Hawley Voter Registration

MISSOURI VOTER REGISTRATION APPLICATION If you checked no in response to either of the above questions, do not complete this form. 3 FOR OFFICE USE ONLY REGISTRATION NO. | 4 | LAST NAME Hawley | FIRST NAME Joshua | MIDDLE NAME | SUFFIX (CIRCLE) JR SR II III IV. | |---|---|---|---|---| | 5 | ADDRESS WHERE YOU LIVE (HOUSE NO., APT NO OR RURAL ROUTE AND BOX - NO PO BOXES) [illegible] | CITY Ozark | COUNTY Christian | ZIP CODE 65721 | | 6 | ADDRESS WHERE YOU GET YOUR MAIL (REQUIRED IF DIFFERENT FROM #5 ABOVE) | CITY | STATE | ZIP CODE | | 7 | DRIVER'S LICENSE NUMBER IF YOU DO NOT HAVE A DRIVER'S LICENSE PLEASE STATE ID NO. | 8 | LAST 4 DIGITS OF SOCIAL SECURITY NUMBER IF YOU DO NOT HAVE SOCIAL SECURITY NUMBER, PLEASE STATE ID NO. | | | | 9 | DATE OF BIRTH (MM/DD/YYYY) 1979 | 10 | PLACE OF BIRTH (OPTIONAL) | 11 | DAYTIME PHONE NO | 12 | EMAIL ADDRESS (OPTIONAL) | 13 NAME AND ADDRESS ON LAST VOTER REGISTRATION NAME ADDRESS CITY STATE COUNTY If currently registered in another county or state please complete this box 14 I hereby certify that I am a citizen of the United States and a resident of the State of Missouri. I am at least seventeen and one half years of age. I have not been adjudged incapacitated by any court of law. If I have been convicted of a felony or a misdemeanor connected with the right of suffrage, I have had the voting disabilities resulting from such conviction removed pursuant to law. I swear under penalty of perjury that all statements made on this card are true to the best of my knowledge and belief. I understand that if I register to vote knowing that I am not legally entitled to register, I am committing a class one election offense and may be punished by imprisonment of not more than five years or by a fine of between two thousand five hundred dollars and ten thousand dollars or by both such imprisonment and fine. Date Signature 15 RURAL VOTERS PLEASE COMPLETE THIS SECTION IF YOU LIVE OUTSIDE THE CITY LIMITS OF ANY CITY I live miles N S E W (circle one) of (landmark or junction) Section, Township and range My neighbors are [ ] Check here if you are interested in working as an election judge. Warning: Conviction for making a false statement may result in imprisonment for up to five years or a fine up to $10,000.

County: Christian Voter History Report Voter Name: HAWLEY, JOSHUA | Election Date | County | | :--- | :--- | | 04/04/2023 | Christian | | 11/08/2022 | Christian | | 08/02/2022 | Christian | | 04/05/2022 | Christian | | 11/03/2020 | Christian | | 08/04/2020 | Christian | | 03/10/2020 | Greene | | 11/06/2018 | Boone | | 08/07/2018 | Boone | | 04/03/2018 | Boone | | 11/07/2017 | Boone | | 08/08/2017 | Boone | | 11/08/2016 | Boone | | 08/02/2016 | Boone | | 04/05/2016 | Boone | | 03/15/2016 | Boone | | 04/07/2015 | Boone | | 11/04/2014 | Boone | | 08/05/2014 | Boone | | 11/06/2012 | Boone | | 08/07/2012 | Boone | | 11/02/2010 | Greene | | 11/02/2004 | Greene | | 08/03/2004 | Greene | | 11/05/2002 | Greene | | 11/07/2000 | Greene |

MISSOURI VOTER REGISTRATION APPLICATION If you checked no in response to either of the above questions, do not complete this form. 3 FOR OFFICE USE ONLY REGISTRATION NO. 4 LAST NAME Hawley FIRST NAME Erin MIDDLE NAME SUFFIX (CIRCLE) JR SR II III IV. 5 ADDRESS WHERE YOU LIVE (HOUSE NO., APT NO. OR RURAL ROUTE AND BOX - NO PO BOXES) [illegible] CITY Ozark COUNTY Christian ZIP CODE 65721 6 ADDRESS WHERE YOU GET YOUR MAIL (REQUIRED IF DIFFERENT FROM #5 ABOVE) CITY STATE ZIP CODE 7 DRIVER'S LICENSE NUMBER. IF YOU DO NOT HAVE A DRIVER'S LICENSE PLEASE LEAVE BLANK 8 LAST 4 DIGITS OF SOCIAL SECURITY NUMBER*. IF YOU DO NOT HAVE SOCIAL SECURITY NUMBER, PLEASE LEAVE BLANK 9 DATE OF BIRTH (MM/DD/YYYY) 1/1/1980 10 PLACE OF BIRTH (OPTIONAL) 11 DAYTIME PHONE NO 12 EMAIL ADDRESS (OPTIONAL) 13 NAME AND ADDRESS ON LAST VOTER REGISTRATION NAME ADDRESS CITY STATE COUNTY If currently registered in another county or state please complete this box. 14 I hereby certify that I am a citizen of the United States and a resident of the State of Missouri. I am at least seventeen and one half years of age. I have not been adjudged incapacitated by any court of law. If I have been convicted of a felony or a misdemeanor connected with the right of suffrage, I have had the voting disabilities resulting from such conviction removed pursuant to law. I swear under penalty of perjury that all statements made on this card are true to the best of my knowledge and belief. I understand that if I register to vote knowing that I am not legally entitled to register, I am committing a class one election offense and may be punished by imprisonment of not more than five years or by a fine of between two thousand five hundred dollars and ten thousand dollars or by both such imprisonment and fine. Date Signature 15 RURAL VOTERS PLEASE COMPLETE THIS SECTION IF YOU LIVE OUTSIDE THE CITY LIMITS OF ANY CITY I live 0 miles N S E W (circle one) of (landmark or junction) Section, Township and range My neighbors are Check here if you are interested in working as an election judge. Warning: Conviction for making a false statement may result in imprisonment for up to five years or a fine up to $10,000.

County: Christian Voter History Report Voter Name: HAWLEY, ERIN | Election Date | County | | :--- | :--- | | 04/04/2023 | Christian | | 11/08/2022 | Christian | | 08/02/2022 | Christian | | 11/03/2020 | Christian | | 08/04/2020 | Christian | | 11/06/2018 | Boone | | 08/07/2018 | Boone | | 04/03/2018 | Boone | | 11/08/2016 | Boone | | 08/02/2016 | Boone | | 04/05/2016 | Boone | | 03/15/2016 | Boone | | 11/04/2014 | Boone | | 08/05/2014 | Boone | | 11/06/2012 | Boone | | 02/07/2012 | Boone |