Hawaii Voter Registration Form

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INSTRUCTIONS FOR COMPLETING THE WIKIWIKI VOTER REGISTRATION FORM	
Filipino, Chinese, and Japanese translations are required 
pursuant to the Voting Rights Act of 1965 as amended.	
For more information, please call the Offi ce of 
the City/County Clerk:
  Honolulu:   (808) 768-3800
  Maui:   (808) 270-7749
  Kauai:   (808) 241-4800
  Hawaii:   (808) 961-8277	
Aloha	  The Office of Elections and the 
Association of Clerks and Election 
Officers of Hawaii are pleased to 
introduce you to Wikiwiki Voter 
Registration, Hawaii’s registration-by-
mail procedure.
  To register to vote, all you need is a 
Wikiwiki form and a postage stamp. 
Follow the instructions and complete 
the form correctly. Once you have 
registered to vote, please remember 
to take the next step and VOTE in the 
upcoming elections. See you there!	
VOTER	
REGISTRATION	
LANGUAGE ASSISTANCE	
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, Business 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 address, describe the location of your residence. Include 
details such as subdivision, village, tax map key no. and zip code.
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.	
STEP 2   Mail the Affidavit on Application for Voter Registration no later than 30 days prior to the  
  election to the appr	
opriate City/County Clerk:
STEP 1   Complete the Affidavit on Application for Voter Registration	
County of Hawaii 
25 Aupuni St., Rm. 105
Hilo, HI  96720-4245
Ph. (808) 961-8277
City and County of Honolulu
530 S. King St., Rm. 100
Honolulu, HI 96813-3077
Ph. (808) 768-3800
County of Maui
200 S. High St., Rm. 708
Wailuku, HI  96793-2155
Ph. (808) 270-7749 County of Kauai
4386 Rice St.
Lihue, HI  96766-1371
Ph. (808) 241-4800	
Notice to First Time Voters Who Register to Vote by Mail:
If you are (1) registering to vote for the fi rst time in the State of Hawaii; and (2) are mailing in this Affi davit on Application 
for Voter Registration, federal law (42 U.S.C. § 15483) requires you to provide proof of identifi cation. Proof of identifi cation 
includes a copy of:
•  A current and valid photo identifi cation, or
•   A current utility bill, bank statement, government check, paycheck or government document that shows your name and 
address.
If you do not provide the required proof of identifi cation with this Affi davit on Application for Voter Registration, you will be 
required to do so at your polling place, or with your voted absentee mail-in ballot.	
Tulong para iti Lengguahe – Filipino (Ilocano)  
Ti Opisina ti Panagpipili ken ti Timpuyog dagiti 
Eskribiente ken Eleksion Opiser ti Hawaii

 
maragsakanda a mangiyammo kenka ti Wikiwiki a 
Panagrehistro ti Botante, ti Panagrehistro iti Hawaii 
babaen ti koreo a wagas.  Dagiti naipatarus a 
kasapulan iti panagbutos a mangtulong kenka 
iti panangileppas iti daytoy a porma maalada iti 
Opisina ti Eskribiente iti Siudad/Ili. Pangaasim 
ta awaganyo ti maitutop a numero iti telepono a 
nailanad ditoy baba.
t ±”ϵ  –  Japanese
\w \fS z 
¬
Ê=\fJå U	

#(pæQ”‘Ots“‡
`h { \•x
¬g•»q(The Office of Elections) 
|t	{Gíz
¬g» q
(The Association of 
Clerks and Election Officers of Hawaii)

Cæw ®¢Ÿ
©¢Ÿ©
¬
Ê=\fJå

e;\b´¯ pb{\w 
 
e ;
\b´G\fÖw\bMt
žAs	¾V	{w\fÔŠ 
x\b7/“w
\b¢‡hx
w	{Gí\bÄ¿	t
(The Office of the City/
County Clerk)
‘“\fÖ 	 pV‡b{ ]\fÖ“;w\bMx<G
w
jøtSðMù˜dXi^M{
English (Translation)
The Office of Elections and the Association of Clerks 
and Election Of ficers of Hawaii ar	
e pleased to 
introduce you to Wikiwiki Voter Registration, Hawaii’s 
registration-by-mail procedure.  Translated voting 
materials to assist you in completing this form are 
available at the Office of the City/County Clerk.  Please 
call the appropriate phone number listed below.	
–  Chinese

