22-3-103. Furnishing of oath forms; contents thereof.
(a) The county clerk shall furnish voter registration oath forms to registry agents which forms shall require the following voter information from the applicant:
(i) His full legal name;
(ii) His current residence address or if living temporarily in another state or nation, his last residence address in Wyoming;
(iii) His postal address if different from his residence address;
(iv) His date of birth;
(v) Acceptable identification as defined pursuant to W.S. 22-1-102(a)(xxxix);
(vi) Either:
(A) The applicant's Wyoming driver's license number, or if the applicant has no current, valid Wyoming driver's license, a statement to that effect and the last four (4) digits of the applicant's social security number, or if the applicant has neither, a statement to that effect; or
(B) A tribal identification card issued by the governing body of the Eastern Shoshone tribe of Wyoming, the Northern Arapaho tribe of Wyoming or other federally recognized Indian tribe that contains the applicant's Wyoming driver's license number, if the applicant has a Wyoming driver's license, and the last four (4) digits of the applicant's social security number.
(vii) His political party affiliation, if any.
(viii) Repealed By Laws 2010, Ch. 3, § 3.
(b) Following the provision of the information required in subsection (a) of this section, the form shall require the applicant's signature in full below the following oath:
I, ...., do solemnly swear (or affirm) that I am a citizen of the United States; that I am a bona fide resident of the state of Wyoming and this county; that if registered in another county or state, I hereby request that my registration be withdrawn; that I will be at least eighteen (18) years of age on or before the next election; that I am not currently adjudicated a mentally incompetent person, that I have not been convicted of a felony, or if I have been convicted of a felony, I have had my civil or voting rights restored by a competent authority; and that the voter registration information contained herein is true and accurate to my best knowledge and belief.
....................... (Signature in full of applicant)
Subscribed and affirmed or sworn to before me by .... this .... day of ...., (year).
....................... (Signature and title of registry agent or person authorized to administer oaths)
(c) Persons in the uniformed services and overseas citizens, as specified in W.S. 22-3-117, shall swear or affirm to the oath under the penalty of perjury. The oath does not require the signature of an oath-taking officer.