VERMONT VOTER AFFIRMATION FORM
(for use by Town Clerks and/or the Board of Civil Authority)

(Revised 07/02/2008)
Vermont law now authorizes the use of a sworn affidavit to allow a citizen who has submitted a voter registration form through the Department of Motor Vehicles, a voter registration drive, to the town clerk's office, or a social service agency in a timely manner, but whose application has not been received by the town, to add that person to the checklist at the polling place on election day. 17 VSA §2147(a)(4)

Click to download the Voter Affirmation Form.

Please review the section of the Vermont Statutes listed below that pertains to alteration of the checklist and the use of this sworn affidavit.

Alteration of Checklist: (17 V.S.A. § 2147)

(a) Pursuant to section 2150 of this title, the board shall add to the checklist posted in the town clerk's office the names of the voters added and the names omitted by mistake, and shall strike the names of persons not entitled to vote. The list so corrected shall not be altered except by:

(1) adding the names of persons as directed by any superior or district judge on appeal;

(2) adding the names of persons who are legal voters at the election but whose names are further discovered to be omitted from the completed checklist solely through inadvertence or error. (Amended 2001, No. 7 § 2.)

(3) adding the names of persons who present a copy of a valid application for addition to the checklist of that town that was submitted before the deadline for applications and who otherwise are qualified to be added to the checklist; (Amended 2001, No. 7 § 2.)

(4) adding the names of persons who sign a sworn affidavit that they completed and submitted a valid application for addition to the checklist of that town before the deadline for applications and who otherwise are qualified to be added to the checklist; or (Added 2001, No. 7 § 2)

(5) subdividing the checklist as provided in section 2501 of this title, including the transfer of names of voters who have moved within a town in which they are already registered from one voting district within that town to another. (Added 2001, No. 7 § 2.)

(b) Any correction or transfer may be accomplished at any time until the closing of the polls on election day. Each voter has primary responsibility to ascertain that his or her name is properly added to and retained on the checklist. (Added 2001, No. 7 § 2.)


If you have questions, please call the Elections Division, Office of the Secretary of State at 1-800-439-8683, or email us at (mhodge@sec.state.vt.us).