ivote.de.gov
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15.197.255.51
Public Scan
URL:
https://ivote.de.gov/VoterView/registrant/newregistrant
Submission: On October 19 via api from DE — Scanned from DE
Submission: On October 19 via api from DE — Scanned from DE
Form analysis 2 forms found in the DOM
POST /VoterView/Registrant/Get
<form action="/VoterView/Registrant/Get" class="form-horizontal" id="FormBreadCrumb" method="post" role="form">
<ul class="breadcrumb">
<li class="breadcrumb-item"><a href="/VoterView">Back to Lookup</a></li>
<li class="breadcrumb-item">New Registration</li>
</ul>
<input name="__RequestVerificationToken" type="hidden" value="CfDJ8K6Jl7FOU4lJuumXsXSKyaSAKlvk7SUbmH9e92yKngWg1aRGuYc4Gu60GyI4B_74osaiUlnHJtAL0s1Ntsdpm4p_KFljeRHaygq_rfxfAEpstbS4_TH4D8zu1SmL_szE63h3ZCpDM4OJ-YeKhc46pL8">
</form>POST /VoterView/Registrant/Save
<form action="/VoterView/Registrant/Save" class="form-horizontal" id="formRegister" method="post" role="form" enctype="multipart/form-data" encoding="multipart/form-data" data-role="validator" novalidate="novalidate"><input id="RegistrationDate"
name="RegistrationDate" type="hidden" value="10/19/2024 6:08:59 PM">
<div class="container-fluid form-group card" id="divWelcome" style="">
<div class="card-header">Terms and Agreement</div>
<div class="card-body">
<div class="row">
<ul class="welcomeText">
<li class="unorderedListLevel1">You may register to vote if you:<ul>
<li class="unorderedListLevel2">Are a citizen of the United States, AND</li>
<li class="unorderedListLevel2">Are a resident of the state, AND</li>
<li class="unorderedListLevel2">Will be 18 years old on or before the date of the next General Election.</li>
</ul>
</li>
</ul>
</div>
<div class="form-check">
<input data-val="true" data-val-required="The TermsAccepted field is required." id="TermsAccepted" name="TermsAccepted" required="True" type="checkbox" value="true">
<label id="labelRegistrantTermsAndAgreement" class="control-label" for="chkRegistrantTermsAndAgreement">I agree to the Terms and Agreement</label>
</div>
<label class="error" name="TermsAccepted-error" id="TermsAccepted-error" for="TermsAccepted" style="display:none"></label>
<div id="divAgreementRequired" class="required-message"><span class="required-indicator">*</span>Agreement is required</div>
</div>
<div class="card-footer">
<div class="float-left">
<button id="buttonWelcomeCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
</div>
<div class="float-right">
<button id="buttonWelcomeNext" class="btn btn-primary" type="button" onclick="showConfirmEligibility()">Next <i class="fas fa-arrow-right fa-lg" aria-hidden="true"></i></button>
</div>
</div>
</div>
<div id="divConfirmEligibility" class="container-fluid form-group card" style="display: none;">
<div class="card-header"> Confirm Eligibility </div>
<div class="card-body">
<div class="form-group">
<label class="control-label-important"><span id="spanCitizenRequiredIndicator" class="required-indicator">*</span>Are you a U.S. Citizen?</label>
<div class="form-check">
<input id="CitizenY" name="Citizen" required="True" type="radio" value="Y">
<label class="control-label-important" for="CitizenY">Yes, I am a U.S. Citizen</label>
</div>
<div class="form-check">
<input id="CitizenN" name="Citizen" required="True" type="radio" value="N">
<label class="control-label-important" for="CitizenN">No, I am NOT a U.S. Citizen</label>
</div>
<span class="field-validation-valid text-danger" data-valmsg-for="Citizen" data-valmsg-replace="true"></span>
<div id="divWarningNotACitizen" style="display:none">
<br>
<div class="card card-alert">
<div class="card-body vertical-align-middle">
<label class="text-alert-card">In order to register to vote, you must be a U.S. Citizen.</label>
</div>
</div>
</div>
<label class="error" id="Citizen-error" for="Citizen"></label>
<div id="divConfirmEligibilityRequired" class="required-message"><span class="required-indicator">*</span>Indicates a required field</div>
</div>
</div>
<div class="card-footer">
<div class="float-left button-navigation">
<button id="buttonConfirmEligibilityCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
</div>
<div class="float-right button-navigation">
<button id="buttonConfirmEligibilityBack" class="btn btn-primary" type="button" onclick="showWelcome()"><i class="fas fa-arrow-left fa-lg" aria-hidden="true"></i> Back</button>
<button id="buttonConfirmEligibilityNext" class="btn btn-primary" type="button" onclick="showPersonalInfo(false)">Next <i class="fas fa-arrow-right fa-lg" aria-hidden="true"></i></button>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divPersonalInfo" style="display: none;">
<div class="card-header"> Personal Information </div>
<div class="card-body">
<div class="form-row">
<div class="form-group col-md-3">
<label class="control-label-important" for="FirstName"><span class="required-indicator">*</span>First Name</label>
<input class="form-control" id="FirstName" name="FirstName" required="True" title="" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="FirstName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important" for="MiddleName">Middle Name</label>
<input class="form-control" id="MiddleName" name="MiddleName" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="MiddleName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important" for="LastName"><span class="required-indicator">*</span>Last Name</label>
<input class="form-control" id="LastName" name="LastName" required="True" title="" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="LastName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important" for="Suffix">Suffix</label>
<select class="form-control" id="Suffix" name="Suffix">
<option value=""></option>
<option value="I">I</option>
<option value="II">II</option>
<option value="III">III</option>
<option value="IV">IV</option>
<option value="IX">IX</option>
<option value="JR">JR</option>
<option value="MD">MD</option>
<option value="SR">SR</option>
<option value="V">V</option>
<option value="VI">VI</option>
<option value="VII">VII</option>
<option value="VIII">VIII</option>
<option value="X">X</option>
</select>
<span class="field-validation-valid text-danger" data-valmsg-for="Suffix" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-row">
<div class="form-group col-12 col-lg-6">
<label class="control-label-important" for="Birthdate"><span class="required-indicator">*</span>Date of Birth</label>
<div class="date-dropdowns"><input type="hidden" id="Birthdate" class="form-control" required="" name="Birthdate"><select class="month date-dropdown date-dropdown-valid" name="Birthdate_[month]" aria-label="Birthdate month">
<option value="">Month</option>
<option value="01">January</option>
<option value="02">February</option>
<option value="03">March</option>
<option value="04">April</option>
<option value="05">May</option>
<option value="06">June</option>
<option value="07">July</option>
<option value="08">August</option>
<option value="09">September</option>
<option value="10">October</option>
<option value="11">November</option>
<option value="12">December</option>
</select><select class="day date-dropdown date-dropdown-valid" name="Birthdate_[day]" aria-label="Birthdate day">
<option value="">Day</option>
<option value="01">1st</option>
<option value="02">2nd</option>
<option value="03">3rd</option>
<option value="04">4th</option>
<option value="05">5th</option>
<option value="06">6th</option>
<option value="07">7th</option>
<option value="08">8th</option>
<option value="09">9th</option>
<option value="10">10th</option>
<option value="11">11th</option>
<option value="12">12th</option>
<option value="13">13th</option>
<option value="14">14th</option>
<option value="15">15th</option>
<option value="16">16th</option>
<option value="17">17th</option>
<option value="18">18th</option>
<option value="19">19th</option>
<option value="20">20th</option>
<option value="21">21st</option>
<option value="22">22nd</option>
<option value="23">23rd</option>
<option value="24">24th</option>
<option value="25">25th</option>
<option value="26">26th</option>
<option value="27">27th</option>
<option value="28">28th</option>
<option value="29">29th</option>
<option value="30">30th</option>
<option value="31">31st</option>
</select><select class="year date-dropdown date-dropdown-valid" name="Birthdate_[year]" aria-label="Birthdate year">
<option value="">Year</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
<option value="1914">1914</option>
<option value="1913">1913</option>
<option value="1912">1912</option>
<option value="1911">1911</option>
<option value="1910">1910</option>
<option value="1909">1909</option>
<option value="1908">1908</option>
<option value="1907">1907</option>
<option value="1906">1906</option>
<option value="1905">1905</option>
<option value="1904">1904</option>
<option value="1903">1903</option>
</select></div>
<input type="hidden" id="DOB" name="DOB">
