Section 1-4-5.4 - Registration; formA. The secretary of state shall prescribe the paper form and ensure that the certificate of registration to be used in any county is compatible with the data processing systems. The secretary of state shall also prescribe the form produced by an online or electronic voter registration transaction.B. The certificate of registration form shall require the following elements of information concerning the applicant for registration: name, gender, residence, municipality, post office, county of former registration, date of birth, political party affiliation, zip code, telephone number at the applicant's option and statement of qualification for voting. The paper form shall contain a space for the qualified elector to provide a driver's license or state identification number issued by the motor vehicle division of the taxation and revenue department or the last four digits of the qualified elector's social security number, while the form resulting from an online or electronic voter registration transaction shall contain the qualified elector's full social security number.C. Provision shall be made for the usual signature or mark of the applicant, for the signature of the county clerk and for the dates of such signatures.D. The certificate form may be multipurpose by providing for an indication of whether the certificate of registration is for a new registration, a change in the existing registration or a cancellation of an existing registration. Provision shall be made on any multipurpose form for entry of any existing registered information for which a change may be requested.E. The certificate of registration forms shall be serially numbered and shall be furnished promptly and in adequate supply by the secretary of state upon application from the county clerk.F. The secretary of state shall maintain on the secretary's website a Privacy Act notice in conformance with the federal Privacy Act of 1974.1953 Comp., § 3-5-24, enacted by Laws 1969, ch. 240, § 125; 1975, ch. 255, § 74; 1987, ch. 249, § 16; 1993, ch. 314, § 39; 1993, ch. 316, § 39; 1995, ch. 166, § 5; 2001, ch. 146, § 8; 1978 Comp., § 1-5-19 recompiled as § 1-4-5.4 by Laws 2011, ch. 137, § 109.Amended by 2019, c. 212,s. 48, eff. 4/3/2019.1953 Comp., §3/5/2024, enacted by Laws 1969, ch. 240, § 125; 1975, ch. 255, § 74; 1987, ch. 249, § 16; 1993, ch. 314, § 39; 1993, ch. 316, § 39; 1995, ch. 166, § 5; 2001, ch. 146, § 8; 1978 Comp., § 1-5-19 recompiled as § 1-4-5.4 by Laws 2011, ch. 137, § 109.