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Certificate of Registration General Instructions: Please use uppercase (CAPITAL) letters only. Please Review Fully Form to be completed by municipal clerk. Completed form is given to Elector to give to Election Inspector at polling location. Polling Location Voting # Ward # Voter Registration # Certificate # STATE OF WISCONSIN Municipality County To: Election Inspectors Name This is to certify that: Street Address City, State, ZIP + 4 Has completed the required voter registration application in the Office of the Clerk and said elector should be permitted to cast his or her vote for the election to be held on: / / Subscribed to in the Office of the Clerk of: This Day of Date Month Municipality Name , Year Signature of Clerk X EL-133 (REV 8/2016) Certificate of Registration Municipal Clerk’s Copy General Instructions: Please use uppercase (CAPITAL) letters only. Please Review Fully Form to be completed by municipal clerk. Completed form is given to Elector to give to Election Inspector at polling location. Polling Location Voting # Ward # Voter Registration # Certificate # STATE OF WISCONSIN Municipality County To: Election Inspectors Name This is to certify that: Street Address City, State, ZIP + 4 Has completed the required voter registration application in the Office of the Clerk and said elector should be permitted to cast his or her vote for the election to be held on: / / Election Date (MM/DD/YYYY) Subscribed to in the Office of the Clerk of: This Day of Date Month Municipality Name , Year Signature of Clerk X EL-133 (REV 8/2016) Election Date (MM/DD/YYYY) ---PAGE BREAK--- Certificate of Registration Instructions General Instructions: Please Review Fully This form is used during the late registration period (between 20 days before the election and the day of the election) to certify that the voter is registered, since the voter’s registration information will not appear on the Poll List. This form is completed after the voter completes a valid Voter Registration Application (EL-131) and the clerk approves the application. The municipal clerk completes this form and gives the top portion to the voter. The voter gives the form to the Election Inspectors at the polling location on Election Day. Since the municipal clerk should keep a copy of the form, the bottom portion has been designed to duplicate the top portion. The municipal clerk may also copy the completed form or use pressure- sensitive or carbon paper to allow for a duplicate to be completed. 1 Polling location: Complete the proper polling location. 2 Ward Complete the proper ward number. 3 Voting Official Use Only. Voter # is completed by the Election Inspectors at the polling location when voter presents the form to them. 4 Voter Registration Office Use only. The unique number given to a voter in WisVote. This is used when information is entered into WisVote at time of late registration. 5 Certificate The serial number issued by the municipal clerk when filing a late registration, i.e. starting with #3 and so forth. The clerk’s agent (provider) issues a serial number followed by i.e. #1c, #2c, #3c and so forth. 6 Municipality: Complete name of municipality. 7 County: Complete name of county in which municipality is located. 8 Name, Address, City: Complete name and voting address of voter. 9 Election Date: Complete the date of the primary or election event. 10 Municipality Name: Fill in the complete name of the municipality. 11 Date: Fill in the date the form was completed. Signature: By signing this form, the municipal clerk certifies that the elector has completed the voter registration application and directs the Election Inspectors to permit the elector to vote for the election to held on the date indicated on the form. EL-133 Instructions (REV 8/2016)