<input type="hidden" id="ElectionDate" name="ElectionDate" value="11/5/2024 12:00:00 AM">
<label class="error" id="Birthdate-error"></label>
<label class="error" id="AgeWarning" data-warningtext="You must be at least 18 years old on election day"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Birthdate" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-12 col-lg-6">
<label class="control-label-important" for="Ssn3">Social Security Number (Last 4 Digits)</label>
<span class="k-widget k-maskedtextbox form-control" style=""><input class="form-control k-textbox" data-validmask-msg="Incomplete" id="Ssn3" name="Ssn3" type="text" value="" data-role="maskedtextbox" autocomplete="off"
style="width: 100%;"><span class="k-icon k-i-warning"></span></span>
<span class="field-validation-valid text-danger" data-valmsg-for="Ssn3" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-6">
<label class="control-label-important" for="StateIdType">Identification Type</label>
<select class="form-control" id="StateIdType" name="StateIdType">
<option value="DL">Drivers License Number</option>
<option value="ID">State Id</option>
</select>
</div>
<div class="form-group col-md-6">
<label class="control-label-important" for="DriversLicenseNumber">Identification Number</label>
<input class="form-control" id="DriversLicenseNumber" name="DriversLicenseNumber" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="DriversLicenseNumber" data-valmsg-replace="true"></span>
</div>
</div>
<div class="required-message"><span class="required-indicator">*</span>Indicates a required field</div>
</div>
<div class="card-footer">
<div class="float-left">
<button id="buttonPersonalInfoCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
</div>
<div class="float-right">
<button id="buttonPersonalInfoBack" class="btn btn-primary" type="button" onclick="showConfirmEligibility()"><i class="fas fa-arrow-left fa-lg" aria-hidden="true"></i> Back</button>
<button id="buttonPersonalInfoNext" class="btn btn-primary" type="button" onclick="showAddress()">Next <i class="fas fa-arrow-right fa-lg" aria-hidden="true"></i></button>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divAddress" style="display: none;">
<div class="card-header"> Address Information </div>
<div class="card-body">
<script type="text/javascript">
$(document).ready(function() {
$("#Zip").kendoMaskedTextBox({
mask: "00000"
});
$("#Zip4").kendoMaskedTextBox({
mask: "0000"
});
$("#Ssn3").kendoMaskedTextBox({
mask: "0000"
});
});
</script>
<div>
<div>
<div class="form-group">
<label class="control-label-important" for="Address1"><span class="required-indicator">*</span> Address Line 1</label>
<input class="form-control" id="Address1" name="Address1" required="True" title="" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="Address1" data-valmsg-replace="true"></span>
</div>
<div class="form-group">
<label class="control-label-important" for="Address2">Address Line 2</label>
<input class="form-control" id="Address2" name="Address2" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="Address2" data-valmsg-replace="true"></span>
</div>
<div class="row row-no-gutters">
<div class="col-6 col-lg-5 form-group padding-left-right-none">
<label for="City" class="control-label-important"><span class="required-indicator">*</span> City</label>
<input class="form-control" id="City" name="City" required="True" title="" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="City" data-valmsg-replace="true"></span>
</div>
<div class="col-6 col-lg-4">
<label class="control-label-important" for="State"><span class="required-indicator">*</span> State</label>
<select aria-label="State" class="form-control" disabled="disabled" id="StateResidential" name="State" required="True">
<option value=""></option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option selected="selected" value="DE">Delaware</option>
<option value="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
<option value="AF">Air Force</option>
<option value="AS">American Samoa</option>
<option value="AA">Armed Forces America</option>
<option value="AE">Armed Forces Europe</option>
<option value="AP">Armed Forces Pacific</option>
<option value="FM">Federated States Of Micronesia</option>
<option value="GU">Guam</option>
<option value="MH">Marshall Islands</option>
<option value="MP">Northern Mariana Islands</option>
<option value="PW">Palau</option>
<option value="PR">Puerto Rico</option>
<option value="VI">Virgin Islands</option>
</select>
<input id="State" name="State" type="hidden" value="DE">
<span class="field-validation-valid text-danger" data-valmsg-for="State" data-valmsg-replace="true"></span>
</div>
<div class="col-12 col-lg-3 form-group padding-left-right-none">
<label for="Zip" class="control-label-important"><span class="required-indicator">*</span> Zip</label>
<div class="form-inline">
<span class="k-widget k-maskedtextbox form-control Zip5" style=""><input class="form-control Zip5 k-textbox" data-validmask-msg="Incomplete" id="Zip" name="Zip" required="True" title="" type="text" value="" data-role="maskedtextbox"
autocomplete="off" style="width: 100%;"><span class="k-icon k-i-warning"></span></span> - <span class="k-widget k-maskedtextbox form-control Zip4" style=""><input aria-label="Zip 4" class="form-control Zip4 k-textbox"
data-validmask-msg="Incomplete" id="Zip4" name="Zip4" type="text" value="" data-role="maskedtextbox" autocomplete="off" style="width: 100%;"><span class="k-icon k-i-warning"></span></span>
</div>
<span class="field-validation-valid text-danger" data-valmsg-for="Zip" data-valmsg-replace="true"></span>
</div>
</div>
</div>
<div class="form-group">
<label class="control-label-important" for="CountyCode"><span class="required-indicator">*</span> County</label>
<select class="form-control" id="CountyCode" name="CountyCode" required="True">
<option value=""></option>
<option value="01">KENT</option>
<option value="02">NEW CASTLE</option>
<option value="03">SUSSEX</option>
</select>
<span class="field-validation-valid text-danger" data-valmsg-for="CountyCode" data-valmsg-replace="true"></span>
</div>
</div>
<script type="text/javascript">
function MailAddressFields(elementId) {
if (RadioChecked(elementId.id)) {
$("#divMailingAddressLines3And4").hide();
$("#divMailingAddressCityStateZip").hide();
if (elementId.id == "MailAddressTypeUS") {
$("#divMailingAddressCityStateZip").show();
$("#MailAddress3").val("");
$("#MailAddress4").val("");
MarkElementAsRequired("MailAddress2", true);
} else if (elementId.id == "MailAddressTypeOverseas") {
$("#MailCity").val("");
$("#MailState").val("");
$("#MailZip").val("");
$("#MailZip4").val("");
$("#divMailingAddressLines3And4").show();
}
SetMailAddressRequiredField();
return true;
}
}
function SetMailAddressRequiredField() {
if (CheckBoxChecked("MailingAddressSameAsResidential")) {
MarkElementAsRequired("MailAddress1", false);
MarkElementAsRequired("MailCity", false);
MarkElementAsRequired("MailState", false);
MarkElementAsRequired("MailZip", false);
$("#divMailingAddressFields").hide();
ClearMailingFields();
} else {
$("#divMailingAddressFields").show();
if (RadioChecked("MailAddressTypeUS")) {
MarkElementAsRequired("MailAddress1", true);
MarkElementAsRequired("MailAddress2", false);
$("#spanMailAddress2Required").hide();
MarkElementAsRequired("MailCity", true);
MarkElementAsRequired("MailState", true);
MarkElementAsRequired("MailZip", true);
} else if (RadioChecked("MailAddressTypeOverseas")) {
MarkElementAsRequired("MailAddress1", true);
MarkElementAsRequired("MailAddress2", true);
$("#spanMailAddress2Required").show();
MarkElementAsRequired("MailCity", false);
MarkElementAsRequired("MailState", false);
MarkElementAsRequired("MailZip", false);
}
}
}
function ClearMailingFields() {
$("#MailAddress1").val("");
$("#MailAddress2").val("");
$("#MailAddress3").val("");
$("#MailAddress4").val("");
$("#MailCity").val("");
$("#MailState").val("");
$("#MailZip").val("");
$("#MailZip4").val("");
}
$(document).ready(function() {
$("#divMailingAddressFields").hide();
UncheckRadioButton
CheckRadioButton("MailAddressTypeUS");
$('#MailingAddressSameAsResidential').change(function() {
SetMailAddressRequiredField();
});
$("#MailZip").kendoMaskedTextBox({
mask: "00000"
});
$("#MailZip4").kendoMaskedTextBox({
mask: "0000"
});
});
</script>
<div>
<span class="medium-text">Mailing Address</span>
<div class="form-check">
<input checked="checked" data-val="true" data-val-required="The MailingAddressSameAsResidential field is required." id="MailingAddressSameAsResidential" name="MailingAddressSameAsResidential" type="checkbox" value="true">
<label class="control-label" for="MailingAddressSameAsResidential" id="labelMailingAddressSameAsResidential">Same As Residential</label>
</div>
<div id="divMailingAddressFields" style="display: none;">
<fieldset aria-label="Mail Address Type" style="padding-bottom:5px;">
<legend><label class="control-label-important">Mailing Address Type</label></legend>
<div class="form-check">
