1994 Memorandums
IM-72      12/22/94




Effective January 1, 1995, use the State of Missouri voter registration form to provide voter registration services to all public assistance applicants, recipients, and individuals who do not seek public assistance but request voter registration services only.  A copy of the form is attached to this memo.  REMEMBER the form cannot be copied for use in Voter Registration activities due to specifications of weight of paper.  A supply of the form will be sent to each office.  In addition, a supply of Federal Mail Registration forms will be provided as soon as they are available for out-of-state residents who need voter registration services.

Have the individual answer the first question on the side of the form that has only a printed half sheet by marking yes or no.  If the individual declines to mark a box, he/she will be considered to have declined voter registration services.  The worker will record the individual’s name, the fact that they declined voter registration services, the date, sign the voter registration form, and then file it in the case record.  An example of this is “Mrs. Ruby Smith refused voter registration services on December 20, 1994.  Jane Doe, Caseworker.”  If no is marked, please ask the individual to sign the form.  Maintain declinations in the case record for two years.

If the individual marks yes, have them complete the Missouri Voter Registration Application.  This is the bottom half of the side with a full printed page and the application includes red accents.  Offer the same degree of assistance to individuals in completing a voter registration form as you would to individuals completing the agency’s own forms, unless the individual refuses such assistance.  The ENTIRE Voter Registration form is forwarded to the election official when the individual completes the application.

Date stamp each completed card.  Place the date stamp directly above Code 04 on the voter registration form.  IMPORTANT:  There is to be nothing on the voter registration card portion of this form to indicate it came from the Division of Family Services.  Regulations state there is to be no reference available indicating where an individual registered to vote.  The agency date stamp determines when a person becomes eligible to vote.  If a date stamp is unavailable, the date should be written by hand.

An adequate supply of this form must be maintained.  There are two booklets which will be sent under separate memo for the County Liaison to maintain for information and use with Voter Registration activities.  They are the “Roster of Missouri Election Officials” which lists all County Clerk addresses and the “Implementation Guide for Public Assistance Agencies”.

  • Effective January 1, 1995 begin using this form for voter registration services.
  • Maintain declinations in the case file for two years and forward the entire completed registrations appropriately.
  • Maintain an adequate supply of forms as copies CANNOT be used.

Distribution #2