Any voter who requires assistance to vote by reason 
of physical, visual, or hearing disability, or an inability 
to read or write may be given assistance by a person 
of the voter’s choice -- other than the voter’s employer, 
agent of the employer, or agent of the voter’s union 
(42 U.S.C. 1973aa-6).
Every polling place has a Voter Assistance Official 
who can provide the following:
Y language assistance materials to voters who have difficulty with the English language;
Y assistance to voters with physical disabilities; and
Y curbside voting services to voters who are unable to leave their vehicles to vote.
VOTING IN HAWAII
SPECIAL VOTING  SERVICES	
Voting is an essential part of our democratic process. By voting, you choose the representatives who will make 
decisions affecting you, your family and your community. If you care about the future of Hawaii. . . .
register and VOTE!!
What Types of Elections Does Hawaii Hold?
In every even numbered year, Hawaii holds a Primary Election
in September and a General Election in November.
Who May Register to Vote?
You may register to vote if you are:
Y  a citizen of the United States of America;
Y  a legal resident of Hawaii; and
Y  at least 16 years of age (Pre-registration is allowed at 
  age 16. You must be 18 years old by election day to vote).
You are not eligible to register or to vote if you are a 
convicted and confined felon or you are declared mentally 
incompetent.
Should I Re-register to Vote?
You should re-register if you changed your name, residence 
address or mailing address.
How Long are the Polls Open?
Polling places are open from  7:00 A.M. to 6:00 P.M. If you are 
not sure of your polling place, call your City or County Clerk.	
Will I Be Notified of My Polling Place?
Ye s . Your City/County Clerk will send you a  Notice of Voter 
Registration and Address Confirmation (NVRAC) card 
with your polling place listed on it.
You are not properly registered if:
Y  you do not receive the NVRAC card;
Y  you no longer live at the address listed on the 
  NVRAC card; or
Y  your residence address on the NVRAC is the address of a  mailing service or a business.
Do I Need an I.D. to Vote on Election Day?
Ye s . Be sure to have an I.D. with a picture and signature 
(such as a Hawaii driver’s license or state I.D. card) when 
you go to vote. The NVRAC card is  not an acceptable form 
of identification.
Do I Have to Take Time Off from Work to Vote?
You may be entitled to not more than two consecutive hours 
off from work on election day in order to vote. Ask your 
employer first and keep your ballot stub as proof of voting 
(ref. HRS 	
§11-95).	
For additional information, call the Voter Hotline at:
(808) 453-VOTE (8683)
Neighbor Islands call toll-free: 1-800-442-VOTE (8683)
Website address: www.hawaii.gov/elections
Persons with hearing or speech disabilities should  call the Office of Elections’ TTY phone at:  (808) 453-6150
Neighbor Islands call TTY toll-free: 1-800-345-5915
or the Sprint Relay Hawaii TRS at: 711 (V/TTY); 847-9508 (FAX)
Voice Carry Over (VCO): 1 (877) 447-5992
Speech to Speech (STS): 1 (877) 447-8711	
Prepared by the Office of Elections and the Association of Clerks and Election Officers of Hawaii (05/08).	
WARNINGWARNING	
AFFIDAVIT ON APPLICATION FOR VOTER REGISTRATION	
STATE OF HAWAII
T County of Hawaii
T County of Kauai
T County of Maui
T City and County of Honolulu	
IMPORTANT: PRINT CLEARLY 
IN BLACK INK.  FAILURE TO 
COMPLETE ALL ITEMS WILL 
PREVENT ACCEPTANCE OF 
THIS APPLICATION.	
I HEREBY SWEAR (OR AFFIRM) THAT THE FOLLOWING INFORMATION IS TRUE AND CORRECT:	
AFFIDAVIT NO.
(FOR OFFICE USE ONLY)	
}	
ss.	
The office at which a person registers to vote is confidential. A person’s declination to register to vote is also confidential and is used for 
voter registration purposes only (National Voter Registration Act of 1993). ANY PERSON WHO KNOWINGLY FURNISHES FALSE INFORMATION MAY BE GUILTY OF A CLASS C 
FELONY, PUNISHABLE BY UP TO 5 YEARS OF IMPRISONMENT AND/OR $10,000 FINE.
* Notice: Section 11-15 of the Hawaii Revised Statutes requires that a person registering to vote provide, under oath, his or her social security number, if any.
An application lacking this information will, therefore, be denied. Pursuant to Section 7 of the Federal Privacy Act (P.L. 93-579), be advised that this 
information may be released to government agencies for government purposes.	
For Offi ce Use Only	
05/08	
1	
SOCIAL SECURITY NUMBER*
___ ___ ___ - ___ ___ - ___ ___ ___ ___ 	
2	
DATE OF BIRTH ___ ___ / ___ ___ / ___ ___
 Month Day  Year	3	
TELEPHONE
Home: Business:	
4	LAST NAME FIRST NAME MIDDLE INITIAL(S)	
5	RESIDENCE ADDRESS IN HAWAII 	(Must be completed. P.O. Box, R.R., S.R. are not acceptable)	CITY/TOWNZIP CODE	
6	MAILING ADDRESS IN HAWAII 	(Street address or P.O. Box)	CITY/TOWNZIP CODE	
7	If no street/residence address, describe location of residence 	(leave blank if box #5 is completed)	CITY/TOWNZIP CODE	
8	
GENDER
T	Female	
T	Male	
9	
ARE YOU A REGISTERED VOTER IN ANOTHER STATE?If “yes”, please complete the following: I was last registered to vote at:
 (Last Registered Address)  (County) (State) (Zip Code)and hereby authorize cancellation of my previous voter registration.	
10	
READ CAREFULLY, MARK APPROPRIATE “YES” OR “NO” BOX, AND SIGN BELOW.
I hereby swear (or affi  rm) that:
FOR FEDERAL, STATE, and COUNTY ELECTIONS:
a.  I am a citizen of the United States of America (Non-U.S. citizens including U.S. nationals do not qualify). 	
T	Yes 	T	No
b.  I am at least 16 years of age. I understand that I must be 18 years old by election day to vote. 	
T	Yes 	T	No
c.  I am a resident of the State of Hawaii.	
  The residence stated in this affi davit is not simply because of my presence in the State, but that the residence was acquired 
  with the intent to make Hawaii my legal residence with all the accompanying obligations therein……… 	T	Yes 	T	No	
11	
WITNESS SIGNATURE (required only if applicant makes a mark) DATE
ADDRESS OF WITNESS PHONE NO. OF WITNESS
SIGNATURE	DATE	
in the county of	
12	
I.D. No.
_____   _____   _____   _____	
13	
LOCATION CODE _____   _____	
14	
REPRESENTATIVE DISTRICT/PRECINCT	
_____   _____   _____   _____