<input id="MailAddressTypeUS" name="Overseas" onclick="MailAddressFields(this)" type="radio" value="0">
<label class="control-label-important" for="MailAddressTypeUS">U.S.</label>
</div>
<div class="form-check">
<input id="MailAddressTypeOverseas" name="Overseas" onclick="MailAddressFields(this)" type="radio" value="1">
<label class="control-label-important" for="MailAddressTypeOverseas">Overseas, APO, FPO</label>
</div>
</fieldset>
<div class="form-group">
<label class="control-label-important" for="MailAddress1"><span id="spanMailAddress1" class="required-indicator">*</span>Mailing Address Line 1</label>
<input class="form-control" id="MailAddress1" name="MailAddress1" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="MailAddress1" data-valmsg-replace="true"></span>
</div>
<div class="form-group">
<label class="control-label-important" for="MailAddress2"><span id="spanMailAddress2Required" class="required-indicator">*</span>Mailing Address Line 2</label>
<input class="form-control" id="MailAddress2" name="MailAddress2" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="MailAddress2" data-valmsg-replace="true"></span>
</div>
<div id="divMailingAddressLines3And4" style="display:none;">
<div class="form-group">
<label class="control-label-important" for="MailAddress3">Mailing Address Line 3</label>
<input class="form-control" id="MailAddress3" name="MailAddress3" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="MailAddress3" data-valmsg-replace="true"></span>
</div>
<div class="form-group">
<label class="control-label-important" for="MailAddress4">Mailing Address Line 4</label>
<input class="form-control" id="MailAddress4" name="MailAddress4" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="MailAddress4" data-valmsg-replace="true"></span>
</div>
</div>
<div id="divMailingAddressCityStateZip" class="row row-no-gutters">
<div class="col-6 col-lg-5 form-group padding-left-right-none">
<label class="control-label-important" for="MailCity"><span id="spanMailAddressCityRequired" class="required-indicator">*</span>Mailing City</label>
<input class="form-control" id="MailCity" name="MailCity" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="MailCity" data-valmsg-replace="true"></span>
</div>
<div class="col-6 col-lg-4">
<label class="control-label-important" for="MailState"><span id="spanMailAddressStateRequired" class="required-indicator">*</span>Mailing State</label>
<select class="form-control" id="MailState" name="MailState">
<option value=""></option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
<option value="AF">Air Force</option>
<option value="AS">American Samoa</option>
<option value="AA">Armed Forces America</option>
<option value="AE">Armed Forces Europe</option>
<option value="AP">Armed Forces Pacific</option>
<option value="FM">Federated States Of Micronesia</option>
<option value="GU">Guam</option>
<option value="MH">Marshall Islands</option>
<option value="MP">Northern Mariana Islands</option>
<option value="PW">Palau</option>
<option value="PR">Puerto Rico</option>
<option value="VI">Virgin Islands</option>
</select>
<span class="field-validation-valid text-danger" data-valmsg-for="MailState" data-valmsg-replace="true"></span>
</div>
<div class="col-12 col-lg-3 form-group padding-left-right-none">
<label for="MailZip" class="control-label-important"><span id="spanMailAddressZipRequired" class="required-indicator">*</span>Mailing Zip</label>
<div class="form-inline">
<span class="k-widget k-maskedtextbox form-control Zip5" style=""><input class="form-control Zip5 k-textbox" data-validmask-msg="Incomplete" id="MailZip" name="MailZip" type="text" value="" data-role="maskedtextbox" autocomplete="off"
style="width: 100%;"><span class="k-icon k-i-warning"></span></span> - <span class="k-widget k-maskedtextbox form-control Zip4" style=""><input aria-label="Mail Zip 4" class="form-control Zip4 k-textbox"
data-validmask-msg="Incomplete" id="MailZip4" name="MailZip4" type="text" value="" data-role="maskedtextbox" autocomplete="off" style="width: 100%;"><span class="k-icon k-i-warning"></span></span>
</div>
<span class="field-validation-valid text-danger" data-valmsg-for="MailZip" data-valmsg-replace="true"></span>
</div>
</div>
</div>
</div>
<div class="required-message"><span class="required-indicator">*</span>Indicates a required field</div>
</div>
<div class="card-footer">
<div class="float-left">
<button id="buttonAddressCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
</div>
<div class="float-right">
<button id="buttonAddressBack" class="btn btn-primary" type="button" onclick="showPersonalInfo(false)"><i class="fas fa-arrow-left fa-lg" aria-hidden="true"></i> Back</button>
<button id="buttonAddressNext" class="btn btn-primary" type="button" onclick="showPreviousRegistration()">Next <i class="fas fa-arrow-right fa-lg" aria-hidden="true"></i></button>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divPreviousRegistration" style="display: none;">
<div class="card-header"> Previous Registration </div>
<div class="card-body">
<div class="form-row">
<div class="form-group col-md-3">
<label class="control-label-important" for="PrevFirstName">First Name</label>
<input class="form-control" id="PrevFirstName" name="PrevFirstName" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="PrevFirstName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important" for="PrevMiddleName">Middle Name</label>
<input class="form-control" id="PrevMiddleName" name="PrevMiddleName" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="PrevMiddleName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important" for="PrevLastName">Last Name</label>
<input class="form-control" id="PrevLastName" name="PrevLastName" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="PrevLastName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important" for="PreviousNameSuffix">Suffix</label>
<select class="form-control" id="PreviousNameSuffix" name="PreviousNameSuffix">
<option value=""></option>
<option value="I">I</option>
<option value="II">II</option>
<option value="III">III</option>
<option value="IV">IV</option>
<option value="IX">IX</option>
<option value="JR">JR</option>
<option value="MD">MD</option>
<option value="SR">SR</option>
<option value="V">V</option>
<option value="VI">VI</option>
<option value="VII">VII</option>
<option value="VIII">VIII</option>
<option value="X">X</option>
</select>
<span class="field-validation-valid text-danger" data-valmsg-for="PreviousNameSuffix" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-group">
<label class="control-label-important" for="PrevResAddress">Street Address</label>
<input class="form-control" id="PrevResAddress" name="PrevResAddress" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="PrevResAddress" data-valmsg-replace="true"></span>
</div>
<div class="row padding-left-right-none">
<div class="col-5 form-group padding-left-right-none">
<label for="PreviousResCity" class="control-label-important">City</label>
<input class="form-control" id="PreviousResCity" name="PreviousResCity" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="PreviousResCity" data-valmsg-replace="true"></span>
</div>
<div class="col-4">
<label for="PreviousResState" class="control-label-important">State</label>
<select class="form-control" id="PreviousResState" name="PreviousResState">
<option value=""></option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
<option value="AF">Air Force</option>
<option value="AS">American Samoa</option>
<option value="AA">Armed Forces America</option>
<option value="AE">Armed Forces Europe</option>
<option value="AP">Armed Forces Pacific</option>
<option value="FM">Federated States Of Micronesia</option>
<option value="GU">Guam</option>
<option value="MH">Marshall Islands</option>
<option value="MP">Northern Mariana Islands</option>
<option value="PW">Palau</option>
<option value="PR">Puerto Rico</option>
<option value="VI">Virgin Islands</option>
</select>
<span class="field-validation-valid text-danger" data-valmsg-for="PreviousResState" data-valmsg-replace="true"></span>
</div>
<div class="col-3 form-group padding-left-right-none">
<label for="PreviousResZip" class="control-label-important">Zip</label>
<div class="form-inline">
<span class="k-widget k-maskedtextbox form-control Zip5" style=""><input class="form-control Zip5 k-textbox" data-validmask-msg="Incomplete" id="PreviousResZip" name="PreviousResZip" type="text" value="" data-role="maskedtextbox"
autocomplete="off" style="width: 100%;"><span class="k-icon k-i-warning"></span></span> - <span class="k-widget k-maskedtextbox form-control Zip4" style=""><input aria-label="Previous Zip 4"
class="form-control Zip4 k-textbox" data-validmask-msg="Incomplete" id="PreviousResZip4" name="PreviousResZip4" type="text" value="" data-role="maskedtextbox" autocomplete="off" style="width: 100%;"><span
class="k-icon k-i-warning"></span></span>
</div>
