1. Agency-Based Voter Registration Program NYS Board of Elections WELCOME! SITE COORDINATOR TRAINING

2. Overview Legal Authority Registering: Initial intake & Recertification Transmittal Form Supply Ordering Reminders Agency-Based Voter Registration Program

3. National Voter Registration Act of 1993 All Department of Motor Vehicles Offices All Disability Agencies All Public Assistance Agencies NYS Election Law 5-211 Governs Agency-Based Voter Registration Procedures Includes additional State Designated Agencies Legal Authority

4. Agency-Based Voter Registration Program Administrative Hierarchy Site NYS Board of Elections Albany, NY Site Coordinator Agency Program Coordinator

5. Agency-Based Voter Registration Program Agency must offer voter registration during initial intake and recertification. Voter registration has no impact on applicant’s benefits. Client’s information will be used for voter registration purposes only and will otherwise remain confidential (including office of origin.) Voter Registration Forms are available in English, Spanish, Chinese, and Korean.

6. Response #1 - Client says “YES” “If you are not registered to vote where you live now, would you like to apply to register here today?” 4 possible responses:

7. YES (If you check yes, please complete VOTER REGISTRATION APPLICATION at bottom of page) If you do not check any box, you will be considered to have decided not to register to vote at this time. (Signature) Date / / / (Please Print Name)

8. ☐ Yes, I need an application for an Absentee Ballot ☐ Yes, I would like to be an election day worker ☐ Yes, I need an application for an Absentee Ballot 2 Are you a U.S. citizen? If you answered NO, do not complete this form. 1 I will be 18 years old on or before election day: Yes ☐ No ☐ If you answered NO, do not complete this form, unless you will be 18 by the end of the year. Yes ☐ No ☐

9. ☐ Yes, I need an application for an absentee ballot ☐ Yes, I would like to be an Election Day worker 2 ☐ Yes, I would like to be an Election Day worker 1 Are you a U.S. citizen? If you answered NO, do not complete this form. Yes ☐ No ☐ I will be 18 years old on or before election day: Yes ☐ No ☐ If you answered NO, do not complete this form, unless you will be 18 by the end of the year.

10. Are you a U.S. citizen? Yes ☐ No ☐ I will be 18 years old on or before election day: Yes ☐ No ☐ If you answered NO, do not complete this form, unless you will be 18 by the end of the year. You must be a U.S citizen to vote ☐ I will be 18 years old on or before election day 1 2 If you answered NO, do not complete this form.

11. Last Name First Name Middle Initial Suffix Smith John C. Sr 3

12. Address Where You Live (do not give P.O. address) Apt. No. City/tTown/Village Zip Code County 54 Redstone Avenue Anytown 11111 Any 4

13. Address Where You Get Your Mail (if different from above) P.O. Box, star rte., etc. Post Office Zip Code PO Box 62 Anytown 11111 5

14. Date of Birth Sex (circle) Home Tel. Number (optional) M F 12/12/54 222-333-5555 6 7 8

15. ID Number - Check the applicable box and provide your number ☐ New York DMV number __ __ __ __ __ __ __ __ __ If you do not have a New York DMV number, please provide ☐ Last four (4) digits of your Social Security number ___ ___ ___ ___ ☐ I do not have a New York DMV number or a Social Security number 9

16. 2003 10 The last year you voted Your address was (give house number, street, and city) In county/state Under the name (if different from your name now) Albany/NYMary Jones 32 Martin Street, Plainsville

17. 1 Choose a Party - Check one box only } ☐ DEMOCRATIC PARTY ☐ REPUBLICAN PARTY ☐ INDEPENDENCE PARTY ☐ CONSERVATIVE PARTY ☐ WORKING FAMILIES PARTY ☐ OTHER (write in) ___________________ ☐ I DO NOT WISH TO ENROLL IN A PARTY

18. Please note: In order to vote in a primary election, you must be enrolled in one of these parties. The Independence Party allows un-enrolled voters to vote in their primaries.

19. AFFIDAVIT: I swear or affirm that ● I am a citizen of the United States ● I will have lived in the county, city, or village for at least 30 days before the election. ● I meet all requirements to register in vote in New York State ● This is my signature or mark on the line below. ● The above information is true. I understand that if it is not true I can be convicted and fined up to $5,000 and/or jailed for up to four years. Signature or mark X Date

20. When applicants decide to complete the voter registration application............give them a Voter Information Card

21. Response # 1 - Client says “YES” Response # 2 - Client says “NO”/Blanks “If you are not registered to vote where you live now, would you like to apply to register here today?” 4 possible responses:

22. NO because I choose not to register to vote OR If you do not check any box, you will be considered to have decided not to register to vote at this time. (Signature) Date (Please Print Name) / / / 8 01 10 John Doe

23. Response # 1 - Client says “YES” Response # 2 - Client says “NO”/Blanks Response # 3 - Client says “Already Registered” “If you are not registered to vote where you live now, would you like to apply to register here today?” 4 possible responses:

24. NO because I choose not to register to vote OR If you do not check any box, you will be considered to have decided not to register to vote at this time. (Signature) Date / / / (Please Print Name) I am already registered at my current address OR 8 1 10 John Doe

25. Response # 1 - Client says “YES” Response # 2 - Client says “NO” / BLANKS Response # 3 - Client says “Already Registered ” Response # 4 - Asked for and received a mail registration form. “If you are not registered to vote where you live now, would you like to apply to register here today?” 4 possible responses:

26. No because I choose not to register OR If you do not check any box, you will be considered to have decided not to register to vote at this time. (Signature) Date / / / (Please Print Name) I am already registered at my current address OR I asked for and received a mail registration form. 8 1 10 John Doe

27. Agency-Based Registration Transmittal Form Section I. [To be completed by agency site coordinator] NVRA 6-digit Site Code Number Date of Transmittal 106459 8/01/10

28. Applications [Number who registered to vote, changed address, name or party enrollment] Number of voter registration applications contained in transmittal 20

29. Agency-Based Registration Transmittal Form Declinations [Number received since last transmittal.......] Enter the number who checked the NO Box on the agency-based form OR left the form blank 58

30. Declinations [Number received since last transmittal.......] Enter the number who checked the ALREADY REGISTERED box on the agency- based form 75 Agency-Based Registration Transmittal Form Enter the number who checked the NO Box on the agency-based form OR left the form blank 58

31. Declinations [Number received since last transmittal.......] Enter the number who checked the ALREADY REGISTERED box on the agency- based form 75 Agency-Based Registration Transmittal Form Enter the number who checked the NO Box on the agency-based form OR left the form blank 58 AND RECEIVED A MAIL REGISTRATION FORM box on the agency- based form Enter the number who checked the REQUESTED 30

32. Other Applications [Individuals who did NOT appear at your agency office] Agency-Based Registration Transmittal Form Enter the number (if any) of voter registration forms SENT to individuals. 250

33. BLANKS ! ❐ Applicant refuses to make any marks on the agency-based form ❐ Applicant is unable to respond to voter registration question ❐ Applicant is not a US citizen ❐ Applicant is a convicted felon ❐ Multiple checkmarks in declination area

34. Declinations [Number received since last transmittal.......] Enter the number who checked the ALREADY REGISTERED box on the agency- based form 75 Agency-Based Voter Registration Transmittal Form Enter the number who checked the NO Box on the agency-based form OR left the form blank MAIL REGISTRATION FORM box on the agency- based form Enter the number who checked the REQUESTED AND RECEIVED A 30 Section I. [To be completed by agency site coordinator] NVRA 6-digit Site Code Number Date of Transmittal 106459 8/01/10 Applications [Number who registered to vote, changed address, name or party enrollment] Number of voter registration applications contained in transmittal Other Applications [Individuals who did NOT appear at your agency office] Enter the number (if any) of voter registration forms SENT to individuals. 58 250 20

35. Number of new registrations contained in this batch Section II. [To be completed by county board of elections] Number of address changes contained in this batch Number of enrollment changes contained in this batch Number of name changes contained in this batch Number of duplicate registrations contained in this batch Number of incomplete forms contained in this batch Number of forms forwarded to other county...

36. Agency-Based Registration Transmittal Form Section I. [To be completed by agency site coordinator] NVRA 6-digit Site Code Number Date of Transmittal 106459 8/01/10 Mail WHITE and YELLOW copies of the transmittal form (with applications) to your LOCAL board of elections and keep the PINK copy for your records.

37. New York City Bronx - Brooklyn - Manhattan - Queens - Staten Island ★ Mail transmittal form and completed voter registration forms to: New York City Board of Elections 32 Broadway, 7th Floor New York, New York 10004

38. NYS Agency-Based Voter registration Additional Supply Order Form Item Quantity Agency Employee Guide# Needed Counter Tents# Needed Transmittal Forms# Needed Transmittal Envelopes Large (10"X13") # Needed Small (4¾”X11") # Needed

39. Agency-Based Voter Registration Form (100 per pack) NYS Agency-Based Voter registration Additional Supply Order Form Language Quantity (order by pack) English# Packs of 100 Spanish# Packs of 100 Chinese# Packs of 100 Korean# Packs of 100

40. Voter Registration Forms Mail Registration -dot coded (100 per pack) NYS Agency-Based Voter registration Additional Supply Order Form Language Quantity (order by pack) English# Packs of 100 Spanish# Packs of 100 Chinese# Packs of 100 Korean# Packs of 100

41. NYS Agency-Based Voter registration Additional Supply Order Form Voter Card Informational Handout (100 per pack) Language Quantity (order by pack) English# Packs of 100 Spanish# Packs of 100 Chinese# Packs of 100 Korean# Packs of 100

42. Poster NYS Agency-Based Voter registration Additional Supply Order Form LanguageQuantity English# Needed Spanish# Needed Chinese# Needed Korean# Needed

43. To order supplies call 518-474-1953 or FAX completed request to 518-473-8315. Ship materials to: Site # 106459 (Only if DIFFERENT than site coordinator)

44. 1. Understand local agency procedures 2. NO volunteers offering voter registration 3. Maintain adequate supplies 4. Train new or reassigned employees in the voter registration program 5. Resolve site questions and problems relating to voter registration Site Coordinator Responsibilities

45. Reminders ▪ Keep signed declinations for 22 months ▪ Keep pink copy of transmittal for 22 months ▪ Citzenship - Age - Felons ▪ ID Requirements ▪ Submit registration forms within 10 days (Even if INCOMPLETE!) ▪ Use only provided envelopes ▪ Mail to your County Board of Elections

46. Agency-based voter registration questions? PLEASE CONTACT: NYS Board of Elections 518-474-1953 Greg Fiozzo