§ 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(viii) Repealed By Laws 2010, Ch. 3, § 3.
(ix) Proof of residence as defined in W.S. 22-1-
102(a)(lv);
(x) Proof of United States citizenship as defined by
W.S. 22-1-102(a)(lvi).
(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; I have resided in the state for not
less than thirty (30) days before the date of the election; 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my registration be withdrawn; that I will be at least eighteen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.