<span class="field-validation-valid text-danger" data-valmsg-for="PreviousResZip" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-group">
<label class="control-label-important" for="PrevCountyCode">County</label>
<input class="form-control" id="PrevCountyCode" name="PrevCountyCode" type="text" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="PrevCountyCode" data-valmsg-replace="true"></span>
</div>
</div>
<div class="card-footer">
<div class="float-left">
<button id="buttonPreviousRegistrationCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
</div>
<div class="float-right">
<button id="buttonPreviousRegistrationBack" class="btn btn-primary" type="button" onclick="showAddress()"><i class="fas fa-arrow-left fa-lg" aria-hidden="true"></i> Back</button>
<button id="buttonPreviousRegistrationNext" class="btn btn-primary" type="button" onclick="showContactInfo()">Next <i class="fas fa-arrow-right fa-lg" aria-hidden="true"></i></button>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divContactInfo" style="display: none;">
<div class="card-header"> Contact Information </div>
<div class="card-body">
<div class="form-row">
<div class="form-group col-md-6">
<label class="control-label-important" for="Phone">Phone</label>
<span class="k-widget k-maskedtextbox form-control" style=""><input class="form-control k-textbox" data-validmask-msg="Incomplete" id="Phone" name="Phone" type="text" value="" data-role="maskedtextbox" autocomplete="off"
style="width: 100%;"><span class="k-icon k-i-warning"></span></span>
</div>
<div class="form-group col-md-6">
<label class="control-label-important" for="CellPhone">Cell Phone</label>
<span class="k-widget k-maskedtextbox form-control" style=""><input class="form-control k-textbox" data-validmask-msg="Incomplete" id="CellPhone" name="CellPhone" type="text" value="" data-role="maskedtextbox" autocomplete="off"
style="width: 100%;"><span class="k-icon k-i-warning"></span></span>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-6">
<label class="control-label-important" for="Fax">Fax</label>
<span class="k-widget k-maskedtextbox form-control" style=""><input class="form-control k-textbox" data-validmask-msg="Incomplete" id="Fax" name="Fax" type="text" value="" data-role="maskedtextbox" autocomplete="off"
style="width: 100%;"><span class="k-icon k-i-warning"></span></span>
</div>
<div class="form-group col-md-6">
<label class="control-label-important" for="WorkPhone">Work Phone</label>
<span class="k-widget k-maskedtextbox form-control" style=""><input class="form-control k-textbox" data-validmask-msg="Incomplete" id="WorkPhone" name="WorkPhone" type="text" value="" data-role="maskedtextbox" autocomplete="off"
style="width: 100%;"><span class="k-icon k-i-warning"></span></span>
</div>
</div>
<div class="form-group">
<label class="control-label-important" for="EmailAddress">Email </label>
<input class="form-control" data-msg="Invalid Email" id="EmailAddress" name="EmailAddress" placeholder="e.g. myname@example.net" type="email" value="">
<span class="field-validation-valid text-danger" data-valmsg-for="EmailAddress" data-valmsg-replace="true"></span>
</div>
<div class="form-check">
<input data-val="true" data-val-required="The AcceptedVrServices field is required." id="AcceptedVrServices" name="AcceptedVrServices" type="checkbox" value="true">
<label class="control-label" for="AcceptedVrServices">I want to receive notifications from the Department of Elections</label>
<span class="field-validation-valid text-danger" data-valmsg-for="AcceptedVrServices" data-valmsg-replace="true"></span>
</div>
</div>
<div class="card-footer">
<div class="float-left">
<button id="buttonContactInformationCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
</div>
<div class="float-right">
<button id="buttonContactInformationBack" class="btn btn-primary" type="button" onclick="showPreviousRegistration()"><i class="fas fa-arrow-left fa-lg" aria-hidden="true"></i> Back</button>
<button id="buttonContactInformationNext" class="btn btn-primary" type="button" onclick="showPoliticalParty()">Next <i class="fas fa-arrow-right fa-lg" aria-hidden="true"></i></button>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divPoliticalParty" style="display: none;">
<div class="card-header"> Political Party </div>
<div class="card-body">
<div class="form-group">
<fieldset>
<legend class="hidden-text">Political Party</legend>
<div class="form-check">
<input id="PartyAMD" name="Party" onclick="displayPartyOptions()" type="radio" value="AMD">
<label class="control-label-important" for="PartyAMD">AMER DELTA</label>
</div>
<div class="form-check">
<input id="PartyAME" name="Party" onclick="displayPartyOptions()" type="radio" value="AME">
<label class="control-label-important" for="PartyAME">AMERICAN</label>
</div>
<div class="form-check">
<input id="PartyBEN" name="Party" onclick="displayPartyOptions()" type="radio" value="BEN">
<label class="control-label-important" for="PartyBEN">BLUE ENIGMA</label>
</div>
<div class="form-check">
<input id="PartyCON" name="Party" onclick="displayPartyOptions()" type="radio" value="CON">
<label class="control-label-important" for="PartyCON">CONSERVATIVE</label>
</div>
<div class="form-check">
<input id="PartyCNT" name="Party" onclick="displayPartyOptions()" type="radio" value="CNT">
<label class="control-label-important" for="PartyCNT">CONSTITUTION</label>
</div>
<div class="form-check">
<input id="PartyDEM" name="Party" onclick="displayPartyOptions()" type="radio" value="DEM">
<label class="control-label-important" for="PartyDEM">DEMOCRATIC</label>
</div>
<div class="form-check">
<input id="PartyGRN" name="Party" onclick="displayPartyOptions()" type="radio" value="GRN">
<label class="control-label-important" for="PartyGRN">GREEN</label>
</div>
<div class="form-check">
<input id="PartyIND" name="Party" onclick="displayPartyOptions()" type="radio" value="IND">
<label class="control-label-important" for="PartyIND">IND PTY OF DE</label>
</div>
<div class="form-check">
<input id="PartyLIB" name="Party" onclick="displayPartyOptions()" type="radio" value="LIB">
<label class="control-label-important" for="PartyLIB">LIBERAL</label>
</div>
<div class="form-check">
<input id="PartyLBT" name="Party" onclick="displayPartyOptions()" type="radio" value="LBT">
<label class="control-label-important" for="PartyLBT">LIBERTARIAN</label>
</div>
<div class="form-check">
<input id="PartyMAN" name="Party" onclick="displayPartyOptions()" type="radio" value="MAN">
<label class="control-label-important" for="PartyMAN">MANDALORIANS</label>
</div>
<div class="form-check">
<input id="PartyNAT" name="Party" onclick="displayPartyOptions()" type="radio" value="NAT">
<label class="control-label-important" for="PartyNAT">NATURAL LAW</label>
</div>
<div class="form-check">
<input id="PartyNOP" name="Party" onclick="displayPartyOptions()" type="radio" value="NOP">
<label class="control-label-important" for="PartyNOP">NO PARTY</label>
</div>
<div class="form-check">
<input id="PartyNON" name="Party" onclick="displayPartyOptions()" type="radio" value="NON">
<label class="control-label-important" for="PartyNON">NONPARTISAN</label>
</div>
<div class="form-check">
<input id="PartyREF" name="Party" onclick="displayPartyOptions()" type="radio" value="REF">
<label class="control-label-important" for="PartyREF">REFORM</label>
</div>
<div class="form-check">
<input id="PartyREP" name="Party" onclick="displayPartyOptions()" type="radio" value="REP">
<label class="control-label-important" for="PartyREP">REPUBLICAN</label>
</div>
<div class="form-check">
<input id="PartySOC" name="Party" onclick="displayPartyOptions()" type="radio" value="SOC">
<label class="control-label-important" for="PartySOC">SOCIALST WR</label>
</div>
<div class="form-check">
<input id="PartyWTP" name="Party" onclick="displayPartyOptions()" type="radio" value="WTP">
<label class="control-label-important" for="PartyWTP">WE THE PEOPLE</label>
</div>
<div class="form-check">
<input id="PartyWOR" name="Party" onclick="displayPartyOptions()" type="radio" value="WOR">
<label class="control-label-important" for="PartyWOR">WORKING FAM</label>
</div>
</fieldset>
<div class="form-check">
<input type="radio" name="PartyOtherNotListed" id="PartyOtherNotListed" onclick="displayOtherPartyOptions()">
<label class="control-label-important" for="PartyOtherNotListed">My Political Party Is Not Listed</label>
<div class="form-group" id="divPartyOtherText" style="display: none;">
<label class="control-label-important"><span class="required-indicator">*</span>Enter your party if it is not listed</label>
<input class="form-control" id="textParty" name="Party" type="text" value="">
</div>
</div>
</div>
<label class="error" name="Party-error" id="Party-error" for="Party"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Party" data-valmsg-replace="true"></span>
<div class="required-message" id="party-required-message"><span class="required-indicator">*</span>Party is required</div>
</div>
<div class="card-footer">
<div class="float-left">
<button id="buttonPoliticalPartyCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
</div>
<div class="float-right">
<button id="buttonPoliticalPartyBack" class="btn btn-primary" type="button" onclick="showContactInfo()"><i class="fas fa-arrow-left fa-lg" aria-hidden="true"></i> Back</button>
<button id="buttonPoliticalPartyNext" class="btn btn-primary" type="button" onclick="showSignature()">Next <i class="fas fa-arrow-right fa-lg" aria-hidden="true"></i></button>
</div>
</div>
</div>
<script type="text/javascript">
function displayOtherPartyOptions() {
$('input[name="Party"]').prop('checked', false);
$("#divPartyOtherText").show();
$("#textParty").val("");
}
function displayPartyOptions() {
$("#divPartyOtherText").hide();
$('input[name="PartyOtherNotListed"]').prop('checked', false);
}
$(document).ready(function() {
displayPartyOptions();
});
</script>
<div class="container-fluid form-group card" id="divSignature" style="display: none;">
<div class="card-header"> Signature </div>
<div class="card-body">
<div id="divSignatureAffirmation"> I hereby swear or affirm that I am a citizen of the United States. I am a permanent resident of the state of Delaware at the address given here, that I am or will be 18 years of age on or before Election day
and all information given here that was provided by me is true and correct to the best of my knowledge. I hereby authorize the cancellation of any previous registration. </div>
<div id="divSignatureAffirmationNotRegistering" style="display:none"> I decline to register to vote. </div>
<br>
<div class="form-group">
<button id="buttonSignatureDMV" type="button" onclick="showDmvSignatureDialog()" class="btn btn-secondary">Retrieve From DMV</button>
<button id="buttonSignaturePrint" type="button" class="btn btn-secondary">Print and Sign Application</button>
</div>
<div id="signature-pad" class="signature-pad" style="display: none;">
<div class="signature-pad--body">
<canvas id="canvasSignature" required="" disabled="" style="touch-action: none;"></canvas>
</div>
<div class="signature-pad--footer">
<div class="description">Sign above</div>
<div id="divSignaturePadActions" class="signature-pad--actions" style="display: none;">
<div>
<button id="buttonSignatureClear" type="button" class="btn btn-secondary clear" data-action="clear">Clear</button>
<button id="buttonSignatureUndo" type="button" class="btn btn-secondary" data-action="undo">Undo</button>
</div>
</div>
</div>
<input type="hidden" name="SignatureImageData" id="SignatureImageData" value="">
</div>
<label class="error" name="Signature-error" id="Signature-error" for="signature-pad"></label>
<div id="divSignatureOnFileError" style="display: none;">
<i class="fas fa-exclamation-circle fa-lg" aria-hidden="true"></i> No Signature On File
</div>
<div id="divSignatureRequired" class="required-message"><span class="required-indicator">*</span>Signature is required</div>
</div>
<div class="card-footer">
<div class="float-left">
<button id="buttonSignatureCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
</div>
<div class="float-right">
<button id="buttonSignatureBack" class="btn btn-primary" type="button"><i class="fas fa-arrow-left fa-lg" aria-hidden="true"></i> Back</button>
<button id="buttonSignatureNext" class="btn btn-primary" type="button">Next <i class="fas fa-arrow-right fa-lg" aria-hidden="true"></i></button>
</div>
</div>
</div>
<div class="modal fade" id="DmvSignatureModal" role="dialog" tabindex="-1" aria-labelledby="DmvSignatureModal" aria-hidden="true">
<div class="modal-dialog">
<div class="modal-content">
<div class="modal-header">
<h2 class="modal-title" id="h4ModalDmvSignatureModalDataTitle"> My Electronic Voter Signature from Division of Motor Vehicles </h2>
</div>
<div class="modal-body" style="font-size:0.9em;" id="sig-search-dialog">
<input type="checkbox" id="bychecking" style="transform:scale(1.3,1.3);"> By checking this box I am choosing to sign and send my Voter Registration application electronically to the Department of Elections. I authorize the Department of
Elections to collect my electronic signature from Division of Motor Vehicle solely for Voter Registration. I am providing the Department of Elections the information below that appear on my Driver License or State ID card in order to search
my record and electronic signature with the Division of Motor Vehicles. <table style="margin-top:10px;margin-bottom:10px;margin-left:20px;">
<tbody>
<tr>
<td id="sub-header" colspan="2" style="color:blue;padding-left:8px;padding-right:8px;font-weight:600;padding-bottom:4px;">Enter all fields exactly as they appear on your DL or ID card.</td>
</tr>
<tr>
<td>ID Type:</td>
<td><input type="radio" name="sig-search-id-type" id="sig-search-type-dl" value="DL">DE Driver License <input type="radio" name="sig-search-id-type" value="ID" id="sig-search-type-id">DE State ID</td>
</tr>
<tr>
<td>ID Number:</td>
<td><input type="text" id="sig-search-dln"></td>
</tr>
<tr>
<td>Issue Date:</td>
<td>
<div class="date-dropdowns"><input type="hidden" name="SigIssueDate" id="sig-search-issue-date"><select class="month date-dropdown date-dropdown-valid sig-search-date" name="date_[month]" aria-label="date month">
<option value="">Month</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select><select class="day date-dropdown date-dropdown-valid sig-search-date" name="date_[day]" aria-label="date day">
<option value="">Day</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select><select class="year date-dropdown date-dropdown-valid sig-search-date" name="date_[year]" aria-label="date year">
<option value="">Year</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
<option value="1914">1914</option>
<option value="1913">1913</option>
<option value="1912">1912</option>
<option value="1911">1911</option>
<option value="1910">1910</option>
<option value="1909">1909</option>
<option value="1908">1908</option>
<option value="1907">1907</option>
<option value="1906">1906</option>
<option value="1905">1905</option>
<option value="1904">1904</option>
<option value="1903">1903</option>
</select></div>
</td>
</tr>
<tr>
<td>Expiration Date:</td>
<td>
<div class="date-dropdowns"><input type="hidden" name="SigExpiryDate" id="sig-search-expiry-date"><select class="month date-dropdown date-dropdown-valid sig-search-date" name="date_[month]" aria-label="date month">
<option value="">Month</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select><select class="day date-dropdown date-dropdown-valid sig-search-date" name="date_[day]" aria-label="date day">
<option value="">Day</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select><select class="year date-dropdown date-dropdown-valid sig-search-date" name="date_[year]" aria-label="date year">
<option value="">Year</option>
<option value="2034">2034</option>
<option value="2033">2033</option>
<option value="2032">2032</option>
<option value="2031">2031</option>
<option value="2030">2030</option>
<option value="2029">2029</option>
<option value="2028">2028</option>
<option value="2027">2027</option>
<option value="2026">2026</option>
<option value="2025">2025</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
<option value="1914">1914</option>
<option value="1913">1913</option>
<option value="1912">1912</option>
<option value="1911">1911</option>
<option value="1910">1910</option>
<option value="1909">1909</option>
<option value="1908">1908</option>
<option value="1907">1907</option>
<option value="1906">1906</option>
<option value="1905">1905</option>
<option value="1904">1904</option>
<option value="1903">1903</option>
</select></div>
</td>
</tr>
<tr>
<td>First Name:</td>
<td id="sig-search-first-name"></td>
</tr>
<tr>
<td>Last Name:</td>
<td id="sig-search-last-name"></td>
</tr>
<tr>
<td>Date of Birth:</td>
<td id="sig-search-dob-area"><input type="hidden" name="SigBirthDate" id="sig-search-birth-date"></td>
</tr>
<tr>
<td>ZIP Code:</td>
<td><input type="text" id="sig-search-zip-code"></td>
</tr>
</tbody>
</table> Note: Your First Name and Last Name on the Voter Registration application must match with the First Name and Last Name that appear on your Driver License or State ID. Otherwise, choose a different method of signing your
application. <div id="sig-search-not-found-message" style="color: red;font-weight: 600;padding-top: 5px; display:none;">We are unable to retrieve a signature from the Division of Motor Vehicles from the entered information. Please review
the information entered and try again or hit the Cancel button below and use the Print, Sign, and Mail method.</div>
<div id="havacheck-error-message" style="color: red;font-weight: 600;padding-top: 5px; display:none;">We are unable to retrieve a signature from the Division of Motor Vehicles at this time as the service is currently unavailable. Please try
again, or hit the Cancel button below and use the Print, Sign, and Mail method.</div>
