NORTH CAROLINA STATE BOARD OF ELECTIONSPhoto Identification Survey

Beginning in 2016, any voter who presents to vote in-person during early voting or on the day of the primary of election will be required to show a photo identification before being allowed to vote a regular ballot. The types of identification (ID) that are:

• Unexpired North Carolina drivers license, including a learners’ permit or provisional license
• Unexpired North Carolina nonoperators identification card (DMV ID Card)
• Unexpired United States passport
• United States military identification card
• Veterans Identification Card
• Tribal enrollment card issued by a federally recognized tribe
• Tribal enrollment card issued by a North Carolina recognized tribe
• Out-of-state drivers license or nonoperators identification card (valid only if the person’s voter registration date in the county is within 90 days of the date of the election)

In order to ensure that all registered voters have access to acceptable identification for purposes of voting, please complete this online form ONLY if you do not have one of the forms of identification listed above.

1. County of Residence

County of Residence

2. Provide your name and contact information:

Provide your name and contact information: Name:
Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

3. What is your date of birth?

	Birth Month	Birth Day	Birth Year
Date of Birth:	What is your date of birth? Date of Birth: Birth Month	Birth Day	Birth Year

4. Are you a registered voter in North Carolina?

Are you a registered voter in North Carolina? Yes

No

5. If you are a registered voter, what is your Voter Registration Number (VRN)? You can locate your VRN on your voter card or by looking up your voter registration information on our website at www.NCSBE.gov. If you cannot locate your VRN, don't worry, we still want you to complete this survey.

If you are a registered voter, what is your Voter Registration Number (VRN)? You can locate your VRN on your voter card or by looking up your voter registration information on our website at www.NCSBE.gov. If you cannot locate your VRN, don't worry, we still want you to complete this survey. VRN:

*

6. Please confirm whether or not you have the following types of identification cards:

	Yes	No
Unexpired North Carolina drivers license, including a learners’ permit or provisional license	*Please confirm whether or not you have the following types of identification cards: Unexpired North Carolina drivers license, including a learners’ permit or provisional license Yes	Unexpired North Carolina drivers license, including a learners’ permit or provisional license No
Unexpired North Carolina nonoperators identification card (DMV ID Card)	Unexpired North Carolina nonoperators identification card (DMV ID Card) Yes	Unexpired North Carolina nonoperators identification card (DMV ID Card) No
Unexpired United States passport	Unexpired United States passport Yes	Unexpired United States passport No
United States military identification card	United States military identification card Yes	United States military identification card No
Veterans Identification Card	Veterans Identification Card Yes	Veterans Identification Card No
Tribal enrollment card (issued by a federally recognized tribe)	Tribal enrollment card (issued by a federally recognized tribe) Yes	Tribal enrollment card (issued by a federally recognized tribe) No
Tribal enrollment card (issued by a North Carolina recognized tribe)	Tribal enrollment card (issued by a North Carolina recognized tribe) Yes	Tribal enrollment card (issued by a North Carolina recognized tribe) No
Out-of-state drivers license or nonoperators identification card (may be used for purposes of voting only if the person’s voter registration date in the county is within 90 days of the date of the election)	Out-of-state drivers license or nonoperators identification card (may be used for purposes of voting only if the person’s voter registration date in the county is within 90 days of the date of the election) Yes	Out-of-state drivers license or nonoperators identification card (may be used for purposes of voting only if the person’s voter registration date in the county is within 90 days of the date of the election) No

The State Board of Elections and the county boards of elections will be actively engaged in assisting voters who do not possess acceptable photo ID. Part of our outreach efforts will involve helping these voters obtain a free nonoperators ID card issued by the North Carolina DMV. The no-cost ID program will begin in 2014. To apply for a DMV-issued ID, persons will need to provide the DMV with proof of age and identity, Social Security number, and residence. please visit the North Carolina DMV's website (http://www.ncdot.gov) for more information on the requirements for obtaining a nonoperators identifcation card.

7. In order to obtain a NC nonoperators identification card, you may need a certified copy of your birth certificate or marriage license. Please indicate whether you have possession of either of the following documents:

	Yes	No
A certified copy of your birth certificate	*In order to obtain a NC nonoperators identification card, you may need a certified copy of your birth certificate or marriage license. Please indicate whether you have possession of either of the following documents: A certified copy of your birth certificate Yes	A certified copy of your birth certificate No
A certified copy of your marriage license	A certified copy of your marriage license Yes	A certified copy of your marriage license No