Restoration of Voting Rights Use this form to help initiate the process of acquiring a Certificate of Restoration of Voting Rights (for persons convicted of a felony on or after May 18, 1981). NoticeA person is not eligible to apply for a voter registration card and have their voting rights restored unless the person is current in all child support obligations. Before restoring the voting rights of an applicant, the Coordinator of Elections will verify with the Department of Human Services that the applicant does not have any outstanding child support payments or arrearages.Is the applicant current in all child support obligations? Yes I don't know No Not Applicable About the ApplicantFirst Name* Middle Name* Last Name* County of Residence* Phone*Felony Conviction* Date of Conviction*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920TOMIS ID: (if applicable)Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Social Security Number* Incarceration StatusAs of this date:Incarceration Status: Month Incarceration Status: Day Incarceration Status: Year (Choose One):* The applicant has received a pardon which contained no special conditions pertaining to the right to vote. A copy of this pardon will be attached to this document (or can be provided); or The maximum sentence imposed for my crime has been served; or The maximum sentence imposed for my crime has expired; or The applicant has been granted final release from incarceration or supervision from either the United States Probation/Parole, a state Board of Probation/Parole, the Department of Correction, or county correction authorities. Restitution & Fee StatusI hereby certify that the following is true and correct: (choose one)* The court did not order the above individual to pay any restitution as part of his or her sentence; or All of the restitution ordered by the court as a part of the sentence for the above individual has been paid; or Restitution ordered by the court is owed. I hereby certify that the following is true and correct: (choose one)* The court did not order the above individual to pay any court cost as part of his or her sentence; or All court cost assessed against the above individual has been paid; or For Federal Convictions Only, 18 U.S.C. § 3613(b) applies in this case and therefore the liability to pay has expired; or The court has made a finding at an evidentiary hearing that the above individual is indigent at the time of application; or Court costs ordered by the court are owed Attachment(s)File attachment(s) Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 32 MB. PDF or Microsoft Word files only.