code >> Division 2. >> Chapter 2. >> Article 4.
2150
. (a) The affidavit of registration shall show:
(1) The facts necessary to establish the affiant as an elector.
(2) The affiant's name at length, including his or her 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 affiant's
given name may be preceded, at the affiant's option, by the
designation of "Miss," "Ms.," "Mrs.," or "Mr." A person shall not be
denied the right to register because of his or her 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 affiant's 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 his or her failure to furnish
a telephone number or email address, and shall be so advised on the
voter registration card.
(4) The affiant's mailing address, if different from the place of
residence.
(5) The affiant's date of birth to establish that he or she will
be at least 18 years of age on or before the date of the next
election.
(6) The state or country of the affiant's birth.
(7) (A) In the case of an affiant who has been issued a current
and valid driver's license, the affiant's driver's 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 affiant's
social security number.
(C) If a voter registration affiant has not been issued a current
and valid driver's license or a social security number, the state
shall assign the applicant 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 affiant's political party preference.
(9) That the affiant is currently not imprisoned or on parole for
the conviction of a felony.
(10) A prior registration portion indicating if the affiant has
been registered at another address, under another name, or as
preferring another party. If the affiant has been so registered, he
or she 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 his or her name and the date of
signing. If the affiant is unable to write, he or she 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 his or her ethnicity or race, or
both. An affiant may not be denied the ability to register because he
or she declines to state his or her 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 affidavit of registration shall also contain a space to
permit the affiant to apply for permanent vote by mail status.
(f) 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.