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Request for Voter Registration Change Form

Complete your name, date of birth, and any changes to be made to your Harford County voter registration record.

Please print form from screen and apply original signature, then mail completed form to:  Harford County Election Office; 133 Industry Lane, Forest Hill, Maryland 21050.
 

(Last Name, First Name, M.I.)
  

(Last Name, First Name, M.I.)
  
Zip Code 
New Address Apt. No. 
Zip Code 

    (Mailing Address If Applicable; i.e., P.O. Box and Zip Code)

Signature:  		                                                                       

(Original Signature Required)

Date:                                  

                    

 

Party Affiliation Change To:

Democrat 
Republican 
Libertarian 
Green
Decline To 
Affiliate
Other (Specify):

Please Complete This Section
Date of Birth:

(Month/Day/Year)
Telephone:
(Include Area Code)
Home: 
Work: