* Please check the box for the City/County in which you live.
1. Print your Social Security Number.
2. Print your Date of Birth.
3. Print your "Home" and "Business" telephone numbers.
4. Print your Name - Last, First and Middle Initial(s).
5. Print your Residence Address in Hawaii (house number and street name). You must be registered to vote in the county and precinct where you live. Note: A Post Office Box, Star Route, Rural Route, General Delivery, Busidness Address or Mailing Service Address is not an acceptable residence address.
6. Print your Mailing Address in Hawaii.
7. If your residence does not have a street addreess, describe the location of your residence. Include details such as subdivision, villiage, tax map key number and zipcode.
8. Check the appropriate "Female" or "Male" box.
9. If you are registered to vote in another state but now wish to register to vote in Hawaii, complete box #9. Your registration in that state will be canceled. Note: You may register to vote in only one state.
10. Read carefully, mark the appropriate "Yes" or "No" box and sign on the line provided. Your application will not be accepted if you fail to mark the appropriate boxes or withhold your signature.
11. If your signature is a mark, a witness signature is required.
Remember to mail the completed Affidavit on Application for Voter Registration to the City/County Clerk. You must mail your application no later than 30 days prior to the election you wish to vote in.