<div id="havacheck-not-citizen-message" style="color: red;font-weight: 600;padding-top: 5px; display:none;"> You cannot electronically sign this application using your Delaware Driver’s License. You may contact Delaware Division of Motor
Vehicles to confirm your U.S. Citizenship Status. If you are a U.S. Citizen and want to submit this application, please hit the Cancel button below and use the Print, Sign, and Mail method. </div>
<div id="havacheck-dl_expired-message" style="color: red;font-weight: 600;padding-top: 5px; display:none;"> We are unable to retrieve a signature from the Division of Motor Vehicle because your DL/ID has expired. Please hit the Cancel
button below and use the Print, Sign, and Mail method. </div>
<div id="havacheck-invalid-message" style="color: red;font-weight: 600;padding-top: 5px; display:none;"> We are unable to retrieve a signature from the Division of Motor Vehicle from the entered information. Please review the information
entered and try again or hit the Cancel button below and use the Print, Sign, and Mail method. </div>
<div id="sig-search-not-found-detail" style="color: red;font-weight: 600;padding-top: 5px; display:none;"></div>
</div>
<div class="modal-footer">
<button type="button" class="btn btn-primary" onclick="callHAVACheck()" id="sig-submit-button">Search</button>
<button type="button" class="btn btn-primary" data-dismiss="modal">Cancel</button>
</div>
</div>
</div>
</div>
<script>
var standardSigOptions = {
dropdownClass: 'date-dropdown date-dropdown-valid sig-search-date',
displayFormat: "mdy",
defaultDateFormat: 'mm/dd/yyyy',
submitFormat: "yyyymmdd",
daySuffixes: false,
monthSuffixes: false,
monthFormat: 'short',
monthShortValues: ['01', '02', '03', '04', '05', '06', '07', '08', '09', '10', '11', '12'],
dayLabel: 'Day',
monthLabel: 'Month',
yearLabel: 'Year'
};
function showDmvSignatureDialog() {
$("#sig-search-first-name").html($("#FirstName").val());
$("#sig-search-last-name").html($("#LastName").val());
if ($("#DriversLicenseNumber").val()) {
$("#sig-search-dln").val($("#DriversLicenseNumber").val());
}
if ("ID" == $("#StateIdType").val()) {
$("#sig-search-type-id").click();
} else {
$("#sig-search-type-dl").click();
}
if ($("#Zip").val()) {
$("#sig-search-zip-code").val($("#Zip").val());
}
var dateOfBirthOptions = JSON.parse(JSON.stringify(standardSigOptions)); // copy the standard options
if ($("#Birthdate").val()) {
dateOfBirthOptions.defaultDate = getFormattedDate($("#Birthdate").val());
}
$("#sig-search-birth-date").dateDropdowns(dateOfBirthOptions);
$("#DmvSignatureModal").modal("show");
}
$(document).ready(function() {
var expiryDateOptions = JSON.parse(JSON.stringify(standardSigOptions)); // copy the standard options
expiryDateOptions.maxYear = new Date().getFullYear() + 10;
$("#sig-search-issue-date").dateDropdowns(standardSigOptions);
$("#sig-search-expiry-date").dateDropdowns(expiryDateOptions);
});
function callHAVACheck() {
$("#sig-search-not-found-detail").hide();
$("#havacheck-error-message").hide();
$("#havacheck-not-citizen-message").hide();
$("#havacheck-dl_expired-message").hide();
$("#havacheck-invalid-message").hide();
if (!$("#bychecking").is(':checked')) {
$("#sig-search-not-found-detail").html('You must check the agreement box before searching.');
$("#sig-search-not-found-detail").show();
return;
}
if (!$("#sig-search-dln").val() || !$("#sig-search-issue-date").val() || !$("#sig-search-expiry-date").val() || !$("#sig-search-zip-code").val() || !$("#sig-search-birth-date").val()) {
$("#sig-search-not-found-detail").html('Please enter all search fields before searching.');
$("#sig-search-not-found-detail").show();
return;
}
var dlnType = $("input[name='sig-search-id-type']:checked").val(); // $("#sig-search-id-type").is(':selected') ? "ID" : "DL";
var HAVARequest = {
"DlOrIdNum": $("#sig-search-dln").val(),
"LastName": $("#sig-search-last-name").html(),
"FirstName": $("#sig-search-first-name").html(),
"IdType": dlnType,
"IssueDate": $("#sig-search-issue-date").val(),
"ExpiryDate": $("#sig-search-expiry-date").val(),
"DOB": getHavaServiceDate($("#sig-search-birth-date").val()),
"ZipCode": $("#sig-search-zip-code").val()
};
$("#sig-search-not-found-message").hide();
$("#sig-search-not-found-detail").hide();
var requestString = JSON.stringify(HAVARequest);
var callStarted = Date.now();
ShowBusyIndicator("DmvSignatureRetrieval");
var posting = $.ajax({
type: "POST",
contentType: "application/x-www-form-urlencoded; charset=utf-8",
url: GetRootPath() + 'HAVACheckRetrieval',
data: "postJsonData=" + requestString,
dataType: "json",
success: function(data) {
HideBusyIndicator("DmvSignatureRetrieval", callStarted);
if (data.Citizen == "N") {
$("#havacheck-not-citizen-message").show();
$("#DmvSignatureModal").modal("show");
} else if (data.Citizen == "X") {
$("#havacheck-dl_expired-message").show();
$("#DmvSignatureModal").modal("show");
} else if (data.Citizen == "I") {
$("#havacheck-invalid-message").show();
$("#DmvSignatureModal").modal("show");
} else if (data.Citizen == "E") {
$("#havacheck-error-message").show();
$("#DmvSignatureModal").modal("show");
} else {
$("#sig-search-not-found-message").hide();
$("#sig-search-not-found-detail").hide();
$("#DmvSignatureModal").modal("show");
$("#hava-search-not-citizen-message").hide();
callSigRetrieval();
}
},
error: function(jqxhr, textStatus, errorThrown) {
HideBusyIndicator("DmvSignatureRetrieval", callStarted);
alert("Error occurred HAVA Check.");
}
});
}
function callSigRetrieval() {
$("#sig-search-not-found-message").hide();
$("#sig-search-not-found-detail").hide();
$("#havacheck-error-message").hide();
if (!$("#bychecking").is(':checked')) {
$("#sig-search-not-found-detail").html('You must check the agreement box before searching.');
$("#sig-search-not-found-detail").show();
return;
}
if (!$("#sig-search-dln").val() || !$("#sig-search-issue-date").val() || !$("#sig-search-expiry-date").val() || !$("#sig-search-zip-code").val() || !$("#sig-search-birth-date").val()) {
$("#sig-search-not-found-detail").html('Please enter all search fields before searching.');
$("#sig-search-not-found-detail").show();
return;
}
var dlnType = $("input[name='sig-search-id-type']:checked").val(); // $("#sig-search-id-type").is(':selected') ? "ID" : "DL";
var sigRequest = {
"DlOrIdNum": $("#sig-search-dln").val(),
"LastName": $("#sig-search-last-name").html(),
"FirstName": $("#sig-search-first-name").html(),
"IdType": dlnType,
"IssueDate": $("#sig-search-issue-date").val(),
"ExpiryDate": $("#sig-search-expiry-date").val(),
"DOB": getSigServiceDate($("#sig-search-birth-date").val()),
"ZipCode": $("#sig-search-zip-code").val()
};
$("#sig-search-not-found-message").hide();
$("#sig-search-not-found-detail").hide();
$("#DmvSignatureModal").modal("hide");
ShowBusyIndicator("DmvSignatureRetrieval");
var requestString = JSON.stringify(sigRequest);
var callStarted = Date.now();
ShowBusyIndicator("DmvSignatureRetrieval");
var posting = $.ajax({
type: "POST",
contentType: "application/x-www-form-urlencoded; charset=utf-8",
url: GetRootPath() + 'DmvSignatureRetrieval',
data: "postJsonData=" + requestString,
dataType: "json",
success: function(data) {
HideBusyIndicator("DmvSignatureRetrieval", callStarted);
if (data == null) {
$("#sig-search-not-found-message").show();
$("#sig-search-not-found-detail").hide();
$("#DmvSignatureModal").modal("show");
} else if (data.HasSignature == "Y") {
$("#sig-search-not-found-message").hide();
signaturePad.fromDataURL("data:image/jpeg;base64," + data.Signature);
CanvasClear("signature-pad");
$("#signature-pad").show();
$("#divSignaturePadActions").hide();
DisableSignaturePad();
$("#Signature-error").empty();
$("#DmvSignatureModal").modal('hide');
$(".dmv-signature-holder").val(data.Signature); // Sets the bytes from the sig service in hidden element.
} else {
// $("#sig-search-not-found-message").show();
$("#sig-search-not-found-detail").html(data.ReturnMessage);
$("#sig-search-not-found-detail").show();
$("#DmvSignatureModal").modal("show");
}
},
error: function(jqxhr, textStatus, errorThrown) {
HideBusyIndicator("DmvSignatureRetrieval", callStarted);
alert("Error occurred retrieving signature.");
}
});
}
function getSigServiceDate(dateString) {
var time = getTime(dateString);
var month = leftPad(time.getMonth() + 1);
var day = leftPad(time.getDate());
var year = time.getFullYear();
return "" + year + month + day;
}
function getHavaServiceDate(dateString) {
var time = getTime(dateString);
var month = leftPad(time.getMonth() + 1);
var day = leftPad(time.getDate());
var year = time.getFullYear();
return "" + month + "/" + day + "/" + year;
}
function getTime(dateString) {
var dateToCheck = dateString;
if (dateString.length == 8) {
// if its like 20080101, add the dashes so it parses correctly
dateToCheck = dateString.substring(0, 4) + "-" + dateString.substring(4, 6) + "-" + dateString.substring(6);
}
var time;
// parsing a date string like 2014-10-03 with standard parser sometimes picks the day before (due to daylight savings).
