Cal. Code Regs. Tit. 2, § 20063 - Cancellation Request Form
Current through Register 2021 Notice, Register No. 40, October 1, 2021
To whom it may concern:
I, _________________________________________ (full name, as
registered to vote), would like to cancel my voter registration. Please cancel
my registration, as authorized by California Elections Code section
Print Full Legal Name (as used to register to vote)
Complete Residence Address (as used to register to vote)
Mailing Address (if different from above)
Confidential Information: (Optional) Please provide the following information to ensure that your voter file record can be accurately identified:
- Date of Birth:
- California Driver License Number or California Identification Card Number:
Note: Authority cited: Section 12172.5, Government Code; and Sections 10 and 2270, Elections Code. Reference: Sections 2201, 2263, 2265, 2266, 2267, 2268 and 2270, Elections Code.
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