Alabama Administrative Code › Title 820 - STATE OF ALABAMA OFFICE OF THE SECRETARY OF STATE › Chapter 820-2-9 - IMPLEMENTATION OF ALABAMA PHOTO VOTER IDENTIFICATION LAW › Section 820-2-9-.13 - Application For Issuance Of Free Alabama Birth Or Marriage Certification To Obtain Free Alabama Photo Voter ID Card

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The following application is to be used
			 by Alabama voters who need a free birth or marriage certificate to obtain a
			 free Alabama Photo Voter Identification Card.
(2) The birth or marriage certificate will be
			 provided electronically to the processing or issuing agent and is for voting
			 purposes only. The voter will not be given a copy of these free birth or
			 marriage certificates. The processing or issuing agent is to transmit both
			 sides of the application to the state office of the Alabama Department of
			 Public Heath using the contact information provided by the Secretary of
			 State.
(3) The processing or
			 issuing agent transmitting the application for free Alabama birth or marriage
			 certificate must include a transmittal form identifying the office that is
			 transmitting the form to the Alabama Department of Public Health.
SIDE A
OFFICE OF THE SECRETARY OF STATE
APPLICATION FOR ISSUANCE OF FREE ALABAMA BIRTH OR
				MARRIAGE
CERTIFICATION TO OBTAIN FREE ALABAMA PHOTO VOTER ID
				CARD
Print Your Name:
				________________________________________________
Address:
				_______________________________________________________
City: __________________________ State:
				_________________________
Zip: _________________ Daytime Phone:( ______)
				____________________
DO NOT COMPLETE THIS FORM IF YOU HAVE ANY OF THE
				FOLLOWING:
1. a valid Alabama
			 driver's license or a valid Alabama nondriver identification card which was
			 properly issued by the appropriate state or county department or
			 agency;
2. a valid Alabama photo
			 voter identification card;
3. a
			 valid identification card issued by a branch, department, agency, or entity of
			 the State of Alabama, any other state, or the United States authorized by law
			 to issue personal identification, provided that such identification card
			 contains a photograph of the elector;
4. a valid U.S. passport;
5. a valid employee identification card
			 containing the photograph of the elector and issued by any branch, department,
			 agency, or entity of the U.S. government, the State of Alabama, or any county,
			 municipality, board, authority, or other entity of this state;
6. a valid student or employee identification
			 card issued by a public or private college, university, or postgraduate
			 technical or professional school located within the State of Alabama, provided
			 that such identification card contains a photograph of the elector;
7. a valid U.S. military identification card,
			 provided that such identification card contains a photograph of the elector;
			 or
8. a valid tribal identification
			 card containing a photograph of the elector.
I, ________________________________, a registered voter in the
				State of Alabama, do hereby swear or affirm that I do not possess any of the
				forms of photo ID listed above. I further swear or affirm that the information
				contained on this form (Side A and Side B) is true and correct. I understand
				that the free birth or marriage certificate will be issued electronically to
				the processing or issuing agent and that said free certification cannot be used
				for any purpose other than obtaining a free Alabama photo voter ID card.
Signature of Alabama registered voter ______________________
				Date __________
SIDE B
APPLICATION FOR ISSUANCE OF A FREE ALABAMA BIRTH OR
				MARRIAGE CERTIFICATION TO OBTAIN FREE ALABAMA PHOTO VOTER ID CARD
SIDE A MUST BE COMPLETED BEFORE COMPLETING SIDE B OF THIS
				FORM
USE ONLY FOR A VITAL EVENT WHICH OCCURRED IN
				ALABAMA
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