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8. If applicant answers yes, is his residence in South Carolina and in his county for temporary purposes Yes No

If yes, write in his occupation

9. (a) If applicant shows that he is now registered to vote in South Carolina, write in the county where he is registered

(b) If applicant shows that he is now listed under the Voting Rights Act, write in the county where he is listed and certificate number if available

11. If applicant answers yes, name the crime

Where and when convicted

Was the conviction for a disqualifying crime Yes No

If a disqualifying crime, has the disqualification been removed by pardon of the GovO Yes No

ernor

If so pardoned, where, when and by whom

12. If the applicant shows that he has been declared legally insane, idiotic, or men

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Voting Rights Act Application

The information requested below is for the purpose of determining whether you are eligible to vote. If you are found eligible to vote, your name will be certified to appropriate state officials for addition to the official voting lists. The solicitation of this information for this purpose is authorized by the Voting Rights Act of 1965, as amended. While you are not required to respond, your cooperation is needed if you wish to be found eligible to vote.

Instructions to the Applicant: Please fill out this side of this form. If you need help in answering any question, the Examiner will help you.

1. Name

(Middle)

if married woman:

2. Sex:

3.

(First)

(Last) Maiden surname

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any, or Route No. or location (Not P.O. Box))

code)

(City)

4. Election Precinct (if known):

(ZIP

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Certificate of eligibility issued-No.
Notice of ineligibility issued-No.-

(5 U.S.C. 1103; Secs. 7, 9, 79 Stat. 440, 411, 441 (42 U.S.C. 1973c, 1973g))

[30 FR 9859, Aug. 7, 1965, as amended at 53 FR 45247, Nov. 8, 1988]

EDITORIAL NOTE: For FEDERAL REGISTER Cİtations affecting this Appendix A, see the List of CFR Sections Affected in the Finding Aids section of this volume.

APPENDIX B

This appendix sets out the qualifications required for listing on an eligibility list.

ALABAMA

A person is qualified to be listed as an eligible voter in elections in the State of Alabama, except municipal elections, if he has all the following qualifications at the time he applies for listing and if he takes the required oath or affirmation.

(1) He is 21 years of age.

(2) He is a citizen of the United States and of the State of Alabama.

(3) He will have lived in the State of Alabama for one year, in his county for six months, and in his ward or precinct for three months by the date of the next election.

(4) He has not been convicted of treason, murder, arson, embezzlement, malfeasance in office, larceny, receiving stolen property, obtaining property or money under false pretenses, perjury, subornation of perjury, robbery, assault with intent to rob, burglary, forgery, bribery, assault and battery on the wife, bigamy, living in adultery, sodomy, incest, rape, crime against nature, or any crime punishable by imprisonment in the penitentiary, or of any infamous crime or crime involving moral turpitude, or of vagrancy or being a tramp, or of selling or of fering to sell his vote or the vote of another, or of buying or offering to buy the vote of another, or of making or offering to make a false return in any election by the people or in any primary election to procure the nomination or election of any person to any office, or of suborning any witness or registrar to secure the registration of any person as an elector, or if so convicted he has been subsequently pardoned with restoration of his right to vote specifically expressed in the pardon.

(5) He has not been declared legally insane by a court, or if so declared he has subsequently been declared legally sane or competent by a court.

(6) He is not otherwise registered or listed as eligible to vote in the county in which he applies for listing.

A person who has all the above qualifications is also qualified to be listed as an eligible voter in municipal elections if he will have lived in his city or town for three months by the date of the next election.

GEORGIA

A person is qualified to be listed as an eligible voter in elections in the State of Georgia, except municipal elections, if he has all the following qualifications at the time he applies for listing and if he takes the required oath or affirmation.

(1) He will be 18 years of age by the date of the next election.

(2) He is a citizen of the United States and of the State of Georgia.

(3) He will have lived in the State of Georgia for 1 year and in his county for 6 months by the date of the next election.

(4) He has not been convicted of treason against the State, embezzlement of public funds, malfeasance in office, bribery or larceny, or of any crime involving moral turpitude, punishable by the laws of Georgia with imprisonment in the penitentiary, or if so convicted he has been subsequently pardoned.

(5) He has not been declared legally insane or idiotic by a court, or if so declared he has been subsequently declared legally sane or competent by a court.

(6) He is not otherwise registered or listed as eligible to vote in the county in which he applies for listing.

LOUISIANA

A person is qualified to be listed as an eligible voter in elections in the State of Louisiana, except municipal elections, if he has all the following qualifications at the time he applies for listing and if he takes the required oath or affirmation.

