Massachusetts Rights and Agreements

Rights and Agreements Forms

Opportunity to register to Vote – Declination Form PART B

OPPORTUNITY TO REGISTER TO VOTE – DECLINATION FORM

PART B / APPLICANT COPY: Please keep this for your personal records.

Applying to register or declining to register to vote will not affect the amount of assistance that you will be provided by this agency.
If you would like help filling out the voter registration application form, we will help you. The decision whether to seek or accept help is yours. You may fill out the application 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 the Commonwealth, Elections Division, One Ashburton Place, Room 1705, Boston, 02108; telephone 617-727-2828 or toll free 1-800-462-8683.

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OPORTUNIDAD PARA REGISTRARSE COMO VOTANTE – DECLINATION FORM

PARTE B / COPIA PARA EL SOLICITANTE: Por favor, guarde para su archivo personal.

Solicitar registrarse o rechazar registrarse para votar no afectará la cantidad de asistencia que esta agencia le proveerá.
Si desea recibir ayuda para llenar la solicitud de registro de votante, con gusto le ayudaremos. La decisión de buscar o aceptar ayuda es suya. Usted puede llenar la solicitud en privado.

Si cree que alguien ha interferido con su derecho a registrarse o solicitar registrarse para votar, o con su derecho a elegir su propio partido político u otra preferencia política, puede presentar una queja ante el Secretario del Commonwealth, División de Elecciones, One Ashburton Place, Room 1705, Boston, MA 02108; o al teléfono 617-727-2828 o al número gratuito 1-800-462-8683.

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Opportunity to register to Vote – Declination Form PART B