Form VRFM003 "Voter Registration Cancellation Request - Close Relative" - Delaware

Form VRFM003 is a Delaware Department of Elections form also known as the "Voter Registration Cancellation Request - Close Relative". The latest edition of the form was released in April 8, 2015 and is available for digital filing.

Download a PDF version of the Form VRFM003 down below or find it on Delaware Department of Elections Forms website.

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Download Form VRFM003 "Voter Registration Cancellation Request - Close Relative" - Delaware

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State of Delaware
Department of Elections
Voter Registration Cancellation Request - Close Relative
Last name
Suffix
Your name
1
(Requestor)
First name
Middle name
I am the
Mother
Father
Sibling
Spouse, or
Child of the below named registrant.
Please cancel his/her voter registration because:
Cancelation
2
He/she no longer lives in Delaware.
reason
Other reasons.
Please specify reason:
Last name
Suffix
Registrant name
3
First name
Middle name
Voter ID (if known)
Identification
4
Birth date
Contact
Telephone
5
information
Email
Street Address (
)
Apt. #
Delaware
not P.O. Box
registration
6
City/Town/Village
address
County
State
Zip Code
Affirmation (REQUIRED)
I hereby swear or affirm, under penalty of perjury, that:
:
 My signature and date herein indicate when I completed this document.
Signature
Print this form, sign, and send in.
 The information on this form is true and complete to the best of my knowledge.
I understand that a material misstatement of fact in completion of this document
Today’s date
may constitute grounds for conviction of perjury.
Instructions
1. Make sure that the information on the form is correct and that all items are completed.
2. Save the form to your computer.
3. Print the form, then sign and date it.
4. Return the form by email, FAX or mail to the office in the County in which you are registered.
Kent County Office
New Castle County Office
Sussex County Office
votencc@state.de.us
email:
votekc@state.de.us
email:
votesc@state.de.us
email:
(302) 739-4515
(302) 577-6545
(302) 856-5082
FAX:
FAX:
FAX:
Department of Elections
mail:
Department of Elections
Department of Elections
mail:
mail:
Kent County Office
New Castle County Office
Sussex County Office
PO Box 699
PO Box 7079
PO Box 457
Wilmington DE 19803-0079
Dover DE 19903-0699
Georgetown DE 19947-0457
FOR OFFICE USE ONLY
In Person
Mail
Email
FAX
Other:__________
Received by: ____________________ Date: __________
Processed by: ____________________ Date: __________
This information is for official use only. Any unauthorized release may be punishable by law.
VRFM003 V1.0 2015-04-08
State of Delaware
Department of Elections
Voter Registration Cancellation Request - Close Relative
Last name
Suffix
Your name
1
(Requestor)
First name
Middle name
I am the
Mother
Father
Sibling
Spouse, or
Child of the below named registrant.
Please cancel his/her voter registration because:
Cancelation
2
He/she no longer lives in Delaware.
reason
Other reasons.
Please specify reason:
Last name
Suffix
Registrant name
3
First name
Middle name
Voter ID (if known)
Identification
4
Birth date
Contact
Telephone
5
information
Email
Street Address (
)
Apt. #
Delaware
not P.O. Box
registration
6
City/Town/Village
address
County
State
Zip Code
Affirmation (REQUIRED)
I hereby swear or affirm, under penalty of perjury, that:
:
 My signature and date herein indicate when I completed this document.
Signature
Print this form, sign, and send in.
 The information on this form is true and complete to the best of my knowledge.
I understand that a material misstatement of fact in completion of this document
Today’s date
may constitute grounds for conviction of perjury.
Instructions
1. Make sure that the information on the form is correct and that all items are completed.
2. Save the form to your computer.
3. Print the form, then sign and date it.
4. Return the form by email, FAX or mail to the office in the County in which you are registered.
Kent County Office
New Castle County Office
Sussex County Office
votencc@state.de.us
email:
votekc@state.de.us
email:
votesc@state.de.us
email:
(302) 739-4515
(302) 577-6545
(302) 856-5082
FAX:
FAX:
FAX:
Department of Elections
mail:
Department of Elections
Department of Elections
mail:
mail:
Kent County Office
New Castle County Office
Sussex County Office
PO Box 699
PO Box 7079
PO Box 457
Wilmington DE 19803-0079
Dover DE 19903-0699
Georgetown DE 19947-0457
FOR OFFICE USE ONLY
In Person
Mail
Email
FAX
Other:__________
Received by: ____________________ Date: __________
Processed by: ____________________ Date: __________
This information is for official use only. Any unauthorized release may be punishable by law.
VRFM003 V1.0 2015-04-08
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