(1) He will be 21 years of age by the date of the next election.

(2) He is a citizen of the United States and of the State of Louisiana.

(3) He will have lived in the State of Louisiana for one year, in his parish for six months, and in his precinct for three months by the date of the next election.

(4)(a) He has not been convicted of any crime punishable by imprisonment in the penitentiary, or if so convicted he has been subsequently pardoned with the express restoration of the franchise, or (b) he has not been convicted of a felony, or if so convicted he has subsequently received a pardon and full restoration of franchise.

(5) He has not been interdicted, that is, declared legally incompetent or insane by a court, or if so interdicted he has been subsequently restored to legal competency or sanity by a court.

(6) He has not been dishonorably discharged from the Louisiana National Guard

or the military service of the United States, or if so discharged he has been reinstated.

(7) He is not a deserter from the military services of the United States or the militia of the State of Louisiana, when called forth by the Governor or, in time of invasion, insurrection, or rebellion, by the President of the United States, or if such a deserter, he has returned to the command from which he deserted, made good the time lost in desertion, and served out the term of his original enlistment.

(8) He is not an inmate of any charitable institution, except the Soldiers Home and the United States Marine hospital at Carville.

(9) He is not otherwise registered or listed as eligible to vote in the parish in which he applies for listing.

A person who has all the above qualifications is qualified to be listed as an eligible voter in municipal elections if he will have lived in his city or town for four months by the date of the next election.

MISSISSIPPI

A person is qualified to be listed as an eligible voter in elections in the State of Mississippi, except municipal elections, if he has all the following qualifications at the time he applies for listing and takes the required oath or affirmation.

(1) He will be 21 years of age by the date of the next election.

(2) He is a citizen of the United States.

(3) He will have lived in the State of Mississippi for two years by the date of the next election.

(4) He will have lived in his election district or his city, town, village, or municipality for one year by the date of the next election. However, if the person is a minister or the wife of a minister of the Gospel in charge of an organized church, that person is qualified if he or she will have lived in the election district for six months by the date of the next election.

(5) He has not been convicted of arson, bigamy, bribery, burglary, embezzlement, forgery, obtaining money or goods under false pretenses, perjury, or theft, or if so convicted his right to vote has been restored by the legislature.

(6) He has not been declared legally insane by a court, or if so declared he has been subsequently declared legally sane or competent by a court.

(7) He is not otherwise registered or listed as eligible to vote in the county in which he applies for listing.

A person who has all the above qualifications is qualified to be listed as an eligible voter in municipal elections if he will have lived in his city, town, or village for one year by the date of the next election, unless he has, within two years before the next mu

nicipal election, been convicted within the municipality of violating the liquor laws of the State or the municipality. However, if the person is a minister or the wife of a minister of the Gospel in charge of an organized church, that person is qualified to be listed as an eligible voter in municipal elections if he or she will have lived in the city, town, or village for six months by the date of the next election.

SOUTH CAROLINA

A person is qualified to be listed as an eligible voter in elections in the State of South Carolina, except municipal elections, if he has all the following qualifications at the time he applies for listing and if he takes the required oath or affirmation.

(1) He is 21 years of age.

(2) He is a citizen of the United States and of the State of South Carolina.

(3) He will have lived in the State of South Carolina for one year, in his county for six months, and in his precinct for three months by the date of the next election. However, if the person is a minister in charge of an organized church or a teacher in the public schools, or the spouse of such a minister or teacher, that person is qualified if he or she will have lived in the State of South Carolina for six months by the date of the next election.

(4) He has not been convicted of burglary, arson, obtaining goods or money under false pretenses, perjury, forgery, robbery, bribery, adultery, bigamy, wife-beating, housebreaking, receiving stolen goods, breach of trust with fraudulent intent, fornication, sodomy, incest, assault with intent to ravish, larceny, challenging or accepting a challenge to duel with a deadly weapon, or crimes against the election laws, or if so convicted his right to vote has been restored by pardon.

(5) He has not been declared legally insane, idiotic, or incompetent by a court, or if so declared he has subsequently been declared legally sane or competent by a court. (6) He is not a pauper supported at public expense.

(7) He is not otherwise registered or listed as eligible to vote in the county in which he applies for listing.

A person who has all the above qualifications is also qualified to be listed as an eligible voter in municipal elections if he will have lived in his city or town for four months by the date of the next election.

