Report Alien Invasion in Virginia

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The documents discuss issues surrounding voting eligibility and findings of illegal voting by non-citizens in Virginia elections.

The documents discuss that only U.S. citizens should be allowed to vote and current safeguards are ineffective at preventing non-citizens from registering and voting.

An investigation found over 1000 instances of non-citizens illegally registered to vote across a few Virginia counties and around 200 verified ballots cast.

The recount is almost over, and in this contest for

attorney general its become apparent that our


campaign is going to come up a few votes short,
Obenshain said, noting that hed already called Herring
to offer his congratulations. It was a vigorous and hardfought campaign, but its over. Obenshains concession
will end a recount process that began on Nov. 5, when
the two candidates were separated by a razor-thin
election night margin. Herring defeated Obenshain by
165 votes out of more than 2.2 million votes cast,
according to results certified by the Virginia Virginia
Department of Elections on Nov. 25.
- Politico, December 18, 2013, covering
Republican Mark Obenshains whisker thin loss
in the Virginia Attorney Generals race.

Only Americans Should Choose American Leaders


Citizenship is the most fundamental element of eligibility to vote in American elections. Every
state requires voters to be U.S. citizens to vote in state elections. 1 The Virginia Constitution,
specifically, delineates that [e]ach voter shall be a citizen of the United States. 2 Only
Americans should choose American leaders. Federal law makes it a crime for an alien to register
to vote or to vote in a federal election. Simply put, it is a felony for a non-citizen to register and
to cast a ballot. 3 Each time such a crime is perpetrated, whether by accident or willfully, a citizen
is effectively disenfranchised.
The right to vote free from dilution by aliens is safeguarded primarily in several placesall of
them appear to be failing to prevent aliens from participating in American elections and in the
Commonwealth of Virginia. On the front end, federal law requires election officials to use
reasonable efforts to identify and remove ineligible registrants from the voter rolls. The Federal
voter registration form purports to prevent aliens from registering to vote, but it is an ineffective
honor system under which the alien need merely lie to get on the voter rolls. On the back end,
federal and state law enforcement officials are entrusted with prosecuting non-citizens who
register and vote as a means to deter others from doing the same. Here too, the system is failing
because the Obama administration has ignored instance after instance of voter fraud.
1

See U.S. Dept. of Just., Federal Prosecution of Election Offenses 66 (7th ed. 2007), available at
https://www.justice.gov/sites/default/files/criminal/legacy/2013/09/30/electbook-rvs0807.pdf
2
Va. Const., Art. II, Sec. 1.
3
18 U.S.C. 1015(f). It is also a felony for an individual to simply falsely and willfully
represent[] himself to be a citizen of the United States. 18 U.S.C 911.
1

In practice, none of these so-called safeguards is functioning correctly. Based on voting history
records, large numbers of ineligible aliens are registering to vote and casting ballots. They are
canceling out the valid votes of American citizens. In some Virginia jurisdictions, the number of
people registered to vote exceeds the number of citizens eligible to vote. When the Justice
Department has been told of aliens registering to vote and committing federal felonies, nothing is
done.

Summary of Findings
An investigation in Virginia by the Public Interest Legal Foundation (PILF) and the Virginia
Voters Alliance (VVA) shows that the cause of this problem is something much worse than
simple ineffective governance. Worse still, Virginia state election officials are obstructing access
to public records that reveal the extent to which non-citizens are participating in our elections.
These obstructionist tactics have led to PILF and VVA obtaining data from only a handful of
Virginia counties so far. But the information from a few counties demonstrates a massive
problem.
In our small sample of just eight Virginia counties who responded to our public inspection
requests, we found 1046 aliens who registered to vote illegally.
The problem is most certainly exponentially worse because we have no data regarding aliens on
the registration rolls for the other 125 Virginia localities. Even in this small sample, when the
voting history of this small sample of alien registrants is examined, nearly 200 verified ballots
were cast before they were removed from the rolls. Each one of them is likely a felony.
Again, this is from just a small sampling of Virginia counties. Each of the aliens we have
discovered to have registered or voted has likely committed a felony. Will the Justice
Department act now that their names, registration records and dates of voting are herein
provided?
Ultimately, the number of illegal votes doesnt matter when the integrity of the process is at
stake. Nobody should tolerate voter fraud, whether it comes in bunches as we describe here,
happens occasionally, or decides the outcome of an election. Lawlessness in elections is a
precursor for lawlessness across our government and culture. The response of law enforcement
officials to both single instances of voter fraud and the hundreds of examples documented in this
report should be the same: swift, sure and unwavering. No excuses should be made for the
lawless who taint the electoral process.

The most alien votes were cast in 2012, followed


by 2008, the year President Obama was elected to
his first term.

In Virginia, like most states, there is


no formal program for identifying
non-citizen registrants. The
Commonwealth formerly arranged to
use the Federal Systematic Alien
Verification for Entitlements (SAVE)
database to detect aliens, but vigorous

use seems to have ended during the administration of Governor Terry McAuliffe. Most
discoveries of non-citizens on the registration rolls are accidental or chance. What this means is
that the number of registered non-citizens thus far identified by this investigation is just the tip
of the iceberg. The true extent of the problem likely runs in the thousands, if not more. And it is
not unique to Virginia.
There is plenty of blame to go around. One culprit, however, is glaringly obviousfederal and
state voter registration forms, which ask registrants to affirm their citizenship with nothing more
than the check of a box. No documentary proof of citizenship must be shown. It is nothing more
than an honor system, one that is unquestionably failing to keep non-citizens from voting. States
that have tried to remedy this problem by asking registrants to prove their citizenship with
documentary proof have uniformly been stonewalled by litigation brought by our own
Department of Justice and legions of attorneys working with left-leaning voter groups committed
to keeping ineligible voters on the rolls.
This report demonstrates the serious problem that unelected election officials have refused to
address and even conspired to hide. It is our hope that this report will result in swift change and
restore confidence in our elections.

When an alien completes a voter registration form, they commit a felony.


This report must begin with the relevant law. It is only with that in mind that the reader can
comprehend the gravity of the problem Virginia and other states are facing when it comes to
non-citizen participation in our elections. When non-citizens register or actually vote, they
violate both state and federal statutes because citizenship is a requirement to vote in both state
and federal elections.
The offenses a fraudulent voter might commit when he registers and votes are numerous:

Virginia Code 24.2-1004: Criminalizes casting an illegal ballot.

Title 18, United States Code 611: Criminalizes voting by illegal aliens in federal
elections.

Title 18, United States Code 911: Criminalizes representing oneself to be a citizen of
the United States.

Title 18, United States Code 1015: Criminalizes false statements in order to register to
vote or to vote in any Federal, State, or local election.

Title 52, United States Code 20511: Criminalizes the fraudulent submission of voter
registration applications and the fraudulent casting of ballots.

The United State Attorney General and the law enforcement officers in the Commonwealth of
Virginia are, respectively, authorized to prosecute violations of all of these statutes. Given that
the integrity of an election is where the consent of the governed is obtained, you would think that
federal and state elections officials would treat these crimes with appropriate seriousness. As will
be discussed later in this report, that is, however, not the case.
3

The National Voter Registration Act and the Help America Vote Act
The problems in Virginia and other states can be traced as far back as 1993. Within months of
assuming the Presidency, Bill Clinton signed into law the National Voter Registration Act
(NVRA) 4, a sweeping piece of legislation that proponents claimed would increase the number
of registered voters and participation in our elections. One thing is for sure it has increased the
number of ineligible voters on state voter rolls.
The NVRA, commonly known as Motor Voter, requires each state to offer voter registration to
any individual that applies for a drivers license. 5 This provision of the law requires the applicant
to swear to his or her citizenship under penalty of perjury, 6 but does not permit nor deny the
states ability to verify citizenship through formal documentation. Instead, the law provides that
the states may require only the minimum amount of information necessary to . . . enable State
election officials to assess the eligibility of the applicant and to administer voter registration and
other parts of the election process. 7
Attempts by various states to require registrants to provide documentary proof of citizenship
during registration for federal elections have been thwarted by lawsuits brought by left-leaning
voter groups and the Department of Justice. Virginia therefore requires applicants to merely
check a box in order to prove their citizenship status.
The NVRA also allows
individuals to register to
vote through the mail using
the federal voter
registration form (the
Federal Form), a
document that is developed
and maintained by a
federal agency called the
Election Assistance Commission. In 2002, the Help America Vote Act added a citizenship
question to the Federal Form. 8 Like Virginias state registration form, the Federal Form requires
only that a registrant check a box to prove his or her citizenship. Under the NVRA, state are
required to accept and use the Federal Form for purposes of registration, 9 but the law does not
prevent states from applying their own eligibility requirements.

52 U.S.C. 20501 et seq.


See 52 U.S.C. 20504(a)(1) and (c)(1).
6
52 U.S.C. 20504(c)(2)(C).
7
52 U.S.C. 20504(c)(2)(B)(ii).
8
52 U.S.C. 21083(b)(4)(A)(i).
9
52 U.S.C. 20505(A)(1).
5

The NVRA also imposes voter list maintenance and record keeping obligations. The law does
not contain of checklist of required actions, but rather states generally that election officials must
conduct a general program that makes a reasonable effort to remove the names of ineligible
voters from the official lists of eligible voters by reason of . . . the death of the registrant or a
change in the residence of the registrant. 10 What constitutes a reasonable effort is not
provided by the statute, which has often made litigation necessary to enforce these list
maintenance obligations.
Election officials must also maintain for at least 2 years and make available for public
inspection all records concerning the implementation of programs and activities conducted for
the purpose of ensuring the accuracy and currency of official lists of eligible voters. 11 Like the
NVRAs list maintenance provision, the public inspection provision suffers from ambiguity,
allowing election officials to deny access to records based on their unilateral determination that
certain records are outside the scope of the statute. In one such example, the nonprofit
organization Project Vote endured three years of litigation simply to obtain copies of completed
voter registration applications requested from the General Registrar of Norfolk, Virginia
records which the Fourth Circuit Court of Appeals ruled were unmistakably within the scope
of records that election officials must make publicly available for inspection. 12
PILF has filed four separate lawsuits in 2016 alone to force election officials to allow inspection
of their election records. In Virginia, election officials have opposed transparency and many
Virginia counties are not in compliance with federal law regarding our requests and may
yet be sued in federal court to obtain requested records.
The NVRA authorizes the federal Attorney General to enforce the NVRAs mandates, including
the statutes list maintenance and public inspection provisions. 13 However, this grant of authority
has been sparingly used during the Obama years because officials within the enforcing agency
the Department of Justice Civil Rights Divisionare ideologically opposed to enforcing this
federal law. Justice Department officials are aware of corrupted voter rolls, but their politics
prevent them from doing the right thing.

10

52 U.S.C. 20507(a)(4).
11
52 U.S.C. 20507(i).
12
Project Vote / Voting for Am., Inc. v. Long, 682 F.3d 331 (4th Cir. 2012).
13
52 U.S.C. 20510(a).
5

Obstruction Begins in Alexandria


The effort to obscure the number of non-citizens who are registering and voting in Virginia
began in the City of Alexandria.
In January 2016, the election integrity group Virginia Voters Alliance (VVA) contacted
Alexandria General Registrar Anna Leider, notifying her that based on implausible registration
data, her office appeared to be in violation of the NVRAs mandate that she use reasonable
efforts to remove ineligible registrants. The letter additionally requested access to ten
categories of records concerning Ms. Leiders list maintenance programs pursuant to the
NVRAs public inspection provision.
In April 2016, PILF, on behalf of VVA and David Norcross, a private Alexandria citizen, sued
Ms. Leider under the NVRAs private right of action, alleging that her office violated the NVRA
by refusing to provide inspection of election records and for failing to conduct reasonable list
maintenance practices.
After a court hearing where Alexandria said it would make the requested records available, VVA
then proceeded to visit Ms. Leiders office to inspect the citys records.
Among the records uncovered at Ms. Leiders office was a list of registrants who had been
purged from the voter rolls because they were determined to not be U.S. citizens. The list
includes hundreds of non-citizen registrants, all of whom had likely committed felonies by
registering to vote.
When VVA asked to photocopy the list, Ms. Leider refused, contradicting her statements made
to the court. Her refusal, however, was directed by state election officials. Ms. Leiders
attorney later stated that she cannot provide the list because of guidance from the
Virginia Department of Elections. The excuse was that the reason for a registrants
cancellationincluding by reason of non-citizen statusis confidential, and such information
can neither be inspected nor duplicated.
A week later, and over eight months after the initial request was made, Ms. Leider finally
capitulated. Her attorney provided VVA with a list, identifying 70 registrants who had been
removed from Alexandrias registration lists after they were determined to not be U.S.
citizens. These were just the aliens who were caught.
Records showing the removal of ineligible non-citizen registrants are quintessentially records
concerning the implementation of programs and activities conducted for the purpose of ensuring
the accuracy and currency of official lists of eligible voters, 14 records that must be made
available for public inspection under the NVRA. Yet it took months of negotiations and a
federal lawsuit to bring these records to the publics attention.

14

52 U.S.C. 20507(i).
6

Did any of the non-citizens removed from Alexandrias registration lists cast votes? Ms. Leider
wouldnt tell PILF. According to her attorney, that information, too, is confidential and
available only for official use by the Department of Elections and general registrars. As
discussed later in this report, some of these individuals have, in fact, participated in Virginias
elections.

The Virginia Alien Voter Cover-up Goes Statewide


Alexandria is not the only jurisdiction that concealed the commission of felonies committed by
non-citizen voters in Virginia. Upon the discovery of Alexandrias list of purged non-citizen
registrants, PILF utilized the NVRAs public inspection provision to request similar
information from 19 Virginia counties and cities on August 8, 2016. Nearly all of the
counties have failed to comply with their federal obligation to provide transparent list
maintenance records to us.
Requests for a list of non-citizens purged from the voter lists since 2011 were made to the
following Virginia counties and cities:

Arlington
Albemarle
Bedford
Chesterfield
Fairfax City
Fauquier
Frederick
Falls Church
Loudon
Hampton
Hanover
James City
Lancaster
Manassas
Prince William
Roanoke
Stafford
Rappahannock
York

The election officials in charge of these jurisdictions were sometimes responsive, at first. Prince
William County provided a list of 433 non-citizens who had registered to vote in the county,
but were then removed after they were determined to not be U.S. citizens. 15
15

See Exhibit 1. PILF notes that, on page 1, one registrant appears to be listed twice. However,
on page 29, Prince William County lists the Declared Non-Citizen Total at 433 individuals.
7

The only indication that any of these potential felons were brought to attention of law
enforcement is one communication provided by the county, which indicates that the United
States Citizenship and Immigration Services contacted the countys general registrar requesting
the voter registration application of one individualMahruk Hassan Zaidi. 16 The discovery was
accomplished by chance and not a result of the countys own list maintenance. An additional
communication shows that registration material for Ms. Zaidi, and one other individual, were
then forwarded to the attorney for Prince William County. The communication notes that both
individuals voted in the November 2012 General Election.
The United States Attorney in Virginia has done nothing about the felonies committed by
433 aliens registering in Prince William County alone.
Bedford County, a relatively small rural county in Virginia with only about 60,000 individuals
of voting age, also provided a list of 35 non-citizens that had been removed from their voter
rolls. Bedford County also provided copies of notices sent to 54 individuals who indicated on
their DMV applications that they were not citizens. Upon learning that these individuals were not
citizens, the county did not cancel their registrations. Rather, the county sent each individual a
Notice of Intent to Cancel, 17 which informed the applicant that although they indicated they were
not a citizen on their DMV application, their registration would remain active if they simply
signed the notice, affirming they were a citizen. Based on the fact that only 35 non-citizens were
removed between 2011 and the present, we can conclude that 19 individuals who swore under
penalty of perjury to the DMV that they were not U.S. citizens returned the notice, stating they
are a U.S. citizen. Like the initial check box used to register, the affirmation notice is nothing
more than an honor system that easily allows non-citizens to remain registered to vote.
One week after providing the list of purged non-citizens, Barbara Gunter, the general registrar
for Bedford County, contacted PILF by phone. The Virginia Department of Elections had since
contacted Ms. Gunter and told her that she should not have provided us with the list because
doing so violates federal lawthe Federal Drivers Privacy Protection Act. She asked that PILF
delete the list. Obviously we did not delete the list, and as we shall see, providing the records to
the public obviously does not violate the federal law the Virginia Department of Elections used
to strong-arm local election officials into noncompliance.
We received no records showing
that election officials had
referred any non-citizen voters
for investigation or prosecution.

Roanoke County acted similarly. After providing a list


of 22 alien registrants, General Registrar Judith Stokes
emailed PILF, asking that we destroy the list she had
previously provided. 18 Like Bedford County, Ms. Stokes
explained that her request originated with the
Department of Elections.

16

See Exhibit 2.
An example of this notice is provided in Exhibit 3.
18
The email is reproduced in its entirety at Exhibit 4 to this report.
17

This is where production of records required to be released effectively stopped. Over the course
of August and September 2016, responses from election officials rolled in, each one explaining
that state election officials had instructed them not to provide lists of non-citizens who had
been removed from Virginias voter rolls.
The responses were nearly identical and soon it became clear that
they were orchestrated by Edgardo Cortes, the Commissioner of
the Virginia Department of Elections, and an appointee of
Governor McAuliffe. According to numerous county election
officials, Commissioner Cortes had issued guidance to them,
instructing them not to respond to our requests for records
pertaining to non-citizen voters. Some election officials kindly
provided us the original communications from Cortes.
The guidance from Commissioner Cortes included these
instructions: 19

This is what a cover-up of alien voting looks like. State election officials are preventing public
access not only to records showing the number of non-citizens who have successfully registered
to vote, but also records showing how many of them voted prior to being removed from the
registration rolls.

19

The email is reproduced in its entirety at Exhibit 5 to this report.


9

Commissioner Cortes guidance was distributed statewide on August 19, 2016. Yet not until
September 16 did Commissioner Cortes contact PILF. In his correspondence, Commissioner
Cortes offered to provide a customized report at a cost of $240, 20 a report that he claimed
would satisfy our request concerning non-citizens. It wouldnt.
Commission Cortes refused to provide a list of non-citizens who have been purged from the
registration list in each jurisdiction. He likewise refused to provide the voting history of
purged non-citizens, reiterating his position that such information is not subject to release under
the NVRAs public inspection provision, but is available only to qualified entities under
limited circumstances. 21

The Virginia State Board of Elections Excuses to Hide the


Scope of Alien Registration
The Drivers Privacy Protect Act
According to the guidance issued to county election officials, Commissioner Cortes states that a
list of registrants purged from Virginias registration lists cannot be provided to the public
because such information is protected from release by the federal Drivers Privacy Protection
Act (DPPA). This is nonsense.
The DPPA makes it unlawful for any person knowingly to obtain or disclose personal
information, from a motor vehicle record, for any use not permitted by one of fourteen
exceptions to the prohibition on disclosure. 22 According to Commissioner Cortes, neither general
registrars nor the Department of Elections can disclose a list of registrations cancelled by
election officials because, according to him, a registrants citizenship status, as indicated on his
drivers license application, is personal information. Commissioner Cortes is plainly wrong for
numerous reasons.
PILF seeks list maintenance records from election officials, not from any other state agency. The
DPPA prohibits only the disclosure of personal information from a motor vehicle record. 23
Motor vehicle record is defined by the law; it includes any record that pertains to a motor
vehicle operators permit, motor vehicle title, motor vehicle registration, or identification card
issued by a department of motor vehicles. 24 Neither the registrants citizenship status nor the
reason for the registrants cancelation is personal information under the DPPA.
20

This cost was later waived after we informed Commissioner Cortes that the NVRA permits
election officials to charge reasonable costs for photocopying only. 52 U.S.C. 20507(i)(1).
It does not permit election officials to impose costs for time spent producing records.
21
The email is reproduced in its entirety at Exhibit 6 to this report.
22
18 U.S.C. 2722(a).
23
18 U.S.C. 2722(a).
24
18 U.S.C. 2722(a).
10

The DPPA prohibits the disclosure of only personal information and highly restricted personal
information. 25 Personal information is defined by the law; it includes information that
identifies an individual, including an individuals photograph, social security number, driver
identification number, name, address (but not the 5-digit zip code), telephone number, and
medical or disability information. 26 Highly restricted personal information is an individuals
photograph or image, social security number, medical or disability information. 27
List maintenance records pertaining to the removal of aliens from the rolls has nothing to do with
a motor vehicle record or any protected personal information or highly restricted personal
information.
Voter History
Commission Cortes guidance directed local election officials to conceal records showing the
voting history of any individual whose registration was cancelled for reasons of citizenship.
According to Commissioner Cortes, documents concerning voting activity are not covered under
the NVRAs public inspection provision and can only be disclosed publicly as permitted by
Commonwealth law, which permits disclosure, at a reasonable cost, only to a list of qualified
entities. 28
In the end, the State Board could not conceal the extent of alien voting because PILF and VVA
worked with a third party with access to voter history to determine which of the aliens who
registered to vote, actually voted. Not surprisingly, many ballots were cast by these aliens.

The Extent of the Non-citizen Registration in Virginia


Despite the cover-up orchestrated by state election officials, PILF was successful in procuring
additional data concerning non-citizen voter registration in Virginia. It was, however, not easy.
Federal law says it should be easy, but Virginia has a great deal to hide when it comes to alien
registration and voting.
By way of dozens of phone calls and in-person visits to election offices, we were able to extract
additional information from local registrars concerning non-citizen participation in Virginias
elections. Some officials, however, stood firm, refusing to provide us with the requested
information. The information we have been able to gather thus far demonstrates what many of us
already knew: non-citizens are registering and voting in our elections. The obstructionist
effort led by state election officials has prevented us from learning how much deeper the
problem runs.

25

18 U.S.C. 2722(a).
26
18 U.S.C. 2725(3).
27
18 U.S.C. 2725(4).
28
Va. Code Ann. 24.2-406.
11

Below is the number of registrants per jurisdiction that have been removed from the voter rolls
since, at most, 2011.

Noncitizens On The Rolls in Eight Counties


TOTAL (1046)
Prince William (433)
Loudon (310)
Stafford (128)
Alexandria (70)

Removed Noncitizens

Bedford (35)
Hanover (28)
Roanoke (22)
Fairfax City (20)
0

200

400

600

800

1000

1200

This data is but a minor snapshot of the problem. It represents non-citizen registrants in only 8 of
Virginias 133 voting jurisdictions and includes only those non-citizens that were discovered to
have been improperly registered. Because no formal programs exist in Virginia to identify noncitizen registrants, the discovery and removal of these non-citizens is either by accident or
because the registrant later indicated to election officials that he or she was not a citizen. The
total number of non-citizens that remain registered to vote therefore cannot be completely
ascertained. It is, however, likely, that based on discoveries to date, thousands of non-citizens
remain registered and eligible to vote throughout the Commonwealth.
At the instruction of Commissioner Cortes, local election officials refused to provide us with
records showing the voting history of non-citizens removed from registration lists.
In the 8 jurisdictions that provided us with lists of aliens recently removed from their voter rolls,
we discovered that 31 non-citizens had cast a total of 186 votes between 2005 and 2015.
The most alien votes were cast in 2012 followed by 2008, the year President Obama was
elected to his first term.
The bill would have required the clerk of court to make such information available to local
elections officials so that they could cancel the registration of those individuals deemed
ineligible to vote. The bills purpose was clear: prevent ineligible residents from registering and
voting in Virginias elections. Governor McAuliffe gave essentially no justification for his
veto of this commonsense law, stating only that the issue needed addition study.29

29

http://leg1.state.va.us/cgi-bin/legp504.exe?151+amd+HB1315AG.
12

It may be no accident that Commissioner Cortes had not done all he could when it comes to
transparency about aliens voting in Virginia elections. Before he was picked by Governor
McAuliffe, he worked at the Advancement Project, an organization strongly opposed to using
citizenship verification tools such as the federal SAVE database.
PILFs request to local election officials asked for all communications with federal and state law
enforcement officials pertaining to non-citizens who had either registered to vote or voted.
However, we received no records showing that election officials had referred any noncitizen voters for investigation or prosecution. In fact, some jurisdictions indicated that they
do not even review voter history to identify fraudulent votes. Like our other requests, this
absence of records is due in part to the obstructionist efforts by Commissioner Cortes, whose
guidance to local election officials informed them that communications with law enforcement
officials were not records covered by NVRA and therefore did not need to be provided to PILF.

Systems Failure: The Tradition of Ignoring Alien Voter Fraud in Virginia


The lack of action by the Department of Justice and law enforcement officials in Virginia is
nothing new. In 2011, members of the Fairfax County Electoral Board alerted the Office of the
U.S. Attorney for the Eastern District of Virginia in Alexandria, as well as the Public Integrity
Section of the Criminal Division of the Justice Department (which coordinates election crime
prosecutions) in Washington, of possible voter fraud by non-citizens.

1: Source Virginia State Board of Elections election results website.


The Fairfax County board had discovered 278 registered voters who had represented to the DMV
that they were not U.S. citizens. Almost half of them117had not only registered to vote,
they had in fact voted in state and federal elections. The Department of Justice never followed
up, leaving nearly 300 gift-wrapped cases of voter fraud untouched.
13

Systems Failure: Voter registration forms easily permit non-citizens to register


and participate in our elections.
The lack of prosecution of election crimes provides a key deterrent to voter fraud, if it is used.
But the existing registration process provides non-citizens with an easy path to the ballot box. As
previously explained, the federal voter registration form and the registration forms used by the
Commonwealth of Virginia rely on nothing more than an honor system to limit voter registration
to citizens of this country. In all cases, these forms include a checkbox at the top of the form,
which asks registrants to answer yes or no to the question Are you a citizen of the United
States? The registrant must additionally sign the form, under penalty of perjury, attesting to the
fact that his or her answer to that question is true and correct. There are no other safeguards in
place to protect the integrity of the registration process.
As the data demonstrates, this honor system has undeniably failed to prevent non-citizens from
registering and voting. PILFs investigation requested that county election officials provide us
with copies of voter registration forms used by the non-citizens those election officials later
removed from voter rolls.
Prince William County, which provided a list of 433 non-citizens removed from its voter rolls
since 2011, provided us with those registration forms for non-citizens removed since 2015.
These forms highlight the failures of our current registration process.
Prince William County removed a total of 84 non-citizens from its voter rolls in 2015 and
2016. 30 Of these registrants, 77 checked yes on their registration form, attesting, under
penalty of perjury, that they were U.S. citizens. Without any other confirmation, these
individuals were registered to vote because Virginia is not using the SAVE database to check all
incoming registrations for citizenship status.
However, a yes answer is not necessary to secure registration. Four individuals actually
answered no to the citizenship question but were registered to vote.

One registrant checked neither yes nor no but was still registered to vote. The citizen
checkbox on federal voter registration forms is failing to keep aliens off American voter rolls.

30

The completed registration applications provided to PILF are available at Exhibit 7. The
applications for at least two registrants were not provided by Prince William County.
14

Only two other jurisdictions, Fairfax City and Hanover County, complied with PILFs request to
inspect voter registration application forms of the aliens who were detected. In Fairfax City, 20
non-citizens were removed from the rolls since 2011. Of those individuals who were registered
to vote, 15 answered yes to the citizenship question, 3 answered no, and 2 answered neither
yes nor no. In Hanover, which also provide 20 applications of purged non-citizens, 17
answered yes to the citizenship question, 2 answered no, and 1 answered neither yes nor
no.
The answer to this problem seems simple: require all applicants to provide documentary
proof of citizenship at the time of their registration.
This obviously solution has, however, faced severe opposition by well-funded organizations and
our own Department of Justice. Several states, including Alabama, Kansas, and Georgia have
tried to safeguard their residents right to vote by requiring all individuals to prove their
citizenship prior to registering to vote.
Virginia Governor Terry McAuliffe is also doing his part to make voting by non-citizens even
easier. In April 2015, Governor McAuliffe vetoed legislation 31 that would have required jury
commissioners to retain information from individuals not qualified to serve as jurors for reasons
that would also disqualify them from voting, such as

not being a citizen of the United States


no longer being a resident of the Commonwealth
being a resident of another county or city in the Commonwealth
having been convicted of a felony and having not provided evidence that their right to
vote has been restored, or
having been adjudicated incapacitated.

The bill would have required the clerk of court to make such information available to local
elections officials so that they could cancel the registration of those individuals deemed
ineligible to vote. The bills purpose was clear: prevent ineligible residents from registering and
voting in Virginias elections. Governor McAuliffe gave essentially no justification for his veto
of this commonsense law, stating only that the issue needed addition study. 32

31

House Bill 1315, available at http://leg1.state.va.us/cgibin/legp504.exe?151+ful+HB1315ER+pdf.


32
http://leg1.state.va.us/cgi-bin/legp504.exe?151+amd+HB1315AG.
15

It is unlikely that this report, or any amount of evidence demonstrating the rampant election
fraud taking place in Virginia, will convince Governor McAuliffe that additional safeguards to
needed to protect the voting rights of his constituents.

Systems Failure: Inviting Aliens to Stay on the Rolls


In one astonishing example, one non-citizen was invited to remain on the voter rolls even
after he had informed election officials he was an alien. When William Leslie Gray registered
to vote in 2007, he checked yes in response to the applications citizenship question. In 2010,
Mr. Gray renewed his drivers license and on his application, he checked no to the citizenship
question. The inconsistencies in Mr. Grays answers alerted election officials that he might not
be eligible to vote. His registration, however, was not canceled. Instead, Mr. Gray was mailed an
Affirmation of Citizenship, which asked Mr. Gray to affirm, subject to penalty of law, that he
was a U.S. citizen. Mr. Gray signed the form and returned it. In May 2015, Mr. Grays voter
registration was cancelled after election officials determined that he was, in fact, not a U.S.
citizen. 33
What can be done?
There are several changes that states and the federal government can and should make to prevent
non-citizens from registering and voting illegally in state and federal elections:

33

The registration process must be changed. The check-box honor system is a failure and is
facilitating voter fraud. All states should require anyone who registers to vote to provide
documentary proof of U.S. citizenship. In the alternative, states should fully utilize the
federal SAVE database which contains the names of aliens who have had contact with the
immigration system.

Congress and state legislatures should require all federal and state courts to notify local
election officials when individuals summoned for jury duty from voter registration rolls
are excused because they are not United States citizens.

State legislatures or state elections officials should enact requirements that force local
election officials to conduct a systematic review of the voter history of all registrants who
were purged from the rolls due to not meeting the requirements of U.S. citizenship.

The database, known as E-Verify, that is being used by U.S. employers to check the
citizenship status of prospective employees should be made available to election officials
and administrators of statewide registration databases so that election officials can easily
identify registered voters who are not U.S. citizens.

Law enforcement at both the federal and state level should exercise their authority to
prosecute cases of voter fraud. Voter registration and voting history records such as those
contained in this report makes prosecution an easy task. Armed with that information,

Mr. Grays registration applications are available at Exhibit 8.


16

prosecutors would simply have to verify whether or not the individual was a citizen at the
time of registration or voting.
Conclusion
The problem is real and the solutions are simple. What is happening in Virginia is happening in
every other state. Your vote is at risk and elected officials must act. You can help. Please contact
your local election officials to ask what they are doing to ensure voter lists are accurate and free
of ineligible voters.

17

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

Declared Non-Citizen
January 2011
PCT

Name
Address

0304

DEIBERT, PHILLIP L.

Registration ID

Cancel
Date

126359207

1/25/2011

Declared NonCitizen

919030525

1/25/2011

Declared NonCitizen

586354707

1/25/2011

Declared NonCitizen

246676112

1/25/2011

Declared NonCitizen

920162839

1/25/2011

Declared NonCitizen

624142784

1/4/2011

Declared NonCitizen

744895902

1/25/2011

Declared NonCitizen

416996211

1/25/2011

Declared NonCitizen

920122794

1/25/2011

Declared NonCitizen

731384574

1/26/2011

Declared NonCitizen

731384574

1/26/2011

Declared NonCitizen

917114572

1/25/2011

Declared NonCitizen

919727204

1/25/2011

Declared NonCitizen

919066776

1/28/2011

Declared NonCit(zen

11173 Timmerman St- Quantico, VA 22134-4224

0304

JOBES, JENNIFER R.
2921A Qtrs Mccdc- QUANTICO, VA 22134

0407

beavers, danielle f.
8054 Portwood Turn- Manassas, VA 20109-8120

0409

ANKRAH, IVY
10642 Blendia Ln Apt 0- Manassas, VA 20109-3479

0409

GARDELLA, VELlA S.
10920 Pope St- Manassas, VA 201098253

0412

MORRIS, CHRISTOPHER S.
6660 Hunting Path Rd- Haymarket, VA 20169-2932

0502

RODNEY, BRIAN A.
1670 Devil Ln- Woodbridge, VA 22192-2830

0602

TRAN, HAlT.
15119 Colder Ln- Woodbridge, VA 22193-1620

0603

ROMERO, WALTER R.
4521 Edinburg Dr- Woodbridge, VA 22193-2616

0605

CHAVEZ, EDGARDO A.
14084 Geraldine Ct- Woodbridge, VA 22193-2400

0605

CHAVEZ, EDGARDO A.
14084 Geraldine Ct- Woodbridge, VA 22193-2400

0706

COLSTON, MITCHELL

0707

GUEVARA, DELIS A.

16504 Boatswain Cir- Woodbridge, VA 22191-3073

13215 Alison St- Woodbridge, VA 22191-1618

0708

DENT, LESLEY J.
1712 Cherry Hill Rd- Dumfries, VA 22026-2935

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 1 of 29

Exhibit 1, page 1 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

February 2011
PCT

Name
Address

0105

FARIA, DULCE D.

Registration ID

Cancel
Date

2/28/2011

Declared NonCitizen

919641969

2/28/2011

Declared NonCitizen

917117205

2/28/2011

Declared NonCitizen

919731965

2/28/2011

Declared NonCitizen

920241170

2/28/2011

Declared NonCitizen

920323122

2/28/2011

Declared NonCitizen

059088157

2/28/2011

Declared NonCitizen

919740335

2/28/2011

Declared NonCitizen

917094751

2/28/2011

Declared NonCitizen

721788390

2/28/2011

Declared NonCitizen

8211 SpruceSt- Manassas, VA 20111-2217

0108

PALMER, ANGELA R.
9901 Gardenia Ln Apt 102- Manassas, VA 20109-5401

0206

KARGBO, ALIKALI
13145 Thrift Ln- Woodbridge, VA 22193-6102

0301

RICHARDSON, JAMES C. Jr.


3800 Port Hope Pt- Triangle, VA 22172

0405

GALO MARTINEZ, INGRIS Y.


9697 Copeland Dr- Manassas, VA 20109-3224

0407

CARRILLO RODRIGUEZ, JAQUELINE D.


9717 Lomond Dr- Manassas, VA 20109-3104

0411

FRIEDRICH, ALEXANDRA
8061 Juliet Ln Apt 204- Manassas, VA 20109-7877

0502

MEACHEM, AARON P.

0609

AMIR, GHAZAL F.

12833 Tumbling Brk LN- Woodbridge, VA 22192

16146 Eagle Beak Cir- Woodbridge, VA 22191-6066

0703

bonilla, elsy n.

Cancel Type

919991605

13593 Lynn St- Woodbridge, VA 22191-2121

March 2011
PCT

Name
Address

0407

TOBAR, WILLIAM A.

Registration ID

919049346

Cancel
Date

3/17/2011

8326 Highland St- Manassas, VA 20110-3671

Cancel Type
Declared NonCitizen

April 2011
PCT

Name
Address

0103

GUTKIN, MARTIN L.

Registration ID

Cancel
Date

920198363

4/4/2011

Declared NonCitizen

817550563

4/4/2011

Declared NonCitizen

917601962

4/4/2011

Declared NonCitizen

7734 Knightshayes Dr- Manassas, VA 20111-2991

0105

DELGADO, ISAAC
7531 Tendring Trl- Manassas, VA 20111-1781

0109

RIVAS, BLANCA L.
8843 Clinton Dr- Nokesville, VA 20181-3204

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 2 of 29

Exhibit 1, page 2 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS

Precinct: ALL

Cancellation Declared Non-Citizen


153 PRINCE WILLIAM COUNTY

0201

PEREIRA, DAISY M.

920097938

4/4/2011

Declared NonCitizen

917939009

4/4/2011

Declared NonCitizen

260597014

4/4/2011

Declared NonCitizen

093889092

4/4/2011

Declared NonCitizen

917965805

4/4/2011

Declared NonCitizen

271463029

4/4/2011

Declared NonCitizen

920168714

4/4/2011

Declared NonCitizen

558681760

4/4/2011

Declared NonCitizen

519239811

4/4/2011

Declared NonCitizen

602014024

4/4/2011

Declared NonCitizen

583168430

4/4/2011

Declared NonCitizen

Registration ID

Cancel
Date

13209 Orkin Ln- Woodbridge, VA 22193-7003

0203

UNDERWOOD, RALPH E.
13987 Napa Dr- Manassas, VA 20112-3821

0302

lee, alexander f.

0307

WIMBERLY, GLENDERINE

16828 Francis West Ln - Dumfries, VA 22026-2110

3349 Esquarre Ct- Woodbridge, VA 22193-1059

0405

AWAN, NAZIR
9522 Covington PI- Manassas, VA 20109-3328

0602

dennis, ross o.
3809 Claremont Ln- Woodbridge, VA 22193-1633

0607

MORALES IRAHETA, BILMA


12910 Ketterman Dr- Woodbridge, VA 22193-5024

0701

Campbell, Peter A.
13339 Colchester Ferry PI- Woodbridge, VA 22191-1224

0703

PECK, AMANDA L.
1870 Gableridge Tum Apt 102- Woodbridge, VA 22191-1981

0704

WONPAT, RICHARD I.
1435 California St- Woodbridge, VA 22191-3501

0706

GRINNER, JAMES M.
2608 Cast Off Loop- Woodbridge, VA 22191-1469

May 2011
PCT

0106

Name
Address
GODENI, LIND

392718844

5/20/2011

Declared NonCitizen

919633215

5/20/2011

Declared NonCitizen

476622522

5/20/2011

Declared NonCitizen

920404346

5/20/2011

Declared NonCitizen

919049722

5/20/2011

Declared NonCitizen

917548131

5/2/2011

Declared NonCitizen

8223 Wycliffe Ct- Manassas, VA 20109-3409

0110

THROPP, AMY J.
15851 Spyglass Hill Loop- Gainesville, VA 20155-3202

0112

CHONGMEECHAI, UTHAI
10033 Naughton Ct- Bristow, VA 20136-3071

0113

SHAHZAD,REHANA
14340 Grackle Ct- Gainesville, VA 20155-5872

0201

CAVERO, ANGEL R.
5708 Ridgedale Dr- Woodbridge, VA 22193-3862

0302

RODRIGUEZ, MARTIN
16870 Francis West Ln- Dumfries, VA 22026-2106

Generated on 08/ 16/2016 09:49:44 AM

Cancel Type

Page 3 of 29

Exhibit 1, page 3 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

0304

YOUNG, BETH M.

920136835

5/20/2011

Declared NonCitizen

594195091

5/2/2011

Declared NonCitizen

918285979

5/2/2011

Declared NonCitizen

221045676

5/20/2011

Declared NonCitizen

607014164

5/20/2011

Declared NonCitizen

940393097

5/20/2011

Declared NonCitizen

918384885

5/20/2011

Declared NonCitizen

917560593

5/2/2011

Declared NonCitizen

006693595

5/20/2011

Declared NonCitizen

919387290

5/2/2011

Declared NonCitizen

359730494

5/2/2011

Declared NonCitizen

773610920

5/20/2011

Declared NonCitizen

589008897

5/20/2011

Declared NonCitizen

917581343

5/20/2011

Declared NonCitizen

919222967

5/20/2011

Declared NonCitizen

918657849

5/3/2011

Declared NonCitizen

919350437

5/2/2011

Declared NonCitizen

246127531

5/2/2011

Declared NonCitizen

830 QTRS MCCDC- QUANTICO, VA 22134

0407

KLEIN, KELLY S.
8079 Portwood Tum- Manassas, VA 20109-8119

0411

GONZALEZ, DAVID C. Jr.


11053 Camfield CtApt 102- Manassas, VA 20109-7505

0412

tadakara, slnduri d.
6908 Witton Cir- Gainesville, VA 20155-4422

0412

THORNTON, AUDREY I.
7025 Sauvage Ln- Gainesville, VA 20155-1673

0501

SLEDGE, PAMELA A.
3190 Narrow Glen Way- Woodbridge, VA 22192-1409

0502

PENA, JUANA D.
1806 Rochelle Ct- Woodbridge, VA 22192-5626

0508

JOHNSON, UNIQUE N.
12142 Salemtown Dr- Woodbridge, VA 22192-6272

0605

BARAHONA, JOSE 0.
4133 Granby Rd- Woodbridge, VA 22193-2509

0609

ACHEAMPONG, AKUA A.
15784 Silent Tree PI - Woodbridge, VA 22191-4279

0701

castillo, marco a.
908 Hopton Rd- Woodbridge, VA 22191-1312

0702

CHAVEZ PORTILLO, JOSE A.


2029 Cumberland Dr- Woodbridge, VA 22191-2552

0703

CANALES FUNES, DOUXSY G.


13565 Lynn St- Woodbridge, VA 22191-2121

0703

NHE, BUN P.
1536 Maurice Dr- Woodbridge, VA 22191-1948

0704

GRANADOS, BLASINA
1431 California St- Woodbridge, VA 22191 -3501

0704

HILAIRE, GILBERT Jr.


14778 Arkansas St- Woodbridge, VA 22191-3506

0704

ROMERO, FLOR D.
2024 Horizon Ct Apt 103- Woodbridge, VA 22191-3937

0708

RUGGIERO, NICHOLAS C.
2925 Wythe Ct- Woodbridge, VA 22191-4637

Generated on 08/16/2016 09:49:44 AM

Page 4 of 29

Exhibit 1, page 4 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

June 2011
PCT

Name
Address

0108

DENNIS, LATOYA N.

Registration ID

Cancel
Date

918378228

6/22/2011

Declared NonCitizen

918450094

6/22/2011

Declared NonCitizen

917857293

6/22/2011

Declared NonCitizen

919711109

6/22/2011

Declared NonCitizen

077132306

6/22/2011

Declared NonCitizen

917951698

6/22/2011

Declared NonCitizen

919946765

6/22/2011

Declared NonCitizen

917065014

6/22/2011

Declared NonCitizen

829448092

6/22/2011

Declared NonCitizen

918789286

6/22/2011

Declared NonCitizen

918219292

6/22/2011

Declared NonCitizen

103031429

6/22/2011

Declared NonCitizen

919814419

6/22/2011

Declared NonCitizen

255849632

6/22/2011

Declared NonCitizen

12538 Haltwhistle Ct- Bristow, VA 20136-1147

0108

WILSON, SHAWN M.
9910 Gardenia Ln Apt 201- Manassas, VA 20109-5412

0204

MCCONNAUGHEY, CHRISTIANE P.
11769 Nates PI- Woodbridge, VA 22192-7410

0209

HULL, EMMA N.
11913 Millpond Ct- Manassas, VA 20112-3285

0210

kopeck, ashlea m.
12564 Clawson Ln- Manassas, VA 20112-3477

0301

MABRY, DERRICK G.
3797 Port Hope Pt- Triangle, VA 22172

0304

TURAY, SAMUEL C.
19322 Belleau Wood Dr Apt T2- Triangle, VA 22172-2304

0306

BENNETT, THOMAS
16213 Cypress Ct- Dumfries, VA 22025-1748

0310

NEDD, LEON E.
4320 Golden Gate Way- Dumfries, VA 22025-2025

0501

WEAVER, KOLLINE E.
12148 Beaverwood PI- Woodbridge, VA 22192-1403

0603

KWANTRENG, Nil A.
14489 Watson LN UNIT 9- Woodbridge, VA 22193-2939

0604

BRAXTON, MARK A.
13911 Hedgewood Dr Apt 116- Woodbridge, VA 22193-7910

0707

URQUIA, JHONY R.
1700 Varsity Dr- Woodbridge, VA 22191-1826

0708

GRIMES, DELISA M.

Cancel Type

2808 Woodmark Dr Apt 304- Woodbridge, VA 22191-4731

July 2011
PCT

Name
Address

0107

LEE, ALLEN
9672 Laurencekirk PI- Bristow, VA 20136-2712

Generated on 08/16/2016 09:49:44 AM

Registration ID

298931275

Cancel
Date

7/21/2011

Cancel Type
Declared NonCitizen

Page 5 of 29

Exhibit 1, page 5 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

0110

ARORA, SANDHYA

920346796

7/21/2011

Declared NonCitizen

520702499

7/21/2011

Declared NonCitizen

909014427

7/21/2011

Declared NonCitizen

609012403

7/21/2011

Declared NonCitizen

920219688

7/21/2011

Declared NonCitizen

104086440

7/21/2011

Declared NonCitizen

150309931

7/21/2011

Declared NonCitizen

874511165

7/21/2011

Declared NonCitizen

303003670

7/21/2011

Declared NonCitizen

15145 Gaffney Cir- Gainesville, VA 20155-4892

0402

potter, stephanie j.
4222 Benvenue Rd- Haymarket, VA 20169-2444

0409

LONIGRO, NICK A. Jr.


