Hummelstown, PA · Dauphin County

No notary required

Voter Registration Application and Mail-In Ballot Request

This form lets eligible residents register to vote, update voter registration details, or optionally request a mail-in ballot from their County elections office.

What this form is

Use this form to register to vote, change your name, address, or party, or request a mail-in ballot. Complete the sections that apply, provide your identifying and residence information, and sign the declaration. Mail or deliver the application to your County elections office; the form lists county office addresses and explains when the office must receive applications for upcoming elections.

Who needs it

Residents who want to register to vote, update their voter registration, or request a mail-in ballot can complete and submit this form.

How to submit it

Mail or deliver the completed form to the Dauphin County elections office at 1251 S 28th St, Harrisburg, PA 17111. The office address is listed on page 2.

About notarization

This document is signed without a notary; the signer affirms that the declaration is true and understands it is the same as an affidavit.

How to submit this form

  1. 1

    Download The Form

    Download the voter registration application and mail-in ballot request form.

  2. 2

    Complete The Applicable Sections

    Fill in the sections that apply, using blue or black ink, and sign and date the declaration.

  3. 3

    Gather Any Needed Information

    Provide the identification and residence information requested; use the map on the form if you do not have a street address or permanent residence.

  4. 4

    Send It To The County Office

    Mail or deliver the completed application to the Dauphin County elections office at the address listed on page 2.

Frequently asked questions

Do I need a notary for the voter registration form?
No. The form is signed without a notary. The signer affirms the declaration, which the form says is the same as an affidavit.
How do I submit the voter registration form?
Mail or deliver it to the Dauphin County elections office, 1251 S 28th St, Harrisburg, PA 17111. The office address is also listed on page 2.
Can I request a mail-in ballot on this form?
Yes. The form has an optional section to request a mail-in ballot for the next election or annual mail-in ballot applications.
What can I change with this form?
You can use it to change your name, address, or political party on your voter registration, as well as register to vote.

Need something notarized?

This Voter Registration Application and Mail-In Ballot Request doesn’t need a notary — but if you have another Hummelstown form that does, a commissioned online notary can help.