(a)(1) The mail voter registration application form may only require identifying information, including signature or mark, and other information, including data relating to previous registration by the applicant, as is necessary to assess the applicant's eligibility and to administer voter registration and other parts of the election process.
(2) Such forms shall include, in identical print, statements that:
(A) Specify voter eligibility requirements;
(B) Contain an attestation that the applicant meets all voter eligibility requirements;
(C) Specify the penalties provided by law for submission of a false voter registration application;
(D) Inform applicants that where they register to vote will be kept confidential; and
(E) Inform applicants that declining to register will also be kept confidential.
(3) The following information will be required of the applicant:
(A) Full name;
(B) Mailing address;
(C) Residence address and any other information necessary to identify the residence of the applicant;
(D) If previously registered, the name then supplied by the applicant, and the previous address, county, and state;
(E) Date of birth;
(F) A signature or mark made under penalty of perjury that the applicant meets each requirement for voter registration;
(G) If the applicant is unable to sign his or her name, the name, address, and telephone number of the person providing assistance;
(H) If the applicant has a current and valid driver's license, the applicant's driver's license number;
(I) If the applicant does not have a current and valid driver's license, the last four (4) digits of the applicant's social security number; and
(J) If the applicant does not have a current and valid driver's license number or social security number, the Secretary of State will assign the applicant a number which will serve to identify the applicant for voter registration purposes, and this number shall be placed on the application.
(4) The following information may be requested on the registration card, but it shall not be required:
(A) Telephone number where the applicant may be contacted; and
(B) Political party with which the applicant wishes to be affiliated, if any.
(5) The mail voter registration application shall not include any requirement for notarization or other formal authentication.
(6) The mail voter registration application form shall include the following questions along with boxes for the applicant to check "yes" or "no" in response:
(A) "Are you a citizen of the United States of America and an Arkansas resident?";
(B) "Will you be eighteen (18) years of age on or before election day?";
(C) "Are you presently adjudged mentally incompetent by a court of competent jurisdiction?";
(D) "Have you ever pleaded guilty or nolo contendere to, or found guilty of a felony without your sentence having been discharged or pardoned?"; and
(E) "Do you claim the right to vote in another county or state?".
(7) The mail voter registration application form shall include the following statements immediately following the questions asked in subdivision (a)(6) of this section:
(A) "If you checked "No" in response to either questions A or B, do not complete this form.";
(B) "If you checked "Yes" in response to one or more of questions C, D, or E, do not complete this form."; and
(C)(i) A statement informing the individual that if the form is submitted by mail and the individual is registering for the first time, a current and valid photo identification or a copy of a current utility bill, bank statement, government check, paycheck, or other government document that shows the name and address of the voter, must be submitted with the mailed registration form in order to avoid the additional identification requirements upon voting for the first time; or
(ii) When the state acquires the capacity to match the registrant's driver's license number and the registrant's social security number to the registrant's name, the mail-in voter registration application form shall include the following statement in lieu of the statement contained in subdivision (6)(a)(7)(C)(i):
"If your voter registration application form is submitted by mail and you are registering for the first time, in order to avoid the additional identification requirements upon voting for the first time you must submit with the mailed registration form: (a) your driver's license number; (b) the last four digits of your social security number; (c) a current and valid photo identification; or (d) a copy of a current utility bill, bank statement, government check, paycheck, or other government document that shows your name and address."
(8) If an applicant for voter registration fails to provide any of the information required by this section, the permanent registrar shall notify the applicant of the failure and provide the applicant with an opportunity to complete the form in a timely manner to allow for its completion before the next election for federal office.
(9) The mail voter registration application shall be pre-addressed to the Secretary of State.