8046 Sudley Rd- Manassas, VA 20109-3401

0501

ROACH, JOHN 0. II
3517 Mount Burnside Way- Woodbridge, VA 22192-1015

0606

AGUILAR CARDENAS, RAMON A.


14822 Danville Rd- Woodbridge, VA 22193-1927

0607

PINEDA, JOSE H.
4416 Hamilton Dr- Woodbridge, VA 22193-5207

0608

roy, mohadeb
5679 Northton Ct- Woodbridge, VA 22193-6906

0701

WATKINS, VANESSA C.

0705

MADISON, ANGELINA M.

14101 Bay Vista Dr Apt 302- Woodbridge, VA 22191-4819

1121 Marseille Ln- Woodbridge, VA 22191-3245

September 2011
PCT

Name
Address

0205

CUELLAR TORRES, ALEX A.

Registration ID

003168997

Cancel
Date

9/30/2011

8141 Hillcrest Dr- Manassas, VA 20111-2821

Cancel Type
Declared NonCitizen

October 2011
PCT

Name
Address

0104

HANSON, LORNE N.

Registration ID

Cancel
Date

073946632

10/11/2011

Declared NonCitizen

918809218

10/11/2011

Declared NonCitizen

918848003

10/11/2011

Declared NonCitizen

919727538

10/11/2011

Declared NonCitizen

918311092

10/11/2011

Declared NonCitizen

10452 Lonesome Rd- Nokesville, VA 20181-1532

0104

HOOSIER, CYNTHIA M.
10709 Lonesome Rd- Nokesville, VA 20181-1525

0104

KLOTZ, NATHAN J.
11705 Nokes St- Nokesville, VA 20181-2223

0111

KAMARA, MARGARET
8941 Benchmark Ln- Bristow, VA 20136-5777

0203

FRANKENBERY, LEE R. Ill


11774 Mente Rd- Manassas, VA 20112-5322

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 6 of 29

Exhibit 1, page 6 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

0204

WALLS, ELIZABETH R.

603006739

10/11/2011

Declared NonCitizen

018535668

10/11/2011

Declared NonCitizen

919218348

10/11/2011

9423 Blackstone Rd- Manassas, VA 20110-3637

0212

BROWN, ANTHONY S.
8307 Leighlex Ct- Manassas, VA 20111 -5267

0301

ARIZAGA, CARMEN R.

0302

GRAVES, MAGDALENA E.

613013769

10/11/2011

JENSEN, RICHARD A.

920092567

10/11/2011

RAGLAND, JOVAN 0.

918749004

10/11/2011

valverde, nelly r.

960020863

10/11/2011

HAJDINI, FATMIRE

920164897

10/11/2011

haynes, amy g.

005205079

10/11/2011

MENDOZA, MARCO E.

111654047

10/11/2011

MANZANO, MARIA E.

918503836

10/11/2011

TURBERVILLE, BRYANT J.

919341160

10/11/2011

GOMEZ, ANA E.

Declared Non-

Citizen

14480 Duran Dr- Woodbridge, VA 22193-2711

0702

Declared Non-

Citizen

13223 Kephart Ln- Woodbridge, VA 22193-4912

0606

Declared Non-

Citizen

3476 Beale Ct- Woodbridge, VA 22193-1702

0602

Declared Non-

Citizen

12763 Wood Hollow Dr Apt 1211 - Woodbridge, VA 22192-6533

0601

Declared Non-

Citizen

3834 Ogilvie Ct- Woodbridge, VA 22192-5026

0512

Declared Non-

Citizen

12498 Skipper Cir - Woodbridge, VA 22192-2350

0508

Declared Non-

Citizen

11986 Coverstone Hill Cir Apt 1114- Manassas, VA 20109-7524

0504

Declared Non-

Citizen

15734 Edgewood Dr- Dumfries, VA 22025-1730

0411

Declared Non-

Citizen

3120 Eagle Ridge Dr- Woodbridge, VA 22191-6521

0306

Declared Non-

Citizen

17915 Milroy Dr - Dumfries, VA 22026-2628

919945146

10/11/2011

Declared Non-

Citizen

2362 W Longview Dr- Woodbridge, VA 22191-2440

November 2011
PCT

Name
Address

0304

MILERSON, MARIA

0607

DUNN, ROBERT P. Jr.

Registration ID

Cancel
Date

11/21/2011

Declared NonCitizen

919738649

11/9/2011

Declared NonCitizen

19321 Belleau Wood Dr Apt T3 - Triangle, VA 22172-2303

4866 Muscogee Ln- Woodbridge, VA 22192-5349

Generated on 08/16/2016 09:49:44 AM

Cancel Type

920016431

Page 7 of 29

Exhibit 1, page 7 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

December 2011
PCT

0108

Name
Address
KHAN, ABDUL R.

Registration ID

Cancel
Date

919332126

12/20/2011

Declared NonCitizen

629384270

12/20/2011

Declared NonCitizen

534295462

12/20/2011

Declared NonCitizen

822595292

12/20/2011

Declared NonCitizen

917697342

12/20/2011

Declared NonCitizen

919242781

12/20/2011

Declared NonCitizen

918770493

12/20/2011

Declared NonCitizen

639700203

12/20/2011

Declared NonCitizen

920226633

12/20/2011

Declared NonCitizen

750574891

12/20/2011

Declared NonCitizen

803197575

12/20/2011

Declared NonCitizen

918118392

12/20/2011

Declared NonCitizen

9205 Campfire Ct- Bristow, VA 20136-5103

0204

BORDEN, JAMES G. Jr.


10123 Woodbury Dr Apt 305- Manassas, VA 20109-3782

0204

CONTRERAS OROZCO, BARBARA A.


10682 Meadow Grove CT- Manassas, VA 20109

0211

MARTINEZ BLASCO, LAURA E.


9121 Mulder Ct- Manassas, VA 20111-8267

0212

NGUYEN, THANG D.
7704 Well St- Manassas, VA 20111-1902

0212

PHAN, DIEU H.
8017 Old Centreville Rd- Manassas, VA 20111-2118

0301

BRAZA, ANAL YN B.
2432 Kilpatrick PI - Dumfries, VA 22026-2559

0301

GREEN, ROSIE D.
17953 Milroy Dr- Dumfries, VA 22026-2630

0302

TAWIAH, LAURENCIA 0.
16949 Toms River Loop- Dumfries, VA 22026-2179

0408

GUZMAN MONTANO, PAULO


9513 Dublin Dr- Manassas, VA 20109-3316

0411

PARK, DAVID K.
10971 Wild Ginger Cir Apt 302- Manassas, VA 20109-8289

0709

BERNUY, JOHNNY

Cancel Type

14757 Winding LOOP- Woodbridge, VA 22191

January 2012
PCT

Name
Address

0102

ROMERO, SAMUEL E.

Registration ID

Cancel
Date

917294494

1/5/2012

Declared NonCitizen

302025726

1/5/2012

Declared NonCitizen

261910865

1/30/2012

Declared NonCitizen

12563 Moray Firth Way- Bristow, VA 20136

0105

NICHOLS, RICHARD D.
8486 Tackhouse Loop- Gainesville, VA 20155-2906

0110

diaz colon, jessenia


7505 Godfrey St Apt 102- Gainesville, VA 20155-4803

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 8 of 29

Exhibit 1, page 8 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153- PRINCE WILLIAM COUNTY

0110

MOORE, RICHARD A.

919983836

1/5/2012

Declared NonCitizen

214733284

1/30/2012

Declared NonCitizen

917885217

1/5/2012

Declared NonCitizen

444387434

1/5/2012

Declared NonCitizen

390655703

1/30/2012

Declared NonCitizen

920131744

1/30/2012

Declared NonCitizen

917541774

1/5/2012

Declared NonCitizen

918388103

1/5/2012

Declared NonCitizen

757023365

1/5/2012

Declared NonCitizen

920404376

1/5/2012

Declared NonCitizen

650669323

1/5/2012

Declared NonCitizen

588798592

1/30/2012

Declared NonCitizen

918219304

1/30/2012

Declared NonCitizen

879409011

1/5/2012

Declared NonCitizen

565236105

1/5/2012

Declared NonCitizen

352016261

1/30/2012

Declared NonCitizen

087801806

1/5/2012

Declared NonCitizen

688340637

1/5/2012

Declared NonCitizen

7503 Equinox Landing Ct # 203- Gainesville, VA 20155-1888

0201

FAULKNER, LEANARD C.
14254 Silverdale Dr - Woodbridge, VA 22193-3415

0212

DELANEY, ANGELA M.
8002 Well St- Manassas, VA 20111-2102

0212

OLIVA SALGADO, BLANCA E.


8587 Cold Harbor Loop- Manassas, VA 20111-2178

0301

JACKSON, VICTORIA M.
2936 Buell Ct- Dumfries, VA 22026-2527

0307

MCMILLON, RONALD D.
3468 Lacrosse Ct- Woodbridge, VA 22193-1050

0308

SORENSEN, BIRTHE E.
5263 Spring Branch Blvd- Dumfries, VA 22025-3090

0411

BUCHANAN, NICHOLE E.
8061 Juliet Ln Apt 103- Manassas, VA 20109-7877

0411

MOODY, VAHN R.
8041 Juliet Ln Apt 103- Manassas, VA 20109

0502

DELWAR, MD S.
12745 Lighthouse Ln- Woodbridge, VA 22192-2625

0505

YONAS, MELATE W.
11576 Hill Meade Ln- Woodbridge, VA 22192-1158

0506

CLEMENT, MARGARET A.
3480 Brookville Ln- Woodbridge, VA 22192-4364

0512

AMBRIZ, RAMIRO
12920 Occoquan RD UNIT 10- Woodbridge, VA 22192-2838

0602

montague, clay
4717 Korvett Dr- Woodbridge, VA 22193-4615

0604

BOATENG, EMMANUEL K. Jr.

0605

VANN, CHRISTOPHER C.

14623 Aurora Dr- Woodbridge, VA 22193-1231

13564 Castlebridge Ln- Woodbridge, VA 22193-5170

0608

ROY, DURGA R.
5679 Northton Ct- Woodbridge, VA 22193-6906

0703

VASASIRI, PASIT
13760 Keelingwood Cir Apt 102- Woodbridge, VA 22191-2491

Generated on 08/16/2016 09:49:44 AM

Page 9 of 29

Exhibit 1, page 9 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

0704

YAKOUB, SAID S.

918044197

1/5/2012

15762 Silent Tree PL- Woodbridge, VA 22191

Declared NonCitizen

April 2012
PCT

Name
Address

0307

LEON, NURIA K.

0307

OTTERBLAD, RYAN M.

Registration ID

Cancel
Date

065949692

4/6/2012

Declared NonCitizen

920092653

4/6/2012

Declared NonCitizen

919211451

4/6/2012

Declared NonCitizen

920031683

4/6/2012

Declared NonCitizen

848260911

4/6/2012

Declared NonCitizen

919865415

4/6/2012

Declared NonCitizen

674301765

4/6/2012

Declared NonCitizen

139035157

4/6/2012

Declared NonCitizen

917648056

4/6/2012

Declared NonCitizen

Registration ID

Cancel
Date

3729 Hetten Ln- Woodbridge, VA 22193-1048

3797 Benson Ct- Dumfries, VA 22025-1821

0311

ABDI, MOHAMUD A.
17260 Wexford Loop- Dumfries, VA 22026-3355

0403

SMARR, WILLIAM H.
6493 Ashby Grove Loop- Haymarket, VA 20169-3211

0603

BOOZER, YOLANDA R.
4316 Eileen Ct- Woodbridge, VA 22193-2633

0603

SELBY, ROBERT L.
4390 Whitmer Dr Apt 13- Woodbridge, VA 22193-2937

0605

LOWE, KRYSTAL A.
14005 Golden Ct- Woodbridge, VA 22193-2435

0701

knapp, michael c.
1314 Bayside Ave Apt 12- Woodbridge, VA 22191-2326

0702

HASNAIN, JUSTINA L.

Cancel Type

14208 Franklin St- Woodbridge, VA 22191-2555

May 2012
PCT

0108

Name
Address
BROOKS, TAMARA D.

918848526

5/9/2012

Declared NonCitizen

919458773

5/9/2012

Declared NonCitizen

507665632

5/9/2012

Declared NonCitizen

920090230

5/9/2012

Declared NonCitizen

001142836

5/9/2012

Declared NonCitizen

9541 Linton Hall Rd # B2- Bristow, VA 20136-1217

0108

CINNAMOND, SCOTT
9062 Zion Park CT- Bristow, VA 20136

0110

GEDDIS-BLOUNT, MORGAN C.
15818 Mackenzie Manor Dr- Haymarket, VA 20169-4924

0110

JUNG, TIMOTHY U.
8385 Pedigrue CT- Gainesville, VA 20155-3240

0201

LEINENBACH, ROGER G.
13491 Photo Dr- Woodbridge, VA 22193-3931

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 10 of 29

Exhibit 1, page 10 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

0204

RIVERA HERNANDEZ, MARIA D.

917975901

5/9/2012

Declared NonCitizen

919268551

5/9/2012

Declared NonCitizen

219847743

5/9/2012

Declared NonCitizen

453781399

5/31/2012

Declared NonCitizen

065938378

5/9/2012

Declared NonCitizen

917314860

5/9/2012

Declared NonCitizen

160438114

5/9/2012

Declared NonCitizen

241532913

5/9/2012

Declared NonCitizen

573998710

5/9/2012

Declared NonCitizen

354697593

5/9/2012

Declared NonCitizen

917935746

5/9/2012

Declared NonCitizen

917979693

5/9/2012

Declared NonCitizen

026702391

5/9/2012

Declared NonCitizen

863429770

5/9/2012

Declared NonCitizen

422290534

5/9/2012

Declared NonCitizen

919557199

5/9/2012

Declared NonCitizen

918093777

5/9/2012

Declared NonCitizen

302013558

5/9/2012

Declared NonCitizen

9436 Victoria St- Manassas, VA 20110-3644

0208

DAVIDSON, DANNY R. Sr.


13446 Carriage Hill Dr- Manassas, VA 20112-3837

0212

KIM, DONG K.
8259 Glade Bank Dr- Manassas, VA 20111-5229

0301

BANAGA, CARLO A.
3869 Fairfax St- Dumfries, VA 22026-2304

0301

sesay, memunatu
17528 Summer Duck Dr- Dumfries, VA 22026-2618

0303

ARNOLD, VERA M.
3375 Dondis Creek Dr- Triangle, VA 22172-2085

0303

OWUSU, AKWASI
4027 Sapling Way - Triangle, VA 22172-2052

0304

RICHARDSON, CAPREE J.
2106 Rowell Rd # 319- Quantico, VA 22134-5174

0308

WHIDBEE, DOMINIQUE L.
4680 Bonneville Ln- Woodbridge, VA 22193-3 131

0310

HILL, LARRY E.
18049 Joplin Rd- Triangle, VA 22172-1629

0403

HERNANDEZ, JOSE 0.
16012 Sheringham Way- Gainesville, VA 20155-4498

0404

khachi, malinda a.
10509 Stonington Ln Apt 18- Manassas, VA 20109-6456

0404

PINEDA ARGUETA, FRANCISCO A.


10473 Butterfield St Apt 34 - Manassas, VA 20109-6815

0405

bull, annemarie m.
10809 Daisy Ct- Manassas, VA 20109-7207

0406

WOOD, STEPHEN M.
15438 Legacy Way- Haymarket, VA 20169-6115

0408

GARCIA, ANA D.
9714 Damascus Dr- Manassas, VA 20109-3242

0508

LOPEZ, LUIS A.
4115 Churchman Way - Woodbridge, VA 22192-5055

0509

GHERARDI, THOMAS G.
6140 Turkey Run Ct- Manassas, VA 20112-3024

Generated on 08/16/2016 09:49 :44 AM

Page 11 of 29

Exhibit 1, page 11 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

0509

LAWRENCE, RHONDA L.

502008377

5/9/2012

Declared NonCitizen

917944745

5/9/2012

Declared NonCitizen

515357306

5/9/2012

Declared NonCitizen

382330936

5/9/2012

Declared NonCitizen

920122372

5/9/2012

Declared NonCitizen

918204786

5/9/2012

Declared NonCitizen

608013493

5/9/2012

Declared NonCitizen

498200683

5/9/2012

Declared NonCitizen

918730720

5/9/2012

Declared NonCitizen

579259786

5/9/2012

Declared NonCitizen

10849 Split Rail Dr- Manassas, VA 20112-3002

0510

INMAN, SHEILA J.
6180 Emerywood Ct - Manassas, VA 20112-3078

0512

SARWAR, BABAR
12850 Tumbling Brook LN - Woodbridge, VA 22192

0604

SANCHEZ, ELSA S.
3592 Forestdale Ave- Woodbridge, VA 22193-2032

0608

WHITAKER, TRANGR
5009 Lynwood Dr- Woodbridge, VA 22193-4309

0701

STURGIS, JEAN E.
1305 Bayside Ave Apt 10- Woodbridge, VA 22191-2353

0701

WAGNER, PAULA K.
13721 Jefferson Davis HWY 89 HOLLY ACRES- Woodbridge, VA 22191 2028

0703

CHAVEZ BERRIOS, ERIKA S.


13661 Cridercrest PI Apt 101- Woodbridge, VA 22191-1989

0703

MERINO, YIMY H.
1612 Frances Dr - Woodbridge, VA 22191-1907

0708

ARAGON, YESENIA A.
2808 Beechtree Ln- Woodbridge, VA 22191-4605

July 2012
PCT

0106

Name
Address
FLORAS, IDES 0.

Registration ID

Cancel
Date

918246807

7/23/2012

Declared NonCitizen

901013974

7/23/2012

Declared NonCitizen

035683799

7/23/2012

Declared NonCitizen

918606304

7/23/2012

Declared NonCitizen

459209630

7/23/2012

Declared NonCitizen

294867301

7/23/2012

Declared NonCitizen

7984 Community Dr - Manassas, VA 20109-3532

0106

THOMAS, PATRICIA A.
8103 Porter Ridge Ln Apt 1- Manassas, VA 20109-8103

0204

GONZALEZ, SAUL H.
9516 Lomond Dr- Manassas, VA 20109-3256

0212

THUNG, KHUONG J.
8001 Towering Oak Way- Manassas, VA 20111-5212

0303

DAVIS, LATOYA L.
18128 Purvis Dr- Triangle, VA 22172-1122

0311

MIRZA, SANA B.
17694 Avenel Ln- Dumfries, VA 22026-4566

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 12 of 29

Exhibit 1, page 12 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation Declared Non-Citizen
153 PRINCE WILLIAM COUNTY

0402

FORMAN, MARIE J.

611010901

7/23/2012

Declared NonCitizen

257009892

7/23/2012

Declared NonCitizen

917250935

7/23/2012

Declared NonCitizen

918242408

7/19/2012

Declared NonCitizen

142646010

7/23/2012

Declared NonCitizen

917017699

7/23/2012

Declared NonCitizen

919168467

7/23/2012

Declared NonCitizen

599444639

7/23/2012

Declared NonCitizen

312801597

7/23/2012

Declared NonCitizen

12011 Bobwhite Dr- Catharpin, VA 20143-1322

0405

DAWSON, JENNIFER L.
10841 Gambril Dr Apt 14- Manassas, VA 20109-6562

0406

THOMAS, JAMES L.
15036 Clementine Way- Haymarket, VA 20169-3318

0505

LEE, KEASHA K.
2779 Bordeaux PI- Woodbridge, VA 22192-1649

0604

alston, stephen I.
2769 Bixby Rd - Woodbridge, VA 22193-1249

0606

WILLIAMS, ROSE M.
14855 Daytona Ct - Woodbridge, VA 22193-1928

0607

VANHORNE, LAKISHA R.
13414 Kerrydale Rd- Woodbridge, VA 22193-5022

0701

CHANDIAS, WILMER J. Jr.


1417 Bayside Ave Apt 9- Woodbridge, VA 22191-2348

0707

MOTA CHAVEZ, CHAGER A.


1606 Hylton Ave- Woodbridge, VA 22191-1607

August 2012
PCT

0106

Name
Address
SOLIMAN, YOUSSEF S.

Registration ID

Cancel
Date

058178037

8/3/2012

Declared NonCitizen

918079884

8/3/2012

Declared NonCitizen

003005706

8/3/2012

Declared NonCitizen

918240022

8/3/2012

Declared NonCitizen

920237539

8/3/2012

Declared NonCitizen

224464838

8/3/2012

Declared NonCitizen

246352686

8/3/2012

Declared NonCitizen

919963988

8/3/2012

Declared NonCitizen

8270 Vernon St - Manassas, VA 20109-3436

0305

CASHWELL, LESLIE F. Jr.


4921 Breeze Way- Dumfries, VA 22025-1254

0307

BUTIGEREIT, DOREEN T.
15525 Golf Club Dr- Dumfries, VA 22025-1114

0307

JACKSON, SHANNON L.
3353 Esquarre Ct- Woodbridge, VA 22193-1026

0401

BENEDETTI, CHRISTOPHER A.
2414 Youngs Dr- Haymarket, VA 20169-1532

0401

ONEILL, DENNIS C.
2526 Little River Rd - Haymarket, VA 20169-1206

0408

CORTES GUZMAN, GREGORIO D.


7373 Roxbury Ave - Manassas, VA 20109-3037

0411

MORALES, DAVID I. Jr.


8090 Juliet Ln Apt 201 -Manassas, VA 20109-7870

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 13 of 29

Exhibit 1, page 13 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153- PRINCE WILLIAM COUNTY

0506

YAAFI, PRISCILLA

063659158

8/3/2012

Declared NonCitizen

278721842

8/3/2012

Declared NonCitizen

323086236

8/3/2012

Declared NonCitizen

918947967

8/3/2012

Declared NonCitizen

918356927

8/3/2012

Declared NonCitizen

223674030

8/3/2012

Declared NonCitizen

3440 Belfry Ln- Woodbridge, VA 22192-4349

0511

GNADT, HARRISON M.
12879 Laurel Hills DR- Woodbridge, VA 22192

0605

REYES, ARTURO
13616 Greenwood Dr- Woodbridge, VA 22193-2523

0703

BAUTISTA, ANA M.
1309 Brice St- Woodbridge, VA 22191-1703

0707

LANHAM, TOMMY D.
1930 Willow Ln- Woodbridge, VA 22191-1848

0708

DOMINGO, RAYMART M.
16454 Steerage Cir- Woodbridge, VA 22191-6023

September 2012
PCT

Name
Address

0110

MOODY, MICHAEL D.

Registration ID

Cancel
Date

9/18/2012

Declared NonCitizen

919704924

9/27/2012

Declared Noncitizen

491068747

9/13/2012

Declared NonCitizen

918603498

9/18/2012

Declared NonCitizen

910014083

9/18/2012

Declared NonCitizen

7340 Yountville Dr Apt 204- Gainesville, VA 20155-3438

0212

PENNINCKX, MAGALI M.
7944 Maplewood Dr- Manassas, VA 20111-1928

0302

RICHARDSON, CHANELL V.
16698 Periscope PI- Dumfries, VA 22026-6804

0307

USMA, GRACIELA
3329 Esquarre Ct- Woodbridge, VA 22193-1059

0407

ERICKSON, MAUREEN H.

Cancel Type

919060070

37a Calle del Espiritu Santo Antigua - Sacatepequez - GUADELOUPE

October 2012
PCT

Name
Address

0405

HUFFMAN, AMY M.

Registration ID

Cancel
Date

10/9/2012

664485475

10/26/2012 Declared Non-

11027 Edgepark Cir Apt 104- Manassas, VA 20109-7723

0406

HAMIDULLAH, ALISHER
MATSHIFI, BENDE J.

920359632

10/16/2012 Declared NonCitizen

3D MLG CLR35 Supply BN SUP.CO UNIT 38422- FPO, AP 96604

0409

HAUBER, RYANNON M.
14928 Southern Crossing St- Haymarket, VA 20169-4908

Generated on 08/16/2016 09:49:44 AM

Declared NonCitizen
Citizen

14912 Simmons Grove Dr- Haymarket, VA 20169-2300

0407

Cancel Type

280089853

995703855

10/9/2012

Declared NonCitizen

Page 14 of 29

Exhibit 1, page 14 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

0501

GOURO, JOEL

920274199

10/9/2012

Declared NonCitizen

166175105

10/9/2012

Declared NonCitizen

483192031

10/9/2012

Declared NonCitizen

917246432

10/10/2012 Declared Non-

11703 Gritton Cir- Woodbridge, VA 22192-1016

0507

KNIGHT, ROHAN A.
3985 Cressida PI- Woodbridge, VA 22192-7632

0602

DARSHAN, AISHWARYA
13057 Quade Ln- Woodbridge, VA 22193-4942

0603

MENDOZA, GARRY L.

Citizen

4593 Perch Branch Way- Woodbridge, VA 22193-1898

0609

ARSHAD, ALIYA

760369835

10/9/2012

918053593

10/30/2012 Declared Non-

12982 Terminal Way- Woodbridge, VA 22193-6121

0609

POULSON, MARIANNE A.

Citizen

5559 Neddleton Ave- Woodbridge, VA 22193-4155

0701

MEJIA, MAURICIO

0701

PREMPEH, HENRIETTA A.

919611688

10/9/2012

Declared NonCitizen

920104501

10/9/2012

Declared NonCitizen

653388162

10/9/2012

Declared NonCitizen

14113 Cove Landing Dr Apt 104- Woodbridge, VA 22191 -2268

1421 Bayside Ave Apt 9- Woodbridge, VA 22191-2350

0709

SIMS, JASON R.

Declared NonCitizen

15125 Beacon Ridge Dr Apt 106 - Woodbridge, VA 22191-4943

November 2012
PCT

Name
Address

0103

LEE, PATRICIA P.

Registration ID

942280716

KAZZI, MARK A.

117543778

BANKS, CHRISTOPHER L.

917619211

WILLIS, DANIEL A. Jr.

434160809

SANABRIA, KARLA D.

028809545

BURKS, TONY B.

918282032

IBRAHIM, OMAR F.

920117569

AZIMI, KHALED
8103 Hard Shale Rd- Manassas, VA 20111-5241

Generated on 08/16/2016 09:49 :44 A M

11/20/2012 Declared NonCitizen

14527 General Washington Dr - Woodbridge, VA 22193-3255

0212

11/20/2012 Declared NonCitizen

5630 Saint Charles Dr - Woodbridge, VA 22193-3512

0207

11/20/2012 Declared NonCitizen

9515 Country Roads Ln- Manassas, VA 20112-2775

0207

11/20/2012 Declared NonCitizen

8620 Boundbrook Ter - Manassas, VA 201 09-4817

0203

11/20/2012 Declared NonCitizen

10043 Pentland Hills Way - Bristow, VA 20136-2663

0109

11/20/2012 Declared NonCitizen

8017 Urbanna Rd- Manassas, VA 20109-3135

0107

Cancel Type

11/20/2012 Declared NonCitizen

14437 Fowlers Mill Dr- Gainesville, VA 20155-3810

0106

Cancel
Date

920303811

11/20/2012 Declared NonCitizen


Page 15 of 29

Exhibit 1, page 15 of 29

COMMONWEALTH OF VIRGINIA
Locality: 153

DEPARTMENT OF ELECTIONS

Precinct: ALL
District: ALL

Start Date: 01/01/2011


End Date: 08/16/2016

Cancellation - Declared Non-Citizen


153 -PRINCE WILLIAM COUNTY

0301

salgado, keyli p.

203822514

0401

SELEME, FLETCHER R.

918448804

TESSITORE, MICHAEL R.

918105867

MCGHEE, JOSEPH D.

920357377

ZAMBRANA, CARLOS A.

395936169

MARFULL, GEORGE E.

304026478

AGYEMANG,KWABENA

421523875

GLASS, ANTHONY R. Jr.

918728755

KEO, PHALLA

920390296

LEWIS, PATRICIA H. .

919301982

WILEN, MONICA E.

918331766

ALLEN, DERRICK J. Sr.

920046603

BEAMON, NICOLAS S.

473676748

DENNIS, CHENELLE M.

568101141

LAWRENCE, PAULETTE P.

183249740

FLORES, EVARISTA D.

919393308

URRUTIA, CHRISTINA 0.

920086958

lam, michelle
13231 Nickleson Dr- Woodbridge, VA 22193-4122

Generated on 08/16/2016 09:49 :44 AM

11/20/2012 Declared NonCitizen

3719 Fairfield Ln- Woodbridge, VA 22193-2140

0609

11/20/2012 Declared NonCitizen

3545 Forestdale Ave- Woodbridge, VA 22193-2053

0606

11/20/2012 Declared NonCitizen

14809 Darbydale AVE- Woodbridge, VA 22193

0606

11/20/2012 Declared NonCitizen

14403 Artery Ln Apt 22- Woodbridge, VA 22193-3047

0603

11/20/2012 Declared NonCitizen

14394 Westminister Ln Apt 21 -Woodbridge, VA 22193-3058

0603

11/20/2012 Declared NonCitizen

3504 Bath Ct- Woodbridge, VA 22193-2007

0603

11/20/2012 Declared NonCitizen

3923 Penshurst Ln Apt 101- Woodbridge, VA 22192-6351

0601

11/20/2012 Declared NonCitizen

12236 Ladymeade Ct Apt 102- Woodbridge, VA 22192-7082

0508

11/20/2012 Declared NonCitizen

12400 Midsummer Ln # 8302- Woodbridge, VA 22192-6704

0508

11/20/2012 Declared NonCitizen

3840 Marquis PI- Woodbridge, VA 22192-6211

0508

11/20/2012 Declared NonCitizen

3513 Lacebark Elm Ct- Woodbridge, VA 22192-4302

0508

11/20/2012 Declared NonCitizen

12599 Plymouth Ct- Woodbridge, VA 22192-2320

0506

11/20/2012 Declared NonCitizen

11170 Privates Ct- Manassas, VA 20109-7741

0504

11/20/2012 Declared NonCitizen

7662 Cass PI Apt 102- Manassas, VA 20109-7662

0411

11/29/2012 Declared NonCitizen

6782 Jefferson St- Haymarket, VA 20169-2904

0411

11/20/2012 Declared NonCitizen

4113 Crescent Hills DR- Haymarket, VA 20169

0409

11/20/2012 Declared NonCitizen

4036 White Haven Dr- Dumfries, VA 22026-2462

546502589

11/20/2012 Declared NonCitizen

Page 16 of 29

Exhibit 1, page 16 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

0702

JEFFERSON, RHONDA J.

919966021

11/20/2012 Declared NonCitizen

14220 Caroline St- Woodbridge, VA 22191-2548

0703

MUBARAK, PRINCE

164022230

11/20/2012 Declared NonCitizen

1459 Ranger Loop Apt 302- Woodbridge, VA 22191-5246

0703

PARADA, ROSA E.

919688418

11/20/2012 Declared NonCitizen

13651 Cridercrest PI Apt 301- Woodbridge, VA 22191-1990

0706

SANTOS, JOSE A.

037640185

11/20/2012 Declared NonCitizen

1425 Maryland Ave- Woodbridge, VA 22191-3628

0708

KELEEKAI, FRANCIS S.

002508796

11/20/2012 Declared NonCitizen

16572 Nanticoke Way Apt 302- Woodbridge, VA 22191-4784

January 2013
PCT

0108

Name
Address
BEST, XIOMARA M.

Registration ID

Cancel
Date

312049588

1/2/2013

Declared NonCitizen

092023883

1/2/2013

Declared NonCitizen

919432013

1/2/2013

Declared NonCitizen

381494685

1/2/2013

Declared NonCitizen

919449141

1/2/2013

Declared NonCitizen

851884782

1/2/2013

Declared NonCitizen

032694225

1/2/2013

Declared NonCitizen

110691140

1/2/2013

Declared NonCitizen

9156 Cascade Falls Dr- Bristow, VA 20136-6106

0111

WHEATON, AMANDA A.

0301

PARADA, ELBA G.

8854 Stable Forest PI- Bristow, VA 20136-5747

17579 Summer Duck Dr- Dumfries, VA 22026-2648

0503

VALLE, VIRGINIA L.
2994 Jamestown Ct- Woodbridge, VA 22192-3212

0508

ASRES, SINA
3861 Ogilvie Ct- Woodbridge, VA 22192-5039

0703

SANDERSON, AKILAH A.
1880 Gableridge Tum Apt 402- Woodbridge, VA 22191-1982

0707

EL GHABBAR, ISSAM E.
1402 Mary St- Woodbridge, VA 22191-1652

0707

JIMENEZ, KEVIN A.

Cancel Type

13152 Putnam Cir- Woodbridge, VA 22191-1032

February 2013
PCT

Name
Address

0404

AMAYA-CASTELLANOS, SANTOS M.
10251 Pelham Ct- Manassas, VA 20109-2914

Generated on 08/16/2016 09:49:44 AM

Registration ID

817671415

Cancel
Date

2/19/2013

Cancel Type
Declared NonCitizen

Page 17 of 29

Exhibit 1, page 17 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

March 2013
PCT

Name
Address

0101

CARNEIRO, JOAQUIM P.

Registration ID

Cancel
Date

918015555

3/5/2013

Declared NonCitizen

917576257

3/5/2013

Declared NonCitizen

920370476

3/5/2013

Declared NonCitizen

304546826

3/5/2013

Declared NonCitizen

015966757

3/5/2013

Declared NonCitizen

285311501

3/5/2013

Declared NonCitizen

10930 Meadow Walk Ln- Bristow, VA 20136-1535

0203

DAVIS, RICHARD E.
8500 Brunger St- Manassas, VA 20112

0305

UPCHURCH, JENNIFER r.
15743 Viewpoint Cir- Dumfries, VA 22025-1223

0509

dorestal, merley
6104 Occoquan Forest Dr- Manassas, VA 20112-3018

0601

NASEEM, AWAIS
15036 Cherrydale Dr- Woodbridge, VA 22193-5332

0709

MARTINE, CAITLIN E.

Cancel Type

15018 Sunny Ridge Ct Apt 203- Woodbridge, VA 22191-3966

May 2013
PCT

Name
Address

0106

ALVARADO LOZANO, ROLANDO M.

Registration ID

Cancel
Date

5/9/2013

Declared NonCitizen

844252367

5/9/2013

Declared NonCitizen

457319060

5/12/2013

Declared NonCitizen

918587174

5/9/2013

Declared NonCitizen

070030753

5/9/2013

Declared NonCitizen

480779693

5/9/2013

Declared NonCitizen

328024538

5/9/2013

Declared NonCitizen

162110068

5/9/2013

Declared NonCitizen

170927161

5/9/2013

Declared NonCitizen

11 007 Tower PI - Manassas, VA 201 09-3442

0106

MERINO RODRIGUEZ, YASMIN Y.


7904 Sharpsburg Ct- Manassas, VA 20109-3560

0202

BELT, SARA A.
13505 Bradford Ln- Manassas, VA 20112-4757

0210

SOLORZANO, JORGE
13237 Orkin Ln- Woodbridge, VA 22193-7003

0303

ZAHID, NASARULLAH
18430 Lotus Ct Apt 304 - Triangle, VA 22172-1762

0310

LUMINGA, MICHAEL
174821sle Royale Ter- Dumfries, VA 22025-1936

0311

BARBOSA, CARLOS A.
17225 Larkin Dr- Dumfries, VA 22026-27 46

0311

COLEMAN, TIONNA B.
3071 Antrim Cir- Dumfries, VA 22026-3318

0311

JENKINS, ANDREEA
17351 Sligo Loop- Dumfries, VA 22026-3347

Generated on 08/16/2016 09:49:44 AM

Cancel Type

919472197

Page 18 of 29

Exhibit 1, page 18 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation Declared Non-Citizen
153 PRINCE WILLIAM COUNTY

0311

RIDDICK, THERESA

246698066

5/9/2013

Declared NonCitizen

168453305

5/9/2013

Declared NonCitizen

917865772

5/9/2013

Declared NonCitizen

919962258

5/9/2013

Declared NonCitizen

17604 Marsh Harbor Ln- Dumfries, VA 22026-4530

0405

ADU, CURTIS N.
8244 Humphrey Ln- Manassas, VA 20109-8268

0504

VENTURA, MARIA E.
2096 Mayflower Dr- Woodbridge, VA 22192-2317

0608

CAMPOS, PATRICIAN.
14100 Maverick Ct- Woodbridge, VA 22193-4413

August 2013
PCT

Name
Address

0408

AMAYA,ODEBELINA

Registration ID

Cancel
Date

918110863

8/4/2013

Declared NonCitizen

087690175

8/4/2013

Declared NonCitizen

920042681

8/4/2013

Declared NonCitizen

7719 Woodstock St- Manassas, VA 20109-3239

0601

LOPEZ QUIJADA, MARIA E.


14611 Brook Dr- Woodbridge, VA 22193-1345

0703

FERNANDEZ, ANTONIO E.

Cancel Type

1308 D St- Woodbridge, VA 22191-1708

January 2014
PCT

Name
Address

0105

GLORIUS, JESSIE R.

Registration ID

Cancel
Date

1/19/2014

Declared NonCitizen

006718212

1/19/2014

Declared NonCitizen

918201826

1/19/2014

Declared NonCitizen

580930450

1/19/2014

Declared NonCitizen

919257550

1/19/2014

Declared NonCitizen

301022847

1/19/2014

Declared NonCitizen

918629730

1/19/2014

Declared NonCitizen

918257920

1/19/2014

Declared NonCitizen

13576 Filly Ct- Gainesville, VA 20155-2975

0111

CHONG, KATHERINE A.
9057 Falcon Glen Ct- Bristow, VA 20136-5737

0311

MADAN, ARVIND

0409

JIMENEZ, NICOLAS L.

3123 Antrim Cir- Dumfries, VA 22026-3323

6734 Abberley LOOP- Gainesville, VA 20155

0411

UMANTA-ZELAYA, LUIS C.
12000 Coverstone Hill Cir Apt 412- Manassas, VA 20109-7531

0504

STEWART, DEBORA A.
12631 Harbor Dr- Woodbridge, VA 22192-2225

0505

PRADA, MARILYN R.
2900 Madeira Ct- Woodbridge, VA 22192-1923

0507

BOZZELLI, ZIBA M.
13218 Barrister PI- Woodbridge, VA 22192-4804

Generated on 08/16/2016 09:49:44 AM

Cancel Type

531791808

Page 19 of 29

Exhibit 1, page 19 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation -Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

0509

SISON, JOEL P.

0511

TAICA, CONCEPCION

610012187

1/19/2014

Declared NonCitizen

943731749

1/19/2014

Declared NonCitizen

920173185

1/19/2014

Declared NonCitizen

918159744

1/19/2014

Declared NonCitizen

273921415

1/19/2014

Declared NonCitizen

918346165

1/19/2014

Declared NonCitizen

389597011

1/19/2014

Declared NonCitizen

4780 Charter Ct- Woodbridge, VA 22192-5532

12205 Tideswell Mill Ct- Woodbridge, VA 22192-5559

0601

MARTINEZ, YOSELIN A.
3431 Castle Hill Dr- Woodbridge, VA 22193-5318

0604

CONSTANZA, SARA C.
14607 Aurora Or-Woodbridge, VA 22193-1231

0610

MIRANDA, ADOLPH S.
3703 Chico Ct- Woodbridge, VA 22193-1632

0706

AVILA, BERTHA A.
15128 Alaska Rd- Woodbridge, VA 22191-3640

0707

VO, TAM D.
1509 Carter Ln- Woodbridge, VA 22191-1508

February 2014
PCT

0110

Name
Address
MOHAMMAD IBRAHIM, MEHRIYA

Registration ID

Cancel
Date

281855639

2/23/2014

Declared NonCitizen

023725341

2/23/2014

Declared NonCitizen

023379393

2/23/2014

Declared NonCitizen

180898720

2/23/2014

Declared NonCitizen

920377744

2/23/2014

Declared NonCitizen

6833 Hartzell Hill Ln- Haymarket, VA 20169-4944

0302

ASARE, ABENOA A.
16500 Telescope Ln- Dumfries, VA 22026-2194

0307

HANI, UMME
15523 Ridgecrest Dr- Dumfries, VA 22025-1109

0411

NGUYEN, SON V.
11241 Lady Jane Loop Apt 204- Manassas, VA 20109-7884

0503

MOSES, MELISSA P.

Cancel Type

12528 Oakwood Dr- Woodbridge, VA 22192-3105

March 2014
PCT

Name
Address

0101

COVELLO, ANGELO

0110

AL SAADI, SURA D.

Registration ID

Cancel
Date

917566483

3/17/2014

Declared NonCitizen

068104551

3/17/2014

Declared NonCitizen

919957671

3/17/2014

Declared NonCitizen

5401 Mapledale Plz- Woodbridge, VA 22193-4526

14764 Soapstone Dr Apt 404- Gainesville, VA 20155-4806

0201

MACDONALD, ELIZABETH M.
13942 Rexburg Ct- Woodbridge, VA 22193-3860

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 20 of 29

Exhibit 1, page 20 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

0303

RAMIREZ, DELFINO

919841808

3/17/2014

Declared NonCitizen

917859175

3/19/2014

Declared NonCitizen

427191477

3/17/2014

Declared NonCitizen

097364809

3/17/2014

Declared NonCitizen

917999304

3/17/2014

Declared NonCitizen

209098190

3/17/2014

Declared NonCitizen

282792701

3/17/2014

Declared NonCitizen

3635 Wharf Ln- Triangle, VA 22172-1056

0404

HEBERT, PAUL D.
10499 Montrose Way- Manassas, VA 20109-6436

0502

marsh, cecilia c.
PO Box 483- Occoquan, VA 22125-0483

0507

WALKER, EARLINE
12844 Misty Ln- Woodbridge, VA 22192-6427

0510

CASTILLO, RONNIE W.
15000 Rumson PL - Manassas, VA 20111

0703

SALEH, AHMED N.
1222 Easy St- Woodbridge, VA 22191-2003

0709

LUCIDO, MATTHEW D.
15175 Beacon Ridge Dr Apt 118 - Woodbridge, VA 22191-4949

May 2014
PCT

Name
Address

0703

RIOS MESIA, JULIO

Registration ID

041281058

Cancel
Date

5/28/2014

13688 Lynn St- Woodbridge, VA 22191-2124

Cancel Type
Declared NonCitizen

June 2014
PCT

Name
Address

0106

TURNER, MARCELLA U.

Registration ID

Cancel
Date

229845966

6/10/2014

Declared NonCitizen

920110290

6/10/2014

Declared NonCitizen

007329012

6/10/2014

Declared NonCitizen

001495905

6/10/2014

Declared NonCitizen

919633250

6/10/2014

Declared NonCitizen

273705786

6/10/2014

Declared NonCitizen

456878490

6/10/2014

Declared NonCitizen

9930 Portsmouth Rd- Manassas, VA 20109-3130

0107

GAHUNIA, RAJINDER K.
10217 lnchberry Ct- Bristow, VA 20136-5606

0110

DEL ROSARIO, JEANNE M.


14736 Deming Dr Apt 203- Gainesville, VA 20155-4820

0110

DEL ROSARIO, JERSON M.


14736 Deming Dr Apt 203- Gainesville, VA 20155-4820

0204

TATE, REBECCA J.
8842 Oak Hollow Ct- Manassas, VA 20109-3711

0206

ANDERSON, SALMA
8104 Ebert Dr- Manassas, VA 20112-4621

0212

CUI, JUN
7507 Bosbury Ct- Manassas, VA 20111-1610

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 21 of 29

Exhibit 1, page 21 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS

Precinct: ALL

Cancellation - Declared Non-Citizen


153 -PRINCE WILLIAM COUNTY

0212

SALGUERO, HAYDEE P.

919313596

6/10/2014

Declared NonCitizen

918705877

6/10/2014

Declared NonCitizen

697945465

6/10/2014

Declared NonCitizen

001622980

6/10/2014

Declared NonCitizen

240479413

6/10/2014

Declared NonCitizen

920055295

6/10/2014

Declared NonCitizen

247182539

6/10/2014

Declared NonCitizen

507770973

6/10/2014

Declared NonCitizen

8219 Glade Bank Dr- Manassas, VA 20111-5236

0311

CROWELL, ANNA M.
17263 Nugent Ln- Dumfries, VA 22026-3340

0404

CRUZ, ALIUSKA

0405

QUINTANILLA, DENY A.

