Alaska Form C03 – Fill Out and Use This PDF

State of Alaska

Division of Elections

Voter Registration Application

To register to vote in Alaska you must be a U.S. Citizen, a resident of Alaska, and at least 18 years old or will be 18 years old within 90 days of completing this application.

Initial registration or registration changes must be made at least 30 days prior to an election. Once your application is processed, a notice will be mailed to you within 3 to 4 weeks.

1.When Completing This Application You MUST Provide:

♦Alaska Residence Address Where You Claim Residency – A complete physical residence address must be included on your application. The residence address you provide will be used to assign your voter record to a voting district and precinct. Your application will not be processed if you leave the residence address blank or if you provide a PO Box, HC No. and Box, PSC Box, Rural Route No., Commercial Address or Mail Stop Address on Line 4 of the application.

If your residence has been assigned a street number, provide that number. If not, indicate exactly where you live such as, highway name and milepost number, boat harbor, pier and slip number, subdivision name with lot and block or trailer park name and space number. If you live in a rural village in Alaska, you may provide the community name as your residence address.

If you have a different mailing address than your residence address, you may choose to keep your residence address confidential. Confidential addresses are not released to the general public, but may be released to government agencies or during election processes as set out in state law.

Are you temporarily out of State? If so, and you have intent to return (active military and military spouses are exempt from intent requirements), you may maintain your Alaska residence as it appears on your current record. If you provide a new residence address, it must be within Alaska.

♦Proof of Identity – Your identity must be verified. If you have been issued a Social Security number, Alaska

Driver’s License, or Alaska State ID card, you MUST provide at least one number on Line 6 of the application. If you have never been issued one of the identification numbers, please indicate so by checking the box on Line 6.

♦Date of Birth – You MUST provide your date of birth.

2.Are you submitting this application by mail, by fax, or email? If so, and if you are not already registered to vote in Alaska, your identity must be verified either at the time you register or the first time you vote. If you

would like to ensure that your identity is verified at the time you register, submit a copy of one of the below:

∙	Current and valid photo identification	∙ Passport	∙	Birth certificate
∙	Driver’s license	∙ State identification card	∙	Hunting and Fishing license

3.Are you registering from outside the State of Alaska? If so, you must provide proof of Alaska residency, such as a copy of your Alaska driver's license, Alaska hunting or fishing license, student loan or college tuition documents showing Alaska as state of residence, proof of employment in Alaska, military leave and earnings statement that identifies Alaska as the state of legal residence or other documentation that supports your claim as an Alaska resident. If you do not provide proof of Alaska residency, your application will not be processed.

4.Have you been convicted of a felony? If so, you may register to vote only if you have been unconditionally discharged. Provide a copy of your discharge papers with this application if available.

5.Political Affiliation. Those parties that have gained recognized political party status under Alaska Statutes 15.60.010(25) are listed under Political Parties. Those groups that have applied for party status but have not met the qualifications to be a recognized political party under Alaska Statutes 15.60.010(25) are listed under Political Groups. Under Other, nonpartisan means you are not affiliated with any recognized political party or group and undeclared means you do not wish to declare a political affiliation. If you do not check a political affiliation, you will be registered as undeclared unless you are already registered under an affiliation.

Mail, fax or email (as a pdf, tiff or jpg attachment) your completed application to one of the offices below:

Visit our website at: www.elections.alaska.gov

Region I Elections Office	Region II Elections Office		Region III Elections	Region IV Elections Office
PO Box 110018	Anchorage Office		Office	PO Box 577
Juneau, AK 99811-0018	2525 Gambell Street Suite 100		675 7th Avenue Suite H3	Nome, AK 99762-0577
(907) 465-3021 –	Anchorage, AK 99503-2838		Fairbanks, AK 99701-4542	(907) 443-5285 – Telephone
Telephone	(907)	522-8683 – Telephone	(907) 451-2835 – Telephone	(907) 443-2973 – Fax
(907) 465-2289 – Fax	(907)	522-2341 – Fax	(907) 451-2832 – Fax	Toll Free 1-866-953-8683
Toll Free 1-866-948-8683	Toll Free 1-866-958-8683		Toll Free 1-866-959-8683	Region IV Email:
Region I Email:	Region II Email:		Region III Email:	electionsr4@alaska.gov
electionsr1@alaska.gov	electionsr2a@alaska.gov		electionsr3@alaska.gov	Yup’ik Language Assistance
	Matanuska-Susitna Office
	North Fork Professional Building			Toll Free 1-866-954-8683
	1700 E. Bogard Road, Suite B102
	Wasilla, AK 99654-6565
	(907)	373-8952 – Telephone
	(907)	373-8953 – Fax