Mississippi Administrative Code
Title 1 - Secretary of State
Part 16 - Elections - Voter Photo Identification
Chapter 3 - Mississippi Voter Identification Card
Rule 1-16-3.3 - Application for Mississippi Voter Identification Card

A. The Registrar shall provide a uniform application for the Mississippi Voter Identification Card in the form designed and published by the Mississippi Secretary of State as set forth in Part 16, Exhibit A.

B. The State of Mississippi shall make proper allowances and reimburse the Registrar for equipment and office supplies reasonably necessary for the issuance of the Receipt for the Mississippi Voter Identification Card.

C. The application shall require the elector to (i) affirm he or she is registered to vote in Mississippi, or is registering to vote at the same time he or she is submitting an application for the Mississippi Voter Identification Card; (ii) affirm he or she does not currently possess Acceptable Photographic Identification as defined by Rule 1.1(A) to vote; and (iii) provide his or her full legal name, date of birth, legal residence address, and mailing address, if different.

D. The application shall be signed under oath, in the presence of the Registrar, and any falsification or fraud committed in making the application for the Mississippi Voter Identification Card shall constitute false swearing as defined and punishable by Miss. Code Ann. Section 97-7-35.