Instructions for Completing a Voter Registration Card

PLEASE NOTE: THE VOTER REGISTRATION CARD MUST BE MAILED OR DELIVERED TO YOUR COUNTY CLERKS OFFICE. NO FAX COPIES OF THE 504 VOTER REGISTRATION CARD ARE ACCEPTABLE UNDER KENTUCKY REVISED STATUES.

• Print the voter registration card provided in the link below.
• Complete the card with blue or black ink, NO PENCIL.
• Check Yes or No box to questions A and B. If you answer no in response to either question, do not complete the voter registration card.
• Check the appropriate box that applies to your request.
• Leave the sections blank under precinct code, precinct name, town and other code. These sections are to be completed by your county clerk.
• Please print your correct Social Security Number, Date of Birth, Work Phone, Home Phone, Gender, Last Name, First Name and Middle Name.
• Circle the correct suffix (if it applies to you).
• Please print the address where you live.
• Please print the address where you receive your mail, if it is different from the address above.
• Check one of the political parties. If you check other, please write the name of your chosen political party. If you choose other, you are eligible to vote only for nonpartisan offices in any primary election. You may, however, vote for any candidate in all general and special elections.
  Note: You may change your political party affiliation at any time on or before December 31st to remain eligible to vote in the following primary election.
• Read the voter declaration, sign and date. If your signature is marked with an "X", you must have two witnesses sign your voter registration card.

Click to Download the Voter Registration Card (PDF Document)