TEXAS

A person is qualified to be listed as an eligible voter in elections in the State of Texas if he has all the following qualifications at the time he applies for listing and if he takes the required oath or affirmation.

(1) He will be 18 years of age within 60 days after applying for registration.

(2) He is a citizen of the United States. (3) He is a resident of the State of Texas. (4) He has not been convicted of a felony, or if so convicted, he has been subsequently restored to full citizenship and suffrage or pardoned.

(5) He has not been declared an idiot or a lunatic by a court, or if so declared, he has been subsequently declared legally sane or competent by a court.

(6) He is not otherwise registered or listed as eligible to vote in the county in which he applies for listing.

EDITORIAL NOTE:: For FEDERAL REGISTER CỈtations affecting this Appendix B, see the List of CFR Sections Affected in the Finding Aids section of this volume.

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(Reorganization Plan No. 2 of 1978 (43 FR

36037))

EDITORIAL NOTE: For FEDERAL REGISTER Citations affecting this Appendix C, see the List of CFR Sections Affected in the Finding Aids section of this volume.

APPENDIX D

This appendix sets out the bases for loss of eligibility to vote and removal from an eligibility list.

ALABAMA

A person loses his eligibility to vote in elections in the State of Alabama if:

(1) He is no longer a legal resident of the State of Alabama or the county for which he is listed (a person may not vote in a county or precinct in which he is not a resident, but when a person removes from one precinct or ward to another precinct or ward within the same county, town, or city within three months before an election, he may vote in the precinct or ward from which he so removed);

(2) He dies;

(3) He is convicted of treason, murder, arson, embezzlement, malfeasance in office, larceny, receiving stolen property, obtaining property or money under false pretenses, perjury, subornation of perjury, robbery, assault with intent to rob, burglary, forgery, bribery, assault and battery on wife, bigamy, living in adultery, sodomy, incest, rape, crime against nature, or any crime punishable by imprisonment in the penitentiary, or of any infamous crime or crime involving moral turpitude, or vagrancy or being a tramp, or selling or offering to sell his vote or the vote of another, or of buying or offering to buy the vote of another, or of making or offering to make false return in any election by the people or in any primary election to procure the nomination or election of any person to any office, or of suborning any witness or registrar to secure the registration of any person as an elector, and has not been subsequently pardoned with restoration of his right to vote specifically expressed in the pardon;

(4) He is declared legally insane by a court and has not been subsequently declared legally sane or competent by a court; or

(5) He loses his citizenship in the United States or the State of Alabama.

A person loses his eligibility to vote in municipal elections only, if he is no longer a legal resident of his city or town. Loss of eligibility to vote in a municipal election because of change of such residence does not result in loss of eligibility in any other election.

GEORGIA

A person loses his eligibility to vote in elections in the State of Georgia if:

(1) He is no longer a legal resident of the State of Georgia or the county for which he is listed;

(2) He dies;

(3) He is convicted of treason against the State, embezzlement of public funds, malfeasance in office, bribery or larceny, or of any crime involving moral turpitude, punishable by the laws of Georgia with imprisonment in the penitentiary, and has not been subsequently pardoned;

(4) He is declared legally insane or idiotic by a court and has not been subsequently declared legally sane or competent by a court; or

(5) He loses his citizenship in the United States or the State of Georgia.

A person loses his eligibility to vote in municipal elections only, if he is no longer a legal resident of his city or town. Loss of eligibility to vote in a municipal election because of change of such residence does not result in loss of eligibility in any other election.

LOUISIANA

A person loses his eligibility to vote in elections in the State of Louisiana if:

(1) He is no longer a legal resident of the State of Louisiana or the parish for which he is listed, however, the removal from one parish to another does not deprive a person of the right to remain listed in the parish from which he has removed for the purpose of voting for district officers to be elected in a district which includes the parish to which he has removed, or for State officers, whether the parish is in the same district or not, until he has acquired the right to register or be listed and vote for such officers in the parish to which he has removed (the removal of a person from one precinct to another in the same parish does not deprive him of his right to remain listed in the parish from which he has removed until three months after the removal);

(2) He dies;

(3)(a) He is convicted of any crime punishable by imprisonment in the penitentiary and has not been subsequently pardoned with the express restoration of the franchise, or (b) he is convicted of a felony and has not subsequently received a pardon and full restoration of franchise.

(4) He is declared legally incompetent or insane by a court and has not been subsequently restored to legal competency or sanity by a court;

(5) He is dishonorably discharged from the Louisiana National Guard or the military service of the United States and has not been reinstated;

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