CalWORKs Policy - Department of Public Social Services

need to complete the form. The potential registrant
should at least sign this form whether they wish to register
or not. Use of this form is required to document that voter
services were offered to the applicant/participant.
PA 106-1, Would You Like to Register to Vote? (out of
drawer):
This is the top half (information section) of the PA 106
only. It is used when mailing out the Voter Registration
Form (below) upon notification of a change of address by
a participant.
Until LEADER is programmed, the appropriate language
Voter Registration Form is to be folded with the PA 106-1
and stapled for mailing by the Eligibility Worker to the
participant.
Voter Registration Form (out of drawer): Participants who
qualify to do so may register to vote or report a change of
address to the Registrar-Recorder’s Office using this form.
The Voter Registration Form should be provided to
participants in their primary language for completion.
NOTE: The Voter Registration forms are available in
English, Spanish, Armenian, Chinese, Cambodian,
Korean, Japanese, Russian, Tagalog, and Vietnamese.
What information should be reviewed by the Eligibility
Worker?
At the beginning of the intake interview, the Eligibility
Worker must review the bolded section to determine if an
applicant wishes to register to vote by reviewing the
possible selections as follows:
• The applicant may check only one of the three boxes
to indicate his/her registration preference. If the PA
106, Would You Like to Register to Vote? (out of
drawer) form is not complete, ask the individual,
verbatim, “If you are not registered to vote where you
live now, would you like to apply to vote here today?”
Have the individual check their response in the
appropriate box and ask that they sign the form.
• If the potential registrant checks “Yes” to the Voter
Registration question, you should have the person
sign the form and provide a Voter Registration Form
(VRF).
• If the potential registrant checks “No” to the voter
registration question, ask the applicant, “If you are not
registered to vote where you live now, would you like