(1) The department shall prescribe by rule a uniform statewide voter registration application for use in this state. (a) The uniform statewide voter registration application must be accepted for any one or more of the following purposes:
1. Initial registration.
2. Change of address.
3. Change of party affiliation.
4. Change of name.
5. Replacement of a voter information card.
6. Signature update.
(b) The department is responsible for printing the uniform statewide voter registration application and the voter registration application form prescribed by the Election Assistance Commission pursuant to federal law. The applications and forms must be distributed, upon request, to the following:
1. Individuals seeking to register to vote or update a voter registration record.
2. Individuals or groups conducting voter registration programs. A charge of 1 cent per application shall be assessed on requests for 10,000 or more applications.
3. The Department of Highway Safety and Motor Vehicles.
4. Voter registration agencies.
5. Armed forces recruitment offices.
6. Qualifying educational institutions.
7. Supervisors, who must make the applications and forms available in the following manner:
a. By distributing the applications and forms in their offices to any individual or group.
b. By distributing the applications and forms at other locations designated by each supervisor.
c. By mailing the applications and forms to applicants upon the request of the applicant.
(c) The uniform statewide voter registration application may be reproduced by any private individual or group, provided the reproduced application is in the same format as the application prescribed by rule under this section.
(2) The uniform statewide voter registration application must be designed to elicit the following information from the applicant:
(a) Last, first, and middle name, including any suffix.
(b) Date of birth.
(c) Address of legal residence.
(d) Mailing address, if different.
(e) E-mail address and whether the applicant wishes to receive sample ballots by e-mail.
(f) County of legal residence.
(g) Race or ethnicity that best describes the applicant:
1. American Indian or Alaskan Native.
2. Asian or Pacific Islander.
3. Black, not Hispanic.
4. White, not Hispanic.
(h) State or country of birth.
(j) Party affiliation.
(k) Whether the applicant needs assistance in voting.
(l) Name and address where last registered.
(m) Last four digits of the applicant’s social security number.
(n) Florida driver’s license number or the identification number from a Florida identification card issued under s. 322.051.
(o) An indication, if applicable, that the applicant has not been issued a Florida driver’s license, a Florida identification card, or a social security number.
(p) Telephone number (optional).
(q) Signature of applicant under penalty for false swearing pursuant to s. 104.011, by which the person subscribes to the oath required by s. 3, Art. VI of the State Constitution and s. 97.051, and swears or affirms that the information contained in the registration application is true.
(r) Whether the application is being used for initial registration, to update a voter registration record, or to request a replacement voter information card.
(s) Whether the applicant is a citizen of the United States by asking the question “Are you a citizen of the United States of America?” and providing boxes for the applicant to check to indicate whether the applicant is or is not a citizen of the United States.
(t) Whether the applicant has been convicted of a felony, and, if convicted, has had his or her civil rights restored by including the statement “I affirm I am not a convicted felon, or, if I am, my rights relating to voting have been restored.” and providing a box for the applicant to check to affirm the statement.
(u) Whether the applicant has been adjudicated mentally incapacitated with respect to voting or, if so adjudicated, has had his or her right to vote restored by including the statement “I affirm I have not been adjudicated mentally incapacitated with respect to voting, or, if I have, my competency has been restored.” and providing a box for the applicant to check to affirm the statement.
The registration application must be in plain language and designed so that convicted felons whose civil rights have been restored and persons who have been adjudicated mentally incapacitated and have had their voting rights restored are not required to reveal their prior conviction or adjudication.
(3) The uniform statewide voter registration application must also contain: (a) The oath required by s. 3, Art. VI of the State Constitution and s. 97.051. (b) A statement specifying each eligibility requirement under s. 97.041. (c) The penalties provided in s. 104.011 for false swearing in connection with voter registration.
(d) A statement that, if an applicant declines to register to vote, the fact that the applicant has declined to register will remain confidential and may be used only for voter registration purposes.
(e) A statement that informs the applicant who chooses to register to vote or update a voter registration record that the office at which the applicant submits a voter registration application or updates a voter registration record will remain confidential and may be used only for voter registration purposes.
(f) A statement informing an applicant who has not been issued a Florida driver’s license, a Florida identification card, or a social security number that if the application is submitted by mail and the applicant is registering for the first time in this state, the applicant will be required to provide identification prior to voting the first time.
(4) A supervisor may produce a voter registration application that has the supervisor’s direct mailing address if the department has reviewed the application and determined that it is substantially the same as the uniform statewide voter registration application.
(5) The voter registration application form prescribed by the Election Assistance Commission pursuant to federal law or the federal postcard application must be accepted as an application for registration in this state if the completed application or postcard application contains the information required by the constitution and laws of this state.
(6) If a voter registration applicant fails to provide any of the required information on the voter registration application form, the supervisor shall notify the applicant of the failure by mail within 5 business days after the supervisor has the information available in the voter registration system. The applicant shall have an opportunity to complete the application form to vote in the next election up until the book closing for that next election.