7887 Blue Gray Cir- Manassas, VA 20109-2825

7671 Helmsdale PI- Manassas, VA 20109-6476

0510

NAVARRETE, ERNESTO I.
6413 Yates Ford Rd- Manassas, VA 20111-2602

0705

FAJARDO, BERTIN A.
14459 Meridian Dr- Woodbridge, VA 22191-2946

0706

GARCIA DE PACHECO, MARIA


1500 Kentucky Ave- Woodbridge, VA 22191-3533

0711

LEON LOPEZ, HERBERTH 0.


14304 Jeffries Rd Apt 709- Woodbridge, VA 22191-2723

July 2014
PCT

0405

Name
Address
MAHARJAN, SAJANA

Registration ID

Cancel
Date

180241999

7/15/2014

Declared NonCitizen

059745339

7/15/2014

Declared NonCitizen

054471482

7/15/2014

Declared NonCitizen

048920344

7/15/2014

Declared NonCitizen

7445 Barbados Ln- Manassas, VA 20109-7104

0508

MARTIN, ALDWIN T.
12510 Kempston Ln- Woodbridge, VA 22192-5061

0701

AMBRIZ, HUGO
13721 Jefferson Davis Hwy Trlr 1- Woodbridge, VA 22191-2014

0706

LITTLES, DENARSHA C.

Cancel Type

15031 Illinois Rd- Woodbridge, VA 22191-3547

October 2014
PCT

Name
Address

0314

BELLINI, JORGE D.

Registration ID

917919116

ESTRADA, NURIA D.

291699308

SLAUGHTER, JOHNNY M.
11718 Tolson PI- Woodbridge, VA 22192-7481

Generated on 08/16/2016 09:49:44 AM

10/13/2014 Declared NonCitizen

9916 Loudoun Ave- Manassas, VA 20109-3234

0501

Cancel Type

10/21/2014 Declared NonCitizen

5313 Box Turtle Ct- Woodbridge, VA 22193-5800

0405

Cancel
Date

124626085

10/21/2014 Declared NonCitizen

Page 22 of 29

Exhibit 1, page 22 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

0505

OMAR, OMAR M.

237227223

10/13/2014

Declared NonCitizen

027166961

10/13/2014

Declared NonCitizen

336279404

10/21/2014

Declared NonCitizen

741877257

10/21/2014

Declared NonCitizen

025358017

10/13/2014

Declared NonCitizen

3244 Foothill St- Woodbridge, VA 22192-1405

0509

CESAITIS, EIMANTAS
5365 Cleburne Ln- Woodbridge, VA 22192-6035

0604

CONWARD, DWAYNE E. Jr.


14506 Aurora Dr- Woodbridge, VA 22193-1230

0606

GIL, CARLOS A.
14508 Del Mar Dr- Woodbridge, VA 22193-2708

0706

CHAVEZ MORA, GABRIEL E.


15212 Michigan Rd- Woodbridge, VA 22191-3712

January 2015
PCT
011 0

Name
Address
BALLADARES, JORGE L.

Registration ID

Cancel
Date

920337683

1/6/2015

Declared NonCitizen

988236715

1/6/2015

Declared NonCitizen

919217409

1/6/2015

Declared NonCitizen

14768 Soapstone Dr Apt 102- Gainesville, VA 20155-4801

0307

MARTINEZ, JOHN
15327 Edgehill Dr- Dumfries, VA 22025-1033

0511

JOHNSON, ANGELlE

Cancel Type

4216 Devonwood Way- Woodbridge, VA 22192-5124

February 2015
PCT

Name
Address

0610

PRICE, TRUNEL R.

Registration ID
620191714

Cancel
Date
2/19/2015

15201 Brickwood Dr Apt 404 - Woodbridge, VA 22193-5598

Cancel Type
Declared NonCitizen

March 2015
PCT
0410

Name
Address
TAYLOR, SOPHIA C.

Registration ID

Cancel
Date

4 78559179

3/18/2015

Declared NonCitizen

917227655

3/18/2015

Declared NonCitizen

6336 Cullen PI- Haymarket, VA 20169-5400

0513

CABALLERO, ROSA

Cancel Type

12668 Dulcinea PI- Woodbridge, VA 22192-3148

April 2015
PCT

Name
Address

0215

ARNEZ, DANIEL A.
13117 Otto Rd- Woodbridge, VA 22193-7013

Generated on 08/16/2016 09 :49:44 AM

Registration ID
708257354

Cancel
Date
4/14/2015

Cancel Type
Declared NonCitizen

Page 23 of 29

Exhibit 1, page 23 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation Declared Non-Citizen
153 PRINCE WILLIAM COUNTY

0301

SMOTHERS, PARREN L.

099700189

4/14/2015

Declared NonCitizen

021864444

4/27/2015

Declared NonCitizen

653937690

4/13/2015

Declared NonCitizen

920072186

4/14/2015

Declared NonCitizen

269417421

4/14/2015

Declared NonCitizen

920144517

4/27/2015

Declared NonCitizen

587709241

4/13/2015

Declared NonCitizen

715729183

4/14/2015

Declared NonCitizen

109273903

4/13/2015

Declared NonCitizen

3624 Anchorage Cv- Triangle, VA 22172-1047

0304

DEL AGUILA COLMENARES, ANGELA J.


333 3rd Ave- Quantico, VA 22134-3408

0409

DUNBAR, RYAN C.
PO Box 433- Gainesville, VA 20156-0433

0412

TRYPANIS, GEORGE
5410 Lick River Ln- Gainesville, VA 20155-1385

0602

SESA Y, RASHIELA
13053 Quade Ln- Woodbridge, VA 22193-4942

0602

SSEKIBENGA, LEONARD
13761 Longwood Ct- Woodbridge, VA 22193-4638

0608

PARADA, ELSY M.
13806 Mapledale Ave- Woodbridge, VA 22193-4466

0706

SOUGHE, EDWIGE

0709

AYALA, STEPHANIE J.

14080 Big Crest Ln Apt 404- Woodbridge, VA 22191-5533

15700 Tassia LN Apt 204- Woodbridge, VA 22191

May 2015
PCT

Name
Address

0106

gonzalez, pablo

Registration ID

Cancel
Date

548889831

5/17/2015

Declared NonCitizen

000773417

5/17/2015

Declared NonCitizen

920128866

5/15/2015

Declared NonCitizen

917856350

5/17/2015

Declared NonCitizen

818325928

5/17/2015

Declared NonCitizen

038947633

5/17/2015

Declared NonCitizen

074400155

5/19/2015

Declared NonCitizen

353939337

5/17/2015

Declared NonCitizen

10159 lrongate Way- Manassas, VA 20109-3540

0106

UMANA, JHOANA
10178 Portsmouth Rd Apt 7- Manassas, VA 20109-8023

0209

gray, WILLIAM L.
14403 Aden Rd- Nokesville, VA 20181-3122

0210

WILKERSON, TRACY D.
13194 Trails End Ct- Manassas, VA 20112-3698

0213

sheffield, jonathan w.
14221 Savannah Dr- Woodbridge, VA 22193-5411

0301

MARAVILLA, RICARDO A.
52 Dumfries Dr- Dumfries, VA 22026-2232

0301

ROBINSON, ANTONIO B.
17619 Overlook Rd- Dumfries, VA 22026-6201

0305

ARRIETA, TARALYN A.
15871 Montview Dr- Dumfries, VA 22025-1358

Generated on 08/16/2016 09:49:44 A M

Cancel Type

Page 24 of 29

Exhibit 1, page 24 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
locality: 153
Precinct: All
District: All

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

0404

DURAN, VICTOR I.

166629405

5/17/2015

Declared NonCitizen

055083094

5/17/2015

Declared NonCitizen

917680285

5/17/2015

Declared NonCitizen

133138103

5/17/2015

Declared NonCitizen

046214360

5/17/2015

Declared NonCitizen

607481203

5/17/2015

Declared NonCitizen

095806633

5/17/2015

Declared NonCitizen

373343730

5/17/2015

Declared NonCitizen

193050641

5/17/2015

Declared NonCitizen

418532438

5/17/2015

Declared NonCitizen

165790551

5/17/2015

Declared NonCitizen

225373968

5/17/2015

Declared NonCitizen

919876702

5/17/2015

Declared NonCitizen

10822 Stone Hill Ln- Manassas, VA 20109-2862

0406

LEE, JIN S.
15705 Foleys Mill PI- Haymarket, VA 20169-6182

0411

BONILLA, VICTORIA
10806 Violet Ct- Manassas, VA 20109-7212

0514

KHAN, SAHIBA H.
2561 Fox Ridge Ct- Woodbridge, VA 22192-2024

0514

TEALE, APRIL R.
12046 Willowood Dr- Woodbridge, VA 22192-1516

0601

WALKER-DEEN, AKIATU B.
14667 Forsythia Ter- Woodbridge, VA 22193-1763

0602

PUZON, GILBERT J. Jr.


13222 Delaney Rd- Woodbridge, VA 22193-4923

0603

MONTANO, JUAN G.
4405 Whitmer Dr Apt 13- Woodbridge, VA 22193-2925

0604

BOATENG, FRED
14623 Aurora Dr- Woodbridge, VA 22193-1231

0606

de los reyes, fernando


3481 Forestdale Ave- Woodbridge, VA 22193-2046

0607

RODAS-TORRES, YANCI C.

0707

JOHNSON, MARICA E.

13004 Kingswell Dr- Woodbridge, VA 22193-5038

951 Annapolis Way# 310- Woodbridge, VA 22191-1215

0709

PHELPS, DEBORAH B.
15650 William Bayliss Ct- Woodbridge, VA 22191-1476

June 2015
PCT

Name
Address

0106

MARTINEZ, EDWIN

Registration ID

Cancel
Date

6/2/2015

Declared NonCitizen

809187667

6/2/2015

Declared NonCitizen

920042033

6/2/2015

Declared NonCitizen

7969 Community Dr- Manassas, VA 20109-3533

0506

GOMEZ, SEBASTIAN
3414 Belfry Ln- Woodbridge, VA 22192-4341

0701

FLORES, MARVIN A.
14224 Fisher Ave- Woodbridge, VA 22191-2237

Generated on 08/16/2016 09:49:44 AM

Cancel Type

026016101

Page 25 of 29

Exhibit 1, page 25 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

August 2015
PCT

Name
Address

0201

OGOE, REGINA W.

Registration ID

Cancel
Date

918938931

8/12/2015

Declared NonCitizen

032167928

8/12/2015

Declared NonCitizen

248940473

8/12/2015

Declared NonCitizen

608210555

8/12/2015

Declared NonCitizen

917857749

8/12/2015

Declared NonCitizen

465542018

8/12/2015

Declared NonCitizen

919979241

8/12/2015

Declared NonCitizen

103600284

8/12/2015

Declared NonCitizen

5714 Rhode Island Dr- Woodbridge, VA 22193-3823

0303

Sexton, Lena L.
18610 Amidon Ave- Triangle, VA 22172-1903

0402

FIKES, MICHAEL T.
14990 Stream Valley Ct- Haymarket, VA 20169-2565

0409

DIAZ, HERBERTH A.
14508 John Marshall Hwy- Gainesville, VA 20155-1605

0504

FREEMAN, LUCIANIA C.
12323 Colby Dr- Woodbridge, VA 22192-2133

0512

NADUTEY,GEOFFREY
1987 Brooke Farm Ct- Woodbridge, VA 22192-5665

0601

BLOUNT, HEIDI A.
15069 Cardin PI- Woodbridge, VA 22193-5344

0608

PARKER, ASHLEY

Cancel Type

5353 Macwood Dr- Woodbridge, VA 22193-4443

September 2015
PCT

Name
Address

0110

DEL ROSARIO, JAYSON RAFAEL M.

Registration ID

Cancel
Date

219351621

9/22/2015

Declared NonCitizen

116703634

9/22/2015

Declared NonCitizen

920420822

9/21/2015

Declared NonCitizen

279040770

9/22/2015

Declared NonCitizen

14736 Deming Dr Apt 203- Gainesville, VA 20155-4820

0111

MOHAMED, MOHONED A.

0207

VALLE, JOSE L.

14236 Catbird Dr- Gainesville, VA 20155-5858

5671 Saffron Ln- Woodbridge, VA 22193-3521

0703

VAZQUEZ, HERMINIO

Cancel Type

13609 Charles Ct- Woodbridge, VA 22191-1903

October 2015
PCT

Name
Address

0201

BURKE, JENNIFER G.

Registration ID

917294452

OTAMENDI, MARIAM.
2814 Powell DR- Woodbridge, VA 22191

Generated on 08/16/2016 09:49 :44 AM

Cancel Type

10/29/2015 Declared NonCitizen

13529 Princedale Dr- Woodbridge, VA 22193-3840

0302

Cancel
Date

891302540

10/14/2015 Declared NonCitizen


Page 26 of 29

Exhibit 1, page 26 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 - PRINCE WILLIAM COUNTY

0305

WEST, NORVIN K.

918948996

10/29/2015 Declared NonCitizen

15761 Viewpoint Cir- Dumfries, VA 22025-1223

0313

ZOU, XUE H.

001932614

10/29/2015 Declared NonCitizen

15523 Kelley Farm Ct- Woodbridge, VA 22193-5783

0606

moreira, joanna a.

244588450

10/14/2015 Declared NonCitizen

3906 Desoto Ct- Woodbridge, VA 22193-1931

0706

OROPEZA, VALERIA I.

482886200

10/29/2015 Declared NonCitizen

1524 Florida Ave- Woodbridge, VA 22191-3604

0710

SMITH, APRIL N.

187233040

10/29/2015 Declared NonCitizen

2785 Beechtree Ln- Woodbridge, VA 22191-4602

December 2015
PCT

Name
Address

0106

HARTSELL, MICHAEL A.

Registration ID

920212651

Cancel
Date

Citizen

10166 Portsmouth Rd Apt 7- Manassas, VA 20109-8014

0303

REINHOLD, SUNG H.

918429751

12/14/2015 Declared NonCitizen

AMC, 4-402nd AFSB- APO, AE 09366

0508

RWEYENDELA, CHARLES B.

Cancel Type

12/14/2015 Declared Non-

410659936

12/14/2015 Declared NonCitizen

3984 Brussels Way- Woodbridge, VA 22192-7637

January 2016
PCT

Name
Address

0212

JARQUIN, LUIS A.

Registration ID

Cancel
Date

128388762

1/5/2016

Declared NonCitizen

919186951

1/5/2016

Declared NonCitizen

029352186

1/5/2016

Declared NonCitizen

918424198

1/5/2016

Declared NonCitizen

221878485

1/5/2016

Declared NonCitizen

313503300

1/28/2016

Declared NonCitizen

8511 SpruceSt- Manassas, VA 20111-2126

0408

ADAIR, SILVIA R.
7785 Gateshead Ln- Manassas, VA 20109-3370

0411

SOLORZANO, YADIRA L.
PO Box 1422- Manassas, VA 20108-1422

0501

KIM, TAE B.
11683 Chanceford Dr- Woodbridge, VA 22192-5565

0511

GOSHORN, PETER C.
12641 Stone Lined Cir- Woodbridge, VA 22192-5592

0608

LAPLANTE, BARBARA
4787 Pearson Dr- Woodbridge, VA 22193-5418

Generated on 08/16/2016 09:49 :44 AM

Cancel Type

Page 27 of 29

Exhibit 1, page 27 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS
Cancellation - Declared Non-Citizen
153 -PRINCE WILLIAM COUNTY

February 2016
PCT

Name
Address

0215

ZOBY, FRANCIS G.

Registration ID

Cancel
Date

2/20/2016

Declared NonCitizen

299795716

2/18/2016

Declared Noncitizen

139776102

2/2/2016

Declared Noncitizen

13360 Packard Dr - Woodbridge, VA 22193-3913

0411

TORRES, GLORIA M.
7601 Yellow Lily Dr Apt 101- Manassas, VA 20109-5669

0512

REYNA GONZALES, LUIS F.

Cancel Type

919269190

1948 Pohick Creek Ct- Woodbridge, VA 22192-2428

March 2016
PCT

0202

Name
Address
MCHAAR,BOUCHRA

Registration ID

Cancel
Date

734135656

3/22/2016

Declared NonCitizen

071897574

3/30/2016

Declared NonCitizen

757117640

3/30/2016

Declared NonCitizen

395840943

3/30/2016

Declared NonCitizen

311025397

3/30/2016

Declared NonCitizen

7524 Century Oak Ct- Manassas, VA 20112-5562

0301

SHAMSUDIN, ZULAIKHA
18075 Tebbs Ln- Dumfries, VA 22026-2412

0601

CAMPBELL, KIMONE M.
14407 Fontaine Ct- Woodbridge, VA 22193-1518

0609

FAISAL, FNU
6052 Ticket Way- Woodbridge, VA 22193-6137

0701

TZINA, DAWN R.

Cancel Type

1304 Bayside Ave Apt12- Woodbridge, VA 22191-2321

June 2016
PCT

Name
Address

0601

WALKER-DEEN, MARIAM

Registration ID

Cancel
Date

159967331

6/2/2016

Declared NonCitizen

368233221

6/2/2016

Declared NonCitizen

919425945

6/2/2016

Declared NonCitizen

14667 Forsythia Ter- Woodbridge, VA 22193-1763

0701

cordero, sandra s.
14101 Cove Landing Dr Apt302- Woodbridge, VA 22191-2251

0704

DAVICH, RICHARD L.
15328 Postillion Ter- Woodbridge, VA 22191-3814

Generated on 08/16/2016 09:49:44 AM

Cancel Type

Page 28 of 29

Exhibit 1, page 28 of 29

Start Date: 01/01/2011

COMMONWEALTH OF VIRGINIA
Locality: 153
Precinct: ALL
District: ALL

End Date: 08/16/2016

DEPARTMENT OF ELECTIONS

Cancellation - Declared Non-Citizen


153 -PRINCE WILLIAM COUNTY

July 2016
PCT

Name
Address

0302

ISLAM, SHAMIM A.

Registration ID

Cancel
Date
7/12/2016

Declared NonCitizen

040024685

7/12/2016

Declared NonCitizen

919689584

7/12/2016

Declared NonCitizen

16611 Telescope Ln- Dumfries, VA 22026-2193

0512

GONZALEZ AVILA, RICARDO


13145 Minnieville Rd Trlr 13- Woodbridge, VA 22192-4034

0606

RODRIGUEZ DE JESUS, MARIA C.


3631 Freemon! PI- Woodbridge, VA 22193-2028

Cancel Type

102975961

Declared Non-Citizen Total: 433

Generated on 08/16/2016 09:49:44 AM

Page 29 of 29

Exhibit 1, page 29 of 29

I-

..... ::

U.S. Department of Homeland Security


2675 Pro~perity AYe.
Fairfax. VA 20598-244 0

U.S. Citizenship

and Immigrat10n
Senices
May 8, 2013
From: The United States Citizenship and Immigration S ervices (US CIS )
To: Diana Dutton
Re: Voter registration application

USCJS appreciates your expedited assistance in furnishing the voter registration application for the
individual below. Attached. please find a copy of the individual's voter registTation card and
authorization to release information. Please fax your response to (703) 285-6077 to the attention of
Officer AKTNJIOLA . Additionally, please call (703) 285-6038 'vith any questions or concerns.

Name: Mahruk H~ssan Zaidi


DOB:
1992
Address: 13255 Fallen Leaf Court
\Voodbridge, VA 221-92-4924

Exhibit 2, page 1 of 2

ELECTORAL BOARD
Keith A. Scarborough, Chairman
Ric-h,.r.-1 r: '' - ' .
irman
etary

COUNTY OF PRINCE WILLIAM


VOTER REGISTRATION and ELECTIONS
9250 Lee A\cnue, Suite 1
iv1anassas, Virginia 20110-5554
(703) 792-6470 FAX: (703) 792-646
\Vww.pwcgov .org/votc
n~
pwcvote@pwcgov .org

A eleric,cJ erro.r w~l ~i's

Kimball W. Brace
Acting General Registrar

Date:
From:
To:
Re:

up()('\

~\/lee.:> m

c.bw mu+-
lJ
'The. h-r}-- \iqlt\eJ ~2~hO"
be. 'lol~ i nric

20

""

.-~.J.. ~ i~ ~~
~r - I
PWC Voter Registration
Co ~rMtJ O"f ~ot,
W. Michael Phipps Assistant Commonweath Attor
Yl
~ ().<). Ci.fi~sh;f
Mahrukh Zaidi and Syed Zaidi
le..~
~../iceS
CvrCJ X'hiMiJraJ-um
May 30, 2013

-n -

~~~~f~

~---~---~~

Enclosed are copies of all documents we have on file regarding Mahrukh Zaidi and Syed Zaidi. They both
registered to vote, Mahrukh on February 4, 2010 and Syed on August 3, 2012. Both ofthem checked the
box indicating that they were a citizen ofthe United States. Both ofthem did vote in the November 2012
General Election. It has since been learned that neither one of them was a citizen at the time of registration
or election. The information came to our attention when Immigration Services contacted us on May 8th,
2012 for registration records pertaining to Mahrukh Zaidi.
Mahrukh Zaidi visited our satellite office at the DMV on Caton Hill Road in Woodbridge on Saturday May
11th to cancel her registration. She was advised at the time that the request could not be handled there, but
would have to be forwarded to the main office in Manassas to be processed. She left with the paperwork
and personally brought the request to the Manassas office on May 14th. The request was processed on May
15th 2013 and a letter of cancellation was mailed to her on May 15th, 2013.
Mahrukh returned to our Manassas office on May 17th and spoke with Diana Dutton. Diana Dutton made a
copy of her cancelled record and notorized it and placed it in a sealed envelope, as requested of her, for
Immigration Services.
We were advised by the State Board of Elections to forward this information to the Prince William County
Commonwealth Attorney.

Kimball W. Brace
Acting General Registrar

An Equal Opportunity Employer

Exhibit 2, page 2 of 2

BEDFORD COUNTY
Office ofVoter Registration
321 N Bridge St Ste 200
Bedford, VA 24523-1927
E-mail:

[email protected]

Phone:

540-586-7649

Website:

http :1/www.co.bed ford. va. us/Res!Vote/index.asp

Fax:

540-586-8358

TO:

CHRISTINE MARSHALL BRAXTON


4915 Everett Rd
Forest, VA 24551-3851

DATE: 8/17/2016

t j(gj~o ''

NOTICE OF INTENT TO CANCEL


We have received information that you indicated on a recent DMV application that you are not a citizen of the
United States. Ifthe information provided was correct, you are not eligible to register to vote. lfthe information
is incorrect and you are a citizen ofthe United States, please complete the Affirmation of Citizenship form and
return it using the enclosed envelope. Ifyou do not respond within 14 days, you will be removed from the list of
registered voters.
Ifyou believe this notice has been issued in error or have any questions about this notification, please call the
Office ofGeneral Registrar.

BARBARA J. GUNTER
General Registrar
Bedford County Office of Elections

Cancei-B..B;l'410.1

Exhibit 3, page 1 of 1

From:
Sent:
To:
Cc:
Subject:

Judith Stokes <[email protected]>


Tuesday, August 23, 2016 10:24 AM
Public Interest Legal - Contact
Vanessa Cahill
August 8th Request for Information

Hello Ms. Powell:


On August 16th I mailed a response to you with information you requested. I have since been advised by the
Commissioner of the Department of Elections that the cancellation information I sent to you should not have been
released because it is protected information under the federal Driver's Privacy Protection Act. Would you please be
so kind as to destroy that information?
I appreciate your cooperation.
Judy
Judy A. Stokes, CERA
General Registrar
County of Roanoke, Virginia
(540) 772-7500
[email protected]

Exhibit 4, page 1 of 1

From: The official communication list for the General Registrars of the Commonwealth
[mailto:[email protected]] On Behalf Of Cortes, Edgardo (ELECT)
Sent: Friday, August 19, 2016 3:42 PM
To: [email protected]
Subject: [GRLIST] Guidance on responding to request from Public Interest Legal Foundation

Good afternoon many of you have received a request for records from the Public Interest Legal Foundation
for certain information to be provided pursuant to the National Voter Registration Act (NVRA). The
Department of Elections will reach out to the requesting organization to offer certain information from a
statewide level in lieu of the individual localities responding. While we will offer this, there is no guarantee the
requesting organization will accept our offer. We will let everyone know the response we receive. Even if the
requesting organization accepts the offer from the Department related to statewide data, it is possible the
organization may still request copies of other related records, such as voter registration forms that are only
maintained or accessible at the local level.
Below is a summary of what we are offering to provide and pursuant to what federal or state authority:
1) The requesting organization seeks documents regarding all registrants who were identified as
potentially not satisfying the citizenship requirements for registration from any information source,
including information obtained from the Virginia Department of Motor Vehicles or from the Virginia
State Board of Elections since 2011. This request extends to all documents that provide the name of the
registrant, the voting history of such registrant, the nature and content of any notice sent to the registrant,
including the date of the notice, the response (if any) of the registrant, and actions taken regarding the
registrant's registration (if any) and the date of the action. This request extends to electronic records
capable of compilation.
In response to this portion of the request:
a. The Department will offer to provide a sample of the correspondence sent to individuals flagged
as potentially non-citizens. This is VERIS generated correspondence so it is uniform across the
state.
b. The Department will offer to provide a data report containing everyone with a correspondence
record in VERIS that was sent a non-citizen letter, the date of correspondence, and current
registration status of the individual. This will be a custom report offered to the organization and
not a ready-made report in VERIS that you can pull locally.
1

Exhibit 5, page 1 of 2

c.

ELECT is working on creating a single cancellation report that does not include the reason for
cancellation and only releasable information to facilitate your response to these types of
requests. We will offer a statewide report to the requesting organization. While there is a
VERIS report that provides a list of registrants canceled due to non-citizenship for your
administrative use, you may not provide the information regarding reason for cancellation
for non-citizen status as this information is received from DMV and is covered under the
federal Drivers Privacy Protection Act (DPPA). The GR/EB Handbook already indicates that
this information is not releasable. The DPPA prohibits the release of covered data. It is not
sufficient to simply redact the reason code column from the current VERIS report since it
contains only individuals identified by DMV as being potentially non-citizen and cancelled as a
result.
d. The Department will not provide voting history as this is not covered under NVRA. The Code
of Virginia establishes who may obtain this information and how in 24.2-406. Only the
Department of Elections may provide this information to authorized individuals and entities. We
will notify the requestor of this fact and you should respond accordingly to this or any other
request for voting history.
2) The requesting organization seeks all communications regarding your list maintenance activities
relating to #1 above to the Commonwealth's Attorney, Virginia Attorney General, Virginia State Police,
any other state law enforcement agencies, the United States Attorney's office, or the Federal Bureau of
Investigation.
a. You should consult with your local attorney regarding this request. These are not records
covered by NVRA and may be covered by state FOIA exemptions related to information about
potential and/or ongoing criminal investigations. Your legal counsel will be able to advise you
appropriately.
3) The requesting organization seeks the total voting-age population in your jurisdiction as of the date of
your response
a. Several registrars provided useful information you can point the requesting organization to, such
as the U.S. Census or Weldon Cooper Center. The Department will also make the requestor
aware that this information is readily available online. You do not need to provide or create
records that you do not have when responding to requests.
4) The requesting organization seeks the total number of voters registered in your jurisdiction as of the
date of your response.
a. The Department posts monthly reports containing voter registration statistics for every locality
in the Commonwealth. You should direct the requesting organization to those reports for
questions regarding number of registered voters. The Department will also make the requestor
aware that these reports are readily available online. Those reports, dating back to 2000, are
available here: http://elections.virginia.gov/resultsreports/registration-statistics/index.html
Edgardo Corts
Commissioner
Virginia Department of Elections
[email protected]
804-864-8903 direct

To unsubscribe from the GRLIST list, e-mail [email protected].

Exhibit 5, page 2 of 2

From:
To:
Subject:
Date:

Cortes, Edgardo (ELECT)


Noel Johnson; Shawna Powell
Response to request for information regarding potential non-citizens
Friday, September 16, 2016 4:51:17 PM

Shawna Powell
Noel Johnson
Public Interest Legal Foundation
209 W. Main Street
Plainfield, IN 46168
Ms. Powell and Mr. Johnson,
We are in receipt of various letters from your organization requesting certain information
from Virginia localities under the public disclosure provisions of the National Voter
Registration Act (NVRA), as well as a September 2 letter directly requesting voter history
data from both the General Registrar for Prince William County and the Department of
Elections.
While the request for information regarding correspondence sent to potential non-citizens was
sent to local election offices around the Commonwealth rather than to the Department of
Elections, the request poses a burden for localities as they are currently busy preparing for
the upcoming election. In an effort to assist you in obtaining the information you are seeking
while reducing the burden on local election officials at this critical time, the Department of
Elections would like to offer you a customized report with information contained in the
statewide voter registration system that will provide you information for the entire state. The
proposed report would contain the following columns:
Voter ID number
Last Name
First Name
Middle Name
Registration Address
Locality
Current Registration Status
Date non-citizen correspondence was sent
I believe this provides the information you are seeking and would negate the need for each
locality to provide these records. In addition, should you wish to inspect any individual
records maintained by general registrars, this report would facilitate finding the appropriate
records more quickly. This would save local election officials and your organization a great
deal of time and effort in producing and reviewing correspondence and registration records.
The cost associated with producing this customized report is $240.00. Please let us know if
you would like to proceed with production of this customized report in lieu of each locality
producing these records.
Additionally, your September 2 correspondence requested voter history information of all
noncitizens purged from the voter rolls in Prince William County from 2011 to the present.
While you have requested voting history for the individuals identified in the report described
above, those records are not voter registration records and therefore are not covered under the
Exhibit 6, page 1 of 2

disclosure requirement of NVRA. The release of voting history information is governed by


the Code of Virginia, specifically 24.2-406, and can only be obtained from the Department
of Elections by qualified entities. To determine whether the Public Interest Legal Foundation
is a qualified entity, and for more information about obtaining voter history from the
Department please refer to our website: http://elections.virginia.gov/candidatepac-info/clientservices/index.html
I look forward to your response regarding this matter.
Edgardo Corts
Commissioner
Virginia Department of Elections
[email protected]
804-864-8903 direct

Exhibit 6, page 2 of 2

._,~nCU:JVII \.rUUIIL'f
2100 Clarendon Blvd, Ste. 320
n~gntana ~oounty
PO Box 1306
Arlington, VA 22201-5400
'"o"numoer.anu \.oounty
PO Box 386
:.mytn t.:ounty
(7031 228 . 3456
Clintwood. VA 24228-1306
PO Box 84
121 Bagley Cir, Ste. 108
Monterey, VA 24465-0386
(2761 926 . 1620
Augusta County
Heathsville,
VA
224
73-0084
(540) 468 . 2013
Marion, VA 24354
Dinwiddie County
PO Box 590
(804) 580 . 4655
(276)
783 . 4511
Hopewell
City
PO Box 365
Norton City
Verona, VA 24482-Q590
Southampton County
309 North 2nd Ave
(5401 245 . 5656
Dinwiddie, VA 23841 -0365
PO Box 225
PO Box 666
Hopewell, VA 23860-2704
Bath County
(8041 469 4500 option 7
Norton, VA 24273-0225
(804) 541 . 2232
Courtland, VA 23837-0666
Emporia City
PO Box 157
(276) 679 . 1162
(757)
653 . 9280
Isle
of
Wight
County
PO Box 1092
Nottoway County
Warm Springs, VA 24484-0157
PO Box 77
Spotsylvania County
(5401 839 . 7266
.
Empona, VA 23847-1092
PO Box 24
PO
Box
133
Isle
of
Wight,
VA
23397-0077
(4341 634 . 9533
Bedford County
Nottoway, VA 23955-0024
(757) 365 . 6230
Spotsylvania. VA 22553-0133
Essex County
(4341
645.
8148
County Admin Building
(540)
507
. 7380
James City County
PO Box 1561
Orange County
122 East Main St. Ste. 204
PO Box 3567
Stafford County
Bedford, VA 24523-2000
Tappahannock, VA 22560-1561
146
Madison
Ad,
Ste.
204
PO Box 301
Williamsburg, VA 23187-3567
(8041 443 . 4611
(540) 586 . 7649
Orange, VA 22960-1449
(757) 253 . 6868
Stafford, VA 225550301
Fairfax County
Bedford City
(5401 -672 . 5262
(540) 658 . 41)00
.
King
&
Queen
County
Page County
215 East Main St
12000 Govt Ctr Pkwy, Ste. 323
Staunton City
PO Box 56
Fairfax, VA 22035-0081
Bedford, VA 24523-2012
551 Mechanic St
PO
Box
58
King
&
Oueen
CH,
VA
23085-o056
(7031 222 . 0776
(5401 587 . 6007
Luray, VA 22835-1 820
(804) 785 . 5980
Staunton. VA 24402-Q058
Fairfax City
Bland Count.,;
(540) 743 . 3986
(540) 332 . 3840
King George County
Sisson House
PO Box 535
Patrick County
Suffolk City
PO
Box
1359
10455 Armstrong St
Bland, VA 24315-0535
PO Box 635
PO Box 1966
K10g George, VA 22485-1359
Fa1rfax,
(2761 688 . 4441
Stuart, VA 24171-0635
Suffolk, VA 23439-1966
--- ........ .,"""'1!'
Botetourt County
/757)
514 . 7750
PO Box 62
17031 31
'
-"
.'
' .'
' - -- . ' '
.
.
. - - . - - -.
unty
Fincastle, VA 24090-0062
i
'
I'
'
'

i
'
'
i
ll
'
l
'
i
l
'
i
ljj
'
264
(5401 473 . 8235
A
23883-0264
Falls
Ct
t7
'
2
:
0
0
t3
0
Z
6
0
T
,.
1:
0
S
5
9
T.
!
0
Z
(7031 2
.
Bristol City
14 . 5213
:J 8
300 Lee St
.ounty
Bristol, VA 24201-4327
'dO .::l O.l
1302
(2761 645 . 7318
VA 23884-0302
Brunswick County
6 . 1047
100 Tobacco St. Am. 103
Floyd c~
~
.::1
=
County
Lawrenceville, VA 23868-1823
201
100Ea:,
" T. Ia :t /.?~J na-;cT &;:IJJ:!T
(4341 848 . 4414
Floyd,7''
"' - ~ - - -- - -
- - - - , 2_ :1!'-l
II, VA 24651-0201
Buchanan County
(540)
L9Z
3!X!N
18
. 1305
PO Box 975
Fluvanna County
PO Box 922
!each City
Grundy, VA 24614-0975
801 l:rawtoro :01, 1st n
PO Box 44
Lexington, VA 24450-0922
.
-6247
(2761 935 . 6534
1540) 462 3706
Portsmouth, VA 23704-3822
Palmyra, VA 22963-0044
Virginia Beach, VA 23456-0247
Buckingham County
(757) 393 . 8644
loudoun County
(434) 589 3593
(757) 385 . 8683
Powhatan
County
PO Box 222
Franklin County
750 Miller Drive, SE, Ste. C
Warren County
3834 Old Buckingham Ad, Ste. G
Buckingham, VA 23921 -0222
1255 Franklin St, Ste . 106
Leesburg, VA 20175-8916
220 North Commerce Ave, Ste. 700
(4341 969 . 4304
Powhatan, VA 23139-7051
Rocky Mount. VA 24151-1289
(703) 777 . 0380
Front Royal, VA 22630
(804) 598 . 5604
Buena Vista City
louisa County
(540) 483 3025
(540)
635 . 4327
Prince Edward County
2039 Sycamore Ave
Franklin City
PO Box 220
Washington County
PO Box J
Buena Vista, VA 24416-3133
PO Box 42
Louisa, VA 23093-0220
25552
Lee Hwy, Ste . 1
(540) 261 . 8605
Farmville, VA 23901
Franklin, VA 23851-0042
1540) 967 . 3427
Abingdon, VA 24211-7466
(434) 392 . 4 767
Campbell County
(757) 562 8545
Lunenburg County
(276)
676
. 6227
PO Box 103
Prince George County
Frederick County
160 Courthouse Sq
Waynesboro City
PO Box 34
Rustburg, VA 24588-01 OJ
107 North Kent St. Ste. 102
Lunenburg, VA 23952-9999
250 S. Wayne Ave, Ste 205
(4341 332 . 9579
Prince George, VA 23875-0034
(4341 696 . 3071
Winchester, VA 22601-5039
Waynesboro, VA 22980
Carolina County
(804) 722 . 8748
1540) 665 5660
lynchburg City
1540)942
. 6620
PO Box 304
Prince William County
Fredericksburg City
3236 Odd Fellows Ad
Westmoreland County
9250 Lee Ave, Suite 1
Bowling Green, VA 22427-0304
Executive Plaza
Lynchburg, VA 24501
PO
Box
354
R01 C:;unlfnP. ~t StP. FiOO-A
IJ1?11\ o ... ..,
1,.nn
Manassas, VA 20110-5554

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Exhibit 7, page 1 of 84
SBlBlS PBl!Un 84l jO UBZ!l!:J e noA BJ'f *

..
Ill -;-

UP TO $2,500.

Are~ a cWzen o_t,ttl~ u-;:;;ied s!ai'es


of America?
0'YES
D NO

Will you be at least 18 years of ag:._o_!Y'ir before


the next General Election day?
~~.YES ONO

If you checked "NO" In response to either of


these questions, do not complete this form.

[j[RJ~ -@~~- ~[LJ[]U]


Daytime Telephone Number

Date of Birth
MARTINEZ, J OHN,
.Last Name

0None
Full Middle or Maiden Name

First Name

0None
Suffix (Jr.,Sr.,III,Etc.)

15327 EDGEHILL DRIVE,DUMFRIES VA 22025


\ Residence (Permanent) Home Address

ApUUniULoURm/Ste

City/Town

If Rural Address or Homeless, please describe where you reside

Zip Code

E-mail address

Mailing Address (If different) Nirginia P.O. Box or Uniformed Service Address, if
D City or 1lD County
applicable (include Zip Code)
Name of City or County of Residence PRINCE WILLIAM
* Have you ever been convicted of a felony?

D YES

NO

If YES, have your voting rights been restored?

D YES

D NO

* Have you ever been judged mentally incapacitated?

If YES, has court restored you to capacity?

DYES

YES

D NO

State where convicted


If YES, when restored?

ca-NQ
If YES, when restored?

ULJ [JL]; DODD


UL..J UL} DDDLJ

Registration Statement: I swear/affirm, under felony penalty


provided on this form Is true. I authorize the cancellation (en
Notice above.

* Signature (or mark if unable to sign)

ZlOZ T

1-''J'V'J

II appllcanlls unablelo sign duelo a physical disability, write

I'm Interested In being


an Election Official on
Election Day. Please
send me Information.

eladdress of person who assisted. (Required).

Check/describe il you have a disability that requires accommodation In order to vote.

You nuyrequesllhal yo.. home addrt" nol be released Hyou ormenilerof~household"' (a) active or retired law enforcement, or (b) ha1ot been ,anted a protective court order, or (c)"' In fur
of yo .. pe!Sonal safely 1om someonel'llo has threatened or stalked you and ha1ot filed uompi.Jinl agalnslllul pOISon l'oilh a nugblrale or lawenfon:emenl ~I attach copy of complaint) or (d) participate In lhe
Address Confidentiality Program. You rrusl show a 'hglnia P.O. box under mailing address In Box J abo"'.
Law Enforcement
Protective Order
Threatened/Stalked
Address qon_!l_dentlallty Program

N! X.V:.

Z07

NFE

ec:
ss

Exhibit 7, page 2 of 84

T ----------------,~

~2~GENDEA[;~~L31

DY~Y Y)

-- -

141DAYTIME~ELEPHON~~UMBER

f
;1 ' (.
'\ 0 ~ G: '1 a -1.5 '1 o
(--~--L-~F~IR~S~T~N A~M~E~~~--~-----=F~U~LL-M~ID~D~L~E~O~A~M~A~ID~E~N~N~A~M~E~----L--L~~~------~S~U~FF~IX~(~JR~.--MALE

-s-

(FEMAL':--f
7

SR, Ill, ETC]

~
..:...'
Cf6\v'"' ;"\
&a~r.:.L!_
6
RESIDENCE IH9-::0':-M~E:-A:-:D::-:D::-:R::-:E::-:S:-:S:--(:c:D-=Es-=-c"'R-IB::-:E::-:B::-:Ec-l0-::-W--c):------\..\

APT/UNIT/LOT/AM/SUITE

CITY OR TOWN

STATE

ZIP CODE

~2..\{o "De_v.._c~o d w~~-=---.,-----,-,......--,------------------

IF AURAL ADDRESS. DESCRIBE WHERE VOUR HOUSE IS LOCATED ]I.E., WHAT IS THE STATE ROAD NUM3ER WHERE VOUR HOUSE IS LOCATED WHICH SIDE OF THE ROADNORTH EAST ETC NEAREST LANDMARK!
1

~odhP-. ~ d ae>

v A.

'=t:-

MAILING ADDRESS (if ditlllrent lrom above) P . 0 . BOX OR UNIFORMED SEF.IVICE ADDRESS, IF AP~LIES [INCLUDE ZIP CODE!

NAME OF CITY OR COUNTY OF RESIDENCE


DeiTY
COUNTY

D9 YOU WANT TO APPLY TO REGISTER TO VOTE OR CHANGE YOUR


~T ~ EGISTRAT ION ADDRESS?
~ E~ . Answer the citizenship question to the right and complete ALL boxes (B- 10 ond A) in
Secti on B and sign your name in the red box below.

ARE YOU A CITIZEN OF THE UNITED STATES oF AMERICA?

BYes

WILL YOU BE 1s YEARS OF AGE oN oR BEFORE ELECTION DAY? DYES

NO

D NO

IF YOU CHECKED " NO" IN RESPONSE TO EITHER OF THESE QUESTIONS, DO NOT


COMPLETE THIS FORM.

NO. STOP HERE - DO NOT FILL OUT SECTION B .


CONVICTION OF FELONY

CIRCUIT COURT JUDGEMENT OF MENTAL INCAPACITY

0
0

HAVE YOU EVER BEEN CONVI CTED OF A FELONY?


IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?
IF YES, W HEN RESTORED?

(R EQUIRED)

HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

OvEs

YES

IF YES, HAS COURT RESTORED YOU TO CAPACITY?

Oves 0

MO____ DAY_ _ YEAR _ _

Yes, I am inlerested in working as


an Election Oflicial on Eleclion Day. Please
send me inlormalion.

ra-NO

YES

IF YES, WHEN RESTORED?

II you are aclive or retired law enlorcement, or il you have a prolective court order, you may requesl thai
your home address not be released . You musl show a Virginia P.O. Box in box 6 above.

ACTIVEJRET LAW ENFORCEMENT

NO

(REQUIRED) MO _ _ OAY _ _ YEAR _ _ _

PROTECTIVE COURT ORDER

Check here il you have a


disability that requires
accommodation in order to vote.

REGISTRATION STATEMENT: I SWEAR/AFFIRM, UNDEH FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S. CITIZEN AND A RESIDENT OF VIRGINIA.,
THE INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THo CANCELLATION, ENTERED IN BOX A BELOW , OF MY CURRENT REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE
BELOW .
"' REMINDER!

S\GN HERE FOR VOTER REGISTR~(OR MARK IF UNABLE TO SIGN)

SIGN

..

\ ,

HERE

::\~"""

.,u

AND COMPLETE BOX A BELOW.

DATE "'

- "'-)._

o::

:-:--:.

.~ _":;.

- l ..,_ -

_Y;_

II applicant is unable lo sign, wrile t~ name/address of person wno ass1sted below (required)

REGISTRATION DATE.'U-1'

PCT

TOWN CODE

LF_EB_I_ 7_ 2_DD_4_..___
l ___jl

OFFII,;E

u::;t:

DENIAL DATE & REASON

OFFICE USE ON_L


"'-Y,___ _ _ __

OFFICE USE ONLY

UNL Y

NEW LAST NAME

NEW FIRST, MIDDLE/MAIDEN NAME AND SUFFIX

OTHER CHANGES

NEW PCT

0
0
0
0

0
0
0

DECEASED
OUT OF STATE
PERSONAL REQUEST

NOTES!

DATE CHANGED

DATE CHANGED

AUTHORIZED BY

JUDGEDINCAPACITATEDL_______________________

ERRORDELETED~--------------------------NVRAPURGE _______________________________

~.(}.reellerU'-liJY\CL\u~'--

CONVICTED OF FELONY

COMMENTS

lbl \l ~
I

0
0
0
0

TRANSFERRED O U T - - - - - - - - - - - - - - - - - RE-REGISTERED - - - - - - - - - - - - - - - - - - - - INACTIVE STATUS


REACTIVATED::._________________________

Exhibit 7, page 3 of 84

...B

VVIII

yuu

UC Cl\ n:::Cio:tL 10 ycal= Ul

the next General Election day?

Ull VI Ut:IVIC'

D YES DNO

IT you cnecKea NU m response to etmer


these questions, do not complete this fon

D Female
3ender

Daytime Telephone Number

Date of Birth

DNone
Full Middle or Maiden Name

PRICE TRUNEL
Last Name

First Name

15201 BRICKWOOD DR APT 404,WOODBRIDGE VA

. AptJUnit/LoURm/Ste

Zip Code

E-mail address

Mailing Address (If different) !Virginia P.O. Box or Uniformed Service Address, if
D City or
applicable (include Zip Code)
Name of City or County of Residence
Have you ever been convicted of a felony?

D YES

r3 NO

State where convicted

If YES, have your voting rights been restored?

D YES

If YES, when restored?

If YES, has court restored you to capacity?

DYES

ON one
Suffix (Jr.,Sr.,III,Etc.)

City/Town

If Rural Address or Homeless, please describe where you reside

* Have you ever been judged mentally incapacitated?

221~9~3~5~59~8~~-----~~=----------------

Residence (Permanent) Home Address

a~C

NO

YES

0NO

Dcounty

~NO
If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form Is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice above.
*Signature (or mark if unable to sign)
if applicant is unable to sign due to a physical disability, wrilelhe "'mrlddro\\ of prr\on ho ""'lrd IRequiredi.
D Check/describe il you have adisability thai requires accommodation in order to v
You llllyteqUOSilhal )QU"home actcms 1101 bt """"' rt """ .. ' , . . . - Rttactive or rettred law enforcement, or(biho"" been p.trd aprotective court order, or (c) in
D I'm Interested in being
of)QU"pti'Oil>lsol!tylomsomeone Mel hos threaten~ or ,t.a,~<-<1 ,... nl """ filfd ""'l'ioinl oginsllhalpt"on Nt!umogislr.llo orlowonbcomonl lnJslallach copyofcon.,loinl)or(d)pipolf in lho
an Election Official on
Address Confidentiality Program ,,....,.,,_,
boonlofmotlllg-.sinBohboloO.
Election Day. Please
D Law Enforcement D Protccttve Oraer - : Threatened/Stalk'd D Address Confidentiality Program
send me information.

...,.o

For Office Use Only


Town code

PCT

Registration date

Date changed

Denial date & reason

Other changes

20~1055543~

!'I' iIi Ii

[] Out of State-----------------Personal Request ________________

[] Convicted of a Felony - - - - - - - -

VA-NVRA-1 7/09

l
I

*1~9Z-08~90-25-39

'I' IIpI,, q'l h\ \\\\I\\ I\\\h\\\\I\\\ II II It h\~_I

[] Deceased ________________________

Date changed

Zfl)?

RETURN TO SENDER
ATTEMPTED - NOT KNOWN
UNABLE TO FORWARD

Date changed

New First, Middle/Maiden Name and Suffix

New Last Name

D Judged Incapacitated _________

[] Transferred Out

[] Error Deleted _____________

D Re-Registered

[] NVRA Purge ______________

[] Inactive Status

[] Reactivated

Exhibit 7, page 4 of 84

Ill

* Are you a citizen of the United States


of America? 'El YES
0 NO

* Will you be at least 1B years of age on or before


If you checked "NO" In response to either of
the next General Election day? !'YES ONO these questions, do not complete this form.
~~==~--~==~~~==~~~~~-

[]~[][)

~w

-[l:]lliJHJ -lliJ~~w

Daytime Telephone Number

* Date of Birth

Gender

====-==-==c.=====:..::.___ - - - - - - - - - - - - - ________.D....._,N..:.;o::..n:=e_

* Full Middle or Maiden Name

First Name

6336 COLLEN PLACE, HAYMARKET

VI>.

'\t

I[ '2 . 0None
* Suffix (Jr.,Sr.,III,Etc.)

20169-5400

* Residence (Permanent) Home Address

ApUUniULoURm/Ste

Cityfrown

If Rural Address or Homeless, please describe where you reside

E-mail address

Mailing Address (If different) Nirginia P.0. Box or Uniformed Service Address, if
D City or 119 County
applicable (Include Zip Code)
Name of City or County of Residence PRINCE WIL
* Have you ever been convicted of a felony?
If YES, have your voting rights been restored?

D YES ,%'NO

State where convicted

D YES

If YES, when restored?

D NO

'0

* Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

-+

DYES

YES

.)(NO
If YES, when restored?

NO

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the Information
provided on this form Is true. I authorize the cancellation (entered In Box 7 below) of my current registration and I have read the Privacy Act
Notice above.
~
""- '--t

r:

*Signature (or mark if unable to sign)

~~\.) = \ ~ ~--

II applicant Is unable to sign due to a physical disability, write the nameladd~ss of.person who asslsled. (Requlred).

UL} []0/ DODD

I'm Interested In being


an Election Official on
Election Day. Please
send me Information.

--

ocr

IQJI!l~!QJ l:iJ[J[JIQJ
14 2010

Check/describe II you have a dlsabUity that requires accommodaHon In order to vote.

You IIIIYftOPSI lhat )Oil' home adchss not be ~tlusecl H)OU ormeni>erof)OU'household n (a) active or retired law enforcement, or!>) 11M been pilld aprotective court order or (c) n illlar
of)OU'pononalsaillyhm _ , . W.Oias threatened or stalked )011 and liM tiled atoftlltml agailstlbatpors4111111h allll!listrale orlawonflmnlnl tnJstallach copyoltoftlllailt)or(d)p311itlpate il the
Address Confidentiality Program. You 111111 show a~ilia P.O. bmnlormallilg adchss il Box3"'

La~rorc:=nt

Pro~ve O~r

Thr~nedl~ked

....kJ Ad~ss C~dentl~ Pro~m

. . \i.o
. \

Exhibit 7, page 5 of 84

ll. ~re ~a
M

a?ihe unii;d' Sta;;


ifvi:s 0 NO

ciij;n

AmP.rir.;~

00

* Will you be at least 18 years of age on or before


the next General Election day?
DYES 0 NO

If you checked "NO" In response to either of


these questions, do not complete this form.

Female

[EGQ]-[llij~ -~[ill]~

Gender

Daytime Telephone Number

* Date of Birth

. c:C:o.=A=B.::..;A:..:L:o.:L::.;E=.R=O:.. z,.::.;R:..:O:..:S:o.:A..::,. __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __.D.........,N.:..:o::;,.n:=-e


* Last Name

* First Name

* Full Middle or Maiden Name

0 None
*Suffix (Jr.,Sr.,III,Etc.)

12668 DULCINEA PL, WOODBRIDGE, VA 221923148


Residence (Permanent) Home Address

ApUUniULoURmiSte

Zip Code

City/Town

If Rural Address or Homeless, please describe where you reside

E-mail address

Mailing Address (if different) I Virginia P.O. Box or Uniformed Service Address, if
applicable (include Zip Code)
Name of City or County of Residence

0
0

Have you ever been convicted of a felony?


If YES, have your voting rights been restored?

YES

IZT'No

State where convicted

YES

If YES, when restored?

Have you ever been judged mentally Incapacitated?


If YES, has court restored you to capacity?

YES

NO

0
D NO

YES ..-e(No
If YES, when restored?

City or

I!J County

PRINCE WILLIAM

UU' UUI DODD


UUI EJEJ1DDDD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the Information
provided on this form Is true. I authorize the cancellation (entered In Box 7 below) of my current registration and I have read the Privacy Act
Notice above.

. . Signature (or mark if unable to

r\/R

r /";( ,

/~ ,? ~

#")

APR

4 2014

IM,]~ p;]!5;l !Y:;l!YlfY:lf.l

sign)....,/V~-'-........::V_~....o....-t/_1/_C...._"--'~.o-""----------------l~ll2JilLJlr.JI L.bJLQJW~
0

Check if you have a disability that reqwres


someone to assist you 1n order to vote.

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted (Required).

ODD
0

Protected Voter Code if applicable. See above.

I'm interested In being an Election Official on Election Day. Please send me Information.

MAR 1 B 2015 t ~
'i'f.,,
~

'

Exhibit 7, page 6 of 84

you a c1t1zen oj)he United States


Ill v ofAreAmerica?
13"YES
D NO

Will you be at least 18 years of ag~or before


the next General Election day?
~YES ONO

--~--~----------

~ale

~emale

ARNEZ DANIEL ALEdANDRO


Last Name

~~~~=
' ~~~.~~~~~~~~~~~~~~-

,______ _

Gender

If you checked "NO" in response to either of


these questions, do not complete this form.

GJQ~[@

~~ -[j[i]J [illGl[g
Daytime Telephone Number

Date of Birth

DNone
Full Middle or Maiden Name

First Name

13117 OTTO RO.WOODBRIDGE VA 221937013


* Residence (Permanent) Home Address

Apt/Unit/Lot/Rm/Ste

EmO'ne
*Suffix (Jr.,Sr.,III,Etc.)

City/Town

Zip Code

f')qo i e I
liiRural Address or Homeless, please describe where you reside

E-mail address

Rme l::ll. 1- Go> ljC4hoo,cc:')"l

Mailing Address (If different) !Virginia P.O. Box or Uniformed Service Address, if
D City or 0County
applicable (include Zip Code)
Name of City or County of Residence PRINCE WILLIAM

;,.

Have you ever been convicted of a felony?


If YES, have your voting rights been restored?

YES

0 YES

* Have you ever been judged mentally incapacitated?

If YES, has court restored you to capacity?

DYES

~0

State where convicted

If YES, when restored?

NO

M!o

0 YES
If YES, when restored?
0NO

LJL.J DL:l DODD


LJL:J DD~ DODD

Registration Statement: I swear/affirm, under felony penalty for making willfully falslit"\aterji'!m_atements or entries, that the information
provided on this form is true. I authorize the cancellation (entere in Box 7 belo~qt my @rrenl ~il'gistration and I have read the Privacy Act
Notice above.
1
Signature (or mark if unable to sign)

~~~~~----- ~~~L!:]}], ~~UJ[g


0

If applicant is unable to sign due to a physical disability, write the namefaddress of person who assisted. (Required).

DOD

Protected Voter Code if applicable. See above.

Chock if you hav a disability thai rquirn


someone to assist you in order lo vote.

~~_,;_,,..,.,

D I'm interested in being an Election Official on Election Day. Please send me information.

~-

For Office Use Only


Registration date

Town code

PCT

Date changed

Denial date & reason

New First, Middle/Maiden Name and Suffix

New Last Name

Authorized by

New PCT

Other changes

Date changed
Date changed

'

Deceased

D Judged Incapacitated

D Transferred Out

Out of State

Err.or Deleted

Re-Registered

Personal Request

NVRA Purge

Inactive Status

Convicted of a Felony

Reactivated

APR 1.,4 2015


VA-NVRA-1 7/09

Exhibit 7, page 7 of 84

Date o(Birth

Daytime Telephone Number

SMOTHERS,PARREN,LINWOOD~---------- Last Name

First Name

0 None

0 None
Suffix (Jr.,Sr.,III,Etc.)

Full Middle or Maiden Name

3624 ANCHORAGE CV, TRIANGLE, VA 221721047


Residence (Permanent) Home Address

ApUUniULoURm/Ste

City/Town

Zip Code

\
E-mail address

If Rural Address or Homeless, please describe where you reside

Mailing Address (if different) I Virginia P .0. Box or Uniformed Service Address, if
applicable (include Zip Code)
Name of City or County of Residence
Have you ever been convicted of a felony?
If YES, have your voting rights been restored?

DYES

pgNo

State where convicted

If YES, when restored?

YES

Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

DYES

NO

NO

YES

[][]1

~No

If YES, when restored? [][]1

City or

[!]County

PRINCE WILLIAM

[J[]t DDDD

DDtDDDD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the ca

ation (entered In Box 7 eiow) o.f my current registration and I have read the Privacy Act

Check if you have a dosability that requires


someone to assist you in order to vote.

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted

....

DOD
0
-

..

Protected Voter Code if applicable. See above.

I'm interested in being an Election Official on Election Day. Please send me information .

-.

APR 1. 4 2015
Exhibit 7, page 8 of 84

11

.-:-Are you a cjjj;n ofthe uni;d' Sta;


of America?
~YES
0 NO

Will you be at least 18 years of age on or before


~YES 0 NO
the next General Election day?

Gender

DEL AGUILA
Last Name

If you checked "NO" in response to either of


these questions, do not complete this form.

Date of Birth

Daytime Telephone Number

COLMENARES~N.:...:G=E=L:....:A:z::,J:__________
First Name
Full Middle or Maiden Name

None

0 Nom
Suffix (Jr.,Sr.,III,Etc.)

333 3RD AVE, QUANTICO, VA 221343408


Residence (Permanent) Home Address

ApUUniULoURm/Ste

City/Town
E-mail address

If Rural Address or Homeless, please describe where you reside

Mailing Address (If different) I Virginia P.O. Box or Uniformed Service Address, if
applicable (include Zip Code)
Name of City or County of Residence

0
0

Have you ever been convicted of a felony?


If YES, have your voting rights been restored?

YES

lXJ NO

State where convicted

YES

If YES, when restored?

If YES, has court restored you to capacity?

YES

NO

Have you ever been judged mentally Incapacitated?

Zip Code

NO

YES

WNo
If YES, when restored?

City or

[!]County

PRINCE WILLIAM

DDDD
UUt LJD,DDDD
IMliMl,
UU !Dl!Dl,
UU

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
1 provided on this form is true. I authorize the cancellation (entered In B
7 below) of my current registration and I have read the Privacy Act

Notice above.

Signature (or mark if unable to sign)

'

!Ml!M:l iDJ/Ol QI'Clfi:llfll

~~'l3J!2_Jf l2:JlQJL.!Jt!.J

[,

Check if you have a dtsability that requires


someone to assist you in order to vote.

If applicant is unable to sign due to a physical disability. write the name/address of person who assisted !Required)

ODD
0

..

Protected Voter Code if applicable. See above.

I'm interested in being an Election Official on Election Day. Please send me information.

SIOZ L g ~d'l

"

Exhibit 7, page 9 of 84

IJ ;

Will you be at least 18 years of age on ~efore


the next General Election day?
[B""(ES ONO

Are you a citizen of tpe""'(Jnited States


of America?
g-<{Es
D NO

....-

B"Male

DDD-DDD-DDDD

!Yl!Yl!Yl!Yl
WL91L1JL4J

D Female

Daytime Telephone Number

3ender

Last Name

~ r~:esraence

If you checked "NO" In response to either of


these questions, do not complete this form .

ON one
Suffix (Jr.,Sr., III,Etc.)

0None
Full Middle or Maiden Name

First Name

(Permanent) Home Aaaresl

ApUUniULoURm/Ste

Zip Code

City/Town

If Rural Address or Homeless, please describe where you reside

E-mail address

PO BOX 433 GAINESVILLE VA 201560433

Mailing Address (If different) Nirginia P.O. Box or Uniformed Service Address, if
D City or D County
applicable (include Zip Code)
Name of City or County of Residence pRINCE wI LLI AM
* Have you ever been convicted of a felony?

D YES

If YES, have your voting rights been restored?

D YES

State where convicted


D NO

* Have you ever been judged mentally incapacitated?

If YES, has court restored you to capacity?

DYES

If YES, 'when restored?

[D..t<tl)

YES

NO

If YES, when restored?

ULJ DD/ UUUU


UL} DD/ UUUU

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the Information
Box 7 b ow) of my current registration and I have read the Privacy Act
provided on this form Is true. I authorize the cancellation (ent
Notice above.
. . * Signature (or mark if unable to sign)

If applicant is unable lo sign due to a physical disability, write the name/address of person who as is!

Check If you have a disability lhal requires


someone to assist you In order to vote.

ODD

Protected Voter Code if applicable. See above.


D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


PCT

Registration date

Town code

Denial date & reason

Date changed

New First, Middle/Maiden Name and Suffix

New Last Name

New PCT

Other changes

Authorized by

Date changed
Date changed

Deceased

D Judged Incapacitated

Transferred Out _ _ _ _ _ __

Out of State

D Error Deleted

Re-Registered _ _ _ _ _ _ __

Personal Request

D NVRA Purge

Inactive Status _ _ _ _ _ _ __

Convicted of a Felony

Reactivated

(\o 1\

o~-z t-\1'

[o.Nc.-Llr

A ll~~"
APR 1 3 2015 Exhibit 7, page 10 of 84

VA-NVRA-1 7109

Will you be 18 years or age on or before election day?

If you checked 'no' In response to either


or these questions, do not complete this
form.

Q~ ONo

APT/UNIT/LOTIRM/SUITE

CITY OR TOWN

ZIP CODE

GAINESVILLE

111 " '""'""

VIRGINIA P.O. BOX OR UNIFORMED SERVICE ADDRESS, 1F APPliCABLE (INCLUDE ZIP CODE)

20155-13

NAME OF CITY OR COUNTY OF RESIDENCE

CITY

'XJ COUNTY OF

HAVE YOU EVER BEEN CONVICTED OF A FELONY?


IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?
IF YES, WHEN RESTORED?

IF YES, WHEN RESTORED? (Required) MO _ _ _ DAY_ _ _ YEAR___

(R~quired)

MO _ _ _ DAY _ _ _ YEAR _ __

REGISTRATION STATEMENT; I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S . CITIZEN AND A
RESIDENT OF VIRGINIA, THE INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION, (ENTERED IN BOX 1 ABOVE) OF MY CURRENT
REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE
.j. REMINDER; SIGN
(OR

SIGN
HERE

DATE-+

If applicant is unable to sign, write below the name/address of person who assisted : (REQUIRED)

Yes, I am interested in workmg as an


Election Official on Elect1on Day Please
send me information

APR 1 4 2015
Exhibit 7, page 11 of 84

*Date of Birth

Daytime Telephone Number

*First Name
*Residence (Permanent) Home Address

Apt/U nit/Lot/Rm/Ste

\ If Rural Address or Homeless, please describe where you reside


------------------------------------------------------------=D~C~iw~o~r~D~Co~u~nw~:_________________
Mailing Address (ifdifferenONirginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of

~0

*Have you ever been convicted of a felony? DYES

State where convicted====--====--======-----------

LJLJ,[JLJ,DDDJ
DYES
NO
If YES, has court restored you to capacity? DYES D NO If YES, when restored? UU 1UU 1DDDJ

If YES, have your voting rights been restored? DYES D NO If YES, when restored?
*Have you ever been judged mentally incapacitated?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 1 below) of my current registration and I have read the Privacy Act
Notice on the front of this form. ~

~ Slgnotme (o, ma<H unble to~<

[][], ~~~Jtl~JBJ[fi]

DEC l1 29!g

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

D Check if you have a disability that requires


someone to assist you in order to vote.

DOD Protected Voter Code if applicable. See instructions.


D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

Denial date & reason

D Deceased--------------------- D Judged Incapacitated _________


0 Out of State _ _ _ _ _ _ _ ___ D Error Deleted _ _ _ _ _ _ _ __
D Personal Request _ _ _ _ _ _ __ D NVRA Cancel _ _ _ _ _ _ _ __
D Convicted of a Felony _ _ _ _ ___

Date changed

New First, Middle/Maiden Name and Suffix

New Last Name


Other changes

Town code

New PCT

D
D
D
D

Date changed
Authorized by

Date changed

Transferred Out _ _ _ _ _ _ _ __
Re-Registered ____________
Inactive Status _ _ _ _ _ _ _ __
Reactivatl!d _____________

APR l. 4.2015

Exhibit 7, page 12 of 84

Will you 11e 18 years at

; ,.,.. you cmzen or VIe UnRIICI- or Am8fie87

-ve on or before 111ec:t1on dlly?

n yau cllel:bd "now In .-poNII!I to


8lther at theM queationa, do not

l'l'lves ONe

~YES

campllltlt thla form.


--------~

~~
SUFAX 1JR , SR , Ill, ETC I

MIDDLE OR MAIDEN NAME

ZIP CODE

IF APPUCAIII..E (INCLUDE ZIP CODE)

( I - ) VIRGINIA

HAVE 'IOU EVER BEEN CONVICTED Of' A FELONY?

HAVE 'IOU EVER BEEN JUDGED MENTALLY INCAPACITA'IE)?

IF YES, HAVE W>UR VOTING RIGHTS BEEN RES!ORED?

IF YES, HAS COURT RESlORED W>U TD c:AMC:IlY?

IF YES. WHEN RESTORED? (R&QJIRED) loiO _ _ DAY _ _ YEAR _ _

IF YES, WHEN RESTORED? (RECIUIRED) MO _ _ _ DAY _ _ YEAR _ _

REG!STBAJJON STJ!TBIENT; I SWEAIVAFRRiot.IHIER FELONY PENAllY FOR MAI<JNG Wll.l..RLIY IW..SE r.wERIAL SDII'BENTS DR EHTRtES. llW I NA A U 5 CIIlZa!l AND A RESt0eNT Of' IIIRGNA, THE
N'ORMATlON I HAVE PIDIIlED ONlHS FORM ISlRIE. I AUTHORIZE THE CNCEUR1DN (ENTERED~ BOlt 1 AIICNE) Of' UV QIRREHT REGIS'TMTlON, AND I HAVE READlHE PfWIC'f K;T NClTlCE NJCNE
'

RE111NDER:

SIGN HERE

OS

DATE-t

from-"""'

"'llu may""'*' 11w1 your '-!8 . . _ nclbel'lleaud I yau (a) 11111Ktlv. or_...._ Mdlw-lt. or (b)'been gnu1lld a...........,._. anllr, or (c) 818111 lear of )lOUt~ ulaly
ha5 llu-..d or
......,... yau .no! '-filed a~ agelnst that...,_. wilh a maglslrate or taw eniOrcMnanl (must abch ccpy ol
complaint) You must lhow a Vorginia P.O bax W1dor mailing address In Box 7 abcM

ACT1VEIRET LAW ENFORCEMENT

OFFICE USE ONLY


NEW~NAME

OTHER CHANGES

PROTl:CTlVE COURT ORDER

THREATENEDISTAU<EO

OFFICE USE ONLY

OFFICE USE ONLY

NEW FIRST, MIODI...EIMAIOEN NAME AND SUFFIX

NEWPCT

tw'E CHANGED

AUTHORIZED BY

DATE CHANGED

0
0
0
0

DECEASED
OUT OF STATE
PERSONAL REQUEST

0
0
0

0
0
0
0

JUDGED INCAPACIT~
ERROR DELETED
NVRAPURGE

CONVICTED OF A FELONY

NOTES:

beu~t ~ o~J- Lt--1-~z; evt (O..q\c-e \le l\


APr:<

?. '7

TRANSFERREDOUI'
RE-REGISTERED
INACTlVE STATVS
REACTlVATED

?nfr

- ...

'.lliJO.t. pants(.Ju pamuu a'(l SJ UOS.Jad aqJ t'll '9101-Z'tt OJ l111J11S.Jnd SJU-saJS a5J11J .IOJ samwaad
AUOJaJ OJ J3llfqns 'JUaMliJWJS 8 Dli!S .10 UO!J83U!JUliP! aoqs OJ uosnd U! :IU!JOA. .lliJOA. A.Ja.t.a Sa.I!Uba.J .... W!Ufll.l!A 'IU!ibA lo]
aop:ata
JW.IapaJ D! ato.t. no.< amn tS.JY aq~ uoqw (q) .10
.lllqt!a SJ8!=wo aon=ata aoqs OJ PU!nbu aq .<em 'a!i)a.~aqto 'SA.Ippw
pn amwu Juo& s.-oqs JWqt taama:op Jaaanua.t.ol n~po .10 lJ:aq;,.(ed ']l:aq: l&aman.t.o:J ;uamaJ811 . - . mq .{J!I!JD JDa.J.ID;J
JO .<do;, (q) Jo uonw=ypaapJ oJoqd PJJVA PU11taann3 .1uo.< JO Ido: (8) nqJJa aO!J83J1ddw SJII1 qp pus tsnm ao.( uoJaq
!afli.IJA D! liJOA OJ pantsf:lu .1uaa uwq no& paa 'l!m &q pan!mqns SJ m.loJ S!qJ Jl 'MBJJW.IllpaJ aaa ~n 'dojiilJSP58 loJ

<>

~N~WDin0~11 NOUV::>I&UN~ai

Exhibit 7, page 13 of 84

-~"ArE yo1

;:; r.itizen af the \

of Am~: i:.a? ...18f'YES [' '

~r;;~ ~~.

If -

w;.: vou ;,,; ;n ',;c,;;r lt. . rs .f ugP on c ::!ure


' '- nr ;~ ~ent;r:-t' Her'

, ~iay? ld'Y'ES

:~. ~ ~:- x~-~~-~~:_,--~

... ~;r,c lEI :ir..: .lflty r.JL,r;;b&r

'

.__ ~

:~b

-~r~At.l

. 'it(.'

__ __ 5"15~---------

"'Last i~ame

of Birth

;:; rst Nr~;,, t:


. tii:i----------- -- - -- ----------..

l \IP

'

! liyou checlted "NO" in rcsj)om;eto eithero-;I t!Jc:;e questions, do not complete this form.
'

it'~~ i~ --ffi~~~r~~- [IT]rn


'DaytimE: Teler-'IOilE: Nt!'nher

_H~tntt.

ONone

u-

"

____._,./'OgOtp ~ ___ gl~_ _ ?W_~_________ _:_(iJp~dbridf3~-.


_________ Vt<
1
.~ ..

. Reside: c.? (Permanen!) ;. : E :,,;,- :; ':

'

.ln iVLat/Rm/St<

_____ --------------..- .______ _____

If Rum l .~,cidres~ or :!a me- p';o ! t des~<;, \'lher;, ,uti ; ;;:at:

"'Hmrfd ~ ~llj mrnr br:en r:n ;:- . . );~ d :;, !i~ 1::

_1

: ..

vc;

X'!

ONone

' ,: ...1
. f,', .,_,J," n, fl/,1a1d"n Na1ne - Su"f:;--(Jr -c-~ Ill Etc)

- - --------

:: t;/T~l

--~-~-

.. ,

v .,

'

_2-7.:1lJ.a __
Zip Code

_ _ _____ ~r_rtd.a. &sy _@a ma-i f.~~~


Ei,-~'. :1 nddress

. ~- w'v:J rs r;onvi -.' .' ... --------~--- ------------------ ____ .

n,,._, :c::; ::, t'ed ' ~--~ Yt: :: 1-J j,!f; ;'ES~ when resto1 2,''' (.-J[L ULJ JL]i~J[[J
- --------- ------------- ------------------------------------*Have "GU ever been JurJ .-. - -n-"'n'!v ;f1!.,. ,. ~i' ''tf!t~~ r ., VJ='~ tv 'd )
If YES~ ilaS court rEsto re:;;. ~~;,; ... ~;;~(:c:~ . ; ~~; ~;~~:;. '[J r:lf~ _..
-: ~- when reston;-:~ -'~][]; DL.J IDODD
If YES, \lave your votin g ,,, , --~

Registtation St<:Jtenu;; ... I ~.,! it l 1 ~11n,Jl , under felony penilhy ! rnallng willfuliy tal .ill tni1terial statements or entries, tnat the information
provided on th. is form _is tnH.. ~t' : .. .-!.~'~ It:~:: ::m:cllr!!m (er
' nn:tl
: /i d
' t 1 below) of my Colt 1ent registration and I have read the Privacy Act
f>lotice e~; thP frnnt (If ~h~-; t: r
~ .P_ AA
1nt-~ ~~~ 0 , l'z}ilJlffll~l

--7 "'Si:tuat::re(nrPJ iii ;,,, J,nr.:.


_ _ _ ----------- _ _
If npollrr ~ i': '.il'?.hl: tn " "ln

DL---,,

'" ,.,

:~~-I
.o.r:cu::~,

-~~--

.... ~~-;:;---

___

._

~ ~J,:

C. I'm il'f_,:..-s;;tP.d in i.te.ir'lC .

I1P

t .~ ._ , t

-,irJr ,)ffll"

, ' 11< .t -,

.!I!

c./.______t}f;11' 1Q\Z _
__ _____ _...
O:P'SOI1 wi'o ~s; .,.,

rf

I ( kqJ

r 'di.

0 5:Jf, ~~L~
l!J~/~_

L 1Che~k if you have a doscl'i ' ,y that requires


so~1eone to aosist vm in oder to vote.

',,_ : ,'til
1 ;

s:rur t, '
r II ' 1 I'J . PI

.e send me info;,,.,.

011

..

..

":

,,
~

~.

c,..---.(.l"~ ~ AP~

f 3 2015
Exhibit 7, page 14 of 84

'

*Are you a citizen~ United States


of America? ~ES D NO

*Will you be at least 18 years of age on or before


the next General Election day? mEs D NO

If you checked "NO" in response to either of


these questions, do not complete this form.

;GJ~GI!J

DMale utfemale
*Gender

9]-~UJ-~~[Q

*Date of Birth

Daytime Telephone Number


DNone

DNone
~-=~~~~~~

*First Name

*Full Middle or Maiden Name *Suffix

\\~ r- Llo
Apt/Unit/Lot/Rm/Ste

"VJ o o]) \Ml,,1) c~G"


City/Town

2--L. \-

Zip Code

.,..,....,...-----,.----:-:----:-----:----:-----:-:---:------:-:-------- f !)> \XI l (;,- E So U C.,-1-! E {)


If Rural Address or Homeless, please describe where you reside
E-mail address

Gf\r-t ,' f, G,

__________________________________________________________ ~D~c~iW~o~r=D~C~o~un~w~:_______________
Mailing Address (if differen~Mrginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of

*Have you ever been convicted of a felony? DYES BNO

of Residence

State where convicted===-===-=====----- - -

UU;DlJ;DODO
*Have you ever been judged mentally incapacitated? DYES
0
If YES, has court restored you to capacity? DYES D NO If YES, when restored? UU;UUtDDDD
If YES, have your voting rights been restored? DYES D NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act

~
. _;

Notice on the front of this form.

~ * Signature (or mark if unable to sign)

'3'

~ :-:;;

JUL ! 5 2013

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

_I

IQJ@ []L8J

-...

lljgllJL3l
9

D Check if you have a disability that requires


someone to assist you in order to vote.

DOD Protected Voter Code if applicable. See instructions.


D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

'

.,
I

PCT Town code

Denial date & reason

Date changed

; I

JUL 2 3 2013

jt

New Last Name

New First, Middle/Maiden Name and Suffix

Other changes

NewPCT

Date changed
Authorized by

Date changed

D Transferred Out ____________


D Deceased---------------- D Judged Incapacitated ___________
D Out of State __________
D Error Delated __________________ D Re-Registered ________________
D Personal Request _______________ D NVRA Cancel _ _ _ _ _ _ _ __ D Inactive Status _ _ _ _ _ _ __
D Convicted of a Felony---------

D Reactivated -----------------

APR 1 4 2015
Exhibit 7, page 15 of 84

*Are you a citizen of the United States


of America? Jll'YES 0 NO

*Will you be at least 18 years of age on or before


the next General Election day? ~YES 0 NO

0 Male ~Female
*Social Security Number

*Gender

If you checked "NO" in response to either of


these questions, do not complete this form.

_____ liJBJffi
_,.

*Date of Birth

~p \-\- f\ N

-::--:-1Al........I--:-!'{L....!.f1:U3....1..!......_ _ _ _

S\

*Last Name

*First Name

\\::.

Daytime Telephone Number

JPn'Y\ \ \..-(TI-\ 0 None


*Full Middle or Maiden Name *

'2-04

*Residence (Permanent) Home Address

Apt/Unit/Lot/Rm/Ste

uDQXllon a ~e

2:2\\1

City/Town

Zip Code

\ ==~~~--~--~~--~--~~----~~--------------~~~~----------------If Rural Address or Homeless, please describe where you reside


E-mail address
Mailing Address If different)/ Virginia P.O.Box or Uniformed Service Address, if applicable 0 City or 0 County
elude
Name of
*Have you ever been convicted of a felony? 0 YES

NO

of Residence

State where convicted==~==:;--;:====::;----=-----

UU UU f DODD
LJLJ,L]LJ,DDDD

If YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored?
*Have you ever been judged mentally incapacitated? 0 YES
NO
If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have
read the Privacy Act Notice on the front of this fo m.

~~Vo I f2lf0lfllr.ll
--7 * Si~E~r~(O ~'fff{' unabte.to sign) --.~r--:7""'~----rt---===------------ ~~I
~U l...}J~ t...=J~~ll.J
ress of person who assisted. (Required). ;=0,-:C:;-h-ec-:-:k/7de-sc-::rib:-e-:::ify-o:-uh:-a-ve-a-::di-sa-:-:bil:-ity:-th-at:-re-q-::uir-es-a-cc-om-m-o7da-::tio-n-=-in-or7de-rt-o-vo-te
0 I'm interested in being an
Election Official on Election Day.
PI
d formation
ease sen me m

You may request that your home address not be released if you or member of your household are (a) active or retired law enforcement, or (b) have been granted a
protective court order, or (c) are in fear of your personal safety from someone who has threatened or stalked you and have filed a complaint against that person with
a magistrate or law enforcement (must attach copy of complaint) or (d) participate in the Address Confidentiality Program. You must show a Virginia P.O. box under
mailing address in Box 3 above. 0 Law Enforcement 0 Protective Order 0 Threatenad/Stalked 0 Address Confidentiality Program

For Office Use Only


Registration date

New Last Name

PCT

Town code

Denial date & reason

Date changed

New First, Middle/Maiden Name and Suffix

Other changes

New PCT

Date changed
Authorized by

Date changed

0 Deceased _ _ _ _ _ _ _ _ _ __

0 Judged Incapacitated _ _ _ _ __

0 Out of State _ _ _ _ _ _ _ _ __

0 Error Deleted _ _ _ _ _ _ _ __

0 Re-Registered _ _ _ _ _ _ _ __

0 Personal Request _ _ _ _ _ _ __

0 NVRA Cancel _ _ _ _ _ _ _ __

0 Inactive Status _ _ _ _ _ _ _ __

0 Convicted of a Felony _ _ _ _ __

VA-NVRA-1 2/10

0 Transferred Out _________

0 Reactivated __________

Exhibit 7, page 16 of 84

..-

*Are ;ou a citi~.rn;;-f the_~nited State-;of America? [LIVES 0NO

If Rural Address or Homeless, please describe where you reside

E-mail address

Address (If different)/ Virginia P.O.Box or Uniformed Service Address,


le (include
Code)

*Have you ever been convicted of a felony? LjvEs


If YES, have your voting rights been restored?L]YES

[]Nc}

of Residence

*Have you ever been judged mentally incapacitated? lJvES


If YES, has court restored you to capacity? [Jvi:s DNo
If YES, when restored?

-4

AUG~

rn/rn /rrrn
rn/rn/rrrn

State where c o n v i c t e d - - - - - - - - - - - - - - If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
Information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read
the Privacy Act Notice on the front of this for~i/'t/7 1 _
,.____y}~
0
*Signature (or mark if unable to sign)

5. -2008

I2JTult3 tf

I _,.,

/~

m-/rzrB/jDft>f~

ltapplicantis unable to sign due to a physical disability. wrke the mime/address of person who assisted. (Required). Ocheck/describe nyou have a disability that requires accommodation in order to \/Ole
Orm Interested In baing an
You may request that your home address noi be released nyou (a) are IICiiwe or notimllaw enfun:emenl, orlb) have been granted a prllllll:lin court order. or lcl are in tear
Election Official on Election Day. of your personal safaty from someone who has th!HIHed or lllllrld you and have filad a complaint against that person with a magistrate or law enforcement lmust attach
Please und me Information.
copy of complaint). You must show a Virginia P.O. boK under mailing addrasa in Box 3 a~e. Olaw Enfoicanent
Order Olbreatened/Sialked

-------

Dl'ruCec1ive

.
Exhibit 7, page 17 of 84

the United States

*Will you be at least lB years of age ~or before


the next General Election day? []1ES 0 NO

If you checked "NO" in response to either (


these questions, do not complete this form.

0 Male sfe'male
Daytime Telephone Number

~n

:-::::--:-::--:--:---:::----:7:"--=--

* Full Middle or Maiden Name *Suffix (Jr., Sr., Ill, Etc.

I (j I

:7.? p 0 r Lt5 .me tAlA

*Residence (Perliianent) Home Address

r~4~'12.L..."'I#~':1L..-::::---:=-fl(llty/).ovzwan :15a6
A t/Unit/Lot/Rm/Ste tihTrt

!ld

-:-:-::------:-:-:-:--------=--:----:-------:-----:----:-:-------=-----:-:------

If Rural Address or Homeless, please describe where you reside

*Have you ever been convicted of a felony? 0 YES

State where convicted

:Jb oo

ZZ.IpQColdoeC('

a Ut1a#Lui{ii).. CD
frlci a
t\ll

E-mail address

==~==::-:=====:------

rn,DDtDDDD
IMl[J DO DDDDv

If YES, have your voting rights been restored? DYES 0 NO If YES, when restored?

cn..mJ

*Have you ever been judged mentally incapacitated? 0 YES


If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the informatio
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Noticeonthefrontofthisform.
~;:;7~ AUG
2012
y
y
y.

---?L

~*Signature (or mark if unable to sig~~


~

ro

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

I'm interested in being an


Election Official on Election Day.
PI 8 e send me information.
e s

[J~/~rgj/~

Check if you have a disability that requir


someone to assist you in order to vote.

You may request that your home address not be released if you or member of your household (a)are active or retired law enforcement. or (b) have been grante
protective court order, (c) are in fear of your personal salety from someone who has. threatened or stalked you and have filed a complaint against that person
a magistrate or law enlorcement (must attach copy ol complaint), or ldl participate in the Address Confidentiality Program. You must show a Virginia P.O. box un
mailing address in Box 3 above. 0 law Enforcement 0 Protective Order 0Threatened/Stalked 0 Address Confidentiality Program

No receipt is required for application

If you have not received a Voter Card

completed in the Voter Registration Office.

On-line: www.sbe.virginia.gov

within thirty (30) days of submitting a Voter

Voice: BOO 552 9745

Registration Application, please contact the


Virginia State Board of Elections.

TTY: BOO 260 3466


Richmond local: 804. B64. 8901

ll/lt l'<IYJIN\

SBlOI

palell!l:JeaH 0 AUOIB::I e JO PBl:l!IIU03 [


snlels all!l:Jeul o
IB:Jue3 'VHAN 0 --------lSBnbal:l leUOSJBd [
- - - - - - - - paJBlS!fiBH-BH 0 ---------PBlBIBO JOJJ3 0
a1e1s JO 1no c
1no paJJaJsueJ! o
pale1pede::~u1 pa6pnr 0 - - - - - - - - - - paseaoaa [

sa6ue1J:> JBIJJO
aweN lSel MBN

Exhibit 7, page 18 of 84

Are you a citizen ol the United States ol America?

~YES

II you checked "no" In response to


either ol these questions, do not
complete this form.

Will you be 18 years ol age on or before election day?

NO

YES

NO

GENDER

SOCIAL SECURITY NUMBER

~ MALE

DATE OF BIRTH

FEMALE

FIRST NAME

ADDRESS (11 dlllerent) VIRGINIA P. 0. BOX OR UNIFORMED SERVICE ADDRESS, IF APPLICABLE (INCLUDE ZIP CODE)

o HAVE YOU EVER BEEN CONVICTED OF A FELONY?

o HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

DYES

~No

o IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

o IF YES, HAS COURT RESTORED YOU TO CAPACITY?

DYES

0No

o IF YES, WHEN RESTORED? (REQUIRED) MO _ _ _ DAY _ _ _ YEAR-- -

o IF YES, WHEN RESTORED? (REQUIRED) MO - --

DAY _ _ _ YEAR -

--

BEGISJBADON STATEMENT; I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WIUFUU.Y FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S. !diJZEtl AND A RESIDENT OF VIRGINIA, THE
INFORMAllON I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCEUAllON (ENTERED IN BOX 1 ABOVE) OF MY CURRENT REGISTRAllON, AND I HAVE READ THE PRIVACY ACT NOllCE ABOVE.

REMINDER: SIGN H
DATE-t

OFFICE USE ONLY

THREATENED/STALKED

OFFICE USE ONLY

NEW LAST NAME

Check here Hyou have a


disability that requires
accommodation In order to vote.

OFFICE USE ONLY

NEW FIRST, MIDDLE/MAIDEN NAME AND SUFFIX

DATE CHANGED

..

~;::r-Lfl~

NEW PCT

5-t&-ID.

AUTHORIZED BY

)2cft~

AfhA-M.< /L_r;-.rk
.

DATE CHANGED

af

CCb:i..uuU :,
c./

DECEASED

JUDGED INCAPACITATED

OUT OF STATE

ERROR DELETED

RE-REGISTERED

PERSONAL REQUEST

NVRAPURGE

INACTIVE STATUS

CONVICTED OF A FELONY

REACTIVATED

NOTES:h~

~-r---~

CIIM.~

")-11-lO

TRANSFERRED OUT

t/-( r;;:-to

'JiiJOA pi!JillSJaiiJ pi!WBU ilql SJ UOSJad ilqllllql '910Jt'PZ OJJUilnSJnd SJUiiWiiJl!lS iiSJilJ JOJ Sil!lJBUild
AUOJiiJ OJ Pilfqns 'JUiiWilllllS II ua1s JO UO!JIIJ!J!JUilpJ Moqs OJ UOSJild UJ au!JOA J3l0A AJiiAil S3JJnbaJ Mill UJUJaJ!;\ ':iU!JOA JO.!J

'UOJlJ;!Jil
111Hpilj II UJ ;J}OA no.\ iiWJlJSJ!J ilq} iiAOQ'B (q) JO ('B) JilqlJa SIII!J!JJO UOJJJiiJil Moqs OJ pi!JJObiiJ aq AIIW no.\ 'aSJM.JaqtQ 'SS3Jpp11
pu11 aw11u Jno.\ sMoqs lllqt JU<~WnJop lU<~wuJaAoa J<~qlo Jo lJJaqJ.\IId 'lJJaqJ JuawuJ<~Aoa 'JuawaJets lJUIIq 'mq .\mnn tUiiJJnJ
II JO .\dOJ 'B (q) JO 'UO!JIIJ!JJlUapJ OJOqd p!JIIA pUB JUiiJJOJ JDOA JO .\doJ II ('B) JaqlJ3 UO!JIIJ!Jddu SJql qtJM puas JSOW no.\ 'iiJOj3Q
I!JUJaJ!;\ UJ iiJOA OJ piiHJSJaiiJ JiiAiiU iiAIIq DOA pUll 'I!'BW AQ paJl!WQDS SJ WJOJ SJql J! 'MUJJIIJapiiJ MiiU II Jilpun 'UOJliiJlSJllall JO.!J

~iV r:- ~

\)Uy~\/

0 ' d \ p<..

d-OlS__...

.LN3J.\13l1In~3ll NOI.g',J~;!.LN301
UIIV 1

z: '>nu::

t'-

Exhibit 7, page 19 of 84

1111111111111111111111111111111~

11111111!11111111111111111111111111111111111111111

COMMONWEALTH OF VIRGINIA

PRINCE. WILLIAM COUNTY

AFFIRMATION OF CITIZENSHIP

VOTER REGISTRATION ANO


ELECTIONS

24.2-410.1 of the Code of Virginia

SUBJECT TO PENALTY OF LAW, I DO HEREBY AFFIRM THAT I AM A


CITIZEN OF THE UNITED STATES OF AMERICA

SIGNATURE~':{;;;

o(.

PRINTED NAME
OF VOTER:

WI '-LuJM

Date of birth:
Current address:

L.

~ISAV
)

I>

Street!P.O. Box/Apt.# I :l/Lf/J3


City/Town/State/Zip

Mailing address [if


different]:
Daytime telephone
number:

f.JDEJf R.D.

NDt(liS~ti..LC, \JIRG,UJJft

:.2tJl(ll ,

n_ 2

Street!P.O. Box/Apt.#
City/Town/Sta_te/Zip

tDJ' 19}--. .t-Jt J J

Email address:

> INTENTIONALLY MAKING A MATERIALLY FALSE STATEMENT ON THIS


FORM IS A FELONY. THE PUNISHMENT IS UP TO TEN YEARS IN PRISON AND
A FINE UP TO $2,500. YOU ALSO LOSE_Y_O_UB_BI_GHT TO_V_OIE- - - - - - - 1 - - IF YOU ARE A CITIZEN, PLEASE RETURN COMPLETED FORM TO:

PRINCE WILLIAM VOTER REGISTRATION AND ELECTIONS

Exhibit 7, page 20 of 84

,-

}
':1

Completion of this section Is requested but not required to apply for a driver's license or ID Card. (VIrginia Code 2.23806)
INFORMATION FOR THE STATE BOARD OF ELECTIONS
Are you a citizen of the United States of America?
Do you want to apply to register to vote or change your voter registration address?

YES

{INITIAL BOX)

NO~

\
!~'N""'

YES

(INITIAL BOX)

(INITIAL BOX)

NO~

(INITIAL BOX)

INFORMATION FOR THE VIRGINIA TRANSPLANT COUNCIL


Yes, I would like to remain or become an organ, eye and tissue donor.

DRIVER'S LICENSE AND IDENTIFICATION CARD APPLICATION

cam

~~'i:!~,~~"~'

--~

DL1P (07t01t2oo9)

LOG#

00303

Purpose:
Use this form to apply for a V1rgm1a Driver's License or Identification Card
Instructions:
Applicants complete the front and back of this application
.
'-.
Note Va Code 46 2-323 and 46 2-342 requ1re that you provide DMV Wllh the mformat1on on th1s form (mclud1ng your soc1al secunty number) Ills not necessary to provide a social
secunty number for an 1den!Jficabon card Th1s sOCial secunty number 1s for record keep1ng purposes and may be d1ssem1nated only m accordance with Va Code 46 2-208 and
46 2-209 Persons conv1cled of certa1n sexual offenses (as listed m Va Code 9 1-902) must reg1ster or re-reg1sler w1th the V1rg1n1a Department of State Pollee as provided In Va. Code
9 1-901. 9 1-903, and 9 1-904 If you proVIde a non-V1rg1n1a residence/home address or non-V1rg1ma ma1hng address. your application for a dnver's license or 1denl1ficellon (ID) card
maybedemed
APPLICATION TYPE (Check one)
2 0 Leamer's Permit ami Dnve~s License

1.f5i3' Dnver's License

5 D Dnve~s License w1th Motorcycle (Class M)


8

9 0 Heanng Impaired ID Card

ldenllflcabon Card

3. 0 COL Leame~s Perm1t or License 4 0 Motorcycle Leamer's Perm1t


7 0 Dnver's L1cense w1th School Bus Endorsement
(to carry ll!U than 16 passengers)
Emancipated Minor ID Card
11 0 Dnver's License Testing for Foreign Diplomats

COL w1th Motorcycle (Class M)


10

If you are applymg for a replacement hcense or 1denl1ficabon card check one of the followmg
@ I am surrendenng my current license or ldenlifJcalion card
0Lost
Ostolen D Destroyed or Mutilated
0 I hereby certify arl}' current license or ID card 1s unavailable for surrender because 111s
Do you currently have or have you ever held a dnver's license or learner's perrmt from V1rg1ma. another stale, U.S. temtory or foreign country? 181 Yes
If yes , provide the followmg
STATE/COUNTRY
11ssu ~~ATE (mmtddtyyyy)
~NSE_NUMBER
e;;;TI~J DATE (mmldd/yyyy)

I
I

FULG1~ fME (last)

l..J/Lltl}/'1

;c.a.

<l03) 7'71"'1137

(middle)

(SU"'X)

Lt:S'L/1;'
STATE

CITY

;U tfr/GS

WEIGHT

11o

HEIGHT

.IJ

LBS

FT

IN.

//

DRIVER'S LICENSE APPLICANTS

'FoR

YES

R.GJfOtiV~ ON/.."{'

13f<ou.J;V
0

2 Do you have a phys1cal or mental conditiOn which reqUires that you take med1cat1on?

g)

3. Have you ever had a seizure. blackout, or loss of consciousness?


4 Do you have a phys1cal cond11ion which reqwes you to use special equ1pmentm order to dnve?

fi(l

5 Have you been conv1cted WJlhm the past ten years m this state or elsewhere of any offense resulting
0
from vour operation of or involvmg, a motor vehicle? (Do not mclude_Q_arkmg t1cketsj_
6 Has your hcense or P...!)Vilege to dnve ever been suspended, revoked, or di~QlJahfied m thls_state_or__ \(]\:'
elsewhere, or 1s 11 currently suspended, revoked or disqualified?

REQUIRED TESTS
VISION

PA~see

rf{\.~

~
~fl
"TQt&
-otlo 4f\!

DL KNOWLEDGE EXAM
DLSKILLS
PV";'IJZl

lb71)3'f4:J-

PROOF OF

(specify)

PROOF OF 10 (sec~)

r_CU_.

PROOF OF LEGAL PRESENCE (s~e~i

~~ON~~

If you answered YES to any of


these quest1ons, please explain (
rAJSIJLt),f- ,V/w .. ;JD fi?J;IJ/.hiJS ~
7

/)/flf!,~Ttc.

~floCK

EJ- c...u~J..'f-s u~PE/IIDF.:D-

FOR DMV USE ONLY- DO NOT WRITE BELOW THIS LINE


REMARKS/PAID STAMP

FAILED

DL ROAD SIGNS EXAM

~CY

8/<0LiJtV

NO

6a

1 Do you wear glasses or contact lenses?

ZIPCODE
:Z.Clftf(- 31 z. 'z...
NAME OF CITY OR COUNlJ OF RESIDENCE
I;;Jf.,t/CE
0 CITY ~ COUNTY OF ILLUJ.tJ..
EYE COLOR
HAIRCOLOR

'IIK((i/;./Ill

t/1L LG

MAILING ADDRESS (If different from above)


IF YOUR NAME HAS CHANGED, PRINT YOUR FORMER NAME HERE

t b:".

\_S_ 1~

ENTER

17iu?r?R~~, ~~~q ~~[E

TRANSACTION TYPE
ORIGINAL
REISSUE

,Jtj.RENEWAL DDUPLICATE

FEE

ff3~.{/))

'ROOF OF SOCIAL SECURITY NUMBER (spec1fy)

627

.. ftC..C.. ...

Docu ... ~.

.~ ....

DAYTIME TELEPHONE NUMBER

l;t~

D FEMALE
(first)

4w.J

V/1?.41#1/J.

APPLICANT INFORMATION
j BIRTHDATE (mm/dd/yyyy)

MALE

STREET ADDRESS

z..:z :z. tJ(tJ

~NDER (check one)

SOCIAL SECURITY NUMBER

J-1'103

0 tJ7 O'?!~DD1

r;; 'f. 35' .391Z

0No

IER SIGNATURE AND NUMBER

Exhibit 7, page 21 of 84

DL1P (07/01/2009) Page 2

PARENT OR GUARDIAN CONSENT FOR APPLICANTS UNDER 18 (Unless applicant is married marriage certificate required)
I aulhonze tssuance of a learner's permtVdnver's hcenselldenllftcallon card lcerttfy that the applicant IS a restdent of V1rg1ma I certtfy that the applicant is
attending school regularly and ts 1n good academtc standtng, but tf not, I authonze tssuance of a Ieamer's permtVdnver's license I certtfy that th1s applicant will
operate a motor vehtcle for at least 45 hours (15 of which Will occur after sunset) whtle holdtng a learner's permit
If my child attends public school, I authonze the pnnc1pal or destgnee of the public school attended by the applicant to notify the JUVemle and domestiC relallons
dtstnct court (w1th1n whose JUnsd1cl1on the applicant res1des) when the applicant has had 10 or more unexcused absences from school on consecutive school
days
I certtfy that the statements made and the 1nformat1on submttted by me regarding thts cert1ficat1on are true and correct
PARENT/GUARDIAN NAME (pnnt)

!PARENT/GUARDIAN SIGNATURE

DATE (mm/dd/yyyy)

APPLICANT UNDER AGE 18 Have you ever been found not mnocent of any offense 1n a Juvenile and Domestic Relations Court rn thrs or any other state?
If you answered YES, a court wrthrn your 1unsdrctron must provrde court consent below
COURT CONSENT In my oprnron the applicant's request for a learner's permrVdnver's licenseD should be granted
Remarks

YES

D NO

should not be granted

JUDGE NAME (pnnt)

JUDGE SIGNATURE

DATE (mm/dd/yyyy)

COMMERCIAL DRIVER'S LICENSE APPLICANTS


Complete thts CERTIFICATION OF QUALIFICATION by checkrng the box for the category
Regulatrons or VA Motor Carner Safety Regula!tons)
INTERSTATE DRIVER
D I meet the qualificatiOn requrrements of Part 391 of the Federal Motor Carner
Safety Regulattons
D I am exempt from the qualification requtrements of Part 391 of the Federal Motor D
Carner Safety Regulations

VEHICLE TYPE

A- Combtnatron.vehtcle wrth GVWR or GCWR of 26,001 lbs or more


B - Stngle vehtcle wtth GVWR of 26,001 lbs or more, or towtng a
vehtcle less than 10,000 lbs GVWR
C -Any vehrcle that does not fit the defrmtron of a Class A or Class B
vehtcle and ts etther used to transport hazardous matenals or
destgned to carry 16 or more passengers, mcludtng the dnver

IAIR BRAKES

D Wtth

INTRASTATE DRIVER
I meet the qualiftcatton requtrements of the Vtrgtma Motor Carner
Safety Regulattons
I am exempt from the qualification requtrements of the Vrrgmia
Motor Carner Safety Regulatrons

ENDORSEMENT

I want to be licensed to operate the type of vehtcle(s) checked below

0
0

that applies (For requtrements refer to the Code of Federal

Wtthout

I want to apply for the followtng


vehtcle endorsement(s)
H - Hazardous Matenals

0
0
D

ldentrfy any state(s) m whrch you have been prevrously


licensed wtthtn the past 10 years Provrde addrbonal
rnformatron usrng the Supplemental Dnver's Ltcenstng
Hrstory Sheet, form DL 1PA
STATE(S)

N -Tank
P - Passenger Carrytng Vehtcle LICENSE NUMBER
(16 or more passengers)

S - School Bus
(16 or more passengers)

LICENSE ISSUE DATE (mm/dd/yyyy)

T- Double/Tnple Trailer

LICENSE EXPIRATION DATE (mm/dd/yyyy)

. ''

GOVERNMENT EMPLOYEES (Fee waiver certification)


I certtfy that I am employed by the
D Commonwealth of Vtrgtma or

D Ctty of D County of

Town of

-----------------------------------------

to operate a motorcycle or commercral motor vehicle and, because of such employment, I am entitled to the watver of the motorcycle class and/or commercral
motor vehtcle endorsement fee, provtded I have patd for and hold a valid Vtrgtma dnver's license or have made application for such

SELECTIVE SERVICE
All males under the age of 26 are requtred to check one of the followmg
am already regtstered wtth- Selecllve Servtce

-o-1

Fatlure to provtde a response wtll result tn dental of your applicatton

I am a non-tmmtgrant allen tn the U S and not requtred to regtster

I authortze DMV to forward to the Selecbve Servtce System personal tnforrnatlon necessary to regtster me wtth Selecttve Servrce

By s1gnmg th1s appltcallon, I consent to be regtstered With Selecttve Servtce, tf requtred by federal law If under age 18, an appropnate adult must complete
'
and stgn below I authonze DMV to send tnformatton to Selectrve Servtce which Will be used to regtster applicant when he ts 1B years old
SIGNATURE (check one and srgn)
PARENT/GUARDIAN
JUDGE, JUVENILE DOMESTIC RELATIONS COURT
EMANCIPATED MINOR

~
[

'1;._

~..... ICERT!FI'G~TION AND SIGNATURES

. ,., ... ... ! ...

I certify and afftrm that I am a restdent of Vtrgmra, that allrnformatron presented m thts applicabon IS true and correct, that any documents I have presented to
DMV are genutne, and that my appearance, for purpo~e 1pf. my DMV .Photograph, ts a true and accurate representation of how I generally appear m public I
make thts certtficatron and afftrmatton under penalty of perjuryan'd understand that knowtngly maktng a false statement on th1s application ts a crtmmal vtolation

APPWA~TtA~E GtR tty

, .A~P~I$;::uRE d'. ~

ID~Ez;;~;~

010

1(~~~--~~~~6~~,~.~--~

Exhibit 7, page 22 of 84

Age

30

Check boxes that apply:

Check if you are:

0 New registration
0 Address Change

0 active law enforcement


':1 retired law enforcement
0 not applicable

0 Name Change

Full Legal Name


Middle or Maiden Name

First Name

Last Name

Suffix

Any Prior Legal Name

0 check here if none

Month & Year Moved to this address:

Place of Birth: (Optional)

Complete Address of Previous Registration

City or County

Address

State or Country

City or Town

0 check here if none


State

Zip Code

.AHave you
DYes
ever been
convicted
of a felony?

tJ"f\io

Have you ever been DYes


judged by a circuit
court to be mentally
~0
incompetent?

If yes to felony, give date when voting rights were


restored: if yes to incompetency, give date of court
order declaring competency.

Day

Year

Are you a
citizen of the
United States?

ONo

REGISTRATION STATEMENT: I do hereby state, subject to the penalties for false statements set forth above that I am a citizen of the United States, a resident of Virginia qualified
and entitled under the Constitution and laws of the Commonwealth of Virginia to register to vote and that the information given aboveis true and correct to the best of my knowledge.
Applicant Signature:
1hereby authorize the cancellation of any previous registration.

(\1\GlCH D4/JLL().B"'

Registrar Use Only


Date of Registration
Month
Day
Year

Date:
PCT Code

Town/PCT Code

.}-

Denial II Applicable
Month Day Year

Reason

ov 15 1996

Dl1M (Rev. 08'96)

Mailing Address: check one:

:l military address

0 residence post office

Zip Code

City or Town and State

Address

Enter Below: 1) the number of the state road and the side of the road (east, west, north or south) on which your house is located; 2) 1n both directions from your house, the
number of the nearest intersecting state road or name of other landmark; 3) the distances and drrectrons travelled from each to your house. For example: RD 678, nort11
side, 1 2 mrle east of RD 743 and 2 miles west of RD 615; or RD 743, west side, 3/4 mile north of Smith's store and 4 miles south of RD 698.

,.

For Registrar Use Only


Changes in Name

For Registrar Use Only

For Registrar Use Only


Date Changed

New FirsUMiddle Maiden Name and Suffix

New Last Name

Other Changes

Authonzed by

New PCT

New Information

Purged/Stricken/Reregistered

Notes:

.J Purged

.J Convicted of Felony

0 Transferred Out

.J Deceased

.J Adjudicated Incompetent

:J

.J Registered Out of State

:J Registrar Delete

Cl Re-registered

..J Personal Request

.,.

~urged

CA!'lc${; ~CV)

tJ'ovJ CF- 1+ -z ~ rJ

- No Vote

':J Inactive Status

Date Changed

D f:=CL--A(>J~_O
M!J.Y 1 7 ?n1'1

Date Removed:

Exhibit 7, page 23 of 84

Are you a citizen of the United States of America?

[i'YES

If you checked "no" In response to


either of these questions, do not
complete this form.

Will you be 18 years of age on or before election day?

0vEs

NO

No

FEMALE

y
SUFFIX fJR ., SR., Ill. ETC.I

APT/UNITILOT/RMISUITE

IF APPLICABLE (INCLUDE ZIP CODE)

NAME OF CITY OR
DeiTY

OR

o HAVE YOU EVER BEEN CONVICTED OF A FELONY?

DYES

o HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

o IF YES. HAVE YOUR VOTING RIGHTS BEEN RESTORED?

DYES

o IF YES, HAS COURT RESTORED YOU ;o CAPACITY?

o IF YES, WHEN RESTORED? (REOUIREO) MO _ _ _ DAY _ _ _ YEAR _ __

NO

ONO

o IF YES, WHEN RESTORED? (REOU iREO) MO _ _ _ DAY _ _ _ YEAR - - -

REGISTRATION STAJEMENTI I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES. THAT I AM A U.S. t<liiZlili AND A RESIDENT OF VIRGINIA. THE
INFORMATION I HAVE PRO\IIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION (ENTERED IN BOX 1 ABO\IE) OF MY CURRENT REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABO\IE.

SIGN HERE FOR

REMINDER:

(DR MARK IF UNABLE TO SIGN).


DATE-+

Yes, I am interested In
worXing as an ElecUon

Official on Elec1lon Day.


Please send me Information.

You may request that your home address not be released if you (a) are active or retired law enforcement, or (b) have
bean granted a protective court order, or (c) are In fear of your personal safely from someone who has threatened or
stalked you and have liled a complaint against that person with a magistrate or law enforcement (must attach copy of
complaint). You must show a Virginia P.O. box under mailing address In Box 7 above.

ACTIVE/RET LAW ENFORCEMENT

PROTECTIVE COURT ORDER

Check here II you have a


disability that requires
accommodation 1n order to vote.

THREATENED/STALKED

VANVRA1 Rev 10/07

OTHER CHANGES

OFFICE USE ONLY

OFFICE USE ONLY

OFFICE USE ONLY

DATE CHANGED

NEW FIRST, MIDDLE/MAIDEN NAME AND SUFFIX

NEW LAST NAME

DATE CHANGED

AUTHORIZED BY

NEWPCT

DECEASED

JUDGED INCAPACITATED

TRANSFERRED OUT

OUT OF STATE

ERROR DELETED

RE-REGISTERED

PERSONAL REQUEST

NVRAPURGE

INACTIVE STATUS

CONVICTED OF A FELONY

REACTIVATED

NOTES:

'.l;JJOA pa.IaJS!~iJ.l paw8U aqJ S! UOS.JiJd aqJ J8QJ '9IOIZ"tZ OJ )UCnS.Jnd SJUiJW;JJBJS aSIBJ .lOj Sa!J18UiJd
.\U013J OJ pafqns 'JU;JWiJJ8JS 8 U~JS .10 UO!J8l!J!JUapJ A\OQS OJ UOS.Iad UJ ~U!JOA .l;JJOA .\.liJAa Sil.lJnbiJ.J M81 8JUJ~.l!A 5u!JOA JO]
'UOJPaliJ
!8.lapaj 8 UJ aJOA no.\ aWIJJS.I!J aqJ aAOQ8 (q) .10 (8) .l;JQJ!iJ SI8!J!JJO UOJP31a MOQS OJ pa.IJnba.l aq .\8W no,\ '3SJAU;JQJ0 'SSa.1pp8
pu8 aw8u .1no.\ sMoqs J81fJ JUawnaop JUawu.IaAo~ o~aqJo .10 lpaqa.\8d '>paqa JUawu.lHO~ 'JU3WaJ8JS l!U8q 'mq A:m!Jn JUa.J.lnJ
8 JO .\doa 8 (q) .10 'UO!J8l!J!JUapJ OJoqd pJ18A pu8 JUil.l.lnJ .Jno.\ JO .\doa 8 (8) nqJ!a UO!J8JJ1dd8 S!QJ I{J!M puas JSnw no.\ 'a.JOJilq
BJUJ~.l!A UJ ;JJOA OJ.P.il.l;JJSJb.l .liJA;JU aA8Q no.\ pu8 '1!8W .\q pamwqns SJ W.lOJ SJQJ J! 'M8118.13paj A\aU 8 .lapun 'UO!Jll.lJS!5a8 .lOif

11 ~c.~U~~ D~ltA~t.v tvu~ (l?t':t? ~~pw:!nnn03:ll Nouv:JuuN:>~m


(_ ~
v~~

MAY 1 7 2015

'""'

Exhibit 7, page 24 of 84

':JA!I no.< :JJ:lljM Al!J JO ,{Juno:> :lljl U! :l:>!JJO

s,JCJlS!i!~J :l!Jl

"Are you a ctttzen/ot the Untted States


of America? l.i.d'YES 0 NO

*Wtll you be at least 18 years of age on or before


the next General Election day? QI-YES 0 NO

If you checked "NO" in response to either of


these questions, do not complete this form.

ale 0 Female
;;;;:-----~ * Gender

*Date of Birth

K' 1 Lu-..rd

Daytime Telephone Number

r~ LJI--->{ 1 3
0 None ----,-----,-----=:::..:.=
*Full' Middle or Maiden Name *Suffix (Jr

* Ffrst Name

.2_~-Q 2--b

*Residence (Permanent) Home Address

ApVUniVLoVRmiSte

City/Town

Zip Code

\~~~~--~~--~~--~~------~--------------~-----------------If Rural Address or Homeless, please describe where you reside


E-mail address
-------------------------------- =O~C~iW~o~r~O~Co~u~nw~:_ _ _ _ _ _ ___
Mailing Address (if different)Ntrginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of City or County of Residence

*Have you ever been convicted of a felony? 0 YES

State where convicted ==::::---c==::-::====:::::--------

If YES, have your voting rights been restored? 0 YES 0 NO


*Have you ever been judged mentally incapacitated? 0 YES

If YES, has court restored you to capacity? 0 YES 0 NO

--7

UU1UU1DDDD
!Ml!Ml UU DODD

when restored?

N0
If YES, when restored? UUI

2 rf

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.
1
fiD~ fiel~
*Signature (or mark if unable to sign)
t.-......(
MAR 3 1
0L3J
I ~L2J I w~ l

nn[]rv;:;-J
liJ

2014

If applicant is unable to sign due to a phy5ical disability, write the name/address of person who assisted. (Required).

DOD Protected Voter Code if applicable. See instructions.

Check if you have a disabiliW that requires


someone to assist you in order to vote.

0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

0
0
0
0

Deceased ____________
Out of State _ _ _ _ _ _ _ ___
Personal Request _________
Convicted of a Felony _______

Denial date &reason

Date changed

New First, Middle/Maiden Name and Suffix

New Last Name


Other changes

Town code

NewPCT

Date changed
Authorized by

Date changed

0 Judged Incapacitated _ _ _ _ __

0 Transferred O u t - - - - - - - - 0
Re-Registered __________
0 Error Deleted---------0 NVRA Cancel __________ 0 Inactive Status-----,.------0 Reactivated _ _ _ _ _ _ _ _ __

Exhibit 7, page 25 of 84

~..-

UP T(;L$2,500.

K1 -;Are you a citize.n,.oof the u-;;ed slaies


ial of America? }9 YES 0 NO

* Will you be at least 18 years of agtJn or before


the next General Election day? ~ YES D NO

If you checked "NO" In response to either of


these questions, do not complete this form.

q]La~ -(Rl[JBJ- ~~~


Social Security Number

ROBINSON, ANTONIO, BERNARD


Last Name

Daytime Telephone Number

Date of Birth

Gender

DNone
Full Middle or Maiden Name

First Name

DNone
* Suffix (Jr.,Sr.,III,Etc.)

17619 OVERLOOK 'RD,DUMFRIES VA 22026-6201


Residence (Permanent) Home Address

ApUUniULoURm/Ste

City/Town

Zip Code

\
If Rurai Address or Homeless, please describe where you reside

E-mail address

Mailing Address (If different) !Virginia P.O. Box or Uniformed Service Address, if
D City or ~County
applicable (include Zip Code)
Name of City or County of Residence PRINCE WILLIAM
~

0
0

Have you ever been convicted of a felony?


If YES, have your voting rights been restored?

YES

~0

State where convicted

YES

If YES, when restored?

* Have you ever been judged mentally incapacitated?

If YES, has court restored you to capacity?

DYES

NO
YES

0NO

If YES, when restored?

LJf:J DD~ DODD


LJLJ~ DD~ DODD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the Information
pro~lded on this form Is true. I authorize the cancella2on (entered In B?x 7 below) of my current registration and I have read the Privacy Act
Notice above.

;;

Signature (or mark if unable to sign)

(;f1v

n L-

11\

)1-v f/JYJ,~ -..._)


I

-------------------------------------------------------------- 0

11 applicant Is unable to sign due to a physical disability, write the nameladdress of person who a:uisted. (Required).

D I'm Interested In being


an Election Official on
Election Day. Please
send me Information.

1:[]1'5.]; 0flllll[QJL[]lJ]
MAY 2120ifWV

Check/describe if you have a disability that requires accommodation in order to vote.

Youmoy,.IJII<ll flal \OU'ho"" adcmsnolbe,.ka.ed if)'>llotmenl!trol)'ll6household ~(a) active or retired law enforcement,Ol(b)h.ll! bten !1"'1td protective court order ,or~~.,. in ltar
oljOU'ptrSonol softly 1om''""'"' Y.ho hos threatened or stalked )'Ill and h.l1o0 filed COflllbinl ogainst flalpt~Son Y.Nla 1mglsll>le Ollawenlottemenl jnlsi!Uch copy of tolll'bill) orld) particlpte in !he
Address Confidentiality Program. You nusl show 'hyinl P.O. box 111der1miling addross in Boxll""'
D Law Enforcement D Protective Order
Q Thr~atened/Stalked D Address Confidentiality Program

MAY 19 Z015

Exhibit 7, page 26 of 84

Ill

:Are;;; a cm;n
of America?

If you checked "NO" In response to either of


these questions, do not complete this form.

Female
Social Security Number

Gender

Date of Birth

Daytime Telephone Number

ARRIET A,TARALYNN,ANNE
Last Name

First Name

None

None

Suffix (Jr.,Sr.,ll

Full Middle or Maiden Name

15871 MONTVIEW DR, DUMFRIES, VA 220251358


Residence (Permanent) Home Address

ApUUniULoURm/Ste

E-mail address

If Rural Address or Homeless, please describe where you reside

Mailing Address (if different) I Virginia P.O. Box or Uniformed Service Address, if
Name of City or County of Residence
applicable (include Zip Code)
Have you ever been convicted of a felony?

YES

YES

NO

Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

City or

[!]County

PRINCE WILLIAM

State where convicted

DYES

If YES, have your voting rights been restored?

Zip Code

CityfTown

YES

NO

If YES, when restored?


NO
If YES, when restored?

!Ml!Ml,
LJLJ

UUt EJEJ,DDDD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below of my current registration and I have read the Privacy Act
Notice above.

..

2 6 2 0 1 3 07 4

SJigUnNatu re (or m a ~k_JAi


f u/$~able to sig~J~O AJri Q!

r:vvL

a__

~n

-f5Jll01. ~l'f151

~~~ ~~l.LJQJ
D

Check if you have a disability that reqUires


someone to asstst you in order to vote.

If applicant is unable to sign due to a physical disability, write the name/address of person who ass1sted (Requlfed).

ODD
0

Protected Voter Code if applicable. See above.

.,

I'm interested In being an Election Official on Election Day. Please send me Information.

MAY 1 7 2015
Exhibit 7, page 27 of 84

*Are you a citizen of the United States


of America? ijj YES 0 NO

*Will you be at least 18 years of age on or before


the next General Election day? ~YES 0 NO

*Residence (Permanent) Home Address

Apt/Unit/Lot/RmiSte

If you checked "NO" in response to either of


these questions, do not complete this form .

Zip Code

City/Town

\
If Rural Address or Homeless, please describe where you reside

E-mail address

------------------------------------------------------------ =D~C~ity~o~r~O~C~o~u~nty~:~---------------
Mailing Address (if dlfferenONirginia P.O.Box or Uniformed Service Address, if applicable (include lip Code) Name of

*Have you ever been convicted of a felony? 0 YES IE NO

of Residence

State where convicted===--====--=====-------------

If YES, have your voting rights been restored? DYES 0 NO lf YES, when restored?
*Have you ever been judged mentally incapacitated? 0 YES ~NO
If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored?

UU10U1DDDD

UU DO DODD
0

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. l authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.

[Jr2J I @JG) I ~[QJ[J[J

ry * Signature (or mark if unable to sign)

DEc 10 20tj

If applicant 1s unable to sig n due to a physical disability, write the name/address of person who assisted . IRequired).

.Zol3

Check if you have a disability that requires


someone to assist you in order to vote.

ODD Protected Voter Code if applicable. See instructions.


0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

New Last Name

PCT Town code

New First, Middle/Maiden Name and Suffix

Other changes

0 Deceased-------------------- 0 Judged Incapacitated _ _ _ _ __


0 Out of State ____________ 0 Error Deleted __________
0 Personal Request _________ 0 NVRA Cancel _ _ _ _ _ _ _ __
0 Convicted of a Felony

Date changed

Denial date & reason

New PCT

0
0
0
0

Date changed
Authorized by

Date changed

Transferred Out--------------Re-Registered----,-------Inactive Status---------------Reactivated----------------

Exhibit 7, page 28 of 84

vvm yvu uc en u: a;::.l ro

y~c:~.r::.

ur

c:~.yt=

IX.l

:...~

Social Security Number

If you cnecked "NO" In response to either of


these questions, do not complete this form .

Male
Daytime Telephone Number

Date of Birth

*Gender

LEE,JIN,SUK
*Last Name

urr ur ut=rurt:

[1j YES O NO

the next General Election day?

0None
* Full Middle or Maiden Name

First Name

0None
Suffix (Jr.,Sr., III,Etc.)

~9-GVE!H:J~N9-9R-AJ:I.'F-H-,-RGAN0K,E-\ll\._2_4 018- 9 3.Q9


* Residence (Permanent) Home Address

ApUUniULoURm/Ste

City/ToW!")

If Rural Address or Homeless, please describe where you reside

Zip Code

E-mail address

Mailing Address (If different) Nirginia P .O. Box or Uniformed Service Address, if
City or ~County
applicable (include Zip Code)
Name of City or County of Residence ROANOKE coUNTY
~

* Have you ever been convicted of a felony?

YES

GNO

State where convicted

If YES, have your voting rights been restored?

YES

If YES, when restored?

Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

I'm Interested In being


an Election Official on
Election Day. Please
send me Information.

--

DYES

NO

G;;3 NO

YES

If YES, when restored?

ONO

NEW NAME:

~~changed)

LJrJ DD~ DODD

You rroyrequestlhat )<Ill" home ad<tm notbo rtloasod H)OUmeni>erof)OI.fhousehold.,. ~I active or retired law enforcement,orlblh.,. boon gr>ntod protective court order, or ~I.,. in~"
vl\ohas threatened or stalked )VU andha.,. filed tOITI'Ialnl;og.~instlhat pem>n v.ilh rrogislnto orlawonfottoment jrusla!Uch copyoltol11'1aini) OJjd)portici>~ in lho
Address Confidentiality Program . YouiiJJslshowl!oJliniaP.O. boxundorrrolling oddr!ss inBor3 abo....

of)OI.fp015wlso~tymsomeono

.Q.

La~forc=:nt

Pro~lve O~r

Thr~ned/~ked

VIRGINIA VOTER REGISTRATION ADDRESS VERIFICATION


NAME: J1n Suk

LJ[l DD~ DODD

lee

C?

Ad.::,ss C=denti~ Program

< PLEASE PRINT >">>

VOTERID:055083094

--~F~IR;;:ST;:;----------:M:-::I:::D=DL:-:E:--------LA-5-T-----

CHECK WHICH ADDRESS BELOW IS YOUR CORRECT


HOME (RESIDENCE} ADDRESS:
YOUR CURRENT VOTER
REGISTRATION ADDRESS:

ADDRESS PROVIDED
BY THE POST OFFICE:

~ 15705 Foleys Mill PI

5129 Overland Dr Apt H


Roanoke, VA 24018-9309

Haymarket, VA 201696182

1111111111111111111111111111111111111
OTHER ADDRESS

(Cannot b~ a P.O. Box unless you have Protected Voter status):

STREET

CITY

STATE

*PROTECTED. VOTERS: You may request that your home


ss not be released if you or member of your household (a) a~e act1ve or retired law ~nforcement, judge, U.S. or Virginia Attorney General attorney, or (b) have been granted
a protective court o~der, (c) are 1n fear of your personal safety from someone who has threatened or stalked you and
have fil.e~ a c~mpla1nt against that person with a magistrate or law enforcement (must attach copy of complaint), or
{d) part1c1pate m the Address Confidentiality Program. You must show a Virginia P.O. box in the space provided above.

)( __

S~I~G~N;ATTIUUR~E~~~e~q;,u~im~d~t~o7ld~rn~~-~~~----~~~~~==~------~~~D~A~J~E_L_[-=z=

_________

If applicant is unable to i n due to a physical disability, write the name/address of person who assisted. (Required)
W~RNING: ln~e~tionally making a materially false statement on this form constitutes the crime of election fraud
pumshab/e under Virgmta law as a felony. Violators may be sentenced to up to 10 years in prison and fined up to $2,500.

ZIP

CHECK ONE:
Q

Q
Q
Q

Law Enforcement Officer


Protective Order
Threatened/Stalked
Address Confidentiality Program

ouNTYtcrr: fF RESIDENCE

(JD1) ?b2- {"?s l -

DAYTIME PHONE On case we have questions)

159488

Exhibit 7, page 29 of 84

Social Security Number

Sex

Date of Birth
Month

Day

Age

Year

Check boxes that apply:

Check if you are:

0 New registration
0 Address Change

0 active law enforcement


0 retired law enforcement
0 not applicable

Middle or Maiden Name

0 Name Change

Sull1x

Any Prior Legal Name

0 check here if none

City or County of Residence

Month & Year Moved to this address:

Da time Phone:

FOR RESIDENCE POST OFFICE BOX, MILITARY ADDRESS OR RURAL ADDRESS DESCRIPTION, CHECK HERE 0

AN D ENTER ON BACK OF FORM -------------~1

Place of Birth: (Optional)

Complete Address of Previous Registration

City or County

Address

State or Country

o;s

Have you
ever been
convicted
of a felony? f/No

Have you ever been u Yes


judged by a circuit
court to be mentally
trNo
incompetent?

City or Town

0 check here if none


State

If yes to felony', give date when voting rights were


restored : if yes to incompetency, give date of court
order declaring competency.

Zip Code

Are you a
citizen of the
United States?

ONo

REGISTRATION STATEMENT: I do hereby state, subject to the penalties for false statements set forth above that I am a citizen of the United States, a resident of Virginia qualified
and entitled under the Constitution and Jaws of the Commonwealth of Virginia to register to vote and that the information given above is true and correct to the best of my knowledge.
I hereby authorize the cancellation of any previous registration.
Applicant Signature:
~

Registrar Use Only

Date:
PCT Code

Date of Registration
Month
Day
Year

-z

Town/PCT Code
Reason

ev. 08/96}

Address

(...-.,

- :J

Mailing A c-.........~

s
~

.:;;zj

:s-~

ti}

LE-n-te_r_B_e_lo_w_:1-) 0
number of the n
side, 112 m1le e ~

Juse, the
north

...w
z
0

.~

~!..)
u::

i=

For Regist
Changes i1
New Last Na1

Other Cha
New Informal

...z

::>

~~ II.a:
t--..~i w~

~~

Only

Cl)

>

==
c
0::
0
u..

w
-'
II.

Q" ~
c
<

---

;;
Z-'

<! ':."': +- "'.~~

~a:

Purged iS
.J Purged
.J Deceas
.J Reglste

.J Person<

...

Ill .

l~

~i
wz

I
~r~i
::Eiii

oa

1
"

[ttl I\

. 1~ .
-~

Exhibit 7, page 30 of 84

-------

*Are you a citizen of the United States


of America? ~~YES D NO

I*Will you be at least 18 years of a~ on or before


the next General Election day? (W_YES D NO

D Male
*Social Security Numoer

~Gender

~~~~-r=r~~=r~~=r~~

'--''--''--'DOD DODD

~Female

~2~S~G ,-~...f~o1L_~R..uo.{!.I4-Lae(;._,_.,.-----lLJcJL__.___._ _ _

w no dh~-~ da e, vA

!......,-l

*Residence (Permanent) HomE/Address

'If you checked "NO" in response to either of


these questions, do not complete this form.

? 2 q2
1

Apt/Unit/Lot/Rm/Ste cltY/Town7

ZipCode

~mht bo.'?bcm2~ l @JJ;-r1


J
- - - - - - - - - - - - - - - - - - - - - - - - - - - DCity or~County: p,; ,e -..t:::r;Nl?'\\.yc
If Rural Address or Homeless, please describe where you reside

E-mail address

((I""

Mailing Address (if differenf!Nirginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of City or County of Residence

1:1~111

*Have you ever been convicted of a felony? DYES

-~o

If YES, have your voting rights been restored? DYES D NO If YES, when restored?
*Have you ever been judged mentally incapacitated? DYES
If YES, has court restored you to capacity? DYES D NO If YES, when restored?

s,

rn,oo,oorn

State where convicted===--===:--::=====-------

[J[J,[JLJ,DDDD
0

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true.l authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
lo.lL>~u.a Notice on the front of this form.
I ~'

- , *Signature(ormarkifunabletosign)

,., hAAJ~

V'..,.......~

~r-D\ I f.lfDl/ ~~6


; v
~[_j.J WltLJ L1dlQlLJt1J

APR 15 2014

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

D Check if you have a disability that requires


someone to assist you in order to vote.

DOD Protected Voter Code if applicable. See instructions.


D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT Town code

New Last Name


Other changes

Denial date & reason

Date changed

New First, Middle/Maiden Name and Suffix

NewPCT

Date changed
Authorized by

Date changed

D Deceased _ _ _ _ _ _ _ _ _ __ D Judged Incapacitated _ _ _ _ __


D Out of State _ _ _ _ _ _ _ _ __ D Error Deleted _ _ _ _ _ _ _ __
D Personal Request _ _ _ _ _ _ __ D NVRA Cancel _ _ _ _ _ _ _ __

D Transferred Out _ _ _ _ _ _ _ __
D Re-Registered _ _ _ _ _ _ _ __

D Convicted of a Felony _ _ _ _ __

D Reactivated----------

D Inactive Status _ _ _ _ _ _ _ __

Exhibit 7, page 31 of 84

the United States

*Will you be at least 18 years of age on or before


the next General Election day? Q(YES 0 NO

If you checked "NO" in response to either of


these questions, do not complete this form.

0 Male !)'Female
Gender

AD:1_,________.___

* F1rst Name

\1...04 \o \Ali\\owooA

Or-

R. 0 ~

\Noodloci

*Residence (Permanent) Home Address

None

----=---:c--:-:-~---=---:::--:-

*Full Middle or Maiden Name *Suffix

Apt/U nit/Lot/Rm/Ste

City(Town

dje.

-z.:z.t .q '2.

Zip Code

CA~f' i I te.a \e.

\ If Rural Address or Hom eless, please describe where you reside

E-ma I address

@ 5Ma t\ Gll

----------------------------------------------------------- =O~C~iw~o~r~O~C~o~u~nw~
: ----------------Mailing Address (if diffe1enf/Nirginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of City or County of Residence

*Have you ever been convicted of a felony? 0 YES

State where convicted c-===--====--======-----------

lf YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored?

UU f [ ] [ ] f DODD

*Have you ever been judged mentally incapacitated? 0 YES


NO
I[][] [][] o
If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored?
1
1

DITJY

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the infonnation
provided on this form is true.l authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.

-7 * Signature (or mark if unable to sign)

APR 25 2013

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted . (Required).

Check if you have a disability that requires


someone to assist you in order to vote.

ODD Protected Voter Code if applicable. See instructions.


0 I'm interested in being an Election Official on Election Day. Please send me informa\ion.

For Office Use Only


Registration date

New Last Name


Other changes

0
0
0
0

PCT Town code

Date changed

Denial date & reason

New First, Middle/Maiden Name and Suffix


New PCT

Date changed
Authorized by

Date changed

Deceased--------------------- 0 Judged Incapacitated------- 0 Transferred Out----------------0 ut of State ------------------- 0 Error Deleted ------------------- 0 Re-Registered---------Personal Request--------------- 0 NVRA Cancel _ _ _ _ _ _ _ __ 0 Inactive Status - - - - 0 - - - - - - - 0 Reactivat~d - - - - - - - - - - Convicted of a Felony ___________

Exhibit 7, page 32 of 84

United States *Will you be at least 18 years of age ~r before


the next General Election day? F!'fES D NO

Gender

*Date of Birth

9h\orU

JZ:nbC'I
DNone
* Fuii'Miiidle or Maiden Name

*First Name

-'--'/L=...>oo<.G~b'_._7___,..._Fo=

If you checked "NO" in response to either of


these questions, do not complete this form.

Hc:t"""-,L-c. . _.i_""]9,...-1,-S'-...__r....__c.....,a..__c=e--- - - ' - - - - - \J((r\'onc\O)P

!.->r>"'-"ll'f-L-1

*Residence (Perman~nt) Home Address

Apt/Unit/Lot/Rm/Ste City/Town

2:uq;.,
Zip Code

=-E--m-a~il-a--:d-:-d-re_s_s_ _ _ _ _ _ _ _ __

\ If Rural Address or Homeless, please describe where you reside

Uincc=~ro:?oUntY
tW\ioms

:-:--::-:-----:A-:-dd-:-r-e-ss-(:-:/f:-d-::-iffi-=-=-e-r-en-tl:-:-1:-V::-ir--:gi--:n--:ia--=P=--=.0:--:.s=-o_x_o_r-:-U:-n:-:-ifo_r_m_e-:-d--::S--:e-rv-:-ic-e-A:-d-d-,re_s_s,-:i:-fa-p-p-:li-ca--:b-:--1
e- Deity or
Name of

of Residence

State where convicted ==::::--:==~=====-------

*Have you ever been convicted of a felony? DYES

UUtrntDDDD
* Have you ever been judged mentally incapacitated? D YES
If YES, has court restored you to capacity? DYES D NO If YES, when restored? UUtUUtDDDD
If YES, have your voting rights been restored? DYES D NO

restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have
read the Privacy Act Notice on the front of t}\\s ~orr
.
*Signature (or mark if unable to sign)
FEn

'-'t.,A!&kr'

f)

mI~ l7JQJITJ

3 2012

If applicant is unable to sign due to e physical disability, write the nama/address of person who assisted. (Required). D Check/describe ij you have a disability that requires accommodation In ordarto vote.

D I'm interested in being an

You may request that your. home address not be released if you or a member of your household (a) are active or retired law enforcement, or (b) have bean granted a
Election Official on Election Day. protective court order, (c) are in fear of your personal safety from someone who has threatened or stalked you 8nd h8V8 fi18d 8 complaint 8Q8inst th8t person with
Please send me infonnation
8 magistr8ta or law enforcement (must attach copy of complaint), or {d) participate in theAddrass Confidentiality Program. You must show a Virginia P.O. box under

mailing address in Box 3 above. D law Enforcement D Protective Order D Threatened/Stalked D Address Confidantlality Program

For Office Use Only


Registration date

New Last Name

PCT Town code

Denial date & reason

Date changed

New First, Middle/Maiden Name and Suffix

Other changes

New PCT

Date changed
Authorized by

Date changed

D Transferred Out _ _ _ _ _ _ _ __
D Deceased----------- D Judged Incapacitated _ _ _ _ __
D Out of State _ _ _ _ _ _ _ __
D Error Deleted--------- D Re-Registered--------D Personal Request _ _ _ _ _ _ __ D NVRA Cancel _ _ _ _ _ _ _ __ D Inactive Status-~------
D Convicted of a Felony _ _ _ _ __
D Reactivated----------

C~T~Z~ i.J MAY 1 7 2015


VANVRA l 7/09

Exhibit 7, page 33 of 84

*Will you be at least 18 years of age on or before


the next General Election day? gyEs 0 NO

*Are you a citizen of the United States


of America? !:d-YES 0 NO

Social Security Number

!2-M ale 0 Female


*Gender

"Date of Birth

Daytime Telephone Number

b >~.tJEJfT ,jBSE/1-1

:Put"Z-6/7
*Last Name

If you checked "NO" in response to either of


these questions, do not complete this form.

*First Name

T / ZtV2

'-)If

None

V It

CvooP/YRit?if
*Residence (Permanent) Home Address

*Full Middle or Maiden Name *Suffix

Apt/Unit/Lot/Rm/Ste

City/Town

.:2 ::?/ 9:3


Zip Code

/;;/fvpwzoa /f-_3(!5J q//?e;,/r.


If Rural Address or Homeless, please describe where you reside

E-mail;?c!dress'-"

------------------------------------------------------------ -O_C_i~~o_r_O_C_o_u_n~~:__________________
Mailing Address (ifdifferent)Nirginia P.O.Box or Uniformed Service Address, if applicable (include lip Code) Name of
of Residence

*Have you ever been convicted of a felony? 0 YES .Q-NO

State where convicted===--:===-======-----------

DLJ rn DODD
!Ml!Ml DO DDDLJv

If YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored?
*Have you ever been judged mentally incapacitated? 0 YES .ffNO
If YES, has court restored you to capacity? 0 YES 0 NO
If YES, when restored?

UU f

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.

-7 *Signature (or mark if unable to sign) ----~=-----k-H---'---I'~H:IQHVf--+1-'1.2':---1-20~+183-i.fr~>+lvn'l'\:r--If applicant is unable to sign due to a physical disabili~. write the name/address of person who assisted . (Required).

DOD

Check if you have a disability that requires


someone to assist you in order to vote.

Protected Voter Code if applicable. See instructions.

0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

New Last Name

Town code

Denial date & reason

Date changed

New First, Middle/Maiden Name and Suffix

Other changes

NewPCT

Date changed
Authorized by

Date changed

0
0
0
0

Deceased _____________________
Out of State _ _ _ _ _ _ _ __
Personal Request _________
Convicted of a Felony _______

0 Judged Incapacitated _ _ _ _ __
0 Error Deleted __________
0 NVRA Cancel _ _ _ _ _ _ _ __

0
0
0
0

Transferred Out _________________


Re-Registered _________________
Inactive Status __________________
Rea ctiva1ed ___________________

MAY 1 7 2015
Exhibit 7, page 34 of 84

Ill

* Are you _a citizen Jlf the United States *Will you be at least 18 years of a~ on or before \If you chec~ed "NO" in response to _either of
of Amenca? [))fES D NO
the next General Elect1on day? Ill YES D NO
these quest1ons, do not complete th1s form.

*Social Security Number

t1oo+oaa

*Last Name

[]J[Q [SJ[z][]J- [g)[]~- ~~[8][5J

M'Male D Female
........
*Gender

~-

*Date of Birth

Daytime Telephone Number

MD AliA- N0 ~7""',_,..)t""""L.._,o0=
--'-------------=--- Giul/e({IJO

'1'1o5 Wh:+~

*First Name

D None

D None

*Full Middle or Maiden Name *Suffix (Jr., Sr., Ill, Etc.)

-:---::-:-+)~3::---:-=-- tRJoalor: J .... :4


Apt/Unit/Lot/Rm/Ste City/Town
~
Zip Code
,)ucoJ~: @_ v-~oo.Cm

Dcve

*Residence (Permanent) Home Address

\ If Rural Address or Homeless, please describe where you reside

addr~

E-mail

Address If different'!/ Virginia P.O.Box or Uniformed Service Address, if applicable D City or D County
Name of

* Have you ever been convicted of a felony? DYES

of Residence

State where convicted===-===--:=====-------

UU;UU;ODDJ
*Have you ever been judged mentally incapacitated? DYES
0
If YES, has court restored you to capacity? DYES D NO If YES, when restored? UU JUU Jrnrn
If YES, have your voting rights been restored? DYES D NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have
read the Privacy Act Notice on the front of this form.
~
rn~; ID:l~ 1r,::;w:1r.v.ll
y
~*Signature (or mark if unable to sign) -=~~~;;;;~""--====<.o=="----------....,""'""-..-.........- - ~ ~ l.iiJlQJWW

DEC 0 9 ?Off

applicant is un

e to sign due to a physical disability, write the name/address of person who assisted. (Required).

Check/describe ijyou have a disability that requires accommodation in order to vote.

I'm intere ed being an


You may request that your home address not be released it you or member of your household are Ia) active or retired law enforcement, or (b) have been granted a
Election 0 Ia I on Election Day. protective court order, or (c) are in fear of your personal safety from someone who has threatened or stalked you and have tiled a complaint against that person with
Please send me information.
a magistrate or law enforcement (must attach copy of complaint) or (d) participate in the Address Confidentiality Program. You must show a Virginia P.O. box under
mailing address in Box 3 above. 0 Law Enforcament 0 Protective Order 0 Threatened/Stalked 0 Address Confidentiality Program

For Office Use Only


Registration date

PCT Town code

Date changed

Denial date & reason

New First, Middle/Maiden Name and Suffix

New Last Name

New PCT

Other changes

Date changed
Authorized by

Date changed

D Transferred Out _ _ _ _ _ _ _ __
D Deceased _ _ _ _ _ _ _ _ _ __ D Judged Incapacitated _ _ _ _ __
D Out of St;:~te _ _ _ _ _ _ _ _ __ D Err.or Deleted--------- D Re-Registered--------0 NVRA Cancel _ _ _ _ _ _ _ __ 0 Inactive Status _ _ _ _ _ _ _ __
D Personal Request _ _ _ _ _ _ __
D Convicted of a Felony

D Reactivated----------

VANVRAl 2/10

Exhibit 7, page 35 of 84

*Are you a citiz.o/' of the United States *Will you be at least 18 years of age on or before
of America? rJ YES 0 NO
the next General Election day? l&YES 0 NO
0 Male 0 Female
* Soc-:-ia"71~S-ec-u""'r":lty
:-'N"u-m-.b,_e_r_~---* Gender

~~

If you checked "NO" in response to either of


these questions, do not complete this form.

*Date of Birth

Daytime Telephone Number

1 13 ol+ TEtJG, -*""Fi+-=rs'"'"'tN:-:-a......cm,_eI _ _ _ _ _ _ _ _ *Full Middle or Maiden0'None


Name
4, ~~~oe.. 14-;,,e
IMxx\?f-;cl~c:

* LastNameCl
J,;:.o;,.~....a *

1t-tl123

Residence (Permanent) Home Address

Apt/Unit/Lot/Rm/Ste City/Town

' -=-=-=---:-:--:-:-----:-:--=-------,----.,----,-------,------:-:-------

If Rural Address or Homeless, please describe where you reside

BN"one

*Suffix (Jr., Sr., Ill, Etc.)


Z1p Code

koo.d-<at-3 --c.< Q

E-mail address I

.c k,J.?.

r,i

Mailing Address (If different'!/ Virginia P.O.Box or Uniformed Service Address, if applicable 0 City or 0 County
(include Zi Code)

Name of City or County of Residence

..,.......""'' *Have you ever been convicted of a felony? DYES ~NO

UU f rn f oorn
!Ml!Ml rno ornyD

State where convicted===--:===--======-------

If YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored?

*Have you ever been judged mentally incapacitated? 0 YES


NO
-~""" If YES, has court restored you to capacity? DYES 0 NO
If YES, when restored? UU 1

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have
"""""'~-' read the Privacy Act Notice on the front of this form.

~ * ~~1rlr9 (~O~r!Jtable to sign)~

[QJ[J I LQ_][] 112JQ]UJE;j

If applicant is unable to sign due'to a physical disability, write the name/address of person who assisted. IRequired). 0 Check/describe if you have a disability that requires accommodation in order to vote.
0 I'm interested in being an
You may request that your home address not be released if you or member of your household Ia) are active or retired law enforcement, or (b) have been granted a
Elecmon Official on Election Day. protective court order, (c) are in fear of your personal safety from someone who has thra~_tenad or stalked you and have filed a complaint against that person with
Please send me information.
a magistrate or law enforcement (must attach copy of complaint), or (d) participate in the Address Confidentiality Program. You must show a Virginia P.O. box under
mailing address in Box 3 above. 0 Law Enforcement 0 Protective Order 0Threatened/Stalked 0 Address Confidentiality Program

For Office Use Only


Registration date

PCT Town code

New First, Middle/Maiden Name and Suffix

New Last Name


Other changes

. NewPCT

VA NVRA-1 5111

Date changed
Authorized by

Date changed

0 Deceased _ _ _ _ _ _ _ _ _ __ 0 Judged Incapacitated _ _ _ _ __


0 Out of S t a t e - - - - - - - - - 0 Error Deleted _ _ _ _ _ _ _ __
0 Personal Request _ _ _ _ _ _ __ 0 NVRA Cancel _ _ _ _ _ _ __
0 Convicted of a Felony _ _ _ _ __

Date changed

Denial date & reason

0 Transferred Out _ _ _ _ _ _ _ __
0 Re-Registered--------0 Inactive Status _ _ _ _ _ _ _ __
0 Reactivate~ _ _ _ _ _ _ _ _ __

Exhibit 7, page 36 of 84

a citizen of the United States of America?

be 18 years of age on or before election day?

E]No

[)No

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

IF

IF

YES. HAVE YOUR VOTING RIGHTS BEEN


YES, WHEN

RESTORED?

RESTORED ? (REQUIRED) MO_ _ _OAY_ _ _YEAR_ __

IF
IF

If you checked 'no' in response


either of these questions, do not
this form.

YES, HAS COURT RESTORED YOU TO CAPACITY?


YES, WHEN

RESTORED?

(REQUIRED) MO_ _ _DAY_ _YEAR_ __

REGISTRATION STATEMENT: I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S. ~AND A RESIDENT OF VIRGINIA, THE
INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION (ENTERED IN BOX 1 ABOVE) OF MY CURRENT REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABOVE.

REMINDER:

MARK IF UNABLE TO SIGN).

DATE-+

Check here Wyou have a


disabilily thai requires
accommodal1on 1n order lo vole

..
VA- NVRA -1 Rev 9/05

Exhibit 7, page 37 of 84

*Are you a citizen of the United States


of America? YES 0 NO

*Will you be at least 18 years of age on or before


the next General Election day? tif!YES 0 NO

Male
... Gender

I Security Number

l2f'\r-lf\.~ ... Torres

~Female

If you checked "NO" in response to either of


these questions, do not complete this form.

[J~ru~
*Date of Birth

[S]l][J- [5][J][5]- [3]~6][3]


Daytime Telephone Number

\I~QU-'(\CO!IIo,4-i- - - - ceci\iO

~-

~t Name

*Residence (Permane t) Home Address

ONone

*Full Middle dr Maiden Name

vU oodbri dg ~

Apt/U nit/Lot/Rm/Ste

City/Town

------=:..:..:c:-=
Zip Code

Q.oda.?.\/Ql'cat}grnajl.cd11

If Rural Address or Homeless, please describe where you reside

E-mail address

Mailing Address (if differenO/Virginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code)

*Have you ever been convicted of a felony? 0 YES ~NO

State where convicted==::-::==-=====-------

UU f [ ] [ ] f DODD
fi[J [][] DODD
U
f
f

If YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored?
*Have you ever been judged mentally incapacitated? 0 YES ~NO
If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (enterd in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front ofthis form.
JAN
20t4

n b

-7' s;gn""'re {oc marH unabl to sign) M~W ~


-:I_

21

1'5l[J,[ITiJ /~

If applicant IS unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

DOD

Check if you have a disability that refjuires


someone to assist you in order to vote.

Protected Voter Code if applicable. See Instructions.

~I'm interested in being an Election Official on Election Day. Please send me inf~rmation.

For Office Use Only


Registration date

New Last Name

PCT

Town code

Denial date & reason

Date changed

New First, Middle/Maiden Name .and Suffix

Other changes

New PCT

Date changed
Authorized by

Date changed

0 Deceased _ _ _ _ _ _ _ _ __

0 Judged Incapacitated _ _ _ _ __

0 Out of State _ _ _ _ _ _ _ __

0 Error Deleted _ _ _ _ _ _ _ __

0 Re-Registered _ _ _ _ _ _ _ __

0 Personal Request _ _ _ _ _ _ __

0 NVRA Cancel _ _ _ _ _ _ _ __

0 Inactive Status _ _ _ _ _ _ __

0 Convicted of a Felony _ _ _ _ __

0 Transferred Out _ _ _ _ _ _ __

0 Reactivated _ _ _ _ _ _ _ _ __

Exhibit 7, page 38 of 84

If you checked "NO" in response to either of


these questions, do not complete this form.

~~-~

*Social Security Number

*Gender

*Date of Birth

Daytime Telephone Number

.,....,.......1/bt.J.LL.fW<~'c!.:....!oa~W~--- ~-4:1-L...L:-_:--11.~VCL!...L.>..!C-1;""--ll-_____ b&~ Y


*Last Name
~L:.J=og;iii=OI

*First Name

None

*Full Middle or Maiden Name *Suffix (Jr., Sr., Ill, Etc.)

*Residence (Permanent) Home Address

WtJtxtJ~Jfi-P!lt;;= -?~#91

Apt/Unit/Lot/Rm/Ste

City(Town

d:JtEL

Zip Code

#oh!1SOI1
E~ail address

If Rural Address or Homeless, please describe where you reside

Mtl'lfi?-yA!ItJCJ

------------------------------------------------------------ =O~C~iw~o~r~O~Co~u~nw~:_________________
Mailing Address (if different)Nirginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of City or County of Residence

*Have you ever been convicted of a felony? 0 YES ~

State where convicted

===-====--======-------------

UU!UU!DDDD
*Have you ever been judged mentally incapacitated? 0 YES OOo
If YES, has court restored you to capacity? ~YES 0 NO If YES, when restored? UU!UU!DDDD
If YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
.__..:.._......... Notice on the front of this form.

~. s;gnntme(O<ma<k ;{unable 'ign~:::t____________________________


tn

0CT 21 2012

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

DOD

Check if you have a disability that requires


someone to assist you in order to vote.

Protected Voter Code if applicable. See instructions.

0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

0 Deceas.ed --------------------- 0 Judged Incapacitated _____________


0 Out of State ___________ 0 Error Deleted ----------------0 Personal Request _______________ 0 NVRA Cancel __________
0 Convicted of a Felony ____________
Notes

Date changed

Denial date & reason

New First, Middle/Maiden Name and Suffix

New Last Name


Other changes

Town code

CAf-Y.:-~1-~D Det:~A~~ N'DIi~cl (J.-z ff/P

New PCT

Date changed
Authorized by

Date changed

0 Transferred Out _________________


0 Re-Registered _________________
0 Inactive Status----'--------------0 Reactivated ____________________

MAY 1 7 2015
Exhibit 7, page 39 of 84

Will you be 18 years of age on or before election day?

Are you a citizen of the United States of America?

~ES

(g<(Es 0No

0No

If you checked
response to
either of these questions, do not
comJ]Iete this fo.uo. ~,-=:;;;;:-.----~

IF YES, HAS COURT RESTORED YOU TO CAPACITY?

IF YES, WHEN RESTORED? (REQUIRED) MO_ _ OAY_ _YEAR_ _

IF YES, WHEN RESTORED? (REQUIRED) MO_

DAY_ _YEAR_ _

REGISTRATION STATEMENT: I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S. CITIZEN AND A RESIDENT OF VIRGINIA, THE
INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION (ENTERED IN BOX 1 ABOVE) OF MY CURRENT REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABOVE .
..... REMINDER: SIGN HERE FOR

(OR MARK IF UNABLE TO SIGN).

who assisted: (REQUIRED)

Yes, I am Interested In
]

You may request that your home address not be released if you (a) are active or retired law enforcement, or (b) have
been gran led a protective court order, or (c) are in fear of your personal safety from someone who has threatened or
stalked
and have filed a complain! against that person with a magistrate or law enforcement (must attach copy of
You must show a Virginia P.O. box under mailing address in Box 7 above.

working as en Election
OffiCial on Eleclion Day.

lAW ENFORCEMENT

PROTECTIVE COURT ORDER

Check here if you have a


disability that requires
accommodation in order to vote.

THREATENED/STALKED

.,

~ ~d i'df(,l

:ssaJPP\1 uew3

?z

:aJeo

<;

1../J rf' "'} ~


'{'I

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IN~
M Onlll:l.:l NOU0313 :10 31\111:10 3Hl S3l/UilSNO:> 1\JI:IOj,SIHl NO Al:llN31:10 lN3W3l\flS 3Sl\f.:l A11\fll:l3l\fl\l \1 DNI>J\fW AlllfNOUN3lNI :oNINI:IVNl
A I
AVa
0~
~paJOisaJ ue4M 'seAJI
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---JeeA _ _ _ AVO
0~
paJOISeJUe4M'seAu '
N ~ S3A 0
~.l)pedeo 01 noA paJOISeJ )Jnoo Se4 ''seA II
ON 0 S3A 0
tpaJOISeJ ueeq s145u 5~QOA moA 8Ae4 'seA II
~PeleJpedeOUJ AI e u w !!'! OJIJnoo e Aq pa5pnl ueeq noA eAeH
ON~ 83 A r l ' ~ej e 10'pa 1 ~uoo ueeq noA
aAeH
31V~3:1
31VI\I
(auo etoJp] Jepuao
'Ava)1\1 :41JI8 10 a1ea
0 L I I:IV3A
t 301:1! 38 O! N
:INI DNIM0110:13Hl 'S311:1!N31:10 SlN3W3llflS 1\fll:l3llfW 3Sl\f:l AllO:IlliM !5NI~~I:IO:I Al1VN3d 1:130Nn wtu~:IV ON\f H\f3MS 1
J 0 1UawaoJoJu3 Mel peJilei:IJ8A1PV 0
:apo:l d!z 'a1e1s '.\il:l 'ssaJPP\1 ao,1uas pawJOJiun Jo JaqwnN xoa Od 'ssaJpp\f Bu!tle~ MaN

900Z

0 MdV

Exhibit 7, page 40 of 84

*Are you a citi~en of the United States


of America?
YES 0 NO

*Will you be at least 18 years of\tge on or before


the next General Election day? 'tJ YES 0 NO

fb

,)

I Security Number

@]Male 0 Female
*Gender

Marn!\~L

*Last Name

*Date-~--of Birth

&:Jw'"

llJL1J~~ [!JJ[TI- ffil?J- ~][IJ~sl


Daytime !eMPhone Number

~one

None

~~~~--~~--~--

*First Name

*Residence (Permanent) Home Address

If you checked "NO" in response to either of


these questions, do not complete this form.

*Full Middle or Maiden Name *Suffix

Apt/Unit/Lot/Rm/Ste

~u.:v-. :J..:YS c-....5


City/Town

Etc.)

2-<ll \ Cl 9
Zip Code

\ ~--~~----~--~--~--~--~--~------~------------------ Ed~'-"'. M\ L.s'-1~'-fo.\-cJ::l .~


If Rural Address or Homeless, please describe where you reside

E-mail address

------------------------------------------------------------ ~O~C~i~~o~r~O~Co~u~n~~:_________________
Mailing Address (if differenf,Nirginia P.O.Box or Uniformed Service
ress, if applicable (include Zip Code) Name of City or

of Residence

*Have you ever been convicted of a felony? 0 YES


If YES, have your voting rights been restored? DYES

NO

~0

State where convicted===-===--====~==------------If

UU;UUtDDDD
[],Fl [][] DODD

when restored?

*Have you ever been judged mentally incapacitated? D.JES


NO
If YES, has court restored you to capacity? 0 YES [31(io If YES, when restored?

U 1

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (e er~d-ifl..Box 1 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.
/
,
.w ~~-L2
~ *Signature (or mark if unable to sign) --~~~~~=?~-~=====------~~!.l..!;!ll-------It applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

Check if you have a disability that requires


someone to assist you in order to vote.

DOD Protected Voter Code if applicable. See instructions.


0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

New Last Name


Other changes

PCT Town code

Date changed

Denial date & reason

New First, Middle/Maiden Name and Suffix


New PCT

Date changed
Authorized by

Date changed

0 Transferred Out _____________


0 Deceased --------------------- 0 Judged Incapacitated _ _ _ _ __
0 Out of State---------------- 0 Error Deleted---------- 0 Re-Registered---------0 Inactive Status _ _ _ _ _ _ _ __
0 Personal Request _ _ _ _ _ _ __ 0 NVRA Cancel _______________
0 Convicted of a Felony _ _ _ _ __

0 Reactivated---------------

Exhibit 7, page 41 of 84

11

Will you be at least 18 years of age Q(1 or before


the next General Election day?
YES 0 NO

-;-Are ;;;-a ciii;npftt;'; un;;d' Stai;;


of America?
Q]YES
0 NO

1!1
Social Security Number

If you checked "NO" in response to either of


these questions, do not complete this form.

KZl

Male

Female

Gender

Date of Birth

Daytime Telephone Number

a'

GOM EZ,SEBASTIAN,

None

Last Name

First Name

Full Middle or Maiden Name

Not

Suffix (Jr.,Sr . III.Etc.)

3414 BELFRY LN, WOODBRIDGE, VA 221924341


* Residence (Permanent) Home Address

ApVUniVLoVRm/Ste

If Rural Address or Homeless, please describe where you reside

E-mail address

Mailing Address (if different) I Virginia P.O. Box or Uniformed Service Address, if
applicable (include Z1p Code)
Name of C1ty or County of Residence

0
0

* Have you ever been convicted of a felony?


If YES, have your voting rights been restored?

YES

~NO

State where convicted

YES

ONO

If YES, when restored?

* Have you ever been judged mentally Incapacitated?

If YES, has court restored you to capacity?

YES

Zip Code

CityfTown

YES

NO

rfJ NO
If YES, when restored?

City or

[!]County

PRINCE WILLIAM

LJD/ LJD/ DDDD


UU! DD,DDDD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
1 provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act

~ ~o~ii~8n:::;: (or mark if unable to sign)

se kas-k; a 14

;~;--?-- -~ .. ~- ~--~~~;5[~ tli)El], [][}][]6]


BOOKS CLOSEctJ

~..,.,

~~

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted (Required).

DOD
0

Check if you ha' a disability that requ~res


someone to ass1Jt you 1n order to vote
~

,JUN 14 2Qt3)

Protected Voter Code if applicable. See above.

I'm Interested in being an Election Official on Election Day. Please send me information.

JUN 0 2 2015
Exhibit 7, page 42 of 84

..
Will y/' be 18 years of age on or before election day?

~YES

If you checked 'no' In response to either


of these questions, do not complete this
form .

ONo

5
MARVIN

ADDRESS {IF RURAL ADDRESS, DESCRIBE BELOV'J)

APTrJNIT/LOTIRM/SUITE

J:/she,-J avenue
MAILING ADDRESS m

dmmoU

VIRGINIA P.O. BOX OR UNIFORMED SERVICE ADDRESS, IF

APPLICABlE

{INCLUDE ZIP CODE)

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

.. HAVE YOU EVER BEEN JUDGED

IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

. . IF YES, HAS COURT RESTORED YOU TO CAPACITY?

IF YES, WHEN RESTORED? (Required)

IF YES, WHEN RESTORED? {Required) MD--===--- DAY

YEAR---==-

~0
-YEAR---=::_

REGISTRATION STATEMENT: I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING W ILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U . S . ~ AND A
RESIDENT OF VIRGINIA, THE INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION, (ENTERED IN BOX 1 ABOVE) OF MY CURRENT
REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABOVE.
REMINDER: SIGN HERE FOR VOTER REGISTRATION {OR MARK IF UNABLE TO SIGN).

.J.

DATE~

0~

//-/9-

If applicant is unable to sign, write below the name/address of person who assisted {REQUIRED)

Yes, I am Interested 1n working as an


Election Official on Election Day Please
send me information

,...,.O.bi~e

u~~d)nlv

..

/"

..... ''t:

..

CJ

Personal Request

Notes:

Date Changed

[] Judged Incapacitated

[] Transferred Out

[] Error Deleted

[] Re-Registered

[] NVRA Purge

[]Inactive Status
[] Re-Activated

[] Convicted of Felony

c. AtJc:Gt,t,~i) ', D e.c.lt4.~-:-e-J

{'JD'I'--' G ::+ize~

"ont;,;

Date Changed

[] Out of State

OHic~ us~

Authorized By

New PCT

Other Changes

Deceased

....

New First, Middle/Maiden Name and Suffix

New Last Name

CJ

- .:::

: , t ':: (if.fi~~ - ui~ nlv

Check here if you have


a disability that requires
accommodation in
to vote.

JUN 0 2 2015

Exhibit 7, page 43 of 84

'"'!!.,

(~

~N CEIH_OM E Af.< RESS (IF, RURAL ADDRESS, COMPLETE BOX 11 B ~

0 fro~

h0

. . . I ' 4--

FIRST NAME

E fr ,,'\JR

DE I s L ;-' ,\) D

v\) rl

\
A~P LI E S

&t

L9-

L'i

....

(INCLUDE ZIP CODE)

ection B and sign your name in the red box below.

0
9

COUNTY

NO. STOP HERE DO NOT FILL OUT SECTION B .


CIRCUIT COURT JUQG!;;M!;;NI OF MENTAL, INCAPACITY

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

DYES i iNo

HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITAT ED?

DYES

~0

IF YES , HAVE YOUR VOTIN G RIGHTS BE EN RESTORED?

DYES

IF YE S, HAS COURT RE STORE D YOU TO CAPACITY?

DNa

DNO

- -DAY_ _YEAR- -

Yes, I am interested in working as


an Election Offici al on Election Day Please
send me information.

YES

IF YES , WHEN RESTORED? (REQUIRED ) MO_ _ DAY _ _YEAR

If you are active or retired law enforcement, or if you have a protective court order, you may request that
your home address not be released. You must show a Virginia P.O. box in box 6 abo~e.
ACTIVE/RET LAW ENFORCEMENT

--

PROTECTIVE COURT ORDER

Check here if you have a


disability that requires
accommodation in order to vote.

REGISIRATION STATEMENT I SWEAR/AFFIRM. UNDER FELONY PENALTY FOR PERJURY, THAT I AM AU S mzJO.tl AND A RESIDENT OF VIRGINIA THE INFORMATION I HAVE PROVIDED ON THIS FORM IS
TRUE, I AUTHORIZE THE CANCELLATION ENTERED IN BOX A BELOW OF MY CURRENT REGISTRATION AND I HAVE READ THE PRIVACY ACT NOTICE BELOW

effi \'"'\~ ( 1~'0

_,_. REMINDER: SIGN HERE FOR VOTER REGISTRATION (OR MARK IF UNABLE TO SIGN) AND COMPLETE BOX A BELOW. COMPLETE BOX 11 BELOW IF RURAL ADDRESS.

:~RNE . . .

DATE

\Ii/_Olf

IF APPLICANT IS UNAB\j. TO SIGN, WRITE THE NAME~ DDRESS OF PERSON WHO ASSISTED BELOW (REQUIRED).

'11

ZIP CODE

('

ES. To apply to reg ister to vote or cha nge your voter reg istration address: CONTINUE
omplete all boxes (8 11 and A) in Section Band sign your name in the red box below.

IF YES , WHEN RESTORED? (REQUIRED ) MO

"'""'

STATE

2'2..

I :NAME OF CITY OR COUNTY OF RES IDENCE


D CITY

~:YOU AU. 8 , CITIZEN?

0 Np. STOP HERE DO NOT FILL OUT SECTION B.


!;;QNVICTION OF FELONY

.-

\ Jo.
7

DO YOU WANT TO APPLY TO REGISTER TO VOTE OR CHANGE YOUR VOTER


REGISTRATION ADDRESS?
~~S . Answer the citizenship question to the right an d compl ete ALL boxes (8 11 and A ) in

10

SUFFIX (JR., SR., Ill., ETC.)

CITY OR TOWN

S7llf

;-s:w .::Z+c:; o }('

T f\JE'-j

~NIT/LOT/RM/SU ITE ,

MA ILING ADDRESS (i f different from above ) P. 0 . BOX OR UNIFORMED SERVICE ADDRESS, IF

~~~ i

] b.L

FULL MIDDLE OR MAIDEN NAME

LAST NArvlt

l l""llllJ

.r

~ - ~ --

~ - ~ ~A~~--0
~'

IF YOU LNE IN A RURAL AREA, DESCRIBE YOUR HOUSE LOCATION (I.E , STATE ROAD NUMBER WHERE YOUR HOUSE IS LOCATED; CLOSEST INTERSECTING ROAD; SIDE OF THE ROAD-NORTH, EAST. ETC;
NEAREST LANDMARK)
/

REGISTRATI ON DATE't(

PCT

DENIAL DATE & REASON

TOWN CODE

COMMENTS

JAN 0 8 Z004
'I<
VA NVRA 1

R~y

I[QO

....... ..,_....

---- --------------------------------------------------------------------------------------------------------------------------------------------------------------------

OFFICE USE ONLY

OFFICE USE ONLY

OFFICE USE ONLY

NEW LAST NAME

NEW FIRST, MIDDLE/MAIDEN NAME AND SUFFIX

DATE CHANGED

OTHER CHANGES

NEW PCT

DATE CHANGED

AUTHORIZED BY

D DECEASED

D JUDGED INCAPACITATED

D TRANSFERRED QUT

D OUT OF STATE

D ERROR DELETED

D RE-REGISTERED

D PERSONAL REQUEST

D NVRA PURGE

D INACTIVE STATUS

D CONVICTED OF FELONY

D REACTIVATED

NOTES:

cAt-Jt:.JU.i11J\ ~

()~t,.A-P. C?D

~.J-Div c-:r;.YI:ffN

AlJ-U..l(l15

Exhibit 7, page 44 of 84

-u.-

Voter Registration Application


Before completing this form, review the General, Application, and State specific instructions.
Are you a citizen of the United States of America?

E]Yes

0No

This space for office use only.

El

Will you be 18 years old on or before election day?


Yes
0No
If you checked "No" in responseto either of these questions, do not complete form.
(Please see state-specific instructions for rules regarding eligibility to register prior to age 18.)

First Name

Last Name

Ms.

Lena

sexton

Home Address

Middle Name(s)

City!Town

State

Zip Code

TRIANGLE

VA

22172

City/Town

State

Zip Code

Apt. or Lot#

18610 AMIDON AVE

Louise

Address Where You Get Your Mail If Different From Above

3
Date of

Bj

Year
Day
Month
Choice of Party
(see ilem 7 in the instructions for your Stale)

Democratic

Telephone Number (optional)

11961

ID Number- (see liem 6tn the instructions for your state)

5 (571) 572-1414

Race or Ethntc Group


(see item B in the instructions for your Stale)

not required in VA

I have reviewed my state 's instructions and I swear/affirm that:


I am a United States citizen
I meet the eligibility requirements of my state and
subscribe to any oath required.
The information I have provided is true to the best of my
knowledge under penalty of perjury. If I have provided false
information , I may be fined, imprisoned, or (if not a U.S.
citizen) deported from or refused entry to the United States.

-,

-;1

;/!.

;)(WY\p__
I /(J) - ZII

s.JP-

222011
:AJ'l-.....:>

Please sig1'1 full name (or put n1'ark) .A.

Date:

Month

Day

z(;20/~ I
Year

Exhibit 7, page 45 of 84

- - - - -

y;;;;

-~
Are you a citizen of Jl:le United States
of America?

O.YES

wiii';ou b";;i lea';1 8


of ; ; or;.-t5r' befo;;the next General Election day?
[!fYES 0 NO

0 NO

0
Social Security Number

If you checked "NO" In response to either of


these questions, do not complete this form.

Female

Gender

Date of Birth

Daytime Telephone Number

-=-F-=-I.::..:KE=.=S'-",M=IC=H:.:..A::.::E=-=L=.z,..::.T=.:H:...:O::...:M.:..::..:..;A::.::S'--- -:-=-~----------

_________.-0.-....:..:N.:.oon=-e

Last Name

Full Middle or Maiden Name

First Name

0 None
Suffix (Jr.,Sr.,III,Etc.)

14990 STREAM VALLEY CT, HAYMARKET, VA 201692:.::.5::..:65:::.___ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - Residence (Permanent) Home Address

ApUUniULoURm/Ste

Zip Code

City/Town

If Rural Address or Homeless , please describe where you reside

E-mail address

Mailing Address (if different) I Virginia P.O . Box or Uniformed Service Address, if
D City or [!)County
applicable (include Zip Code)
Name of City or County of Residence PRINCE WILLIAM
Have you ever been convicted of a felony?
If YES, have your voting rights been restored?

DYES

0"No

State where convicted

DYES

0NO

If YES, when restored?

Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

DYES

NO

YES

NO
If YES, when restored?

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (RequiW I)!\.1

ODD
0

UU' [](}DODD

UUt []LJ,DDDD

3 ti

LUH

Protected Voter Code if applicable. See above.

I'm Interested In being an Election Official on Election Day. Please send me Information.

Exhibit 7, page 46 of 84

*Are you a citizen of the United States


of America? cf11ES D NO

urity Number

*Will you be at least 18 years of a~on or before


the next General Election day? ~YES D NO

*Gender

If you checked "NO" in response to either of


these questions, do not complete this form.

*Date of Birth

HUl?-e.d11J

Daytime Telephone Number

J\nhif\1~

*First Name

DNone

DNone

*Full Middle or Maiden Name *Suffix (Jr., Sr., II Etc


ApVU niVLoVRm/Ste

Elaiv1 6Vi \\f_

CiiYJTown

=:LlQ.~lJ.w..\:----Zip Code

hetbertbelia~moltrtet

\If Rural Address or Homeless, please describe where you reside

E-mail address

t]t 40.'1c6 co
I

------------------------------------------------------------=D~C~i~~o~r~D~C=o~u~n~~:~---------------
Mailing Address (if differenl)Nirginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of City or County of Residence

*Have you ever been convicted of a felony? 0 YES

}?J_ NO

State where convicted-------------------------------

UU!UU!DODD
FlFl UU DODD

If YES, have your voting rights been restored? DYES D NO If YES, when restored?
It

*Have you ever been judged mentally incapacitated? 0 YES ~NO


If YES, has court restored you to capacity? DYES D NO
If YES, when restored?

UU/

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.
~Y7'
.
NOV 2 0 2013
~F.l [D;lro:;J w~rv:J
~ *Signature (or mark if unable to sign) ~
LlJW
I
I [BLQ]~ll.J

LlJLJJ

If applicant is unable to sign due to a physical disabili~. write the name/address of person who assisted. (Required).

ODD

D Check if you have a disabili~ that requires


someone to assist you in order to vote.

Protected Voter Code if applicable. See instructions.

0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

Town code

Date changed

Denial date & reason

New First, Middle/Maiden Name and Suffix

New Last Name

NewPCT

Other changes

Date changed
Authorized by

Date changed

0 Deceased ____________________

D Judged Incapacitated _______

D Transferred Out _ _ _ _ _ _ _ __

D Out of St.ate _ _ _ _ _ _ _ __

D Error Deleted _ _ _ _ _ _ _ __

D Re-Registered ___________

0 Personal Request _________

0 NVRA Cancel _ _ _ _ _ _ _ ___ 0 Inactive Status __________

D Convicted of a Felony _______

D Reactivated ____________

Exhibit 7, page 47 of 84

*Will you be at least 18 years of!i,E! on or before


the next General Election day?lj)YES 0NO

States

0Male rz!)Female
*Gender
Freeman
*Last Name

Daytime Telephone Number


D-Jone _
~
Clurice
*Full Middle or Maiden Name *Suffix (Jr., Sr., Ill, Et

Luciania
*First Name

Woodbridge
Apt/Unit/Lot/Rm/Ste City{fown

12323 Colby Dr.


*Residence (Permanent) Home Address

22192
Zip Code

[email protected]
E-mail address

If Rural Address or Homeless, please describe where you reside

Prince William
of Residence

*Have you ever been convicted of a felony? [JvES fZ]NO

If YES, have your voting rights been restored?0YES

DNo

LJ[] rn ITIJD

State where convicted---------==----If YES, when restored?


I
I

*Have you ever been judged mentally incapacitated? DYES IZ)NO

If YES, has court restored you to capacity? [JivEs

ONo

If YES, when restored?

Registration Statement: I swear/affirm,


inform!!tion provided on this form is true.
the Privacy Act Notice on the front of thiis-1-onn

~ *Signature (or mark if unable to


2000

rn DD rnrn
I

false material statements or entries, that the

-7'L-_..Ljtl(.;.UlJ~~:Z._G&C!l~~J1~L---1Jdl~ ,LJ]9] ,LJatm

H;;;;;l;;;;;;1~~~~~!t;;;i~~~;(d;;;;b~~t.ii;;;;;;;;;;Jlcid;;~~~~~~rted:iil.;;;;;i~ 0

Check/describe Hyou have a disability that requires accommodation in order to 1

Orm interested in being an


You may request that your home address not be released if you (a) are active or retired law enforcemen~ or (b) have been granted a protective court order, or (c) ere in
Election Official on Election Day. of your personal safety from someone who has threatened or stalk~d you and have filed a complaint against that person with a magistrate or (aw enforcement (must at
Please send me information.
copy of complaint). You must show a Virginia P.O. box under mailing address in Box 3 above. 0 Law Enforcement 0Protective Order OThreatened/Stalke

---

Exhibit 7, page 48 of 84

*Are you a citizen Jlf the United States


uw~;c,.r of America? Q1Es 0 NO

*Will you be at least 18 years of age ..9n or before


the next General Election day? 0"YES 0 NO

If you checked "NO" in response to either of


these questions, do not complete this form.

\~--~~--~~~--~--~~~~------~----------------=--~~------------------If Rural Address or Homeless, please describe where you reside


E-mail address
------------------------------------------------------------~O~C~i~~o~r~O~C~o~u~n~~:----------------Mailing Address (if different)Nirginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of City or County of Residence

*Have you ever been convicted of a felony? 0 YES rlNO


If YES, have your voting rights been restored? 0 YES

12J'No

UU 1UUt orno
rnM DO DODD

State where convicted===--===:-::=====----------If YES, when restored?

* Have you ever been judged mentally incapacitated? 0 YES


If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
'-""'""'""...... Notice on the front of this form.

~ *Signature (or mark if unable to sign) --"-Ji.!::.._L/_..1_ _ _ _ _ _ _---1Af-\1.PHR'\---:!l~5J--l:120tH114f.4---0


If applicant is unable to sign due to a physical disability, write the name/address of person who assisted . (Required).

Check if you have a disability that requires


someone to assist you in order to vote.

ODD

Protected Voter Code if applicable. See instructions.


0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

New Last Name

PCT

Town code

Date changed

Denial date & reason

New First, Middle/Maiden Name- and Suffix

Other changes

0 Deceased------------------- 0 Judged Incapacitated---------0 Out of State---------------- 0 Error Deleted----------0 NVRA Cancel _ _ _ _ _ _ _ __


0 Personal Request----------0 Convicted of a Felony _________

NewPCT

Date changed
Authorized by

Date changed

0 Transferred Out-----------0 Re-Registered----=----------0 Inactive Status------------0 Reactivated - - - - - - - - - - - - - - - -

Exhibit 7, page 49 of 84

......,,..

II
D
6~~~~--~

Are you a citizen ofJhe United States


of America?
[!?YES
NO

Social Security Number

Will you be at least 18 years of age o_o. or before


[0'YES ONO
the next General Election day?

lmw~lfJ~~[]
Daytime Telephone Number

Gender

BLOUNT,HEIDI,ANN
Last Name

If you checked "NO" in response to either of


these questions, do not .complete this form.

0None
Full Middle or Maiden Name

First Name

ON one
Suffix (Jr.,sr.,III,Etc.)

15069 CARDIN PL,WOODBRIDGE VA 22193


Residence (Permanent) Home Address

Apt/Unitllot/Rm/Ste

City/Town

If Rural Address or Homeless, please describe where you reside

Zip Code

E-mail address

Mailing Address (If different) Nirginia P.O. Box or Uniformed Service Address, if
0 City or [)County
applicable (Include Zip Code)
Name of City or County of Residence PRINCE WILLIAM
~

* Have you ever been convicted of a felony? 0 YES


If YES, have your voting rights been restored?

YES

NO

State where convicted

NO

If YES, when restored?

* Have you ever been judged mentally incapacitated?


0 YES
NO
If YES, when restored?
DYES
ONO
If YES, has court restored you to capacity?

LJ[l LJ[l DODD


LJLJ, D[l DODD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
"---' / .
Notice above.
7
(or marl< if unable to sign)
C

+ s~9nature

JAN I 2 2010

~ d...t_

LA_
/? '-'rc._.;t:s

If applicant Is unable to sign due to a physical disability, write the name/address of person who asslsted. (Requlred).

I'm Interested In being


an Election Official on
Election Day. Please
send me Information.

r.J::-

liiJ[jJ LQ]LfJ, 12J:dllJ~

Check/describe If you have a disability that requires accommodation In order to vote.

You.,.yrtqUeSIIIut)OII'hameadchunotbe~tte.sed H)'IUarlllliDrof)OII'household (o)actlve or retired law enforcement,ar(b)hMbeenplodaprotectlve court order ,ar (c) ilu

of)OII'personalsal!tyhnnomeone l'ilohas threatened or stalked )'Ill ond 11M lied aCOII1'1ai1t agailst thalpenonlillla maglstrm arlawenbtemont taJstallach copyofc0111>1aill)ar(d)pmlpat! illle
Address Confidentiality Program. You IIIIS!showalfl!lilla P.O. boKIIldernaifng adcftss In Box3abow.

0 La~forc~nt 0 Pro~ve O~r 0. Thr~ned/~ked ....GJ A~ss C~denti~ Pro~m

AUG 1 .2 2015
Exhibit 7, page 50 of 84

*Are you a citizen of the United States *Will you be at least 18 years of age on or before
of America? lil1fs 0 NO
the next General Election day? ~S 0 NO
liil~o;,-.~'"'"~-.,._....-;:"i'"'""-:------".*

DMale
Gender

If you checked "NO" in response to either of


these questions, do not complete this form.

~male
*Date of Birth

As.l..R-~

Daytime Telephone Number


DNone

*First Nam

ONone

*Full Middle or Maiden Name *Suffix (J

""5~:S-:-S~3~Y'Vl:-:-=~=<-=W<..::v,.::-<.J;=~:............::\):'-7
. ( 4 7 - - - - - - -.,...,...--,.........,.- Wa t>"L~,-.-~ ~ Jf-._.

.....,.;-~.,~ *Residence

(Permanent) Home Address

Apt/Unit/Lot/Rm/Ste City/Town

If Rural Address or Homeless, please describe where you reside

Ill, Etc.)

d-e?- J7 3
Zip Code

E-mail address

Address (If different)/ Virginia P.O.Box or Uniformed Service Address, if applicable 0 City or 0 County
Name of

*Have you ever been convicted of a felony? 0 YES ~

of Residence

State where convicted ====---c===--======-------

UU 1rn 1oorn
*Have you ever been judged mentally incapacitated? 0 YES
If YES, has court restored you to capacity? DYES ONO If YES, when restored? m,DD,DDDD
lf YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have
read the Privacy Act Notice on the front of this form.
I'R!ifl
z !Sl' l...LILJL!JL.:J
~M
, 1!;1
~ * Signature (or mark if unable to sign) C/s6 (\_
1 1 ~
Jl1 h1 1 4 2 '<>c...
~~ ' ~D=J
~L2J

r-"'~w~~

. ' ,

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required). 0Check/describe if you have a disability that requires accommodation in order to vote.
0 I'm interested in being an
You may request that your home address not be released if you or member of your house~old (a)are active or retired law enforcement, or (b) have been granted a
Election Offieial an Eleetian Day. proteetive eourt order, Ic) are in fear of your personal safety from someone who has threatened or stalked you and have filed a complaint against that person with
Please sand me infannatian
a magistrate or law enforcement (must attach copy of complaint), or (d) participate in the Address Confidentiality Program. You must show a Virginia P.O. box under

mailing address in Box 3 above. 0 law Enforcement 0 Protective Order 0 Threatened/Stalked 0 Address Confidontielity Program

For Office Use Only


Registration date

New Last Name

PCT Town code

New First, Middle/Maiden Name and Suffix

Other changes

0
0
0
0

Date changed

Denial date & reason

Deceased----------- 0 Judged Incapacitated _ _ _ _ __


Out of S t a t e - - - - - - - - - 0 Error Deleted--------Personal Request _ _ _ _ _ _ __ 0 NVRA Cancel _ _ _ _ _ _----''-Convicted of a Felony _ _ _ _ __

New PCT

Date changed
Authorized by

Date changed

0 Transferred O u t - - - - - - - 0 Re-Registered _ _ _ _ _ _ _ __
0 Inactive St~tus - - - - - - - - 0 Reactivated----------

Exhibit 7, page 51 of 84

*Are you a citizen of th~ United States *Will you be at least 18 years of age on or before
the next General Election day? 0 YES ~0
of America? DYES }'it NO

If you checked "NO" in response to either of


these questions, do not complete this form.

*Date of Birth

eJ .
*
:11 .;t.o ?J
btittllc.-s viii~
Apt/Unit/Lot/Rm/Ste City/Town

*Residence (Permanent) Home Address

Zip Code

\~~~--~~--~~~~~----~-----------~~~--------------If Rural Address or Homeless, please describe where you reside


E-mail address
Mailin Address (If different)/ Virginia P.O.Box or Uniformed Service Address, if applicable 0 City or 0 County
*Have you ever been convicted of a felony? 0 YES ~ NO

rn,rn,oorn
DD oorny

State where convicted=====--====-======-------

If YES, have your voting rights been restored? DYES 0 NO If YES, when restored?

*Have you ever been judged mentally incapacitated? 0 YES !){NO


fMlfMl
If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored? UU f

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have
read the Privacy Act Notice on the front o~this"'{ _ .
~~
!Mfllfl I fD(l~ I ~Mrvql

,01ig~atgrej!~O'ark if unable to sign) --,(,L-_)t--JJ-~--1----=-------------- ~[_J l!Jl:J CJLJ[_Jl21


11 applicant is unable to sign due to a physical disability, write the name/address of parson who assisted. (Required).

I'm interested in baing an


Election Official on Election Day.
Please send me information

~----~-~--~---~~~---

Check/describe ffyou have a disability that requires accommodation in order to vote.

You may request that your home address not be released if you or e member of your household (a) are active or retired law enforcement, or (b) have been granted a
protective court order, (c) are in fear of your personal safety from someone who has threatened or stalked you and have filed a complaint against that person with
a magistrate or law enforcement (must attach copy of complaint), or (d) participate in the' Address Confidentiality Program. You must show a Virginia P.O. box under
mailing address in Box 3 above. 0 law Enforcement 0 Protective Order 0 Threatened/Stalked 0 Address Confidentiality Program

For Office Use Only


Registration date

PCT Town code

Date changed

Denial date & reason

tl- 11 - oq

New Last Name


Other changes

0
0
0
0

New First, Middle/Maiden Name and Suffix

Deceased _ _ _ _ _ _ _ _ _ __ 0 Judged Incapacitated _ _ _ _ __


0 Error Deleted _ _ _ _ _ _ _ __
Out of State _ _ _ _ _ _ _ __
Personal Request _ _ _ _ _ _ __ 0 NVRA Cancel _ _ _ _ _ _ _ __
Convicted of a Felony _ _ _ _ __

VANVRAl 7/09

NewPCT

Date changed
Authorized by

Date changed

0 Transferred Out _ _ _ _ _ _ _ __
0 Re-Registered _ _ _ _ _ _ _ __
0 Inactive S t a t u s - - - - - - - - 0 Reactivated--~-------

Exhibit 7, page 52 of 84

1-\re you a CitiZen or me umtea ::itates


of America? Q.->fES
ONO

Will you be at least 18 years of age on or before


the next General Election day?
0 YES ONO

If you checked "NO" in response to either of


these questions, do not complete this form.

la[][] -rn~. [g)GJ[]~


Social Security Number

Daytime Telephone Number

Gender

0None
Full Middle or Maiden Name

MOHAMED MOHONEP ABPELSAMEEI


Last Name
First Name

0None
*Suffix (Jr.,Sr.,III,Etc.)

14236 CATBIRD DRIVE,GAINESVILLE VA 201555858 ______________ ~----------------- Residence (Permanent) Home Address
ApUUnit/LoURm/Ste City/Town
Zip Code
I~Rural

~'oo\ 1:"\.2.o

E-mail address

Address or Homeless, please describe where you reside

Mailing Address (If different) Nirginia P.O. Box or Uniformed Service Address, if
0 City or
applicable (Include Zip Code)
Name of City or County of Residence
:.4

* Have you ever been convicted of a felony?

0 YES

Gf\lO

State where convicted

If YES, have your voting rights been restored?

0 YES

ONO

If YES, when restored?

Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

DYES

DYES
!Q1\io
If YES, when restored?
0NO

w;

ruma\L
~C.ooo
7
~

Ocounty

LJ[J LJE:l [][][][]


LJLJ~ LJ[l LJLJLJLJ

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice above.
Signature (or mark if unable to sign)

--~~A.....,..../.).,_''.->==~_ _ _J__
AN_2__1_2__
011_ !M:l[j]/
!D:lD P:;l/ ~l[VDl[Y,l\ ~
QJ
IQJlfLJ l.ZdlQJWW

--::;:;;; ~

If appllcanlls unable lo sign due to a physical disability, write lhe name/address of person who assisted. (Required).
Check/describe If you have a disability that requires accommodation in order to vote.
You""y'"""st11Wyowhool2addotss not be ..~,,.d H)'OU ormoni>erofyowhousehold.,.(a)active or retired law enforcement,or(b)hawbttnpl!daprotectlve court order ,or (c).,. In f"r
ofyowpmonalsafttylunsonnne\'110has threatened or stalked )OUand ha"' fi~ atOill>lalntagalnstthatpe!SOIIIIith a1111g~trate orlawmforcoment (nustattachcopyofc~~~q~lalnt)or(d)piOiicipate In lhe
an Election Official on
Address Confidentiality Program . You1111Stshowa ~lnia P.O.boxunder1111illng addross inBoxJahoiO,
Election Day. Please
Law Enforcement
Protective Order
Threatened/Stalked
Address Confidentiality Program
send me Information.

O I'm Interested In being

--

- -0

For Office Use Only


Registration date

Town code

PCT

Date changed

Denial date & reason

New First, Middle/Maiden Name and Suffix

New Last Name

New PCT

Other changes

Authorized by

Date changed
Date changed

[] Deceased ______________________

Judged Incapacitated ___________

Transferred Out ______________

Out of State-------------------

Error Deleted-------------------

Re-Registered _______________

[] Personal Request ________________

NVRA Purge ___________________

Inactive Status ______________

Reactivated

Convicted of a Felony ------------

Notes

Exhibit 7, page 53 of 84

*Will you be at least 18 years of ag~n or before


the next General Election day? !21'YES 0 NO

S6 t l S"cJ&,.ovt_ La.M.e

\*Residence (Permanent) Home Address

If you checked "NO" in response to either of


these questions, do not complete this form.

ooJ bv,Jae
U

i AJ
Apt/Unit/Lot/Rm/Ste City/Town

If Rural Address or Homeless, please describe where you reside

Zip Code

E-ma)J_ address

~t. ''\I.e
Mailing Address If different,/ Virginia P.O. Box or Uniformed Service Address, if applicable 0 City or IQ'County

lJ . t,\-,'atiM

------____,.--,----,-,--,--------,.,......,...,..--------,----.,.-,-include

Name of

* Have you ever been convicted of a felony? 0 YES

of Residence

State where convicted==:::--:==:-::=====-------

DO 1DODD
rna ITJDvv D

If YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored? [][] 1
* Have you ever been judged mentally incapacitated? 0 YES
M
M
If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored? [][] 1

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

OJ di2!!E!Jd&$cn

have a disability that requires accommodation in order to vote.

I'm interested in being an


You may request that your home address not be released if you or member of your household are (a) active or retired law enforcement, or (b) have been granted e
Election Official on Election Day. protective court order, or (c) are in fear of your personal safety from someone who has thr;atened or stalked you and have filed a complaint against that person with
Please sand me information.
a magistrate or law enforcement (must attach copy of complaint) or (d) participate in the Address Confidentiality Program. You must show a Virginia P.O. box under
mailing address in Box 3 above.
Law Enforcement
Protective Order
Threatened/Stelked
Address Confidentiality Program

For Office Use Only


Registration date

New Last Name


Other changes

0
0
0
0

PCT

Town code

Denial date & reason

Date changed

New First, Middle/Maiden Name and Suffix


New PCT

Date changed
Authorized by

Date changed

-/'J

Deceased _ _ _ _ _ _ _ _ _ __ 0 Judged Incapacitated _ _ _ _ _ __ flSlTransferred Out9 - Q;2


0 Error Deleted _ _ _ _ _ _ _ __
Out of State _ _ _ _ _ _ _ __
0 Re-Registered _ _ _ _ _ _ _ __
Personal Request _ _ _ _ _ _ __ 0 NVRA Cancel _ _ _ _ _ _ _ __ 0 Inactive Status _________
0 Reactivated _ _ _ _ _ _ _ _ __
Convicted of a Felony _ _ _ _ __

Notes

VANVRAl VlO

Exhibit 7, page 54 of 84

*Are you a citizen of the United States *Will you be at least 18 years of age on or before
of America? ~YES 0 NO
the next General Election day? .181YES 0 NO

Number
*LastName

VA"Z...QU~Z

If you checked "NO" in response to either of


these questions, do not complete this form.

g] Male 0 Female
*Gender

Daytime Telephone Number

Ide em a, a

~None

*First Name

c&J:x::i!londsc

*Residence (Permanent) Home Address

~~~--~~~~

*Full Middle or Maiden Name *Suffix


Apt/U nit/Lot/R m/Ste City/Town

2 Zl 9

Zip Code

vozqce? .... 230AS@td rro1 J. con

If Rural Address or Homeless, please describe where you reside

E-mail address

------------------------------------------------------------=D~C~iw~o~r~D~C~o~u~nw~:_________________
Mailing Address (if differendNirginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of
or County of Residence
*Have you ever been convicted of a felony? 0 YES ~NO

State where convicted===-==::--::=====-------------

If YES, have your voting rights been restored? DYES D NO If YES, when restored?

[][]/D[]/[1][0

*Have you ever been judged mentally incapacitated? 0 YES ~NO

If YES, has court restored you to capacity? 0 YES 0 NO

DO 1DODD

If YES, when restored? [][] 1

If applicant is unable to sign due to a physical disabiliW. write the name/address of person who assisted. (Required).

Check if you have a disabiliW that requires


someone to assist you in order to vote.

DOD

Protected Voter Code if applicable. See instructions.


0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

0 Deceased ____________________

Date changed

Denial date & reason

New First, Middle/Maiden Name and Suffix

New Last Name


Other changes

Town code

0 Judged Incapacitated _ _ _ _ __
0 Out of State--------------- 0 Error Deleted __________
0 Personal Request _________ 0 NVRA Cancel _ _ _ _ _ _ _ __
0 Convicted of a Felony _ _ _ _ __

NewPCT

Date changed
Authorized by

Date changed

0 Transferred Out-------------0 Re-Registered __________


0 Inactive Status __________
0 Reactivated------------------

Notes

Exhibit 7, page 55 of 84

..,

--1 1

r:--------------Ar~ a citizen of the United States of America?

YES

-"il

NO

:{., I

, ~L SECU..JlLO'~=

ir ~ I
, -.~q

LAST NAME (PRINl)

,
.._

FIRST NAME

--

-If you checked 'no' In response to either

Will you be 18 years of age on or before elction dily?

MAIDEl~

C NO
-~

GENDER

:4

FULL MIDDLE OR

YES

of these questions, do not complete this


form.

0MALE
NAME

5.

IX) FEMALE

SUFFIX (JR ,SR.,III,ETC)

1]._

_2_

y
y
M
M
0
DAYTIME TELEPHONE NUMBER

~ _1
y

BURKE, JENNIFER, GRANT

.'i

RESIOENCEJHOME ADDRESS (IF RURAL ADDRESS, DESCRIBE BEL0\"1)

13529 PRINCEDALE ~
IF

..

RURAL ADDRESS, DESCRIBE

ZIP CODE

CITY OR TOWN

APT/UNIT/LOT/RM/SUITE

Dri v ~

22193 .

WOODBRIDGE

WHERE VOUR HOUSE 15 lOCATED II E , WHAT IS THE STATE ROAD NUMBER WHERE YOUR HOUSE IS LOCATED? WHICH SIDE OF THE ROAD-NORTH. EAST, ETC. NEAREST LANDMARKJ

f ':
f_

MAILING ADDRESS nr

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

DYES

B_NO

IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

DYES

ONO

IF YES, WHEN RESTORED? (Required) MO

~
~

. .il
.:,.

;\.:f

l 'O,

(INCLUDE ZIP CODE)

'X'

IF YES, HAS COURT RESTORED YOU TO CAPACITY?

YES

NO

jIF YES, WHEN RESTORED? (Required) MO _ _ _ DAY _ _ _ YEAR _ _ _

YEAR

RESIDENT OF VIRGINIA, THE INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION, (ENTERED IN BOX 1 ABOVE) OF MY CURRENT
REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABOVE.

.J.

DAY

J.

~~ ~~ ~ NAME OF CITY OR COUNTY OF RESIDENCE


~~ 0 CITY
OR
COUNTY OF
,';1' l?RINCE WILLIAM
~
HAVE YOU EVER 8EEN JUDGED MENTI'.LLY INCAPACITATED?
0 YES~O

APPLICABLE

REGISTRATION STATEMENT: I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S. CITIZEN AND .

1If ~~;:E
I~

VIRGINIA P.O. BOX OR UNIFORMED SERVICE ADDRESS, w

....

'JI

"'""'"u

REMINDER: SIGN HG&EGISTRATION (OR MARK IF UNABLE TO SIGN).

Ill-

\.

J.

_lo

DATE ...

@Ct?/O~

~applicant IS unable to sign, writ~elow the name/address of person who assisted: (REQUIRED)

You may request that your home address not be released if you (a) are active ~r retirej law enforcement ''r (~) have
been granted aJ'rotective court order, or (c) are in fear of your personal safety from someone who has ,t,J ea:.Jned o;
stalked you an have filed a complaint a8a1nst that person with a magistrate or law enforcement (must atl3ch copy oi
complaint) You must show a Virgmra P. . box under mailing address in box 7 above.
THR<:ATEHED/STALKED
I'.CTIVEIRET LAW ENFORCEMENT
PROTECTIVE COURT ORDER
COMMENTS
TOWN CODE
DENIAL DATE & REASOI!

Yes, I am interested in wcrking as an


Election Official on Election Day Please
send me information.

REGISTRATION DATE

AUG 2 7 2008

PCT

VA-NVRA-1 Rev. 7/04

[
L__j

Exhibit 7, page 56 of 84

Check here if you ha>


a disability that requir
accommodation in or
to vote

~;:Are~ a c'iti;e

...
..

of America?

of the United States


YES
0 NO

Will you be at least 18 years of age on or before


the next General Election day?
YES 0 NO

18"'-:-=--:-:-=-~ Social Security Number

~[]-GJ~BJ-[][ill-

Gender

Daytime Telephone Number

Date of Birth

OTAMENDI,MARIA,M
Last Name

If you checked "NO" In response to either of


these questions, do not complete this form.

ONone
Full Middle or Maiden Name

First Name

ONone
Suffix (Jr.,Sr.,III,Etc.)

2814 POWELL DR,WOODBRIDGE VA 22191-4227


Residence (Permanent) Home Address

Apt/Unit/Lot/Rm/Ste

City/Town

If Rural Address or Homeless, please describe where you reside

Zip Code

E-mail address

Mailing Address (If different) Nirginia P.O. Box or Uniformed Service Address, if
0 City or j!g County
applicable (Include Zip Code)

Name of City or County of Residence PRINCE WILLIAM

0
0

Have you ever been convicted of a felony?


If YES, have your voting rights been restored?

YES

~ NO

State where convicted

YES

If YES, when restored?

* Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

YES

NO

YES

~ NO

If YES, when restored?

NO

UL} LJ[J DODD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the Information
provided on this form Is true. I authorize the cancellation (entered In Box 7 b w) of m current registration and I have read the Privacy Act

SE.P 2, 4 2.010

Notice above.
* Signature (or mark if unable to sign)
If appllcanlls unable to sign due to a physical dlsabllily, wrile lhe name/address of per> on

ULJ [][] DODD

I'm Interested In being


an Election Official on
Election Day. Please
send me Information.

sslsted.)Requlred).

Check/describe If you have a dlsablllly lhat requires accommodation In order to vote.

YDIInayl!queslbi)'Uholread!ftssnolbel!iemdH)'>UormeM>erof)OII"householdn (a) active or retired law enforcement,or)b)hMbeen"anltth protective court order ,or ~)n llu
oi)'UporsonaiAiotymsomeoneW..has threatened or stalked )'>Umdhawlletlocotq>llitlagailsllhalpononi'HItiii!Jlmltorlawenlotconnl .....lal!achcopyolc""l'llitl)orfd)pric"* lllhe
Address Confidentiality Program. y,.. nustshowo 'II!JillaP.O.boulldertnillilg ad!ftss llBoxhbow.
Law Enforcement
Pro~ve O!!r
Thr~ned/~ked
Ad_!!ss Confidentiality Program

.J;l

Exhibit 7, page 57 of 84

-- ------------------------------------

--------------

1 l2 J~ER

1 ift<:!CIAL SECURITY NUMBER

1-:r" fi
5

ALE

I.\

w~r

l3_,

(circle one)
FEMALE

FIRST NAME

5'8 3z.. kt 1-f.E.w ~ cf-~

DYES

DYES

DNo

Yes, I am interested in working as


an Election Official on Election Day. Please

MO

YEAR

DAY

2oJt2-

NAME OF CITY OR COUNTY OF RESIDENCE


D CITY
0'COuNTY

NO. STOP HERE - DO NOT FILL OUT SECTION B.

DYES~

!:,;IRCUJI !:<QUBI JUQ~t;MEtH QE MI;I'!IAL II'!!:,;APACIIY


HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?
IF YES , HAS COURT RESTORED YOU TO CAPACITY?
IF YES, WHEN RESTORED? (REQUIRED)

MO

ACTIVE/RET LAW ENFORCEMENT

DYES
DAY

If you are active or retired Jaw enforcement, or if you have a protective court order, you may request that
your home address not be released . You must show a Virginia P.O. box in box 6 above.

send me information.

ZIP CODE

CONTINUEplele all boxes (8 - 11 and A) in Section B and sign your name in the red box below.

!:,;OI'!'ii!:<TJOI'! QE E!;;!.QNY

IF YES, WHEN RESTORED? (REQUIRED)

STATE

ll/4-

~~~AU.
8. cmmN?
To apply Ia register to vote or change your voter registration address:

NO\ STOP HERE -DO NOT FILL OUT SECTION B.

IF YES, HAVE YOUR VOTING RIGHTS BEEN RE~TORED ?

~
r=

CITY OR TOWN

~S-A~

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

kovc.De.LL.--

APT/UNIT/LOT/RM/SUITE

MAILING ADDRESS (if different from above) P. 0 . BOX OR UNIFORMED SERVIC E ADDRESS , IF APPLIES (INCLUDE ZIP CODE)

I!(!ES. Answer the citizenship question to the right and complete ALL boxes (8 - 11 and A) in
Section B and sign your name in the red box below.
D

SUFFIX (JR., SR .. Ill., ETC.)

" iiAIDEN NAME

-c

N ot2-'h~

RESIDENCE/HOME ADDRESS (I F RURAL ADDRESS , Cp MPLETE BOX 11, BELOW)

IDA3~3LEP;;N~~~&'9

f~';-

~c:rir'il.'lfC

DO YOU WANT TO APPLY TO REGISTER TO VO'TC?

------------ -----------------------------------------------------------------------------

YEAR

DNO/
'-~

Check here if you have a


disability that requires

accommodation in order to vote.

PROTECTIVE COURT ORDER

BEGJSTRA!IQf'! S!AIEMEf'!T: I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR PERJURY. THAT I AM A U.S.~ AND A RESIDENT DF VIRGINIA, THE INFORMATION I HAVE PROVIDED ON THIS FORM IS
TRUE, I AUTHORIZE THE CANCELLATION. ENTERED IN BOX A BELOW, OF MY CURRENT REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE BELOW
" ' REMINDER: SIGN HERE FOR VOTER REGISTRATiON (OR MARK IF UNABLE TO SIGN) AND COMPLETE BOX A BELOW. COMPLETE BOX 11 BELOW IF RURAL ADDRESS.

SIGN~

HERE
..

~L

DATE " '

udL_

'

-""

IF APPLICANT IS UNABLE TO SIGN, WRITE THE NAME/ADDRESS OF PERSON WHO ASSISTED BELOW (REQUIRED):

(if

IF YOU LIVE IN A RURAL AREA DESCRIBE YOUR HOUSE LOCATION (I.E., STATE ROAD NUMBER WHERE YOUR HOUSE IS LOCATED; CLOSEST INTERSECTING ROAD; SIDE OF THE RQAD.NORTH, EAST. ETC.;
NEAREST LANDMARK.)

--

CstM
-m GISTRATION DATE

JUN

PCT

TOWN CODE

-------

'v

---- ---.---------- .... .

-------- - --~-----~- ~

OFFICE USE ONLY

OFFICE USE ONLY

OFFICE USE ONLY

l
I

'

COMMENTS

l 3 2002

'l'-<.-.f"-~1>1\.: 1__ CI,y .7JOO. ,. , .............................

DENIAL DATE & REASON

DATE CHANGED

NEW FIRST. MIDDLE/MAIDEN NAME AND SUFFIX

NEW LAST NAME

---

-NEW 1-'CT

OTHER CHANGES

"

DATE CHANGED

AUTHORIZED BY

1--

---

D DECEASED

D JUDGED INCAPACITATED

D TRANSFERRED OUT

D OUT OF STATE _ _ _ _

0 ERROR Dr=LE TED

D RE-REGISTERED

D PERSONAL qEQUEST

D NVRA PURGE

D INACTIVE STATUS

D CONVICTED OF FELONY

[]

NOTES: (_

/J.v\J:.tvcf~ \)tl \,

l't

P.EACTIVII TED

1 I"-Gf' - (_ ,,

~G .Q J\

...

Exhibit 7, page 58 of 84

*Are you a citizen of the United States *Will you be at least 18 years of age .on or before
of America? DYES
0
the next General Election day? mES D NO

If you checked "NO" in response to either of


these questions, do not complete this form.

DFemale
*Date of Birth

Apt/Unit/Lot/Rm/Ste C

Zip Code

, :-:-::----:--:--:--:--------:-:---:-------=---=----::-----:------;-;------

' If Rural Address or Homeless, please describe where you reside

*Have you ever been convicted of a felony? DYES

ucudr/&. ob- /~ ftn~v''/auq

E-mail address

State where convicted==:::-:===--======-------

UU!UU!DDDD
*
0 YES
0
If YES, has court restored you to capacity? DYES 0 NO If YES, when restored? UU!UU!DDDD
If YES, have your voting rights been restored? DYES D NO If YES, when restored?

Have you ever been judged mentally incapacitated?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true.l authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
~=.:..~ Notice on the front of this form.
, ,
~

=7 . Signature ~rerT'4r2'lf130 sign) - - - - - - h - ' - " . d O = > t - \ 1 - - - - - - - - - - - - - If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

~~ !Db1N 1SlnnM
1v
~ l:JL,lJ ~~~

Check if you have a disability that requires


someone to assist you in order to vote .

DOD

Protected Voter Code if applicable. See instructions.


0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

D
0
0
0

Date changed

Denial date &reason

New First, Middle/Maiden Name and Suffix

New Last Name


Other changes

Town code

NewPCT

Date changed
Authorized by

Date changed

0 Transferred Out _ _ _ _ _ _ _ __
Deceased----------- 0 Judged Incapacitated-----0 Re-Registered--------Out of S t a t e - - - - - - - - - 0 Error Deleted--------0 Inactive S t a t u s - - - - - - - - 0 NVRA Cancel _ _ _ _ _ _ __
Personal Request-------0 Reactivated---------Convicted of a Felony - - - - - -

Exhibit 7, page 59 of 84

*Are you a citizen -the United States


of America? 19'fES 0 NO

*Will you be at least 18 years of age _g.p-or before


the next General Election day? B'YES 0 NO

If you checked "NO" in response to either of


these questions, do not complete this form.

* Da~e of Birth

Daytime Telephone Number

AkL-Ct'16

0 None

*Full Middle or Maiden Name. *Suffix

3G9 G

uooO&ttf'X:J~V. A.

[2es o\-o

* Residen3 ~DfPent) Home Address

Apt/Unit/Lot/Rm/Ste

ZZ\93

City/Town

Zip Code

bo~
\nan eetYa.h oo
actfeSs

If Rural Address or Homeless, please describe where you reside

E-matl

Address, if applicable 0 City or 0 County


Name of
* Have you ever been convicted of a felony? 0 YES

of Residence

State where convicted

If YES, have your voting rights been restored?

0 NO If YES, when

*Have you ever been judged mentally incapacitated? 0 YES EJNO


[Ml[Ml
If YES, has court restored you to capacity? 0 YES 0 NO If YES, when restored? LJLJ/

DD oorn
y

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have
read the Privacy Act Notice on the front of th
rm. 1

~ *Signature (or mark if unable to sign)

6~ec!escribe

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required)S

\
if you have a disabiUty

'I

2require{ac?ammod!l::i~rdf

IBJ
to?ate

You may request that your home address not be released if you or member of your household (a) are active or retired law enforcement, or (b) have been granted a
0 I'm interested in being an
Election Official on Election Day. protective court order, (c) are in fear of your personal safety from someone who has threatened or stalked you and have filed a complaint against that person with
Please send me information.
a magistrate or law enforcement (must attach copy of complaint), or ldl participate in the Address Confidentiality Program. You must show a Virginia P.O. box under
mailing address in Box 3 above. 0 law Enforcement 0 Protective Order 0Threatened/Stalked 0 Address Confidentiality Program

For Office Use Only


Registration date

PCT

Town code

Date changed

Denial date &reason

New First, Middle/Maiden Name and Suffix

New Last Name

New PCT

Other changes

Date changed
Authorized by

Date changed

0 Transferred Out _ _ _ _ _ _ _ __
0 D e c e a s e d - - - - - - - - - - - 0 Judged Incapacitated _ _ _ _ __
0 Re-Registered _ _ _ _ _ _ _ __
0 Out of S t a t e - - - - - - - - - 0 Error D e l e t e d - - - - - - - - 0 Personal Request _ _ _ _ _ _ __ 0 NVRA Cancel _ _ _ _ _ _ _ __ 0 Inactive S t a t u s - - - - - - - - 0 Convicted of a Felony _ _ _ _ __

VANVRAl 11/11

0 Reactivated----------

Exhibit 7, page 60 of 84

il -:-Are~

a ciii;enk'iJM"u-;ed s!aies 2ES


D NO
of America?

Will you be at least 18 years of age on or before


the next General Election day?
D YES DNO

1p

Soc;al Security Number

ODD -DOD-DODD
Gender

Day1ime Telephone Number

Date of Birth

0None
Full Middle or Maiden Name

OROPEZA VALERIA ISABEL


Last Name

If you checked "NO" in response to either of


these questions, do not complete this form.

First Name

~ ~66Effl1tt0'6E-'d~5'05 Residence (Permanent) Home Address

ApUUniULot/Rm/Ste

ON one
* Suffix (Jr.,Sr.,III,Etc.)

Cityrrown

Zip Code

\
If Rural Address or Homeless, please describe where you reside

E-mail address

0 City or Dcounty
Mailing Address (If different) !Virginia P.O. Box or Uniformed Service Address, if
applicable (Include Zip Code)
Name of City or County of Residence PRINCE WILL I AM
Have you ever been convicted of a felony?

D YES

If YES, have your voting rights been restored?

D YES

.' Have you eve; been Judged mentally incapacitated?


If YES, has court restored you to capacity?

DYES

UL} EJD/UUUU

If YES, when restored?

YES

0 NO

Registration Statement: I swear/affirm, under felony penalty for makl


provided on this form is true. I authorize the cancellation (entered
Notice above.

State where convicted

If

YEs, when restored?

UL} 00

1 [][][][]

willfully false material statements or entries, that the information


below) of my current registration and I have read the Privacy Act

Signature (or mark if unable to sign)

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

Chock if you have a disability lhal requires


somoonolo assisl you in ordorlo vole.

ODD
--

Protected Voter Code if applicable. See above.


D I'm interested in being an Election Official on Election Day. Please send me information.

for urr1ce use uuy


Registration date

Town code

PCT

----------------------------------------

New Last i' me

Date changed

Denial date & reason

----------------------------------------New First, Middle/Maiden Name and Suffix

-------------------Date changed
Oat? ?hanged

~ Deceased

t1 lro I '}. JJ()'

D Judged Incapacitated

Transferred Out
Re-Registered

:J

Out of State

D Error Deleted

:J

Personal Request

D Inactive Status

:J

Convicted of a Felony

JANVRA1 7/09

NVRA Purge

D Reactivated

Exhibit 7, page 61 of 84

11111111111111111111~11111111111111111111111111111111111111111111~ 1111111~1111111
COMMONWEALTH OF VIRGINIA

AFFIRMATION OF CITIZENSHIP
24.2-410.1 of the Code of Virginia

SUBJECT TO PENALTY OF LAW, I DO HEREBY AFFIRM THAT I AM A


CITIZEN OF THE UNITED STATES OF AMERICA

SIGNATURE OF VOTER
PRINTED NAME
OF VOTER:

Date of birth:
Current address:

Street/P.O. ox/Apt.#
City/Town/State/Zip

Mailing address [if


different]:

Street/P.O. Box/Apt.#
City/Town/State/Zip

Daytime telephone
number:
Email address:

)SZLfEOnf

I !lccd6i.l,&'e VA

e_

'1? 1q I

~AHe

5~/330 325Q._R\ e0CL0CA..\erz_t'A


AolHAi D(Of(

> INTENTIONALLY MAKING A MATERIALLY FALSE STATEMENT ON THIS


FORM IS A FELONY. THE PUNISHMENT IS UP TO TEN YEARS IN PRISON AND
A FINE UP TO $2,500. YOU ALSO LOSE YOUR RIGHT TO VOTE.
IF YOU ARE A CITIZEN, PLEASE RETURN COMPLETED FORM TO:

PRINCE WILLIAM COUNTY OFFICE OF ELECTIONS


Office of Voter Registration
9250 LEE AVENUE, STE. 1
MANASSAS, VA 20110-5554

SBE-410.1

Exhibit 7, page 62 of 84

If you checked "NO" in response to either of


these questions, do not complete this form.

'Daytime
--''--''--'Telephone
-DODNumber
-::-t:--A~neJ:::..!........J___ ~leA (O) e D
*Firs'tName
* Fufl Middle or Maiden Name *Suffix

L-JL_JL__)(___J

Gender

Smt n

None

* Last Name

~ ~s-

.........:~~ *Residence

*Date of Birth

kti .httee

(Permanent) Home Address

IittdbJ1' ~

l C1 Of

Apt/Unit/Lot/Rm/Ste City/Town

.,.------,-,---,--,----::-----L......>----,-

d~ L"'t ]
Zip Code

If Rural Address or Homeless, please describe where you reside


Mailing Address (if different)Nirginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of

*Have you ever been convicted of a felony? DYES

of Residence

State where convicted===--====--======-------

UUJUU!rnDD
!Ml!Ml rnD DODD

If YES, have your voting rights been restored? DYES D NO If YES, when restored?
*Have you ever been judged mentally incapacitated? DYES

If YES, has court restored you to capacity? DYES D NO

0
If YES, when restored? UU/

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the infonnation
provided on this fonn is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.

[Jiif\1 I fOil\ ~I 02WOfVIll~

;7/~ ~

~*Signature (or mark if unable to sign)_.....~;..../~L....J:~::~-....:...._


=----==------------t..=:l W~ lbl~~
QCT 2 Q2QP
D Check if you have a disability that requires
__

If applicanti;um;ble t[;~gi\ due to a physical disability, write the name/address of person who assisted. (Required).

orn

someone to assist you in order to vote.

Protected Voter Code if applicable. See instructions.


D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

New Last Name

Town code

Denial date & reason

Date changed

New First, Middle/Maiden Name and Suffix

Other changes

NewPCT

Date changed
Authorized by

Date changed

D
0
D
D

Deceased _ _ _ _ _ _ _ _ _ __
Out of State _ _ _ _ _ _ _ _ __
Personal Request _ _ _ _ _ _ __
Convicted of a Felony _ _ _ _ __

D Judged Incapacitated _ _ _ _ __
D Error Deleted _ _ _ _ _ _ _ __
D NVRA Cancel _ _ _ _ _ _ _ __

D Transferred Out _ _ _ _ _ _ _ __
D Re-Registered - - - - - - - - 0 Inactive Status---,-------0 Reactivated _ _ _ _ _ _ _ _ __

Exhibit 7, page 63 of 84

B1 "'7Are y; 11 ciii;er> ofthe


..

of America?

GrfES

United States
D NO

Social Security Number

. _7* -=
o~a':"'
te-o"'!f"':B~irt
~h~

Gender

[]~~~

HARTSELL,MICHAEL,ANTHONY

IISJ

Last Name

* Full Middle or Maiden Name

*First Name

Suffix (Jr.,Sr.,III,Etc.)

7730 BLACKHORSE COURT,MANASSAS VA 20109


Residence (Permanent) Home Address

Apt/Unit/Lot/Rm/Ste

Zip Code

City/Town

If Rural Address or Homeless, please describe where you reside

E-mail address

Mailing Address (If different) /Virginia P.O. Box or Uniformed Service Address, if
D City or KJ County
Name of City or County of Residence PRINCE WILLIAM
applicable (Include Zip Code)

12(YES

* Have you ever been convicted of a felony?

~S

If YES, have your voting rights been restored?

* Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

DYES

D
D

NO
NO

D YES
D NO

If YES, wh

~0
If YES, when restored?

UL} DODD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered In Box 7 below) of my current registration and I have read the Privacy Act
Notice above.

If applicant is unable to sign due to a physical disability, write the nameladdress of person who assisted. (Required).

UL~l

I'm Interested In being


an Election Official on
Election Day. Please
send me information .

Check/describe if you have a disability that requires accommodation in order to vote.

You Aliyrtquest !hat )Ourhoft addrtss not be rtleased if)OU ormerdJerofyoll'housellold art {a{ active or retired law enforcement, or(blhve been gl>nted protective court order, or ~{art in f"r
of)OII'peJSonalsafttyioiASoftOne mo hos threatened or stalked )'IU ondhove iled ocoq>bintag>inst llatpersonyjlh Aligisr.ote orbwen~~ement {niJstait>chcopyofcoq>loint)or{d)participote in lie
Address Confidentiality Program. You IRISI show ~ini.l P.O. boxWlderAiiiling oddr!ss in Boxl obo>t.

Law Enforcement

Protective Order

Threatened/Stalked

fJ

Ad~ss C=denti~ Pro~m

Exhibit 7, page 64 of 84

e-

YYI"'\1,1'111'1tt.:.f.

1\.lttJnltJI.J

1"'''-"""""'":J --- - -

::.tanoara t-erm teA (Kev 1U-UO!l

REGISTRATION AND ABSENTEE BALLOT REQUEST- FEDERAL POST CARD APPLICATION (FCPA)
1. I REQUEST ABSENTEE BALLOTS FOR ALL ELECTIONS IN WHICH I AM ELIGIBLE TO VOTE AND I AM (Mark

[8]

D
D

(a) A MEMBER OF THE UNIFORMED SERVICES OR MERCHANT MARINE ON ACTIVE DUTY. OR AN ELIGIBLE
(b) A

u.s. CITIZEN

RESIDING OUTSIDE THE

(c) A

u.s. CITIZEN

RESIDING OUTSIDE THEUS. INDEFINITELY

2. MY INFORMATION (Required)

u.s. TEMPORARILy

a. TYPED OR PRINTED NAME (Last, First, Middle)

SUFFIX (Jr.,
Sr. , Ill, etc.)

b. PREVIOUS.NAME (if applicable)

REINHOLD, SUNG H.
g. STATE DRIVER'S LICENSE OR I D. NUMBER

c. SEX

+93793853867
EMAIL ADDRESS

S [email protected] .MIL
3. MY VOTING RESIDENCE ADDRESS (Required) (Military, use legal residence. Overseas citizens, use last legal residence in U.S.)
a

NUMBER AND STREET (Cannot be a P.O. Box)

18516 Jefferson Davis Hwy


b. CITY. TOWN OR VILLAGE

c. COUNTY

d. STATE e. ZIP CODE

PRNWM

Triangle

va

22172

4. WHERE TO SEND MY VOTING MATERIALS_


a. MY CURRENT ADDRESS (Where /live now) (ReqUired)

b MY FORWARDING ADDRESS (NOTE Complete 4b only if you do not want you


ballot matted to the address tn Block 4a )

AMC, 4-40IST AFSB

APO AE 09355

I PREFER TO RECEIVE MY ABSENTEE BALLOT, AS PERMITTED BY MY STATE, BY:

[8]

MAIL

EMAIL

5. MY POLITICAL PARTY PREFERENCE (Optional, but may be required by states to


register to vote in primary elections):
6. ADDITIONAL INFORMATION (Designate the period for which you want to receive ballots- see instructions for Block 6, paragraph (3).
Consult the Voting Assistance Guide for other specific state instructions.)

7. AFFIRMATION (Required)
I swear or affirm, under penalty of perjury, that:

1. I am a member of the Uniformed Services or merchant marine on active duty or an eligible spouse or dependent of such a member, or a U.S.
citizen temporarily residing outside the U.S., or other U.S. citizen residing outside the U.S .. and
2. I am a U.S. citizen, at least 18 years of age (or will be by the day of the election), eligible to vote in the requested jurisdiction, and
3. I have not been convicted of a felony or other disqualifying offense or been adjudicated mentally incompetent, or if so, my voting rights have
been reinstated, and
4. I am not registering. requesting a ballot. 9r voting in any other jurisdiction in the U.S., and
5. My signature and date below indicate when I completed this document, and
6. The information on this form is true and complete to the best of my knowledge.
I understand that a material misstatement of fact in completion of this document may constitute grounds for conviction of perjury.

Date

1$ .:J.-.6.)..cl/j
(MMDDYYYY)

Stgned:~Date:
(~)

D:>.2{;..)t:Jf{

The information contained here in is for official use only. Any unauthorized release of this information may be punishable by law.

Exhibit 7, page 65 of 84

(MMDDYYYY)
Adobe Protesstonal

Will you be 18 years of age on or before election day?

0No

If you checked "no" In raaponee to


alther of thaae queetlona, do not
complete thla form.

SUFFIX (JR., SR., Ill, ETC.]

APT/UNIT/LOT/AM/SUITE

ADDRESS (If different) VIRGINIA

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

DYES

HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

DYES

DYES

IF YES, HAS COURT RESTORED YOU TO CAPACITY?

DYES~

IF YES, WHEN RESTORED? (REQUIRED) MO - - - DAY - - - YEAR _ __

g!)l6

IF YES, WHEN RESTORED? (REQUIRED) MO - - - DAY _ _ _ YEAR---

REGISJRATION STATEMENT; I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILUFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S. !:diJZEN AND A RESIDENT OF VIRGINIA, THE
INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION (ENTERED IN BOX 1 ABOVE) OF MY CURRENT REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABOVE.
'

REMINDER:

SIGN

(OR MARK IF UNABLE TO SIGN).

DATE-+

You may request that your home address not ba released If you (a) are active or raUred lew enforcement, or (b) have
been granted a protective court order, or (c) are in fear of your personal safety from someone who has threatened or
stalked you and have filed a complaint against that person w~h a magistrate or law enforcement (must aHach copy of
complaint), You must show a Virginia P.O. box under mailing address In Box 7 above.

ACTIVE/RET LAW ENFORCEMENT

PROTECTIVE COURT ORDER

here if you have a


D Check
disability that requires
accommodation In order to vote.

THREATENED/STALKED

...

OFFICE USE ONLY

OFFICE USE ONLY

OFFICE USE ONLY

DATE CHANGED

NEW FIRST, MIDDLE/MAIDEN NAME AND SUFFIX

NEW LAST NAME

OTHER CHANGES

AUTHORIZED BY

NEWPCT

DATE CHANGED

DECEASED

JUDGED INCAPACITATED

OUT OF STATE

ERROR DELETED

TRANSFERRED OUT
RE-REGISTERED

PERSONAL REQUEST

NVRAPURGE

INACTIVE STATUS

CONVICTED OF A FELONY

REACTIVATED

NOTES:

"JiiJOA paJ3JSJ~3.i paWliU aqJ SJ UOSJad ill!J Jlll!J '9IOJZ"!>Z OJ JUllns.md SJU3W3JliJS iiSJliJ JOJ Sil!lJliUad
AUOJiiJ OJ pi!fqns 'JU3W3JliJS ll U~JS JO UOJlli:>!JJlUiiP! A\Oqs OJ UOSJ3d UJ ~UJlOA J3JOA AJ3A3 SiiJJnbiiJ MliJliJUJ~J!A '~U!JoA lo:!l
"UOJPillil
JliJ3p3J ll UJ 3JOA no,{ iiWJlJSJ!J aqJ iiAOqll (q) JO (ll) Jill!J!il SJliJ:>!JJO UOJPillil A\Ol!S OJ p3JJnb3J ilq AliW no,{ 'iiSJA\JilqJQ "SS3Jppll
pull awllu Jno.i: sMoqs JllqJ JUilwnaop wawuJuo~ nqJo Jo lpilq:>.\lld 'lpaqa JUiiWUJiiAO~ 'JUiiWiiJliJS lfUllq 'JJ!q A:mnn JUiiJJna
ll JO A:doa ll (q) Jo 'UOJlli:>!JJlU"P! OJOqd P!lliA pull JUiiJJna Jno.i: JO .i:doa ll (ll) Jilql!" UO!Jll:>!lddll SJqJ qlJM puils JSnw no.!: 'aJOJaq
li!U!~J!A u! 3JOA OJ pi!JiiJS!:I"J J3Aau 3Allq no.!: pull 'nuw .i:q P"mwqns S! WJOJ S!l!J J! 'MliJJliJ"P"J Milu u Japun 'Do!Jolls!~:JS Jo:!l

/ 1/\t-. vC:.r I ~it'\


v !-'1\'-U--VU._..v

{\ ir. . _ 11

~ "C.l.n. o

t..IA"'

'"'df'-

' H'"" ...... ~ ""

C L~N3'W3'Hin~:HI NOUV::>I.!IUN3'01
v 1 ~ (_ 1

"'\-"~!,

t""""'

1/ )

'1 oO"'!)

':lh!l no,{ :JJ:lljM hl!:l JO h) UnO:> :lljl U! :l:l!.JJO S,JllJlS!i!:JJ :lljl

Exhibit 7, page 66 of 84

"'"'"'-"nuf ';)"''J!rlc:! ~rn Tlf ~ ~ "'\Tn n 'P. H l n1~T OUP. -'1UHHJ JnO( ;tPJM 'DdOli\OJd 'it 1P.IIl ~dOJrlAUd Ulnl~J aq1 lf:J'Bl;)(l

..

-4

Ill -;E

Are you a ciii;en ofthe. I ;jed S.tates


of America?
YES
0 NO

Si

DDD-DDD-DDDD
Daytime Telephone Number

Date of Birth

JARQUIN,LUIS,ALBERTO
Last Name

0None
Full Middle or Maiden Name

First Name

ONon1
*Suffix (Jr.,Sr.,III,Etc.)

City/Town

If Rural Address or Homeless, please describe where you reside

Zip Code

E-mail address

Q9 City or 0 County
Mailing Address (If different) /Virginia P.O. Box or Uniformed Service Address, if
applicable (include Zip Code)
Name of City or County of Residence MANASSAS
~

Have you ever been convicted of a felony?

YES

If YES, have your voting rights been restored?

YES

t;l:J- NO
D NO

Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

DYES

State where convicted

LJrJ DD~ DODD

If YES, when restored?

jlN-Jo

YES

If YES, when restored?

ONO

aq

DCJ DD~ DODD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the Information
provided on this form is true. I authorize the cancellation (entj!red In Box 7 below) of my current registration and I have read the Privacy Act
.~

Notice above.

C'

~ }JJ;:;u

* Signature (or mark if unable to sign)

:4AP(;~/V\./'-

Obi"" J)QAX' .. (o (llo{\ \

lQJ~/ LQJI~J i]IQ[l]ISJ

=---------

0 Check/describe if you have a disability that requires accommodation In order to'


You mayrtquestlhat )'Oil' home ddrtss not be rtlmed Hyou ormenl>erofyourhousehold.,. ()active or retired law enforcement, or (b) hi,. been granted protective court order, or (c)art in
ofyoll'p"'onlu~ly 1om someone l'ho hiS threatened or stalked )'IU and h,. filed co"l'liintginstlht person .ilh magistrate or lweni>rcement (m>stltlch copyofcO"l'liint) or (d)pwc .. te in the
Address Confidentiality Program. You ntJSt show Vrgini<l P.O. box oodermailing ddrtss in Boxl abo,..

If applicant is unable to sign due to a phys1cal disability, write the nameladdress of person who assisted. (Required).

I'm interested in being

an Election Official on
Election Day. Please
send me information.

Law Enforcement

Protective Order

Threatened1Stalked

D. Address Confidentiality Program

012880<

Luis Alberto Jarquin


MALE

128388762
-~

NEW NAME (if changed):


CHECK WHICH ADDRESS IS YOUR CORRECT HOME (RESIDENCE) ADDRESS:
(Military please check your address of record; full time students please check your permanent address)

Where you are registered to vote:

Given by Post Office:

8511 SPRUCE ST

10241 Gregory's Grove CT

Other (can NOT be PO Box):

-MANASSAS. VA 201112126

Manassas. VA 201108451

0
Street

v5\ l

:J::o
c:::

en

City, State, Zip

'5~0("

M~N-1:\SS~~ I\{~

w \l ~

!o-d
N

1111111111111111111111111111111111111111111111111111111111111111111111111111111111111

c::::l

You may request that your home address not be released if you or a member of your household (a) arWctive or retired law
enforcement, judge or attorney employed by the US Attorney or Attorney General of VA, or (b) have been granted a protective
court order, (c) arc in fear of your personal safety from someone who has threatened or stalked you and have filed a complaint
against that person with a magistrate or law enforcement (must attach copy of complaint}, or (d) participate in the Address
Confidentiality Program. You must show a Virginia P.O. box or other commercial mailing address in space provided to the right.

(Check One) D Law Enforcement OfficerNA & US Judge/attorney D Protective Order D Threatened/Stalked D Address Confidentiality Program

COUNTY/CITY RESIDENCE:

X ~~~

SIGNATURE (can not accekt}POA/s ~cond party sign~tures)


VA-NRVA 2 (Rev. 06-05)

- -

l_\ ~~ \\ ~
DATE

f\J\~t>?;~ 't>S
DAYTIME PHONE:

t;'l \ Exhibit
S1S 7,~(?bb
page 67 of 84
.IAN 0 fi ?n11i

-.... . JAre you a citizen of the United States of America?


.
ro..e
. .
rvrES
NO

t+r

- :;.

_,

~ES
0
~ "

~o~ O~=~E[{Y(MALE

FULL MIDDLE OR MAIDEN NAME

ADAIR

SILVIA

(a dalmU

APT/UNIT/LOT/RM/SUITE

VIRGINIA p 0. BOX OR UNIFORMED SERVICE ADDRESS,

/h

_..Ll
/)
1 't0!7CI7S0..5 1 i/.r; r::.LO/Oq

:::r:::
::}}
::;:::;

lil}
\'::_::

~ ~ ~ ~

!/

DAYTIME TELEPHONE NUMBER

REBECCA

:;Y:fs~R_Z;;;::1:U~:O;:S L;;;;;;;HAT IS THE STATE ROAD NUMBER WHERE


MAILING ADDRESS

lllliL- M

SUFFIX (JR ,SR .. III,ETC.)

RESIDENCE/HOME ADDRESS (IF RURAL ADDRESS, DESCRIBE BELOW)

IF

CITY OR TOWN

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

YES

ef NO

IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

YES

DAY

NO

r ;I NAME OF CITY OR COUNTY OF RESIDENCE

APPLICABLE (INCLUDE ZIP CODE)

-,--,_

10

YEAR

ZIP CODE

YOUR HOUSE IS LOCATED1 WHICH SIDE OF THE ROAD-NORTH, EAST, ETC, NEAREST LANDMARKJ

.--

IF YES, WHEN RESTORED? (Requ~red) MO

\):

If you checked 'no' In response to either


of these questions, do not complete this
form.

NO

- - - - -..--J~
-:~_-__; :_1~=------~r~ -

7 4~:

Will you be 18 years of age on or before election day?

0CITY

OR

~UNJY

OF.

-f?~w-" -{;,~

HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

YES

"!i:j NO

IF YES. HAS COURT RESTORED YOU TO CAPACITY?

YES

NO

.. .. IF YES, WHEN RESTORED? (Requrred) MO _ _ _ DAY_ _ _ YEAR _ __

REGISTRATION STATEMENT: I SWE:AR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM AU S CITIZEN AND A
RESIDENT OF VIRGINIA , THE INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE I AUTHORIZE THE CANCELLATION, (ENTERED IN BOX 1 ABOVE) OF MY CURRENT
REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABOVE

.J.

REMINDER: SIGN

~~:E ~

HERE FOR VOTER REGISTRATION (OR MARK IF UNABLE TO SIGN),

SV,<.-'

/JZ-:::.

DATE-.

::-:-:-:1 M~=-----=~==~=====================================~~==============--1
;::::::::r-:-

lf applicant IS unable to s1gn, write below the name/address of person who assisted (REQUIRED)

Yes, I am interested m workmg as an


You may request that your home address not be released if you (a) are active or retired law enforcement, or (b) have
Election O!IJcJai on Election Day Please been granted aJ'rotective court order, or (c) are in fear of your personal safety from someone who has threatened or
stalked you an have flied a complaint against that person with a magistrate or law enforcement (must attach copy of
send me mformat1on
complaint) You must show a V1rginra P 0 box under mailing address in box 7 above
ACTIVE/RET LAW ENFORCEMENT
PROTECTIVE COURT ORDER
THREATENED/STALKED
REGISTRATION DATE
PCT
I TOWN CODE
DENIAL DATE & REASON
j
COMMENTS

AUG ?

R.

VA -NVRA'-

?nn
l"ff~W~.

7/04

Check here if you have


a disability that requ1res
accommodation in order
to vote.

_. oHi~~t :us~- :oniy :

..

. .,,-::

-:,.:.:.:.

: :=:t;.

...

, _.

'' '?"- Office

Us~ : oniy

,_,_.

:::.

New First, Middle/Maiden Name and Suffix

New Last Name

New PCT

Other Changes

'OHice. Us~ 'OnW


Date Changed

Authorized By

Date Changed

Deceased

Judged Incapacitated

Transferred Out

Out of State

Error Deleted

Re-Registered

Personal Request

NVRA Purge

Inactive Status

Convicted of Felony

Re-Activated

Notes:

[ecv'--0t- l \..~

;:

6~c Lo-'\t.~

u-.J .Y v\.

L..r--~ ~ L- e.-v-""'\..

JAN 0 5 2015

Exhibit 7, page 68 of 84

..

*Are you a citizen)lfthe United States


America? ~ES D NO

*Will you be at least 18 years of age on or before


the next General Election day? Es D NO

DMale
*Gender

If you checked "NO" in response to either of


these questions, do not complete this form.

UJ~~[Q

~le
*Date of Birth

~0[2]- ~[J[[]- ffi[LJ[]


Daytime Telephone Number

LJJ. 1Tf{

*Have you ever been convicted of a felony? DYES

;a1J'o

lf YES, have your voting rights been restored? DYES

D None ----,-------=.:..:..:.:.:.::

State where convicted =,___,.==--c===-=====:::------

[JLJ,DD,DDDD
when restored? UU1 DD1 DODD

.Q1'(c) If YES, when restored?

*Have you ever been judged mentally incapacitated? DYES ~0

If YES, has court restored you to capacity? DYES D NO

If YES,

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my curi'I!('!Te!li?{'&1ind I have read the Privacy Act
9
Notice on the front of this form.
U
'11

~ Slgno.,<e(o, m"bf ""'''"" ,;gn) lfdti-fT ~ JSo /o L'V'l:J'00

[JrQL[\:~ f ~

'

D Check if you have a disability that requires


If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

someone to assist you in order to vote.

DOD Protected Voter Code if applicable. See instructions.


D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

New Last Name

PCT

Town code

Denial date & reason

New First, Middle/Maiden Name and Suffix


New PCT

Other changes

D Deceased _ _ _ _ _ _ _ _ _ __
D Out of State _ _ _ _ _ _ _ __
D Personal Request _ _ _ _ _ _ __

Date changed

D Judged Incapacitated _ _ _ _ __
D Error Deleted _ _ _ _ _ _ _ __
D NVRA Cancel _ _ _ _ _ _ _ __

D Convicted of a Felony _ _ _ _ __

JAN 0 5 2015

Date changed
Authorized by

Date changed

,[J.::rrans~rred Out--~-----0

Re-Registere~d

_ _ _ _ _ _ _ __

D Inactive S t a t u s - - - - - - - - 0 Reactivated _ _ _ _ _ _ _ _ __

Exhibit 7, page 69 of 84

i,t.

Will you be 1 8 years of age on or before election day?

Are you a citizen of the United States of America?

