Voter Registration Form

This is the Voter Registration Form for Cache County, Utah.

If you need to register to vote in a different county within Utah, please visit the statewide voter registration website at vote.utah.gov

Download a Printable Version HERE
Are you a citizen of the United States? **If no, do not complete form.*

YesNo
Will you be at least 18 years of age on or before election day?*

YesNo
Are you 16 or 17 years of age and preregistering to vote? *If no, do not complete form?*

YesNo

Voter Registration Form
Name*

First NameMiddle NameLast NameSuffix
Name at birth or previous legal name
If different from above
Residential Address *
No PO Boxes
Unit or Apt Number
City or Town*
County in Utah*
Zip Code*
Select one*

My mailing address is the same as my residence.My mailing address is different than my residence.
Mailing Address or PO Box
Millville and Paradise PO Box is Required
Unit or Apt Number
CityStateZip Code
Birthdate*

MonthDayYear
Date
Place of Birth state or country*
Choose one of the following to provide*

Utah Driver's LicenseLast 4 of Social Security NumberI do not have a valid UT Driver's Licence, ID card, or a Social Security Number.Tribal Identification Number or Alien Registration Number
Last 4 of Social Security Number*
Utah Driver's License Number*
A minimum of 9 digits is required
Tribal Indentification Number or Alien Registration Number (optional):
Place of naturalization
If applicable
Date of naturalization

MonthDayYear
If applicable
Political party preference*

Constitution PartyDemocratic PartyForward PartyGreen PartyIndependent American PartyLibertarian PartyRepublican PartyPeople's Freedom PartyUnaffiliated (no party preference)Other
To ensure we can reach you for verification purposes, please provide your email address and/or phone number. Email addresses and phone numbers are confidential and will not be shared.
Phone Number
Format: (000) 000-0000.
Email address
Do you consent to receive communications about the status of your ballot and other official communications, by text, at the phone number you provided above?*

YesNo
Indicate below how you want to vote in upcoming elections:*

Mail a ballot to me, I intend to vote by mail.Do not mail a ballot to me, I will vote in person.
Check any that apply to you.

I am a voter with a disability.I would like to be a pollworker.I am a voter residing out of the US.I am an active military voter or a dependent of one.
As an overseas or active-duty military voter, you are eligible to receive your ballot by email. Would you like us to send your ballot to the email address you provided above?*

YesNo
Select one*

I have previously registered to vote.I have never registered to vote.
Previous Voter Residential Address
Unit or Apt Number
CityStateZip Code
Privacy Information

Voter registration records contain some information that is available to the public, such as your name, address, and age range. Your date of birth, driver license number, state identification card number, and social security number are available only to an authorized government entity. Your email address and phone number are also only available to an authorized government entity.

REQUEST FOR ADDITIONAL PRIVACY PROTECTION: In addition to the protections provided above, you may request that your voter registration record be withheld from public disclosure if you are, or reside with: an individual who is a victim of, or is threatened with, domestic violence or dating violence; a law enforcement officer; a member of the armed forces; a public figure; or an individual who is protected by a court order. To make this request for additional privacy protection, you must prove that you qualify by submitting an at-risk designation request form, and any required proof, to your county clerk. You may obtain the form, and information on the proof required, from your county clerk or at vote.utah.gov.
Read and Sign below

Voter Declaration: I do swear (or affirm), subject to penalty of law for false statements, that the information contained in this form is true and that I am a citizen of the United States and a resident of the State of Utah, residing at the above address. Unless I have indicated above that I am preregistering to vote in a later election, I will be at least 18 years of age and will have resided in Utah for 30 days immediately before the election.I am not a convicted felon currently incarcerated for commission of a felony.

Citizenship Affidavit: I hereby swear and affirm, under penalties for voting fraud set forth below in Utah Code Section 20A-2-401, that I am a citizen and that to the best of my knowledge and belief the information above is true and correct.
Signature
Todays Date

MonthDayYear
Date

Since you selected "No," you are unable to fill out this form. You must be United States Citizen in order to register to vote.

Since you selected "No," you are unable to fill out this form. You must be at least 18 to register to vote or 16 to preregister.

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Please Preview Your Form and Click the SUBMIT Button
Should be Empty:

Voter Registration Form

Privacy Information

Since you selected "No," you are unable to fill out this form. You must be United States Citizen in order to register to vote.

Since you selected "No," you are unable to fill out this form. You must be at least 18 to register to vote or 16 to preregister.

You Are Almost Done!