한국어로 정보 : 유권자 등록 양식을 스페인
어로 얻으려면 1-800-367-8683으로 전화하십시오.
中文信息:如果您有兴趣以西班牙语取得该
选民登记表,请致电1-800-367-868
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Información in español: si le interesa obtener
este formulario de registro del votante en
español, llame al 1-800-367-8683.
ADDRESS CHANGE
Change your address online at dmv.ny.gov
INSTRUCTIONS TO UPDATE YOUR ADDRESS
New York State (NYS) law requires you to notify DMV within 10 days of any PERMANENT address change if you have a NYS driver license,
learner permit or non-driver ID card, or a NYS registration for a vehicle, boat, or snowmobile. Do NOT report a temporary address change.
You can change your address online at: dmv.ny.gov or use this form.
Write your new address on your current regular or enhanced NYS license, permit, or non-driver ID card and on your NYS registration document.
If your regular or enhanced NYS license, permit, non-driver ID card or registration will expire within the next 75 days, call DMV
Monday through Friday from 8:00AM to 4:00PM at any of the numbers listed below for information about how to change your address at the
same time you renew your document by mail:
Upstate New York: (518) 486-9786
New York City
(from area codes 212, 347, 646, 718, 917 or 929): (212) 645-5550, or (718) 966-6155
Other Downstate Areas and Long Island (from area codes 516, 631, 845, or 914): (718) 477-4820
From Outside New York State: (518) 473-5595
DMV does not require that you get a new license, permit, non-driver ID card, or registration document, but you have the option to get a new document.
If you want a new document, complete Part 1 and Part 2 on page 2 of this form, sign your name in the “Certification” section, and
mail your completed form with your payment to DMV at the address shown below. Keep your current document(s) until you receive
your new document(s) in the mail in 4 to 6 weeks. If you request an enhanced license, permit, or ID card, your residence address will
be shown on your document; your document will be mailed to your mailing address. If you request a regular license, permit, or ID card,
your mailing address will be shown on your document.
If you DO NOT want a new document, complete Part 1 but do not complete Part 2. DMV will update your DMV record(s) at no cost.
If you moved to NYS from a location outside of NYS, you can find information about how to get a NYS driver license, permit, non-driver ID
card, an enhanced version of those documents, and a vehicle registration at dmv.ny.gov or you can call DMV Monday through Friday from
8:00AM to 4:00PM at any of the telephone numbers listed above.
If you have unpaid Traffic Violations Bureau (TVB) tickets, you must use this form to report your address change and you must call TVB to
provide your new address and make arrangements to pay your fines. In the downstate area, call (718) 488-5710. In the Buffalo and Rochester
area, call (518) 474-0941. A list of all TVB office locations can be found at dmv.ny.gov/tvboffice.htm.
Complete and sign this form. If you want to purchase a replacement document, write a check or money order made payable to
“Commissioner of Motor Vehicles” for the total fee. Mail the completed, signed form and, if applicable, a check or money order to:
NYS DMV License Production Bureau
PO Box 2895
Albany, NY 12220-0895
NEW YORK STATE VOTER REGISTRATION APPLICATION INFORMATION
(Please read before you complete the NYS Voter Registration application on Page 2.)
Use the NYS Voter Registration Application to Register
To Register You Must:
to Vote in NYS Elections, and/or:
be a U.S. citizen
change the name or address on your voter registration
be 18 years old by the end of this year;
become a member of a political party
not be in prison or on parole for a felony conviction;
change your party membership
not claim the right to vote elsewhere
OFFICE USE ONLY
If you do not complete the NYS Voter Registration Application, you will be considered to have declined to register to vote. If you decline to register to vote,
the fact that you have declined to register will remain confidential and will be used only for voter registration purposes. If you do register to vote, the office at
which you submit a voter registration application will remain confidential and will only be used for voter registration purposes. If you believe that someone
has interfered with your right to register or decline to register to vote, your right to privacy in deciding whether to register or in applying to register to vote, or
your right to choose your own political party or other political preference, you may file a complaint with the NYS Board of Elections, 40 Steuben Street,
Albany, NY 12207-2109 (phone: 1-800-469-6872).
Your completed application will be sent to the Board of Elections and you will be notified by your County Board of Elections when your application has been
processed. If you have any questions about filling out the voter registration application or registering to vote, you should call your County Board of Elections
or call 1-800-FOR-VOTE (TDD/TTY enter 711) (only for voter registration questions). If you reside in New York City, you should call 1-866-VOTE-NYC or
visit the NYS Board of Elections website: www.elections.ny.gov
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PAGE 2 OF 2
ADDRESS CHANGE Change your address online at dmv.ny.gov
PART 1 - Complete this section to CHANGEYOURADDRESS
Provide the information in Part 1 that applies to the type of document that you want to update. Mark the box for each type of document that you have and
that must be changed to show your new address.
State (not Enhanced) License/Permit/Non-Driver ID Card Enhanced License/Permit/non-Driver ID Card Registration
IMPORTANT: If you are registered to vote, your voter registration record will be updated when you complete and submit this form. If you do NOT want your new address
on your voter registration record, mark this box . If you do not mark the box, your new address will be sent to the Board of Elections of your county of residence.
TELEPHONE NUMBER
( )
LICENSE/PERMIT/NON-DRIVER ID CARD:
DATE OF BIRTH
GENDER
Year Document Expires
Enter the ID number as it is printed on the front
of your license, permit or non-driver ID card
M F
NAME (Print your name - Last, First, MI)
NEW ADDRESS - WHERE YOU GET YOUR MAIL (Required - Include Street No. and Name, Rural Delivery, Apt. No., and/or P.O. Box No. Also fill in residence address below.)
STATE ZIP CODE COUNTY
CITY OR TOWN
NEW ADDRESS – WHERE YOU LIVE (Required - Include Street No. and name, and Apt. No.)
STATE ZIP CODE COUNTY
CITY OR TOWN
PREVIOUS NYS ADDRESS (Include Street No. and Name, Rural Delivery, Apt. No., and/or Box No.)
CITY OR TOWN
COUNTY
REGISTRATION: Provide the information below for each registration in your name.
License Plate No.
Type of Registration (Mark One)
Passenger Commercial Snowmobile Boat Other (Specify)
Passenger Commercial Snowmobile Boat Other (Specify)
Passenger Commercial Snowmobile Boat Other (Specify)
Passenger Commercial Snowmobile Boat Other (Specify)
CERTIFICATION: I certify that I am the individual named above and that the information provided is true to the best of my knowledge.
Sign Here
:
x
Sign Name in Full Date
WARNING! Knowingly providing false information on this form is a misdemeanor and will result in penalties authorized by law.
PART 2 Complete this section to PURCHASE A REPLACEMENT DOCUMENT THAT SHOWS YOUR NEW ADDRESS
Mark the box for each type of document that you currently have and want to update to show your new address. Then, write a check that has the
account holder’s name pre-printed or a money order payable to “Commissioner of Motor Vehicles” for the total fee.
Driver License/Learner Permit
Non-Driver Identification Card
Driver License (Fee: $17.50)
Non-Driver ID Card (Fee: $8.00)*
Learner Permit (Fee: $17.50)
*
For Non-Driver ID Holders ONLY
Registration(s)
Registration (Fee: $3.00 per registration)
If 62 years old OR a Supplemental Security Income recipient, the fee is $6.50.
Boat Registration (Fee: $2.00 per registration)
If 62 years old AND a Supplemental Security Income recipient, there is No Fee.
Snowmobile Registrations cannot be processed by mail,
*
If you are a Supplemental Security Income recipient, you must provide proof with this form.
you must go into your local DMV Office
PART 3 NEW YORK STATE VOTER REGISTRATION APPLICATION
Complete this application if you want to register to vote or update your voter registration information with the Board of Elections.
Telephone Number (optional)
Are you a citizen of the U.S.? Yes No
Will you be 18 years of age or older on or before election day? Yes No
If you answer NO, you cannot register to vote unless you will be 18 by the end of the year.
If you answer NO, you cannot register to vote
Have you voted before?
Voting information that Your name was
Your state or NYS
Yes No
has changed:
County was:
What Year?
skip if this has not changed or Your address was
you have not voted before.
Political Party
I wish to enroll in a political party:
AFFIDAVIT: I swear or affirm that
Democratic party
I am a citizen of the United States.
Republican party
I will have lived in the county, city, or village for at least 30 days before the election.
Conservative party
I meet all requirements to register to vote in New York State.
Green party
This is my signature or mark on the line below.
Working Families party
The above information is true. I understand that if it is not true, I can be convicted and fined up to $5,000 and/or
Independence party
jailed for up to four years.
Women’s Equality party
Reform party
Other
You must make 1
selection. Political
party enrollment is
optional but that, in
order to vote in a
primary election of a
political party, a
voter must enroll in
that political party
unless state party
rules allow
otherwise.
I do not wish to enroll in a political party
Sign
X
Date
No party
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