business reply mail - texas · 2016-10-11 · 10 xxx-xx-3 4 6 7 ( ) 9 8 2 1 5...

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Page 1: BUSINESS REPLY MAIL - Texas · 2016-10-11 · 10 xxx-xx-3 4 6 7 ( ) 9 8 2 1 5 州務卿辦公室規定 VR17.2016E.I3 請以清晰的字跡填寫以下內容。如果䓟有任何關於填寫此申請表的問題,請致

Fold on line and seal before mailing

Fold on line and seal before mailing

17 10 18

30 18

www.sos.state.tx.uswww.votetexas.gov

HARRIS COUNTY REGISTRAR OF VOTERS PO BOX 3527 HOUSTON TX 77253-9899

NO POSTAGENECESSARY

IF MAILEDIN THE

UNITED STATES

BUSINESS REPLY MAILFIRST-CLASS MAIL AUSTIN, TXPERMIT NO. 4511

POSTAGE WILL BE PAID BY ADDRESSEE

Artwork for User Defined (4" x 6")Layout: sample BRM Env with IMB.lytOctober 26, 2011

Produced by DAZzle Designer, Version 9.0.05(c) 1993-2009, Endicia, www.Endicia.comU.S. Postal Service, Serial #

IMPORTANT: DO NOT ENLARGE, REDUCE OR MOVE the FIM and POSTNET barcodes. They are only valid as printed! Special care must be taken to ensure FIM and POSTNET barcode are actual size AND placed properly on the mail piece to meet both USPS regulations and automation compatibility standards.

CHINESE_HARRIS_2016_VR17.16EI3.indd 1 1/27/2016 1:32:30 PM

Page 2: BUSINESS REPLY MAIL - Texas · 2016-10-11 · 10 xxx-xx-3 4 6 7 ( ) 9 8 2 1 5 州務卿辦公室規定 VR17.2016E.I3 請以清晰的字跡填寫以下內容。如果䓟有任何關於填寫此申請表的問題,請致

10

xxx-xx-

3

4

6 7( )

9

8

2

1

5

州務卿辦公室規定 VR17.2016E.I3

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請以清晰的字跡填寫以下內容。如果您有任何關於填寫此申請表的問題,請致電哈里斯郡選民登記員

我既沒有 州駕駛執照 / 州個人識別證號碼,也沒有社會安全號碼

本人瞭解:依據州法與聯邦法律規定,若本人在此提供不實資訊而獲取選民登記,即觸犯偽證罪。一旦定罪,將可被處達180天之監禁, 和/或科以達2000之罰款。請確認以下三個聲明,並簽名。

• 本人從未被認證法庭裁定為完全精神上無行為能力或部分精神上無行為能力而喪失投票權

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