if (dateToCheck.indexOf('-') > 0) {
var parts = dateToCheck.split('-');
time = new Date(parts[0], parts[1] - 1, parts[2]);
} else {
time = new Date(dateToCheck)
}
return time;
}
function getFormattedDate(dateString) {
var time = getTime(dateString);
var month = leftPad(time.getMonth() + 1);
var day = leftPad(time.getDate());
var year = time.getFullYear();
return month + "/" + day + "/" + year;
}
function leftPad(val) {
var str = "" + val;
var pad = "00";
var padded = pad.substring(str.length) + str;
return padded;
}
</script>
<div class="modal fade" id="divSignatureUploadFile" role="dialog" tabindex="-1" aria-labelledby="divSignatureUploadFile" aria-hidden="true">
<div class="modal-dialog">
<div class="modal-content">
<div class="modal-header">
<h2 class="modal-title" style="color:black" id="UploadModalLabel">
<i class="fas fa-file-image fa-lg" aria-hidden="true"></i> Upload An Image File
</h2>
</div>
<div class="modal-body">
<div class="form-group"> Select a image file to upload as your signature. Files types supported: PNG or JPG <br>
<div class="k-widget k-upload k-header k-upload-sync k-upload-empty">
<div class="k-button k-upload-button" aria-label="Upload Signature Image"><input aria-label="files" class="btn" id="FileName" name="FileName" type="file" data-role="upload" multiple="multiple" autocomplete="off"><span>Upload Signature
Image</span></div>
</div>
</div>
<div id="divFileError" style="display:none">
<label id="file-error" class="error">Please select a valid file</label>
</div>
</div>
<div class="modal-footer">
<button id="buttonSelectFileOK" type="button" class="btn btn-primary HideBusyIndicator" onclick="">Close</button>
</div>
</div>
</div>
</div>
<script src="/VoterView/lib/signaturepad/signature_pad.js"></script>
<script src="/VoterView/lib/signaturepad/signature.js"></script>
<script>
function showSignaturePadForSigning() {
$("#divSignatureOnFileError").hide();
$("#signature-pad").show();
$("#divSignaturePadActions").show();
EnableSignaturePad();
resizeCanvas();
}
function showUploadFile() {
$("#divSignatureUploadFile").modal('show');
}
$(document).ready(function() {
HideOptions();
// If the model failed server validation, require the signature again since it does not always repopulate on the canvas
function HideOptions() {
$("#signature-pad").hide();
$("#divSignaturePadActions").hide();
$("#divFileError").hide();
$("#divSignatureOnFileError").hide();
}
$("#buttonSignaturePadOK").click(function() {
$("#divSignaturePad").modal('hide');
});
$("#buttonSignatureUploadFile").click(function() {
$("#divSignatureOnFileError").hide();
$("#divSignatureUploadFile").modal('show');
});
$("#buttonSelectFileOK").click(function() {
$("#divFileError").hide();
$("#divSignatureUploadFile").modal('hide');
});
$("#buttonCloseSignatureNotFound").click(function() {
$("#divSignatureNotFound").hide();
});
$("#FileName").kendoUpload({
select: function(e) {
// Clear any existing file
$("#divFileError").hide();
var callStarted = Date.now();
ShowBusyIndicator("FileUpload");
var upload = $("#FileName").data("kendoUpload");
//signaturePad.clear();
//alert("Clearing");
CanvasClear("signature-pad");
upload.clearAllFiles();
if (GetFileByteArray(e)) {
$("#signature-pad").show();
$("#divSignaturePadActions").hide();
$("#Signature-error").empty();
$("#divSignatureUploadFile").modal('hide');
}
DisableSignaturePad();
HideBusyIndicator("FileUpload", callStarted);
},
validation: {
allowedExtensions: ['JPG', 'PNG'],
maxFileSize: 900000,
},
localization: {
select: "Upload Signature Image"
}
});
$('#SignatureDMV').change(function() {
if (this.checked) {
HideOptions();
}
});
$('#SignatureMail').change(function() {
if (this.checked) {
HideOptions();
}
});
$('#SignatureSign').change(function() {
if (this.checked) {
HideOptions();
$("#signature-pad").show();
}
});
$("#buttonSignatureOnFile").click(function() {
strURL = GetRootPath() + "Registrant/GetSignature";
ShowBusyIndicator("GetSignature");
var callStarted = Date.now();
$("#Signature-error").empty();
$.ajax({
type: "POST",
async: true,
url: "/VoterView/Registrant/GetSignature",
data: $("#FormGetSignatureOnFile").serialize(),
success: function(response) {
if ($.trim(response) !== '') {
signaturePad.fromDataURL(response);
$("#signature-pad").show();
DisableSignaturePad();
HideBusyIndicator("GetSignature", callStarted);
} else {
signaturePad.clear();
HideBusyIndicator("GetSignature", callStarted);
$("#signature-pad").hide();
$("#divSignatureOnFileError").show();
}
},
error: function(response) {
alert("Error: " + response.status + " " + response.statusText);
HideBusyIndicator("GetSignature", callStarted);
}
});
});
});
</script>
<input id="EzVoterSignature_SignatureImageString" name="EzVoterSignature.SignatureImageString" type="hidden" value=""><input class="dmv-signature-holder" id="EzVoterSignature_DmvSignatureImageString" name="EzVoterSignature.DmvSignatureImageString"
type="hidden" value="">
<div id="divConfirm" style="display: none;">
<h2>Confirmation</h2>
<div class="container-fluid form-group card" id="divConfirmEligibilityDisplay">
<div class="card-header">Eligibility</div>
<div class="card-body">
<div class="form-group">
<label class="control-label-important">U.S. Citizen</label>
<br>
<label id="labelConfirmationCitizen" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Citizen" data-valmsg-replace="true"></span>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divConfirmPersonal">
<div class="card-header">Personal Information</div>
<div class="card-body">
<div class="form-row">
<div class="form-group col-md-3">
<label class="control-label-important">First Name</label>
<br>
<label id="labelConfirmationNameFirst" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="FirstName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important">Middle Name</label>
<br>
<label id="labelConfirmationNameMiddle" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="MiddleName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important">Last Name</label>
<br>
<label id="labelConfirmationNameLast" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="LastName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-2">
<label class="control-label-important">Suffix</label>
<br>
<label id="labelConfirmationNameSuffix" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Suffix" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-6">
<label class="control-label-important">Date of Birth</label>
<br>
<label id="labelConfirmationDateOfBirth" class="control-label-no-input"></label>
<label class="error" id="labelConfirmationAgeWarning"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Birthdate" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-6">
<label class="control-label-important">Social Security Number (Last 4 Digits)</label>
<br>
<label id="labelConfirmationSSN3" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Ssn3" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-6">
<label class="control-label-important">Identification Type</label>
<br>
<label id="labelConfirmationStateIdType" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="StateIdType" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-6">
<label class="control-label-important">Identification Number</label>
<br>
<label id="labelConfirmationDriversLicenseNumber" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="DriversLicenseNumber" data-valmsg-replace="true"></span>
</div>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divConfirmAddress">
<div class="card-header">Address Information</div>
<div class="card-body">
<div class="form-group">
<label class="control-label-important">Address Line 1</label>
<br>
<label id="labelConfirmationAddress1" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Address1" data-valmsg-replace="true"></span>
</div>
<div id="divConfirmatiobAddress2" class="form-group">
<label class="control-label-important">Address Line 2</label>
<br>
<label id="labelConfirmationAddress2" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Address2" data-valmsg-replace="true"></span>
</div>
<div class="row padding-left-right-none">
<div class="col-5 form-group padding-left-right-none">
<label for="City" class="control-label-important">City</label>
<br>
<label id="labelConfirmationCity" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="City" data-valmsg-replace="true"></span>
</div>
<div class="col-4">
<label class="control-label-important">State</label>
<br>
<label id="labelConfirmationState" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="State" data-valmsg-replace="true"></span>
</div>
<div class="col-3 form-group padding-left-right-none">
<label for="ZipCode" class="control-label-important">Zip</label>
<br>
<label id="labelConfirmationZip" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Zip" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-group">
<label class="control-label-important">County</label>
<br>
<label id="labelConfirmationCounty" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="CountyCode" data-valmsg-replace="true"></span>
</div>
<div id="divConfirmationMailingAddressSameAsResidentail">
<div class="form-group">
<label class="control-label-important">Mailing Address</label>
<br>
<label id="labelConfirmationMailingAddress" class="control-label-no-input">Same As Residential</label>
</div>
</div>
<div id="divConfirmationMailingAddressFields">
<div class="form-group">
<label class="control-label-important">Mailing Address Line 1</label>
<br>
<label id="labelConfirmationMailAddress1" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="MailAddress1" data-valmsg-replace="true"></span>
</div>
<div id="divConfirmationMailingAddress2" class="form-group">
<label class="control-label-important">Mailing Address Line 2</label>
<br>
<label id="labelConfirmationMailAddress2" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="MailAddress2" data-valmsg-replace="true"></span>
</div>
<div id="divConfirmationMailingAddress3" class="form-group">
<label class="control-label-important">Mailing Address Line 3</label>
<br>
<label id="labelConfirmationMailAddress3" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="MailAddress3" data-valmsg-replace="true"></span>
</div>
<div id="divConfirmationMailingAddress4" class="form-group">
<label class="control-label-important">Mailing Address Line 4</label>
<br>
<label id="labelConfirmationMailAddress4" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="MailAddress4" data-valmsg-replace="true"></span>
</div>
<div id="divConfirmationMailCityStateZip" class="row padding-left-right-none">
<div class="col-5 form-group padding-left-right-none">
<label class="control-label-important">Mailing City</label>
<br>
<label id="labelConfirmationMailCity" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="MailCity" data-valmsg-replace="true"></span>
</div>
<div class="col-4">
<label class="control-label-important">Mailing State</label>
<br>
<label id="labelConfirmationMailState" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="MailState" data-valmsg-replace="true"></span>
</div>
<div class="col-3 form-group padding-left-right-none">
<label for="ZipCode" class="control-label-important">Mailing Zip</label>
<br>
<label id="labelConfirmationMailZip" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="MailZip" data-valmsg-replace="true"></span>
</div>
</div>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divConfirmPreviousRegistration">
<div class="card-header">Previous Registration</div>
<div class="card-body">
<div class="form-row">
<div class="form-group col-md-3">
<label class="control-label-important">First Name</label>
<br>
<label id="labelConfirmationPrevFirstName" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PrevFirstName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important">Middle Name</label>
<br>
<label id="labelConfirmationPrevMiddleName" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PrevMiddleName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important">Last Name</label>
<br>
<label id="labelConfirmationPrevLastName" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PrevLastName" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-3">
<label class="control-label-important">Suffix</label>
<br>
