Duchesne County Political Party Affiliation
Change Form
734 North Center Street Duchesne, Utah 84021
Name: (Please Print)
Last
First
Middle
Date of Birth:
Required: month/day/year
Voter’s Residence Address:
Street (primary physical residence- no P.O. Box)
Apt.#
City
State
Zip Code
Mailing Address (if P.O. Box or different from above)
Apt.#
City
State
Zip Code
I am Currently a registered voter who is affiliated with the Party, and I now want to change my party affiliation. I hereby direct the County Clerk to update my voter registration record accordingly.
Check one box to make your affiliation selection:
| Constitution Party | No Labels Party |
| Democratic Party | Republican Party |
| Independent American Party | Utah Forward Party |
| Green Party | United Utah Party |
| Libertarian Party | Unaffiliated (no party preference) |
Voter Signature (signature must be a manual signature, not digital)
X
E-mail: (optional)
Phone number: (optional)