Sec. 5. An affidavit executed under this chapter must contain the following information:

(1) The person’s last, first, and middle name, in that order.

Terms Used In Indiana Code 3-10-11-5

  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • United States: includes the District of Columbia and the commonwealths, possessions, states in free association with the United States, and the territories. See Indiana Code 1-1-4-5
(2) The person’s date of birth.

(3) Whether the person is a United States citizen.

(4) The person’s current address, including the county. If the person resides in a municipality, the address must include the street address, including apartment number or other designation, or the name and room number of the hotel or lodging house. If the person does not reside in a municipality, the address must include the mailing address and the street or road.

(5) The address of the person’s previous residence, including the county.

(6) The person’s statement that the person satisfies the conditions set forth in section 2 of this chapter.

(7) Responses to the questions listed in Ind. Code § 3-7-22-5(3) and Ind. Code § 3-7-22-5(4).

(8) The person’s voter identification number to permit transfer of the registration under Ind. Code § 3-7-13-13.

As added by P.L.12-1995, SEC.69. Amended by P.L.209-2003, SEC.103; P.L.164-2006, SEC.79; P.L.64-2014, SEC.38; P.L.169-2015, SEC.85.