Affidavit on letterhead
from a public or private
social service agency
CODE
RECORDING
TYPES OF DOCUMENTS FOR
PROOF OF RESIDENCE
A
Bank or credit union statement
B
This is a very broad category.
See examples listed, to the right
G
Paycheck
P
Residential lease
R
effective on the day of registration
Student ID
accompanied by a college fee
statement
issued in the past 9 months
(note that any document, including a fee
statement, issued by the
University of Wisconsin is a
government document, but a fee
statement issued by Edgewood College
would need to be accompanied by an ID)
Real estate tax bill or receipt
for the current year or the previous year
S
T
Utility Bill
issued within the past 90 days
(water, gas, electric, cable, internet,
landline phone, or cellular phone)
Wisconsin Driver License
or Wisconsin ID card
issued by the DMV
must be current and valid
Government Agencies
*
Fishing and hunting licenses
providing services to an individual who is
homeless (identifies the homeless voter
and describes his or her residence for
voting purposes
Government document
or government check
Government Issued
Proof of Residence Documents
U
Wisconsin City and County
Government agencies and offices
Vehicle registrations
State Social Service Programs
FoodShare / SNAP
Wisconsin Works
Wisconsin Shares
BadgerCare notices & correspondence
Medicare notices
Medicare Explanation of Benefits
(not from 2nd party providers or
other health insurance providers)
Social Security
SSI notices and benefits statements
Public High School
Technical College
Public University
correspondence & documents including:
admissions correspondence
financial aid notices
report cards
Schedules
MyUW-Madison / Student Center
webpage screen
Federal student loan
correspondence and notices
Billing statements and collection notices
from a governmental entity
Correspondence from a federally recognized
Native American Tribe living in Wisconsin.
W
Local units of government
State units of government
State of Wisconsin
agencies and offices
Federal units of government
US Government
agencies and offices
Native American Tribes
Examples of documents that
cannot be used
for proof of residence *
insurance statement
medical bill
business card
magazine subscription
expired driver license/ID card
out-of-state driver license
piece of mail addressed to voter
* THESE LISTS ARE NOT COMPREHENSIVE. THEY ARE ONLY EXAMPLES.
PREPARED 6-2014
HOW TO COMPLETE PROOF OF RESIDENCE INFORMATION ON THE REGISTRATION FORM
Write the type of Proof of Residence.
You may use the one letter abbreviation listed in this brochure.
Write the identifying number, if any, on the proof of residence document
such as an account or identification number.
If the document has an account/identification number of more than 6 digits,
record the last 4 digits of that number
If the document has an account number of 6 or fewer digits,
record the last 2 digits of that number.
If there is no account/identifying number,
write n/a in the document number field or skip that field on the registration form.
Write the name of the entity issuing the proof of residence document.
If using an older version of the form (revised prior to May 2014),
write the name of the entity at the very bottom of the voter registration form.
( * See below—lower right side of graphic - “old form option” )
Elector Signature:
Today’s Date (m/d/yyyy)
/
11
/
Proof of Residence type
(official use only)
Proof of Residence #
(official use only)
X
B
0045
Proof of Residence Issuing Entity
(official use only)
Park Bank
Election Day Voter #
(official use only)
Falsification of information on this from is punishable under Wisconsin law as a Class I felony.
12
Assistant Signature:
Assistant Address:
Official Signature:
Date complete & POR received
/
Ward
Sch. Dist.
Alder
GAB-131 (REV 2014/05)
Cty.
Supr
.
Ct. of App.
SRDs printed name and SRD#:
/
Assembly St.
( * “old form option”
Senate
)
Congress
Park Bank
ADDITIONAL INFORMATION
Voters may continue to write their driver license/state ID number on line 2 of the voter registration
form without showing an SRD the actual license or ID.
The voter shows a driver license/state ID to an SRD only if the voter chooses to use the driver
license/state ID as proof of residence.
All versions of the voter registration form currently available, including the form dated REV 6/2011,
can still be used as long as all of the newly required proof of residence information is included
on the form.
NEW
Proof of Residence
Requirements for
Voter Registration
NEW BASIC INFORMATION
As of April 4, 2014, Wisconsin law
requires all voters to provide
proof of residence whenever
and wherever they register to
vote.
Documents showing proof of
residence must have the
voter’s current name and
current address on a
single document.
Special registration deputies
(SRDs) must view and record
information from the voter’s
proof of residence document
to verify the name and address.
Checking a voter’s proof of
residence during open
registration is the same as
checking a voter’s proof of
residence at the polls.
Paper or electronic format
(computer, smart phone, tablet
or laptop) of the document is
acceptable.
For more information
Government Accountability Board:
http://gab.wi.gov/node/3151
Madison City Clerk:
608-266-4601