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<br />§ 163-82.4. Contents of application form. <br />(a) Information Requested of Applicant. -The form required by G.S. 163-82.3(a) <br />shall request the applicant's: <br />(1) Name, <br />(2) Date of birth, <br />(3) Residence address, <br />(4) County of residence, <br />(5) Date of application, <br />(6) Gender, <br />(7) Race, <br />(7a) Ethnicity, <br />(8) Political party affiliation, if any, in accordance with subsection (c) of <br />this section, <br />(9) Telephone number (to assist the county board of elections in contacting <br />the voter if needed in processing the application), <br />(10) Drivers license number or, if the applicant does not have a drivers <br />license number, the last four digits of the applicant's social security <br />number, <br />and any other information the State Board finds is necessary to enable officials of the <br />county where the person resides to satisfactorily process the application. The form shall <br />require the applicant to state whether currently registered to vote anywhere, and at what <br />address, so that any prior registration can be cancelled. The portions of the form <br />concerning race and ethnicity shall include as a choice any category shown by the most <br />recent decennial federal census to compose at least one percent (1%) of the total <br />population of North Carolina. The county board shall make a diligent effort to complete <br />for the registration records any information requested on the form that the applicant does <br />not complete, but no application shall be denied because an applicant does not state race, <br />ethnicity, gender, or telephone number. The application shall conspicuously state that <br />provision of the applicant's telephone number is optional. If the county board maintains <br />voter records on computer, the free list provided under this subsection shall include <br />telephone numbers if the county board enters the telephone number into its computer <br />records of voters. <br />(al) No Drivers License or Social Security Number Issued. -The State Board shall <br />assign a unique identifier number to an applicant for voter registration if the applicant has <br />not been issued either a current and valid drivers license or a social security number. That <br />unique identifier number shall serve to identify that applicant for. voter registration <br />purposes. <br />(b) Notice of Requirements, Attestation, Notice of Penalty, and Notice of <br />Confidentiality. -The form required by G.5. 163-82.3(x) shall contain, in uniform type, <br />the following: <br />(1) A statement that specifies each eligibility requirement (including <br />citizenship) and an attestation that the applicant meets each such <br />LOCATION: 506 NORTH HARRINGTON STREET • RALEIGH, NORTH CAROLINA, 27603 <br />3 <br />