Any voter who requires assistance to vote by reason 
of physical, visual, or hearing disability, or an inability 
to read or write may be given assistance by a person 
of the voter’s choice -- other than the voter’s employer, 
agent of the employer, or agent of the voter’s union 
(42 U.S.C. 1973aa-6).
Every polling place has a Voter Assistance Official 
who can provide the following:
Y language assistance materials to voters who have difficulty with the English language;
Y assistance to voters with physical disabilities; and
Y curbside voting services to voters who are unable to leave their vehicles to vote.
VOTING IN HAWAII
SPECIAL VOTING  SERVICES	
Voting is an essential part of our democratic process. By voting, you choose the representatives who will make 
decisions affecting you, your family and your community. If you care about the future of Hawaii. . . .
register and VOTE!!
What Types of Elections Does Hawaii Hold?
In every even numbered year, Hawaii holds a Primary Election
in September and a General Election in November.
Who May Register to Vote?
You may register to vote if you are:
Y  a citizen of the United States of America;
Y  a legal resident of Hawaii; and
Y  at least 16 years of age (Pre-registration is allowed at 
  age 16. You must be 18 years old by election day to vote).
You are not eligible to register or to vote if you are a 
convicted and confined felon or you are declared mentally 
incompetent.
Should I Re-register to Vote?
You should re-register if you changed your name, residence 
address or mailing address.
How Long are the Polls Open?
Polling places are open from  7:00 A.M. to 6:00 P.M. If you are 
not sure of your polling place, call your City or County Clerk.	
Will I Be Notified of My Polling Place?
Ye s . Your City/County Clerk will send you a  Notice of Voter 
Registration and Address Confirmation (NVRAC) card 
with your polling place listed on it.
You are not properly registered if:
Y  you do not receive the NVRAC card;
Y  you no longer live at the address listed on the 
  NVRAC card; or
Y  your residence address on the NVRAC is the address of a  mailing service or a business.
Do I Need an I.D. to Vote on Election Day?
Ye s . Be sure to have an I.D. with a picture and signature 
(such as a Hawaii driver’s license or state I.D. card) when 
you go to vote. The NVRAC card is  not an acceptable form 
of identification.
Do I Have to Take Time Off from Work to Vote?
You may be entitled to not more than two consecutive hours 
off from work on election day in order to vote. Ask your 
employer first and keep your ballot stub as proof of voting 
(ref. HRS 	
§11-95).	
For additional information, call the Voter Hotline at:
(808) 453-VOTE (8683)
Neighbor Islands call toll-free: 1-800-442-VOTE (8683)
Website address: www.hawaii.gov/elections
Persons with hearing or speech disabilities should  call the Office of Elections’ TTY phone at:  (808) 453-6150
Neighbor Islands call TTY toll-free: 1-800-345-5915
or the Sprint Relay Hawaii TRS at: 711 (V/TTY); 847-9508 (FAX)
Voice Carry Over (VCO): 1 (877) 447-5992
Speech to Speech (STS): 1 (877) 447-8711	
Prepared by the Office of Elections and the Association of Clerks and Election Officers of Hawaii (05/08).	
WARNINGWARNING	
AFFIDAVIT ON APPLICATION FOR VOTER REGISTRATION	
STATE OF HAWAII
T County of Hawaii
T County of Kauai
T County of Maui
T City and County of Honolulu	
IMPORTANT: PRINT CLEARLY 
IN BLACK INK.  FAILURE TO 
COMPLETE ALL ITEMS WILL 
PREVENT ACCEPTANCE OF 
THIS APPLICATION.	
I HEREBY SWEAR (OR AFFIRM) THAT THE FOLLOWING INFORMATION IS TRUE AND CORRECT:	
AFFIDAVIT NO.
(FOR OFFICE USE ONLY)	
}	
ss.	
The office at which a person registers to vote is confidential. A person’s declination to register to vote is also confidential and is used for 
voter registration purposes only (National Voter Registration Act of 1993). ANY PERSON WHO KNOWINGLY FURNISHES FALSE INFORMATION MAY BE GUILTY OF A CLASS C 
FELONY, PUNISHABLE BY UP TO 5 YEARS OF IMPRISONMENT AND/OR $10,000 FINE.
* Notice: Section 11-15 of the Hawaii Revised Statutes requires that a person registering to vote provide, under oath, his or her social security number, if any.
An application lacking this information will, therefore, be denied. Pursuant to Section 7 of the Federal Privacy Act (P.L. 93-579), be advised that this 
information may be released to government agencies for government purposes.	
For Offi ce Use Only	
05/08	
1	
SOCIAL SECURITY NUMBER*
___ ___ ___ - ___ ___ - ___ ___ ___ ___ 	
2	
DATE OF BIRTH ___ ___ / ___ ___ / ___ ___
 Month Day  Year	3	
TELEPHONE
Home: Business:	
4	LAST NAME FIRST NAME MIDDLE INITIAL(S)	
5	RESIDENCE ADDRESS IN HAWAII 	(Must be completed. P.O. Box, R.R., S.R. are not acceptable)	CITY/TOWNZIP CODE	
6	MAILING ADDRESS IN HAWAII 	(Street address or P.O. Box)	CITY/TOWNZIP CODE	
7	If no street/residence address, describe location of residence 	(leave blank if box #5 is completed)	CITY/TOWNZIP CODE	
8	
GENDER
T	Female	
T	Male	
9	
ARE YOU A REGISTERED VOTER IN ANOTHER STATE?If “yes”, please complete the following: I was last registered to vote at:
 (Last Registered Address)  (County) (State) (Zip Code)and hereby authorize cancellation of my previous voter registration.	
10	
READ CAREFULLY, MARK APPROPRIATE “YES” OR “NO” BOX, AND SIGN BELOW.
I hereby swear (or affi  rm) that:
FOR FEDERAL, STATE, and COUNTY ELECTIONS:
a.  I am a citizen of the United States of America (Non-U.S. citizens including U.S. nationals do not qualify). 	
T	Yes 	T	No
b.  I am at least 16 years of age. I understand that I must be 18 years old by election day to vote. 	
T	Yes 	T	No
c.  I am a resident of the State of Hawaii.	
  The residence stated in this affi davit is not simply because of my presence in the State, but that the residence was acquired 
  with the intent to make Hawaii my legal residence with all the accompanying obligations therein……… 	T	Yes 	T	No	
11	
WITNESS SIGNATURE (required only if applicant makes a mark) DATE
ADDRESS OF WITNESS PHONE NO. OF WITNESS
SIGNATURE	DATE	
in the county of	
12	
I.D. No.
_____   _____   _____   _____	
13	
LOCATION CODE _____   _____	
14	
REPRESENTATIVE DISTRICT/PRECINCT	
_____   _____   _____   _____

