Third-Party Voter Registration Notification

San Francisco Residents Only

To notify the Department of Elections that a voter has moved, complete and submit this form. Note: This form cannot be used to update your own address.

The following person(s) no longer resides at the following address in San Francisco (list up to 4 names):

Name of Voter

Residential address of voter(s) listed above

Please provide your name and address:

Full Name

Residential address

Contact information (telephone number/email address in case we must contact you)

The Department of Elections appreciates your contacting us to update this record.

By clicking “Submit,” I declare under penalty of perjury under the laws of the State of California that the information on this form is true and correct.