South Dakota Regulations § 5:02:03:12 Agency voter registration instructions

The declination form and instructions provided with each voter registration form used by an agency which provides food stamps; temporary assistance for needy families (TANF); the women, infants, and children nutrition program (WIC); military recruitment; or assistance to the disabled as provided by the Department of Human Services must be in the following form:

SOUTH DAKOTA AGENCY VOTER REGISTRATION FORM

If you are (bold) not registeredto vote where you live now (unbold), would you like to apply to register to vote here today? Yes _______ No _______

If you do not check either box, you will be considered to have decided not to register to vote at this time.

If you register to vote, the information regarding the office to which the voter registration form was submitted will remain confidential and be used only for voter registration purposes.

If you don't register to vote, this decision will remain confidential and be used only for voter registration purposes.

If you would like help filling out the voter registration form, we will help you. The decision whether to seek or accept help is yours. You may fill out the form in private.

If you believe that someone has interfered with your right to register or to decline to register to vote, your right to privacy in deciding whether to register or in applying to register to vote, or your right to choose your own political party or other political preference, you may file a complaint with the Secretary of State, 500 E. Capitol, Pierre, SD 57501, 605-773-3537.

Applying to register or declining to register to vote will not affect the amount of assistance that you will be provided by this agency.

To register, please complete the entire voter registration form by printing the requested information. If you are currently registered to vote, please also fill out the previous voter registration information at the bottom of the form. Return the voter registration form to the county auditor in your county of residence or to your local TANF, food stamp, WIC, military recruitment, or Department of Human Services office. (bold) The deadline for registration is 15 days before any election. (unbold)