INSTRUCTIONS FOR COMPLETING THE WIKIWIKI VOTER REGISTRATION FORM	
Filipino, Chinese, and Japanese translations are required 
pursuant to the Voting Rights Act of 1965 as amended.	
For more information, please call the Offi ce of 
the City/County Clerk:
  Honolulu:   (808) 768-3800
  Maui:   (808) 270-7749
  Kauai:   (808) 241-4800
  Hawaii:   (808) 961-8277	
Aloha	  The Office of Elections and the 
Association of Clerks and Election 
Officers of Hawaii are pleased to 
introduce you to Wikiwiki Voter 
Registration, Hawaii’s registration-by-
mail procedure.
  To register to vote, all you need is a 
Wikiwiki form and a postage stamp. 
Follow the instructions and complete 
the form correctly. Once you have 
registered to vote, please remember 
to take the next step and VOTE in the 
upcoming elections. See you there!	
VOTER	
REGISTRATION	
LANGUAGE ASSISTANCE	
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, Business 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 address, describe the location of your residence. Include 
details such as subdivision, village, tax map key no. and zip code.
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.	
STEP 2   Mail the Affidavit on Application for Voter Registration no later than 30 days prior to the  
  election to the appr	
opriate City/County Clerk:
STEP 1   Complete the Affidavit on Application for Voter Registration	
County of Hawaii 
25 Aupuni St., Rm. 105
Hilo, HI  96720-4245
Ph. (808) 961-8277
City and County of Honolulu
530 S. King St., Rm. 100
Honolulu, HI 96813-3077
Ph. (808) 768-3800
County of Maui
200 S. High St., Rm. 708
Wailuku, HI  96793-2155
Ph. (808) 270-7749 County of Kauai
4386 Rice St.
Lihue, HI  96766-1371
Ph. (808) 241-4800	
Notice to First Time Voters Who Register to Vote by Mail:
If you are (1) registering to vote for the fi rst time in the State of Hawaii; and (2) are mailing in this Affi davit on Application 
for Voter Registration, federal law (42 U.S.C. § 15483) requires you to provide proof of identifi cation. Proof of identifi cation 
includes a copy of:
•  A current and valid photo identifi cation, or
•   A current utility bill, bank statement, government check, paycheck or government document that shows your name and 
address.
If you do not provide the required proof of identifi cation with this Affi davit on Application for Voter Registration, you will be 
required to do so at your polling place, or with your voted absentee mail-in ballot.	
Tulong para iti Lengguahe – Filipino (Ilocano)  
Ti Opisina ti Panagpipili ken ti Timpuyog dagiti 
Eskribiente ken Eleksion Opiser ti Hawaii

