Alaska Form C03 PDF Details

In Alaska, engaging in the democratic process begins with completing the Alaska Voter Registration Application, known commonly as the C03 form. This critical document serves as the gateway for residents to exercise their voting rights, ensuring their participation in shaping the future through ballots. To be eligible, applicants must affirm their U.S. citizenship and be at least 18 years old or reach this age within 90 days of applying. The form requires detailed personal information, including an Alaska residence address—a PO Box won't suffice—as this address determines the voter's district and precinct. Confidentiality options are available for those who wish to keep their residence address private. Importantly, the form accommodates a wide spectrum of voters, offering provisions for individuals with disabilities seeking alternative voting methods and for residents interested in serving as election officials. Political affiliation is another significant section, guiding the applicant through a selection of recognized political parties or the option to remain nonpartisan or undeclared. For first-time registrants submitting the form via mail, fax, or email, or for those not previously registered in Alaska, proof of identity is mandatory. Additionally, individuals registering from outside the state must provide evidence of Alaska residency, while those with a felony conviction can only register upon providing proof of unconditional discharge. By completing the C03 form, residents affirm their information under penalty of perjury, acknowledging the serious legal implications of providing false information. Mailed to one of the four regional elections offices, this application is a fundamental step in enabling Alaskans to voice their choices on the political landscape, perform civic duties, and contribute to the democratic fabric of their state.

QuestionAnswer
Form NameAlaska Form C03
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesC03 alaska voting registration form

Form Preview Example

STATE OF ALASKA VOTER REGISTRATION APPLICATION

Refer to instructions on the reverse side for specific information and identification requirements.

Please print clearly in blue or black ink.

1.You MUST complete this section for registration.

Yes

No

I am a citizen of the United States.

Yes

No

I am at least 18 years old or will be within 90 days of completing this application.

If you checked NO to either question, do not complete this form as you are not eligible to register to vote.

2. Last Name

First Name

Middle Initial Suffix (Sr., Jr., etc.)

3.Former Name: (If your name has changed)

4.You MUST provide the Alaska residence address where you claim residency. Do not use PO, PSC, HC or RR.

 

 

 

ALASKA

House # Street Name

Apt #

City

State

*Keep my residence address confidential. (Your mailing address in section 5 must be DIFFERENT from your residence address in section 4 to remain confidential.)

5.

Mailing Address:

 

 

 

 

 

 

 

 

 

10.

I am a voter with a disability and would like

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

information on alternative voting methods.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11. I am interested in serving as an election official.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Provide your phone number and/or email address in section 12.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12.

Daytime Phone No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Evening Phone No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Email Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. Political Affiliation For information on political

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

types see reverse No. 5.

6.

You MUST provide at least ONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Social Security No.

 

 

 

 

 

 

 

 

 

 

 

Select only ONE Below

 

 

 

 

 

 

 

 

 

 

 

 

Political Parties:

 

*Last 4 Digits of Social Security No.

 

 

 

 

 

 

 

 

 

 

 

Alaska Democratic Party

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Alaska Driver’s License No.

 

 

 

 

 

 

 

 

 

 

 

Alaska Libertarian Party

 

*Alaska State ID Card No.

 

 

 

 

 

 

 

 

 

 

 

 

 

Alaska Republican Party

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Alaskan Independence Party

 

I have not been issued a Social Security, Alaska

 

 

 

 

or

Political Groups:

 

 

Driver’s License or State ID number.

 

 

 

 

 

Green Party of Alaska

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

You MUST provide

 

 

 

 

 

 

 

 

 

 

 

Alaska Constitution Party

 

*Date of Birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Veterans Party of Alaska

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month

 

Day

 

Year

 

or

Other:

8.

*AK Voter Number

 

 

 

 

 

 

 

 

 

 

 

Nonpartisan (no party affiliation)

 

 

 

 

 

 

 

 

 

 

(If known)

 

 

 

 

 

Undeclared (no party declared)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_________________________________

9.

Sex Male Female

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.If you are registered to vote in another state, you MUST cancel that registration by providing the following:

City:

 

State:

 

County:

 

Zip Code:

 

 

 

 

 

 

 

Voter Certificate. Read and Sign: I certify, under penalty of perjury, that the above information I provided on this document is true and correct. I am not registered to vote in another state, or I have provided information to cancel that registration. I further certify that I am a resident of Alaska and I have not been convicted of a felony, or having been so convicted, have been unconditionally discharged from incarceration, probation and/or parole.

WARNING: If you provide false information on this application you can be convicted of a misdemeanor AS 15.56.050.

*SIGNATURE:DATE:

Registrar/Agency/Official – Check ID and complete this section

Registrar Name

Voter # or SSN

OR

Agency Name

For Office Use Only

VN

D/P

*Items are kept confidential by the Division of Elections and are not available for public inspection except that confidential addresses may be released to government agencies or during election processes as set out in state law.

C03 (Rev. 05/28/2014)

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

 

 

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