<label id="labelConfirmationPrevNameSuffix" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PreviousNameSuffix" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-group">
<label class="control-label-important">Street Address</label>
<br>
<label id="labelConfirmationPrevStreetAddress" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PrevResAddress" data-valmsg-replace="true"></span>
</div>
<div class="row padding-left-right-none">
<div class="col-5 form-group padding-left-right-none">
<label for="PreviousResCity" class="control-label-important">City</label>
<br>
<label id="labelConfirmationPrevResCity" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PreviousResCity" data-valmsg-replace="true"></span>
</div>
<div class="col-4">
<label for="PreviousResState" class="control-label-important">State</label>
<br>
<label id="labelConfirmationPrevResState" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PreviousResState" data-valmsg-replace="true"></span>
</div>
<div class="col-3 form-group padding-left-right-none">
<label for="PreviousResZip" class="control-label-important">Zip</label>
<br>
<label id="labelConfirmationPrevResZip" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PreviousResZip" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-group">
<label class="control-label-important">County</label>
<br>
<label id="labelConfirmationPrevCounty" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="PrevCountyCode" data-valmsg-replace="true"></span>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divConfirmContact">
<div class="card-header">Contact Information</div>
<div class="card-body">
<div class="form-row">
<div class="form-group col-md-6">
<label class="control-label-important">Phone</label>
<br>
<label id="labelConfirmationPhone" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Phone" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-6">
<label class="control-label-important">Cell Phone</label>
<br>
<label id="labelConfirmationCellPhone" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="CellPhone" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-row">
<div class="form-group col-md-6">
<label class="control-label-important">Fax</label>
<br>
<label id="labelConfirmationFax" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Phone" data-valmsg-replace="true"></span>
</div>
<div class="form-group col-md-6">
<label class="control-label-important">Work Phone</label>
<br>
<label id="labelConfirmationWorkPhone" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="WorkPhone" data-valmsg-replace="true"></span>
</div>
</div>
<div class="form-group">
<label class="control-label-important">Email</label>
<br>
<label id="labelConfirmationEmail" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="EmailAddress" data-valmsg-replace="true"></span>
</div>
<div class="form-group">
<label class="control-label-important" for="AcceptedVrServices">I want to receive notifications from the Department of Elections</label>
<br>
<label id="labelConfirmationReceiveNotifications" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="AcceptedVrServices" data-valmsg-replace="true"></span>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divConfirmPoliticalParty">
<div class="card-header">Political Party</div>
<div class="card-body">
<div class="form-group">
<label class="control-label-important">Party</label>
<br>
<label id="labelConfirmationPoliticalParty" class="control-label-no-input"></label>
<span class="field-validation-valid text-danger" data-valmsg-for="Party" data-valmsg-replace="true"></span>
</div>
</div>
</div>
<div class="container-fluid form-group card" id="divConfirmSignature">
<div class="card-header">Signature</div>
<div class="card-body">
<div id="divConfirmationSignature">
<div class="signature-pad--body">
<canvas id="canvasConfirmationSignature" class="canvasConfirmationSignature" disabled=""></canvas>
</div>
</div>
</div>
</div>
<div class="g-recaptcha" data-callback="recaptchaCallback" data-expired-callback="recaptchaExpiredCallback" data-sitekey="6Ldn0sEUAAAAAIBxMRnABuFf8Bj2qX4oho2Flb43">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-h9oieutdr0p2" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Ldn0sEUAAAAAIBxMRnABuFf8Bj2qX4oho2Flb43&co=aHR0cHM6Ly9pdm90ZS5kZS5nb3Y6NDQz&hl=de&v=lqsTZ5beIbCkK4uGEGv9JmUR&size=normal&cb=45auiouadz8c"></iframe></div>
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<i class="far fa-hand-paper"></i> reCAPTCHA Warning
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<button id="buttonRegisterCancel" class="btn btn-primary" type="button" onclick="breadcrumbRegistrantEdit()"><i class="fas fa-ban fa-lg" aria-hidden="true"></i> Cancel</button>
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</form>Text Content
STATE AGENCY - ONLINE VOTER REGISTRATION Select How Registered OK * Agencies * News * Topics * Contact * Delaware Department of Elections * Voter Registration Information * Candidate Services * Election Results * REGISTER * Back to Lookup * New Registration Your Progress 1 Terms and Agreement 2 Confirm Eligibility 3 Personal Information 4 Address Information 5 Previous Registration 6 Contact Information 7 Political Party 8 Signature 9 Confirmation Terms and Agreement * You may register to vote if you: * Are a citizen of the United States, AND * Are a resident of the state, AND * Will be 18 years old on or before the date of the next General Election. I agree to the Terms and Agreement *Agreement is required Cancel Next Confirm Eligibility *Are you a U.S. Citizen? Yes, I am a U.S. Citizen No, I am NOT a U.S. Citizen In order to register to vote, you must be a U.S. Citizen. *Indicates a required field Cancel Back Next Personal Information *First Name Middle Name *Last Name Suffix I II III IV IX JR MD SR V VI VII VIII X *Date of Birth MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDay1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th15th16th17th18th19th20th21st22nd23rd24th25th26th27th28th29th30th31stYear20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903 Social Security Number (Last 4 Digits) Identification Type Drivers License Number State Id Identification Number *Indicates a required field Cancel Back Next Address Information * Address Line 1 Address Line 2 * City * State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Air Force American Samoa Armed Forces America Armed Forces Europe Armed Forces Pacific Federated States Of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico Virgin Islands * Zip - * County KENT NEW CASTLE SUSSEX Mailing Address Same As Residential Mailing Address Type U.S. Overseas, APO, FPO *Mailing Address Line 1 *Mailing Address Line 2 Mailing Address Line 3 Mailing Address Line 4 *Mailing City *Mailing State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Air Force American Samoa Armed Forces America Armed Forces Europe Armed Forces Pacific Federated States Of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico Virgin Islands *Mailing Zip - *Indicates a required field Cancel Back Next Previous Registration First Name Middle Name Last Name Suffix I II III IV IX JR MD SR V VI VII VIII X Street Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Air Force American Samoa Armed Forces America Armed Forces Europe Armed Forces Pacific Federated States Of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico Virgin Islands Zip - County Cancel Back Next Contact Information Phone Cell Phone Fax Work Phone Email I want to receive notifications from the Department of Elections Cancel Back Next Political Party Political Party AMER DELTA AMERICAN BLUE ENIGMA CONSERVATIVE CONSTITUTION DEMOCRATIC GREEN IND PTY OF DE LIBERAL LIBERTARIAN MANDALORIANS NATURAL LAW NO PARTY NONPARTISAN REFORM REPUBLICAN SOCIALST WR WE THE PEOPLE WORKING FAM My Political Party Is Not Listed *Enter your party if it is not listed *Party is required Cancel Back Next Signature I hereby swear or affirm that I am a citizen of the United States. I am a permanent resident of the state of Delaware at the address given here, that I am or will be 18 years of age on or before Election day and all information given here that was provided by me is true and correct to the best of my knowledge. I hereby authorize the cancellation of any previous registration. I decline to register to vote. Retrieve From DMV Print and Sign Application Sign above Clear Undo No Signature On File *Signature is required Cancel Back Next MY ELECTRONIC VOTER SIGNATURE FROM DIVISION OF MOTOR VEHICLES By checking this box I am choosing to sign and send my Voter Registration application electronically to the Department of Elections. I authorize the Department of Elections to collect my electronic signature from Division of Motor Vehicle solely for Voter Registration. I am providing the Department of Elections the information below that appear on my Driver License or State ID card in order to search my record and electronic signature with the Division of Motor Vehicles. Enter all fields exactly as they appear on your DL or ID card. ID Type:DE Driver License DE State ID ID Number: Issue Date: Month010203040506070809101112Day01020304050607080910111213141516171819202122232425262728293031Year20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903 Expiration Date: Month010203040506070809101112Day01020304050607080910111213141516171819202122232425262728293031Year203420332032203120302029202820272026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903 First Name: Last Name: Date of Birth: ZIP Code: Note: Your First Name and Last Name on the Voter Registration application must match with the First Name and Last Name that appear on your Driver License or State ID. Otherwise, choose a different method of signing your application. We are unable to retrieve a signature from the Division of Motor Vehicles from the entered information. Please review the information entered and try again or hit the Cancel button below and use the Print, Sign, and Mail method. We are unable to retrieve a signature from the Division of Motor Vehicles at this time as the service is currently unavailable. Please try again, or hit the Cancel button below and use the Print, Sign, and Mail method. You cannot electronically sign this application using your Delaware Driver’s License. You may contact Delaware Division of Motor Vehicles to confirm your U.S. Citizenship Status. If you are a U.S. Citizen and want to submit this application, please hit the Cancel button below and use the Print, Sign, and Mail method. We are unable to retrieve a signature from the Division of Motor Vehicle because your DL/ID has expired. Please hit the Cancel button below and use the Print, Sign, and Mail method. We are unable to retrieve a signature from the Division of Motor Vehicle from the entered information. Please review the information entered and try again or hit the Cancel button below and use the Print, Sign, and Mail method. Search Cancel UPLOAD AN IMAGE FILE Select a image file to upload as your signature. Files types supported: PNG or JPG Upload Signature Image Please select a valid file Close CONFIRMATION Eligibility U.S. Citizen Personal Information First Name Middle Name Last Name Suffix Date of Birth Social Security Number (Last 4 Digits) Identification Type Identification Number Address Information Address Line 1 Address Line 2 City State Zip County Mailing Address Same As Residential Mailing Address Line 1 Mailing Address Line 2 Mailing Address Line 3 Mailing Address Line 4 Mailing City Mailing State Mailing Zip Previous Registration First Name Middle Name Last Name Suffix Street Address City State Zip County Contact Information Phone Cell Phone Fax Work Phone Email I want to receive notifications from the Department of Elections Political Party Party Signature RECAPTCHA WARNING Please check the I'm not a robot checkbox. OK Cancel Back NEW REGISTRATION PRINT REGISTRATION FORM Your registration form has been sent to your device as a PDF. Print and sign the form and mail it in to complete your registration. Back To Registration Process OK CONNECTION ISSUE We encountered an issue connecting to the server and need to reload the page. OK -------------------------------------------------------------------------------- © Copyright 2024 - ESSVR, LLC. All rights reserved. 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