Cancellation of Voter Registration

This form is intended to provide notification of a voter's request to cancel his or her voter registration. Upon submission of this form, the county board of elections will remove the voter from the county's list of registered voters. Requested information will only be used to ensure that we are removing the correct voter.

This form can only be completed by the voter. Voter should complete form as thoroughly as possible.

Voter Information

Last Name:*

First Name:*

Middle Name:

Suffix:

Date of Birth:*

Age:

Gender:

Last 4 digits of SSN:

Driver License or ID No.:

Voter Registration Number:

Voter Registration Address:*

City:*

State:

Zip code:

County:(in which you were last registered)

By signing this form, I give the county board of elections consent to cancel my voter registration record.

Printed Signature:

Date Signed:

FRAUDULENTLY OR FALSELY COMPLETING THIS FORM IS A CLASS I FELONY UNDER CHAPTER 163 OF THE NC GENERAL STATUTES.

Security Question:

Notice: In an effort to prevent Spam form submissions, you will need to type the word 'cvrvoter2022' in the field below, without any quotation marks, in order to submit your registration.

Page last updated: October 6, 2022