 
maragsakanda a mangiyammo kenka ti Wikiwiki a 
Panagrehistro ti Botante, ti Panagrehistro iti Hawaii 
babaen ti koreo a wagas.  Dagiti naipatarus a 
kasapulan iti panagbutos a mangtulong kenka 
iti panangileppas iti daytoy a porma maalada iti 
Opisina ti Eskribiente iti Siudad/Ili. Pangaasim 
ta awaganyo ti maitutop a numero iti telepono a 
nailanad ditoy baba.
t ±”ϵ  –  Japanese
\w \fS z 
¬
Ê=\fJå U	

#(pæQ”‘Ots“‡
`h { \•x
¬g•»q(The Office of Elections) 
|t	{Gíz
¬g» q
(The Association of 
Clerks and Election Officers of Hawaii)

Cæw ®¢Ÿ
©¢Ÿ©
¬
Ê=\fJå

e;\b´¯ pb{\w 
 
e ;
\b´G\fÖw\bMt
žAs	¾V	{w\fÔŠ 
x\b7/“w
\b¢‡hx
w	{Gí\bÄ¿	t
(The Office of the City/
County Clerk)
‘“\fÖ 	 pV‡b{ ]\fÖ“;w\bMx<G
w
jøtSðMù˜dXi^M{
English (Translation)
The Office of Elections and the Association of Clerks 
and Election Of ficers of Hawaii ar	
e pleased to 
introduce you to Wikiwiki Voter Registration, Hawaii’s 
registration-by-mail procedure.  Translated voting 
materials to assist you in completing this form are 
available at the Office of the City/County Clerk.  Please 
call the appropriate phone number listed below.	
–  Chinese