As Amended
SEC. 23-15-39. Form of application for registration; allowances for office supplies; determination on application; notice to applicant; assistance to applicant; voter registration number; fees and costs; forwarding of application.
(1) Applications for registration as electors of this state, which are sworn to and subscribed before the registrar or deputy registrar authorized by law and which are not made by mail, shall be made upon a triplicate form in the following words and figures:
"APPLICATION FOR REGISTRATION
(You may receive assistance in filling out this form from any person of your choosing. It is not necessary that this form be filled out in the presence of the registrar, however, the oath must be executed in the presence of the registrar or his deputy.)
1. What is your full name, including maiden name, if you have one?
______________________________________________________
2. Please give your social security number. ______________
3. What is your date of birth? _____________________
4. Are you a citizen of the United States? _______________
5. What is your present residence address and each place you have resided during the past year, stating when you lived at each place, and specifying the municipality or community, the street name and number and/or any other designation which accurately describes the geographic location of your present residence address?
(a) Present address: __________________________
From ________________ (month) to date.
(b) Previous address: _________________________
From ________ (month) to ________ (month).
(c) Previous address: _________________________
From ________ (month) to ________ (month).
(If you need additional space, use the backside of this form.)
6. What is your present mailing address? __________________
7. Are you now a resident of this state and county? _______
8. Do you now reside within the city limits of a city or town located within this county? _______
9. Have you ever registered to vote before in any other county or state? If so, give the last place or last two (2) places if registered more than once. ________ ________
10. Have you ever been convicted of the crime of murder, rape, bribery,
theft, arson, obtaining money or goods under false pretenses, perjury,
forgery, embezzlement or bigamy or convicted in any court of any felony
other than convictions of manslaughter and violations of the United States
Internal Revenue Code or any violations of the tax laws of this or another
state unless the offense also involved misuse or abuse of public office
or money coming into your hands by virtue
of that office? ________
11. The following questions may be answered by you at your option and are solely for the purpose of aiding in registering you in the proper precinct:
(a) Are there any registered voters living at your present residence? ________ If so, give the name of each such person. ________________________________________________
(b) Do you have a telephone at your present residence? ________ If so, give the telephone number of such telephone.
________ Please give your work telephone number. ___________
After you have answered 1 through 11 above, sign or make your mark on the following oath in the presence of the registrar or deputy registrar.
STATE OF MISSISSIPPI
COUNTY OF _________
I do solemnly swear (or affirm) that I am at least eighteen (18) years old (or I will be before the next general election in this county), and that I am now in good faith a resident of this state and of ________ Election Precinct in this county, and that I am not disqualified from voting by reason of having been convicted of any crime listed in Question 10 of the application; that I have truly answered all questions propounded to me in the foregoing application for registration, and that I will faithfully support the Constitutions of the United States and of the State of Mississippi, and will bear true faith and allegiance to the same. So help me God.
Applicant sign here: ______________________
SWORN TO AND SUBSCRIBED before me, this the ____ day of ________ 2___.
_____________________ (Registrar)
By _________________ (Deputy Registrar)"
(2) The boards of supervisors shall make proper allowances for office supplies reasonably necessitated by the registration of county electors.
(3) If the reply to Question 8 above is affirmative, the county registrar
shall forward notice of registration, a copy of the application for registration,
and any changes to such registration when they occur, either by certified
mail to the clerk of the municipality indicated in the present residence
address stated in answer to Question 5(a) above or by personal delivery
to such clerk provided that a numbered receipt is signed by such clerk
in return for the described documents. Upon receipt of the copy of the
application for registration or changes to such registration, and if a
review of same indicates that the applicant meets all the criteria necessary
to qualify as a municipal elector, then the clerk of said municipality
shall make a determination of the municipal voting precinct in which the
person making the application shall be
required to vote. The clerk shall send this municipal voting precinct
information by United States first-class mail, postage prepaid, to such
person at the address provided on the application. Any and all mailing
costs incurred by the county registrar or the clerk of the municipality
in effectuating this subsection shall be paid by the governing authority
of such municipality. If a review of the copy of the application for registration
or changes to such registration indicates that the applicant is not qualified
to vote in said municipality, the clerk of said municipality shall challenge
such application. The municipal election commissioners responsible for
said municipality shall review any such challenge or disqualification after
having notified the applicant by certified mail of such challenge or disqualification.
(4) If the reply to Question 9 above is affirmative, the registrar or clerk shall on a monthly basis send notice of this new registration to the registrar or clerk of the county stated in Question 9 as the voter's previous place of registration. The election commission of the voter's previous place of registration shall be responsible for having such voter's name erased from the appropriate registration book and pollbook.
(5) The registrar shall issue to the person making the application a copy of such application upon which has been written the county voting precinct in which said person shall vote. The registrar shall assign a voter registration number to such person, which shall be that person's social security number if such a number is provided, and said voter registration number shall be clearly shown on the application.
(6) Any person desiring an application for registration may secure the
same from the registrar of the county of which he is a resident and may
take said form with him and secure assistance in completing said form from
any person of the applicant's choice. It shall be the duty of all registrars
to furnish forms for registering to all persons requesting the same, and
it shall likewise be his duty to furnish aid and assistance in the completing
of said forms when requested by an applicant. The application for registration
shall be sworn to and subscribed before the registrar or deputy registrar
at the municipal clerk's office, the county registrar's office or
any other location where the applicant is allowed to register to vote.
No fee or cost shall be charged the applicant by the registrar for accepting
the application or administering the oath or for any other duty imposed
by law regarding the registration of electors.
(7) The receipt of a copy of the application for registration sent pursuant to Section 23-15-35(2) shall be sufficient to allow the applicant to be registered as an elector of this state, provided that such application is not challenged as provided for therein.
(8) In any case in which a municipality expands its corporate boundaries
by annexation, the municipal clerk shall, within ten (10) days after the
effective date of such annexation, forward to the county registrar a map
which accurately depicts the annexed area. The county registrar shall,
within ten (10) days after the receipt of such map, forward to the municipal
clerk a copy of the most recent county precinct or subprecinct pollbook
for the county precincts in which such annexed area is included, or equivalent
computer data or information as will permit the identification of county
electors who reside in the annexed area. The municipal clerk shall add
those county electors who have resided in the annexed area for at least
thirty (30) days after annexation to the municipal registration books as
registered voters of the municipality and shall forward to such persons
written notification of such addition and of the municipal precinct or
ward in which such persons reside.
SOURCES: Derived from 1972 Code § 23-5-17 [ (Codes, 1942, § 3209.6; Laws, 1955, Ex ch. 102, § 1; Laws, 1960, ch. 449, § 1; Laws, 1962, ch. 569, § 1; Laws, 1965, Ex Sess, ch. 10, §§ 1-4) and § 23-5-303 (Codes, 1942, § 3203-502; Laws, 1972, ch 490, § 502; Laws, 1975, ch 502, § 1; Laws, 1984, ch. 457, § 1); repealed by Laws, 1986, ch 495, §§ 335, 337]; en Laws, 1986, ch. 495, § 12; Laws, 1988, ch. 350, § 3; Laws, 1991, ch. 440, § 8; Laws, 2000, ch. 592, § 1; Laws, 2001, ch. 308, § 1, SB 3003, eff June 13, 2001 (the date the United States Attorney General interposed no objection under Section 5 of the Voting Rights Act of 1965, to the amendment of this section.)
PREVIOUS VERSIONS: Pre-2001