(b)(1) The voter registration application portion of the process used by the Office of Driver Services and state revenue offices shall include:
(A) The question: "If you are not registered to vote where you live now, would you like to apply to register to vote here today?";
(B) A statement that, if an applicant declines to register to vote, the fact that the applicant has declined to register will remain confidential and will be used only for voter registration purposes;
(C) A statement that if an applicant does register to vote, the office at which the applicant submits a voter registration application will remain confidential and will be used only for voter registration purposes;
(D) Voter registration eligibility requirements;
(E) Penalties provided by law for providing false information;
(F) An attestation that the applicant meets each eligibility requirement; and
(G) A space for the applicant's signature or mark.
(2) The voter registration application portion shall require the signature of the applicant under penalty of perjury, but shall not require notarization or other formal authentication.
(c) Public assistance agencies and disabilities agencies shall provide, in addition to the federal or state mail voter registration application form, a declination form, to be approved by the State Board of Election Commissioners, which includes the following question and statements:
(1) The question, in prominent type, "IF YOU ARE NOT REGISTERED TO VOTE WHERE YOU LIVE NOW, WOULD YOU LIKE TO APPLY TO REGISTER TO VOTE HERE TODAY? YES ... NO ...";
(2) The statement in close proximity to the question above and in equally prominent type, "IF YOU DO NOT CHECK EITHER BOX, YOU WILL BE CONSIDERED TO HAVE DECIDED NOT TO REGISTER TO VOTE AT THIS TIME";
(3) The statement, "APPLYING TO REGISTER OR DECLINING TO REGISTER TO VOTE WILL NOT AFFECT THE AMOUNT OF ASSISTANCE THAT YOU WILL BE PROVIDED BY THIS AGENCY";
(4) The statement, "IF YOU WOULD LIKE HELP IN FILLING OUT THE VOTER REGISTRATION APPLICATION FORM, WE WILL HELP YOU. THE DECISION WHETHER TO SEEK OR ACCEPT HELP IS YOURS. YOU MAY FILL OUT THE APPLICATION FORM IN PRIVATE";
(5) The statement, "IF YOU BELIEVE THAT SOMEONE HAS INTERFERED WITH YOUR RIGHT TO REGISTER OR TO DECLINE TO REGISTER TO VOTE, YOUR RIGHT TO PRIVACY IN DECIDING WHETHER TO REGISTER OR IN APPLYING TO REGISTER TO VOTE, OR YOUR RIGHT TO CHOOSE YOUR OWN POLITICAL PARTY OR OTHER POLITICAL PREFERENCE, YOU MAY FILE A COMPLAINT WITH THE SECRETARY OF STATE AT ......." (filled in with the address and telephone number of the Secretary of State's office);
(6) The statement, "IF YOU DECLINE TO REGISTER TO VOTE, THE FACT THAT YOU HAVE DECLINED TO REGISTER WILL REMAIN CONFIDENTIAL AND WILL BE USED ONLY FOR VOTER REGISTRATION PURPOSES"; and
(7) The statement, "IF YOU DO REGISTER TO VOTE, THE OFFICE AT WHICH YOU SUBMIT A VOTER REGISTRATION APPLICATION WILL REMAIN CONFIDENTIAL AND WILL BE USED ONLY FOR VOTER REGISTRATION PURPOSES". [As amended by Acts 1971, No. 828, § 1; 1995, No. 947, § 2; 1995, No. 964, § 2; 2003, No. 995, § 1.]
Publisher's Notes. Prior to amendment by Acts 1971, No. 828, subdivision (8) read: "number or name of the voter's school district and number or name of the voter's precinct."
The proviso to subdivision (a)(8)(b) read exactly as it appeared in the 1971 amendment prior to further amendment in 1995.
Acts 1971, No. 828, § 2 read: "The amendment of Subsection (8) of Section 6 of Amendment 51 of the Constitution of the State of Arkansas, as provided in Section 1 hereof, is hereby made in conformance with the provisions of Section 19 of said Amendment 51 to the Constitution of the State of Arkansas, it being the determination of the General Assembly that said Amendment is germane to Amendment 51 and is consistent with its policy and purposes."