Ohio Voter Registration and Information Update Form

The Ohio Voter Registration and Information Update Form is a form that is used for registering to vote in the State of Ohio. The mentioned form can also be used for updating the current Ohio Registration.

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Voter Registration and Information Update Form	
Please read instructions carefully. Please type or print clearly with bl\
ue or black ink.  
For further information, you may consult the Secretary of State’s web\
site at:  www.OhioSecretaryofState.gov	 or call (877) 767-6446.	
Eligibility
You are qualified to register to vote in Ohio if you meet all the 
following requirements:
 1. You are a citizen of the United States. 
  2. You will be at least 18 years old on or before the day of the 
general election. 
  3. You will be a resident of Ohio for at least 30 days 
immediately before the election in which you want to vote. 
  4. You are not incarcerated (in jail or in prison) for a felony 
conviction. 
  5. You have not been declared incompetent for voting 
purposes by a probate court. 
  6. You have not been permanently disenfranchised for 
violations of election laws. 
Use this form to register to vote or to update your current Ohio 
registration if you have changed your address or name.
NOTICE: This form must be received or postmarked by the 30th day 
before an election at which you intend to vote. You will be notified by \
your county board of elections of the location where you vote. If you 
do not receive a notice following timely submission of this form, 
please contact your county board of elections. 
Numbers 1 and 2 below are required by law.  You must answer 
both of the questions for your registration to be processed.
Registering in Person
If you have a current valid Ohio driver’s license, you must provide t\
hat 
number on line 10. If you do not have an Ohio driver’s license, you 
must provide the last four digits of your Social Security number on 
line 10. If you have neither, please write “None.”	
Registering by Mail
If you register by mail and do not provide either an Ohio driver’s 
license number or the last four digits of your Social Security number, 
you must enclose with your application a copy of one of the following 
forms of identification:
Current and valid photo identification, a military identification, or a \
current (within the last 12 months) utility bill, bank statement, 
government check, paycheck, or government document (other than 
a notice of voter registration mailed by a board of elections) that 
shows the voter’s name and current address.
Residency Requirements
Your voting residence is the location that you consider to be a 
permanent, not a temporary, residence. Your voting residence is the 
place in which your habitation is fixed and to which, whenever you 
are absent, you intend to return. If you do not have a fixed place of 
habitation, but you are a consistent or regular inhabitant of a shelter \
or other location to which you intend to return, you may use that 
shelter or other location as your residence for purposes of registering \
to vote. If you have questions about your specific residency 
circumstances, you may contact your local board of elections for 
further information.
Your Signature
In the area below the arrow in Box 14, please write your cursive, 
hand-written signature or make your legal mark, taking care that it 
does not touch the surrounding lines so when it is digitally imaged by 
your county board of elections it can effectively be used to identify 
your signature.
Please see information on back of this form to learn how  to obtain an absentee ballot.
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A FELONY OF THE FIFTH DEGREE	
Registering as an Ohio voter	Updating my address	Updating my name	I am:
1. Are you a U.S. citizen?	Yes	No	
2. Will you be at least 18 years of age on or before the next general el\
ection?	Yes	No	
If you answered NO to either of the questions, do not complete this form\
.	
3. Last Name	First Name	Middle Name or Initial	Jr., II, etc.	
4. House Number and Street (Enter new address if changed) Apt. or Lot #	5. City or Post Office	6. ZIP Code	
7. Additional Mailing Address (if necessary)	8. County 
(where you live)	
9. Birthdate (MM/DD/YYYY) (required)	10. Ohio Driver’s License number OR Last Four 
Digits of Social Security number (one form of ID 
required to be listed or provided)	11. Phone Number (voluntary)	
12. PREVIOUS ADDRESS IF UPDATING CURRENT REGISTRATION - Previous House Number and Street
Previous City or Post Office	Previous 
County	Previous 
State	
13. CHANGE OF NAME ONLY Former Legal Name	Former Signature	
14.  
I declare under penalty of 
election falsification I am a 
citizen of the United States, 
will have lived in this state 
for 30 days immediately 
preceding the next election, 
and will be at least 18 
years of age at the time of 
the general election.	Your Signature	Date (MM/DD/YYYY)	
FOR BOARD 
USE ONLY 
SEC4010 (rev. 4/15)
City, Village, Twp.	
Ward
Precinct
School Dist.
Cong. Dist.
Senate Dist.
House Dist.

TO ENSURE YOUR INFORMATION IS RECEIVED, PLEASE DO THE FOLLOWING:	
 1. Print this form. 
  2. Make sure all required fields are complete. 
  3. Sign and date your form. 
  4. Fold and insert your form into an envelope. 
  5. Mail your form to your county board of elections.  
For your county board's address please visit 	
www.OhioSecretaryofState.gov/boards.htm
If you have additional questions, please call the office of the Ohio 
Secretary of State at (877) SOS-OHIO (877-767-6446).	
HOW TO OBTAIN AN OHIO ABSENTEE BALLOT	
You are entitled to vote by absentee ballot in Ohio without providing a \
reason. Absentee 
ballot applications may be obtained from your county board of elections \
or from the 
Secretary of State at:  www.OhioSecretaryofState.gov	
 or by calling (877) 767-6446.	
OHIO VOTER IDENTIFICATION REQUIREMENTS	
Voters must bring identification to the polls in order to verify identit\
y. Identification may 
include current and valid photo identification, a military identificatio\
n, or a copy of a 
current (within the last 12 months) utility bill, bank statement, gove\
rnment check, 
paycheck, or other government document (other than a notice of voter re\
gistration 
mailed by a board of elections) that shows the voter’s name and curr\
ent address. Voters 
who do not provide one of these documents will still be able to vote by \
providing the last 
four digits of the voter’s Social Security number and by casting a pr\
ovisional ballot 
pursuant to R.C. 3505.181. For more information on voter identification \
requirements, 
please consult the Secretary of State’s website at:  www.OhioSecretaryofState.gov	
 or 
call (877) 767-6446.	
WHOEVER COMMITS ELECTION FALSIFICATION IS GUILTY OF A  FELONY OF THE FIFTH DEGREE.