~~~fYEs

Mn

If you checked 'no' In response to either


of these questions, do not complete this
form.

QYES

~-t;~i(~l

~_I?ER

~ALE 0

LE OR MAIDEN NAME

)tJ~\i~i;lyl-=iy by t.Ly

FEMALE

SUFFIX (JR.,SR.,III,ETC.)

DAYTIME TELEPHONE NUMBER

lo-, bio 11 ~?
RESIDENCE/HOME ADDRESS (IF RURAL ADDRESS, DESCRIBE .BELOW)

APT/UNIT/LOT/RMISUITE

CITY OR TOWN

.,.

IF

RURAl ADDRESS,

\MAILING ADDRESS m

,.
I
f

'

;.. '.1
- .

VIRGINIA P 0 BOX OR UNIFORMED SERVICE ADDRESS, 1F

d;t'"'""

. '! ,.1
~

APP LICABLE

(INCLUDE ZIP CODE)

YES

J~f NO

IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

YES

NO

p,ft
1.,

oi . ~NAME OF CITY OR COUNTY OF RESID:~.CE

lI

0 CITY
OR
~COUNTY
~ - RINCE WILLIAM

HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

IF YES, HAS COURT RESTORED YOU TO CAPACITY?

~"

OF

YES

e~o

YES

NO

IF YES, WHEN RESTORED? (ReqUired) MO _ _ _ DAY_ _ _ YEAR _ __

REGISTRATION STATEMENT: I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES. THAT I AM A U.S. CITIZEN AND A
RESIDENT OF VIRGINIA, THE INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION, (ENTERED IN BOX 1 ABOVE) OF MY CURRENT
REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABOVE

l!!l- q J.
~:~.

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

IF YES, WHEN RESTORED? (Required) MO _ _ _ DAY_ _ _ YEAR_ __

22192

DESCRIBE WHERE VOUII HOUSE IS LOCATED (IE , WHAT IS THE STATE ROAD NUMBER WHERE VOUft HOUSE IS lOCA'TEDl' WHICH SIDE Of THE IIOADNORTH, EAST, ETC : NEAREST LANDMARK)

ZIP CODE

PRINCE WILLIAM

11683 CHANCEFORD DR

REMINDER:

SIGN
HERE

H~RE FOR VOTER REGISTRATION (OR MARK IF UNABLE TO SIGN).

SIGN

....

- ,

'--

L..

( .

- :\

. 7

c-"

~-

c::: -

DATE-+

If applicant IS unable to sgn, write below the name/address of person who assisted: (REQUIRED)

Yes 1 am interested in working as an

El D
PI
El ec't.Jon orr
. ICJa 1 on ectJon ay. ease
I Pl_cend me Information .
'/.(//;

J~EG ISTRATION

DATE

DEC 1 1 2006

VANVRA-1 Rev. 7/04

PCT

You may request that your home address not be released if you (a) are active or retired law enforcement, or (b) have
been granted a protective court order, or (c) are in fear of your personal safety from someone who has threatened or
stalked you and have filed a complaint against that person with a magistrate or law enforcement (must attach copy of
complaint) You must show a Virginia P.O. box under mailing address in box 7 above.
0 ACTIVE/RET LAW ENFORCEMENT
0 PROTECTIVE COURT ORDER
0THREATENED/STALKED

TOWN CODE

DENIAL DATE & REASON

Check here if you have


a disability that requires
accommodation in order
to vote

COMMENTS

..

Exhibit 7, page 70 of 84

* Will you be at least 18 years of age on or before


~YES D NO
the next General Election day?

Male

[]~]][7]

D Female

Gender
GOSHORN, PETER, CHARLES
*Last Name

If you checked "NO" In response to either of


these questions, do not complete this form.

rzJQJlJJ -~~[Q]- ~[]oo~


Daytime Telephone Number

* Date of Birth

0None
* Full Middle or Maiden Nam~

*First Name

ON one
*Suffix (Jr.,Sr.,III,Etc.)

.12641 STONE LINED CIRCLE,WOODBRIDGE VA 22192


\. Residence (Permanent) Home Address

Apt/Unit/Lot/Rm/Ste

City/Town

If Rural Address or Homeless, please describe where you reside

Zip Code

E-mail address

Mailing Address (If different) !Virginia P.O. Box or Uniformed Service Address, if
D City or 29 County
applicable (include Zip Code)
Name of City or County of Residence PRINCE WILLIAM
~

* Have you ever been convicted of a felony?

YES

~NO

State where convicted

If YES, have your voting rights been restored?

YES

D NO

If YES, when restored?

* Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

-+

DYES

0 YES ~NO
If YES, when restored?
ONO

LJ[J LJ[l [][][][]

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the Information
provided on this form Is true. I authorize the cancell n (entere n Box 7 below) of my current registration and I have read the Privacy Act
Notice above.
* Signature (or mark if unable to sign)
If applicanlls unablelo sign duel physical dlsabllily, wrilelhe name/address of person who assisled. (Required).

LJ[J DD~ DODD

I'm Interested In being


an Election Official on
Election Day. Please
send me Information.

Check/des.~ribe If you have a dlsablllly lhat requires accommodation in order to vote.

You mayl!quesllhal )O .. homo ddress not be re~ased H)OU ormell'borof)O.. household.,. (a) active or retired law enforcement, or(b)haw been granl<d a protective court order, or It).,. 11 !tar
of)OII'pemnai saftlyium someone Yl10 has threatened or stalked )OU and haw filed aco"''lalll agallst lhalpmon Yilh a magbbal< orlawenfoltemenl trust altath copy of to"''lailt)orjd)p..ticipate il lhe
Address Confidentiality Program. You must show a 'II!Jinia P.O.boxundormallilg address iiBoxlabow,
0 Law Enforcement 0 Protective Order 0 Threatened/Stalked 0 Address Confidentiality Program

JAN 0 5 20\5
Exhibit 7, page 71 of 84

I 12

LASTNAMt:

~ER (circle one)


MAL

1 1

~/1-A/C ;-

Zo6, ;

SUFFIX (JR , SR , Ill., ETC )

t/- tv~-ofi ~

APT/UNITI LOURM/SUITE

NO. STOP HERE - DO NOT FILL OUT SECTION B.


!;;Q!:jlli!;;!!Qt:! OE F!;!.Qt:!Y
DYES

~0

IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED ?

DYES

DNo

IF YES, WHEN RESTORED? (REQUIRED) MO

Yes, I am interested in working as


an Election Official on Election Day. Please
send me information .

~- TRUE, I AUTHORIZE THE CANCELLATION

DAY

CITY

~TY

Y . o apply to register to vote or change your voter registration address: CONTINUEComplete all boxes (8 - 11 and A) in Section B and sign your name in the red box below.

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

NO. STOP HERE - DO NOT FILL OUT SECTION B.


!;;IB!;;UII COURI JUDGEMEt:!T OE Ml::t:IIAL lt:!!;;A~A!;;I!Y
HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

DYES lit"No

IF YES, HAS COURT RESTORED YOU TO CAPACITY?

DYES

IF YES, WHEN RESTORED? (REQUIRED) MO_ _ DAY

YEAR

If you are active or retired law enforcement, or if you have a protective court order. you rnay request that
your home address not be released. You must show a Virginia P.O. box in box 6 above.
D

Ar/A~ff! M I I ,--1'4

I:NAME O F CITY OR COUNTY OF RESIDENCE

~ S. CfTlZEN?

DO YOU WANT TO APPLY TO REGIS'TER TO VOTE?

~ Answer the citizenship question to the right and complete ALL boxes (8 11 and A) in
Section B and sign your name in the red box below.

ZIP CODE

VA- ; ?)'7 3

1,

D
I

STATE

CITY OR TOW( ,

j'}/f I r- C",

MAILING ADDRESS (if different from above) P. 0 . BOX OR UNIFORMED SERVICE ADDRESS, IF APPLIES (INCLUDE ZIP CODE)

7o ~-ttrro-7'3?- :;-

FULL MIDDLE OR MAIDEN NAME

R/3~~~E ~DRES;;:U;L ;:S~C:;;E BOX /J~W~

DAYTIME TELEPHONE NUMBER

.::':.', :~;1 1~ 50

'

FIRST NAME

,.-rn"t

yy Y)

FEMALE

ACTIVE/RET LAW ENFORCEMENT

--

YEAR

PROTECTIVE COURT ORDER

DNO

Check here if you have a


disability that requires
accommodation in order to vote.

BEG!STBATtON STATEMENT: I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR PERJURY, THAT I AM A U.S Q.IIze,j AND A RESIDENT OF VIRGINIA, THE INFORMATION I HAVE PROVIDED ON THIS FORM IS
ENTERED IN BOX A BELOW, OF MY CURRENT REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE BELOW

+"'"'~"~
SIGN....

HERE

'"~~ ""~~' m~' "~'m'"' "~ ~~' '"" oa~ '"-~""'

""

JrV

/<

IF APPLICANT IS UNABLE TO SIGN WR~E NAM~ RESS OF PERSON WHO ASSISTED BELOW (REQUIRED):

rn-

IF YOU LIVE IN A RURAL AREA, DESCRIBE YOUR HOUSE LOCATION (I.E., STATE ROAD NUMBER WHERE YOUR HOUSE IS LOCATED; CLOSEST INTERSECTING ROAD; SIDE OF THE ROAD-NORTH, EAST, ETC.;
NEAREST LANDMARK)

- ~'

REGISTRATION DATE

PCT

fEB 0 7 2002
--

._

__

COMMENTS

..

..

..... ,.,:----------- ...--.-------.-----.-----,----:.---- .. ----------------------------------------------------------------------,----------.---- ---

.1:'.1(111\:JI:!eY.JiOO

~~--

DENIAL DATE & REASON

TOWN CODE

---

--- .
--- - - OFFICE USE ONLY

---- -------------- -- --

OFFICE USE ONLY

OFFICE USE ONLY

DATE CHANGED

NEW FIRST, MIDDLE/MAIDEN NAME AND SUFFIX

NEW LAST NAME

----------- -- -- -

SUBJECT TO PENALTY OF LAW, I DO HEREBY AFFIRM THAT I AM A


CITIZEN OF THE UNITED STATES OF AMERICA

PRINTED NAME

AJ?
y

~
H!1-.N (is-c . z

SIGNATUREOFVOTER

0'

OF VOTER:

Date ofbirth:
Current address:

Street/P.O. Box/Apt.#
City!Town/State/Zip

Mailing address [if10._


different]:
\ "\

St_reet/P.O. Box/A).?~#

Daytime telephone
number:
Email address:

JJ 10 "
VA- :? ?-I 7 7

k
.

VY>

/
c:-/. j \/AJS

'?

_;
1
c,;_

CttyfTown/State/~
S _;Q /- t
~k> .SZ}-~.f/c;,_ _'fi
Y \...A/~
3- (t ~(}- 7 ~) ~

2{)-

/1-

5EP 2 ;~ 2010
Exhibit 7, page 72 of 84

.:.: . .

=~t.l~~-..n lll l llllr,I,IVII

111

uy

llldll

Y~

t\r~,; you a citi7en oi the Uniteg S_0$


of AmeriGa?
[]YES
M"HO

Soci<JI

~>ccurity

' Wiii;ou b;;llea';i18


of ag; 01'
the next General Election day?

f'!umb:!r

~!_iJRI<ESLGI.Q_l~IA,!\i~!!.!:'_ENF:._

La~t

D:~te

If you checked "NO" in response to oither of


these questions, do not complete this form .

or Birth

_________ ,____________________..l=o!...!.None

Hesidence (Permanent) Home Add res~:

Apt/Unit!Lot/Rm/Ste

None.

Suffix (Jr.,Sr.,lll,

Full Middle or Maiden Name

First Name

Name

~or;-

~~"[]NO

Zip Code

Citynown

\
If Huml /\ddmr.s ur! lo111eless, pleilse dP.scribe where you reside

Mailing /',dcJress (;i cldfent:l,l/ V1rgini:1 P.O. Bo:o.


applicable (inci!Jclo Z,p Code)

01

' Havt: yell ever been convic:.ted of a felony?


If '.'i.:S, have yo11r \oling riuhts t)er:n restorc:cl?

Have y.1u

t~ver

bcnn judyed mentally

E-mail address

Uniformed Service Address , if


of City or Co(Jn/y of Residence

County

YFS

ilocapacitat~cf?

If i'ES, has couol restored you to capaciiy?

City or

MANASSAS

icted

[] YE'S

LJ

DYES

, when restored?

!Ml!Ml 151Vl
UL.JI LJUI

0. 000.
1

Registration Sbternent: I swear/affirm, under !~tony r~n3lty for making willfully false material statem~nts or entries, that the information
pr<.>videcl on lhi~ forlll i~ true. I aulhori~~ the canr.dblion (enterod in Box 7 h~low) of rny current registration and I have read the Privacy Act

+- '

Notice aLovc.
Signature (or tniJt'if if unable !o

r//7~

MO'l!M71 jBJ?l[O;'J

Sign)_~--

Pll!YllDD

~LSJL.fJI ~ji_Qjl W~

Check il)'ou haw a disability that reqwes


~omconc to ass1st you in order to vote

- - - - - - - - - - - - _____
If Llppllc:nnt s unable 'o sg--: :tutJ

[JD[J
0

'~J cl

pltysttal ciisabihty, t.rilc li1c name/Address uf person who ass1stecJ (Requ1rad)

Protected Voter Codi.' il apphcab!e. See above.

I'm inlerestnd in being an Election Ofricia! on Election Day. Pleas~ send m~ information.

DENIAL/CANCELLATION DATE:
REASON #1:

ANSWERED NO TO CITIZEN ?

REASON #2:
REASON #3:

2/2/2016

REASON #4:

Exhibit 7, page 73 of 84

*Are you a citizen of the United States


of America? DYES !NO

*Will you be at least 18 years of age on or before


the next General Election day? ~YES D NO
~Male

. .~~~~~~;,-~-r~~--~~Gender

If you checked "NO" in response to eitner of


these questions, do not complete this form.

D Female

LVfs

p,.

If Rural Address or Homeless, please describe where you reside

E-mail address

*Have you ever been convicted of a felony? DYES ~NO State where convicted-====-===-======-----If YES, have your voting rights been restored? DYES D NO

[][];00;0000

If YES, when restored?

*Haveyoueverbeenjudgedmentallyincapacitated? DYES ~NO


lfYES, has court restored you to capacity? DYES D NO lfYES, when restored?

UU;00;00DD

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the
information provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have
read the Privacy Act Notice on the front of this form. ~

*Signature(ormarkifunabletosign)

7 - :_......-...:.,

~/

IQJL];[~]li];QL!]~~

.........._ )

JAN 2 9 20lS

Check if you have a disability that requires


Uj D someone
to assist you in order to vote.

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required)j

DOD

Protected Voter Code if applicable. See instructions.


,
D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT Town code

New Last Name

Denial date & reason

Date changed

New First, Middle/Maiden Name and Suffix

Date changed
Authorized by Date changed

DENIAL/CANCELLATION DATE:
D Deceased_
D Out of State _
D Personal Requ'
D Convicted of a
Notes

2/3/2016

REASON #1:

CHECKED NO TO CITIZENSHIP?

REASON #2:

WAS CALLED SAID WAS NOT A CITIZEN

REASON #3:
REASON #4:

Exhibit 7, page 74 of 84

of:; o~efor;-

wiii;'ou b';;j lea;-:jB y:=;;


the next General Election day?

(\tYES

If you checked "NO" In response to either of


these questions, do not complete this form.

NO

Date of Birth

Daytime Telephone Number

..::S:.:.H:..:.A..:.:M=S..::U..::D:...:I"-N:.z.:,Z::..U:::..L=..:...:A..:.:IK=H:.:..A::.~.,_ _ _ _ _ _ _ _ _ _ _ _ _ _ ---,------,----,-----'""OoL..!..O.No::.:.n:..::..e
0 None
Last Name
First Name
Full Middle or Maiden Name
* Suffix (Jr.,Sr.,III,Etc.)

18075 TEBBS LANE, DUMFRIES, VA 22026


\ Residence (Permanent) Home Address

ApUUniULoVRm/Ste

E-mail address

If Rural Address or Homeless, please describe where you reside

Mailing Address (if different) I Virginia P.O. Box or Uniformed Service Address, if
applicable (include Zip Code)
Name of City or County of Residence
Have you ever been convicted of a felony?
If YES, have your voting rights been restored?

D
D

YES

YES

D NO
0

Have you ever been judged mentally Incapacitated?


If YES, has court restored you to capacity?

DYES

NO

Zip Code

CityfTown

YES

State where convicted


If YES, when restored?
NO
If YES, when restored?

City or

[!]County

PRINCE WILLIAM

UL} UUt DODD


UUt EJD,DDDD

ony enalty for making willfully false material statements or entries, that the Information
x 7 below) of my current registration and I have read the Privacy Act
enter

If applicanl is unable lo sign due to a physical disability, write the name/address of person who assisted (Requirec()EC

ODD
0

0 4 2014

Check if you have a disability that requires


someone to assist you in order to vote.

Protected Voter Code if applicable. See above.

I'm Interested in being an Election Official on Election Day. Please send me information.

Exhibit 7, page 75 of 84

If you checked "NO" in response to either of


these questions, do not complete this form.
0 Male Oeffiale
*Gender

*Date of Birth

Daytime Telephone Number

Me..lt

S. S 0\
D None
*Full Middle or Maiden Name *Suffix

*First Name

~~~~~~~~

7:/::Li--:-L,_..
t o----=l~f,-o
;__"~t;-:-;C,-t i "'--=-e..
-:-:--C_.....\ _ __ _ ...,------,..,........,.-,.-------,--- ( ,Jo ccH:> r:&~ e..
* Residence (Permanent) Home Address

2 "2 l
Zip Code

Apt/Unit/Lot/Rm/Ste CitV/Town

.,..,...,...---,-....,.....,--,------ - - . , - ---:----:--:-:-:------:--- - - : - : - - -- - - - - kif'YlOI1e. Cct ()"')I~

If Rural Address or Homeless, please describe where you reside

-----------------------------------------------------------Mailing Address (if differenf/Mrginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code)
*Have you ever been convicted of a felony? DYES

!d-N1r'

if:5 _yal-,oo C

E-mail address
D City or 9-tounty: :f>11'nce..
Name of

~ 2

W1

ll 1C<rv\

of Residence

State where convicted ===---c====--======-----------

[J[J,[J[],O[IJD
*Have you ever been judged mentally incapacitated? DYES
If YES, has court restored you to capacity? DYES D NO If YES, when restored? [J[J,OD,DDDD
lf YES, have your voting rights been restored? DYES D NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information

provided on this form is true. I authorize the Cl!ncellation (entered in aox 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this f~
L:}.
~~

-7 Sig""""lo'm"'k ;Fu;;;;,,D,;~= ~
SEP 06 2012

[fl],[[J[IJ,~

D Check if you have a disability that requires

If applicant is unable to s1g due to a physical disability, write the name/address of person who assisted. (Required).

someone to assist you in order to vote.

DOD Protected Voter Code if applicable. See instructions.


D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT Town code

New Last Name


Other changes

Denial date & reason

New First, Middle/Maiden Name and Suffix

0 Deceased _____________________ D Judged Incapacitated _______


0 Out of State _ _ _ _ _ _ _ ___ 0 Error Deleted __________
0 Personal Request _________ D NVRA Cancel _ _ _ _ _ _ _ __
0 Convicted of a Felony ________

Date changed

NewPCT

Date changed
Authorized by

Date changed

D Transferred Out _________________


D Re-Registered _ _ _ _ _ _ _ __
D Inactive Status---'-------D Reactivated -------------------

Notes

Exhibit 7, page 76 of 84

*Will you be at least 18 years of age


the next General Election day?

~ore

If you checked "NO" in response to either of


these questions, do not complete this form.

lfvEs' -C:i'No

*Full

Apt/U nit/Lot/Rm/Ste City/Town

Z1p Code

~t f4-{ ~6

II SCV()~Au/'.ar

If Rural Address or Homeless, please describe where you reside

E-mail ad ress

Mailing Address (if different)Mrginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code)

itv or g{ounty:
Name of City or County of Residence

ft-C_

D YES

*Have you ever been convicted of a felony?

If YES, have your voting rights been restored? DYES

DODD
rn I DD I DODD
FlfMll
UU fDlroll
UU

D NO If YES, when restored?

*Have you ever been judged mentally incapacitated? DYES

NO

If YES, has court restored you to capacity? DYES D NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy
Act Notice on the front of this form.
*Signature (or mark if unable to sign~.,

OCT O ZQt49
D Check if you have a disability that

lf applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

III

Protected Voter Code if applicable. See instructions.

requires someone to assist you in order to


vote.

.,

D I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


PCT

Registration date

Town code

Other changes

, ,~'f(,

1/2.olrr; Corri'dtol ~b -from


I

Deceased----------Out of State
Personal Request
Convicted of a Felony _ _ _ _ _ __

Date changed

New First, Middle, Maiden Name and Suffix

New Last Name

0
0
0
0

Denial date & reason

0
0
0

Judged Incapacitated _ _ _ _ _ __
Error Deleted _ _ _ _ _ _ _ _ __
NVRA Cancel _ _ _ _ _ _ _ _ __

New PCT

Date changed
Authorized by

KB

0
0
0
0

D;];:J;~d
I

Transferred Out _ _ _ _ _ _ _ __
Re-Registered _ _ _ _ _ _ _ __
Inactive Status _ _ _ _ _ _ _ __
Reactivat~d

_ _ _ _ _ _ _ _ __

Exhibit 7, page 77 of 84

*Will you be at least 1Byears of age on or before


the next General Election day? bJ_YES--EJ NO

If you checked No" in response to either c


these questions, do not complete this form.

If Rural Address or Homeless, please describe where you reside

E-mail address

Address If different)/ Virginia P.O.Box or Uniformed Service Address, if applicable 0 City or 0 County
Name of
Have ycu ever been convicted of a felony? 0 YES

of Residence

State where convicted===-:==::-::====::;-----If YES, have your voting rights been restored? 0 YES CJ.Nfrlt YES, when restored?

.... Have y111u ever been judged mentally incapacitated? 0 YES ~


If YES, has court restored you to capacity? -DYES 0 NO If YES, when restored?

m,rn,rrm
rn,rn,DillJ

II applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required). QChackldescribe ~you have a disabilitytllat requires accommodation in ordarto vote.
I'm lntaraatad In baing an
You may request that your home address not be released if you or mambar of your household (a)are actin or ratirad law anlorcament, or (b) have been granted
EIICllon Olficial on Elaction Day. protectiva coun order, (c) are in lear of your personal salaty from someone who has ttireatanad or ltalkad you and have filed a complaint against that parson with
Plllll aend tnelnlormetion.
a magiatrata or law enlorcemant (must attach copy of complaint), or (d) participate in the Addre11 Confidantlallty Program. You must show a Virginia P.O. box under
mailing address in Box 3 abova.
law Enloraamant
Protective Ord.r nThraatenad/Stalked n Add1111 Confidentiality Program

Exhibit 7, page 78 of 84

*Are you a citizerl)lf the United States


of America? [}3"\'ES 0 NO

Number

If you checked "NO" in response to either of


these questions. do not complete this form.

0 Male ""ffiemale
*Gender

\Alai!'-! -iler)

*Last Name

*Will you be at least 18 years of a~on or before


the next General Election day? MYES 0 NO

f'-.Aa.:-1AIY\
*First Name

lLthb=f ~Clrt?u-W\\0 \ <i!x:Cace


*Residence (PermanGilt) Home Address

t."Z.\ l13

VdrnAh.::,.Aot.
Apt/Unit/Lot/Rm/Ste

City/Town

Zip Code
~

~-.,....,....,...,----,-.,----,----.,----.,-----,.,----,----~-------- \.VaiY-en-:\eeoiYRI:rqm '1@ ;f':\C03\\ .(ci


w~ere

If Rural Address or Homeless, please describe

you reside

E-mail address

---------------------------------------------------------- ~O~C~i~~o~r~O~Co~u~n~~:_________________
Mailing Address (if differendNirginia P.O .Box or Uniformed Service Address. if applicable (include Zip Code) Name of City or County of Residence

*Have you ever been convicted of a felony? 0 YES .M.('NO

State where convicted==:;---;=


- =;--;:====:;-----------

UU! UU1 DODD


!Ml!Ml UU DODD

If YES, have your voting rights been restored? 0 YES 0 NO If YES, when restored?
*Have you ever been judged mentally incapacitated? 0 YES _NO

If YES, has court restored you to capacity? 0 YES 0 NO

If YES, when restored? UU f

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.

~ *Signature (or mark if unable to sign) --Nf-"--'~LL~-k~.

-"'~2"7t-+lt+01t4.!4-----

\_,_,\'-'-"ec=...._
_ _ _ _ _ _J;-AH'f'-t-!

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted.IRequired).

Check if you have a disability that requires


someone to assist you in order to vote.

DOD Protected Voter Code if applicable. See instructions.


0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

PCT

Denial date &reason

0 Deceased -------------------- 0 Judged Incapacitated _ _ _ _ __


0 Out of State _ _ _ _ _ _ _ _ __ 0 Error Deleted _ _ _ _ _ _ _ __
0 Personal Request _ _ _ _ _ _ __ 0 NVRA Cancel _ _ _ _ _ _ _ __
0 Convicted of a Felony _ _ _ _ __

Date changed

New First, Middle/Maiden Name and Suffix

New Last Name


Other changes

Town code

NewPCT

Date changed
Authorized by

Date changed

0 Transferred Out _ _ _ _ _ _ _ __
0 Re-Registered __________
0 Inactive Status----------0 Reactivated ___________

Notes

Exhibit 7, page 79 of 84

*Are you a citizen of the United States


of America? j8l YES 0 NO

*Will you be at least 18 years of a!il3 on or before


the next General Election day? LZi YES D NO

3oZ

If you checked "NO" in response to either of


these questions, do not complete this form.

C.t.xx:c\bc\dQQ
2219\
(._j
Zip Code

ApUUniULoURm/Ste City/Town
If Rural Address or Homeless, please describe where you reside

E-mail address

---------------------------------------------------------------

~D~C~ity~o~r~D~c~o~u~n~tv~:________________

Mailing Address (if different)Mrginia P.O.Box or Unifonned Service Address, if applicable (include Zip Code)

Name of City or County of Residence

If YES, have your voting rights been restored? DYES

D NO If YES, when restored?

*Have you ever been judged mentally incapacitated? D YES


If YES, has court restored you to capacity?

YES

DLJ m CJDDD
rn I UU I [J[JCJCJ

t(NO State where convicted ---===--===--======--------

*Have you ever been convicted of a felony? DYES

NO

NO If YES, when restored?

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy
Act Notice on the front of this form.

Q]~ I [j[] I []]QJ[ID

JUN ] 0 20!5
ue to a physical disability, write the name/address of person who assisted. (Required).

D Check if you have a disability that


requires someone to assist you in order I
vote.

BOOKS ClOSED

D I'm interested in being an Election Official on Election Day. Please send me information.
~

,.,.n.-~-

- -

For Office Use Only


Registration date

New Last Name

PCT

Town code

Denial date & reason

Date changed

New First, Middle, Maiden Name and Suffix

Other changes

New PCT

0 Deceased-------------- 0 Judged Incapacitated _ _ _ _ _ __


0 Out of State

0 Error Deleted

0 Personal Request
0 Convicted of a Felony _ _ _ _ _ __

0 NVRA Cancel

-------------------------

Date changed
Authorized by

Date changed

0 Transferred O u t - - - - - - - - 0 Re-Registered--------0 Inactive Status

----------

0 Reactivated----------

Notes

Exhibit 7, page 80 of 84

-:-Ar~';;; a ciii;n o!Jfre un;d Stai;'


of America?

efYES

* Will you be at least 18 years of age ~before


the next General Election day?
E::] YES 0 NO

0 NO

If you checked "NO" in response to either of


these questions, do not complete this form.

DDD-DDD-DDDD
* Date of Birth

* Social Security Number

Daytime Telephone Number

. =D:..:.A.:. V. :. c:=-IC:::.H::..::..z. :,R:.::.I:.. :C::..:H:..::..:. .:A:.::.R==D::..:!,=L:..::O:.. .:Y:.. :D=---- - = - - - - - - - - - - - - *Last Name

*First Name

--=--.,.,...,.-,----,----,-----'0='-:..::No:::.n=-e
0 None
*Full Middle or Maiden Name
*Suffix (Jr.,Sr.,III,Etc.)

15328 POSTILLIONTER, WOODBRIDGE, VA221913814-'---------------- _ _ _ _ _ _ __


* Residence (Permanent) Home Address

ApUUniULoURm/Ste

If Rural Address or Homeless, please describe where you reside

Zip Code

Cityffown
E-mail address

Mailing Address (If different) I Virginia P.O. Box or Uniformed Service Address, if
0 City or [!]County
applicable (mc/ude Zip Code)
Name of City or County of Residence PRINCE WILLIAM

0
D

* Have you ever been convicted of a felony?


If YES, have your voting rights been restored?

YES

* Have you ever been judged mentally incapacitated?


If YES, has court restored you to capacity?

YES

YES

NO

0J'YES
0 NO

State where convicted


If YES, when restored?

DDDD
[]LJ,DDDD

[][]/ IDliDl,
UU

NO

If YES, when restored? [ ] [ ] 1

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form Is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice above.
11>-

~IM.:l/ ~~ 1Y;111YQ11Y,llV(

~ ~;, MG. (\y- . ,..(') ,

*Signature (or mark if unable to signJ,L#'VIILrt:T

~~

JUN @,i 2014

---------------------------------'=-=..:....:._ __::'::...._____
If applicant

IS

ODD
0

ltlJ~ ~~ 1 lLJ~L!Jt!J
0

Check if you have a disability that requires


someone to assist you in order to vote

unable to sign due to a physical disability, write the name/address of person who assisted. (Required)
Protected Voter Code if applicable. See above.

I'm interested in being an Election Official on Election Day. Please send me information.

Exhibit 7, page 81 of 84

If you checked "NO" in response to either of


these questions, do not complete this form.
-

0 Male ~Female
*Gender

-=p

';~;~-

;~:~.. .. .&: ~..

'*

-~-

~Lillt ~- ~~- @ill[]2]

*Date of Birth

Daytime Telephone Number

ARA

*Full Middle or Mai

*First Name

~~-=-~6~ll___,.,Tc,.....L-:.-~=.J~:~'--"-=-:-=-e=--.J...i!/'~\:>-~--- -=-----::-:--:--c::-----:=----=--- -?.1~:::.::::=-:-~~=::........::..._Y~


*Residence (Permanent) Home Address

Apt/Unit/Lot/Rm/Ste City/Town

E-mail address

It Rural Address or Homeless, please describe where you reside

Mailing Address (ifdifferen~Mrginia P.O.Box or Uniformed Service Address, if applicable (include Zip Code) Name of

*Have you ever been convicted of a felony? 0 YES M.NO

':L2D ?k

Zip Code

of Residence

State where convicted===--:===--======-------

UU f UU f DODD
*Have you ever been judged mentally incapacitated? 0 YES
It YES, has court restored you to capacity? DYES fii.NO It YES, when restored? [J[J,[JLJ,DDDD
It YES, have your voting rights been restored? 0 YES

~NO

It YES, when restored?

~NO

Registration Statement: I swear/affirm, under felony penalty for making willfully false material statements or entries, that the information
provided on this form is true. I authorize the cancellation (entered in Box 7 below) of my current registration and I have read the Privacy Act
Notice on the front of this form.

1
~*Signature (or mark if unable to sign) _C.t. :l/~(c.=v.="-'-=.....,:....:~~....-=---...:~:...._
_ _\~S[l----_
: .!o

_ _ _ _ _ _ _ _ _ __

APR ~ 2 2013

If applicant is unable to sign due to a physical disability, write the name/address of person who assisted. (Required).

Check if you have a disability that requires


someone to assist you in order to vote.

DOD Protected Voter Code it applicable. See instructions.


0 I'm interested in being an Election Official on Election Day. Please send me information.

For Office Use Only


Registration date

New Last Name

PCT Town code

Denial date & reason

New First, Middle/Maiden Name and Suffix

Other changes

New PCT

0 Deceased _ _ _ _ _ _ _ _ _ __ 0 Judged Incapacitated _ _ _ _ _ __


0 Out of State _ _ _ _ _ _ _ __
0 Error Deleted _ _ _ _ _ _ _ __
0 Personal Request _ _ _ _ _ _ __ 0 NVRA Cancel _ _ _ _ _ _ _ __
0 Convicted of a Felony
Notes

Date changed

0
0
0
0

Date changed
Authorized by

Date changed

Transferred Out _ _ _ _ _ _ _ __
Re-Registered _ _ _ _ _ _ _ __
Inactive ~tatus _ _ _ _ _ _ _ __
Reactivated _ _ _ _ _ _ _ _ __

cftll..l4f3't,.-0..{;.1J t~t?tA-A/1 eJ IJepV L;r'-;J:"C/3r-l ~

-;; rJ/'}c>loExhibit 7, page 82 of 84

Will you De 111 years of age on or before election day?

ciJ<s

QNO

If you checked 'no' In response to either


of these questions, do not complete this
form .

GENDER
K:)MALE

FEMALE

SUFFIX (JR ,SR ,III,ETC.)

RESIDENCE/HOME ADDRESS (IF RURAL ADDRESS, DESCRIBE BELOW)

APT/UNIT/l.OTIRMISUITE

CllYORTOWN

13145 MXNHXEVZLLE ROAD TRL #13


RURAL ADDRESS,

IF

MAILING ADDRESS

111

ZIP CODE

WOODBRXDGE

DESCIUBE WHERE YOUR HOUSE IS LOCATED (I.E., WHAT IS THE STATE ROAD NUMBEII WHERE

" """"u VIRGINIA P.O. BOX OR UNIFORMED SERVICE ADDRESS,

yOUfi

22192-~

HOUSE 15 LOCAT01 WHICH SIDE OF THE ROADNORTH, EAST, ETC., NEAREST LANDMARK)

OF APPLICABLE

(INCLUDE ZIP CODE)

NAME OF CllY OR COUNTY OF RESIDENCE


0 CITY

OR

!Xi COUNTY OF

RXNCE WJ:LLXAM
HAVE YOU EVER BEEN CONVICTED OF A FELONY?

YES

NO

IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

YES

O NO

IF YES, HAS COURT RESTORED YOU TO CAPACilY?

YES

NO

YES

0NO

IF YES, WHEN RESTORED? (Required) MO _ _ _ DAY_ _ _YEAR _ __

IF YES, WHEN RESTORED? (Required) MO _ _ _ DAY_ _ _ YEAR_ __

REGISTRATION STATEMENT: I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WILLFULLY FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S. CITIZEN AND A
RESIDENT OF VIRGINIA, THE INFORMATION I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCELLATION, (ENTERED IN BOX 1 ABOVE) OF MY CURRENT
REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE ABOVE.
,J. REMINDER: SIGN HERE FOR VOTER REGISTRATION (OR MARK IF UNABLE TO SIGN).

SIGN

Gon~a(c:z_

HERE

DATE-+

~5/2'3 /Qq

If applicant is unable to sign, write below the name/address of person who assisted (REQUIRED)

Yes, I am interested in working as an


Election Official on Election Day. Please
send me information.

You may request that your home address not be released ff you (a) are active or retired law enforcement, or (b) have
been granted a!rotectlve court order, or (c) are in fear of your personal safety from someone who has threatened or
stalked you an have filed a complaint aga1nst that person with a magistrate or law enforcement (must attach copy of
complaint) You must show a Virginia P.O. box under mailing address in box 7 above.
0 PROTECTIVE COURT ORDER
0 THREATENED/STALKED
0 ACTIVE/RET LAW ENFORCEMENT

Check here 1f you have


a disability that require
accommodation in ordc
to vote

BOOKS CLOSED

'

1/"1'2-)?.to ~
~l?
Exhibit 7, page 83 of 84

D YTIME TELEPHONE NUMBER

)5ct8l558
SUFFIX (JR., SR., Ill , ETC.

U.S.CnlZEN?

YES. Answer the citizenship question to the right and complete ALL boxes (8 - 11 and A) in
Sec,tion 8 and sign your name in the red box below.
NO.I STOP HERE DO NOT FILL OUT SECTION B.

CONVICTION OF FELONY
HAVE YOU EVER BEEN CONVICTED OF A FELONY?

DYES

IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

IF YES, WHEN RESTORED? (REQUIRED)


Yes, I am interested in working as
an Election Official on Election Day. Please
send me information.

10

0
9

~NO

YES

To apply to register to vote or change your voter registration address: CONTINUE ete all boxes (8 - 11 and A) in Section B and sign your name in the red box below.
NO. STOP HERE DO NOT FILL OUT SECTION B.
CIRCUIT COURT JUDGEMENT OF MENTAL INCAPACITY

IF YES, HAS COURT RESTORED YOU TO CAPACITY?

MO_ _DAY_ _YEAR

IF YES, WHEN RESTORED? (REQUIRED)

ACTIVE/RET LAW ENFORCEMENT

YES

NO

MO _ _ DAY_ _ YEAR _ _

If you are active or retired law enforcement, or if you have a protective court order, you may request thai
your home address not be released . You must show a Virginia P.O. box in box 6 above.

DYES~O

HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

NO

Check here if you have a


disability that requires
accommodation in order to vote.

PROTECTIVE COURT ORDER

REGISTRATION STATEMENT: I SWEAR/AFFIRM. UNDER FELONY PENALTY FOR PERJURY, THAT I AM A U.S ~AND A RESIDENT OF VIRGINIA. THE INFORMATION I HAVE PROVIDED ON THIS FORM IS
TRUE, I AUTHORIZE THE CANCELLATION, ENTERED IN BOX A BELOW, OF MY CURRENT REGISTRATION, AND I HAVE READ THE PRIVACY ACT NOTICE BELOW

~ REMINDER:

SIGN HERE FOR YOTER REGISTRATION lOR MARK IF UNABLE TO

N) AND COMPL TE BOX A BELOW. COMPLETE BOX 11 BELOW IF RURAL ADDRESS.

SIGN .......

DATE

--- l-\7-0

HERE,.....

IF YOU LIVE IN A RURAL AREA, DESCRIBE YOUR HOUSE LOCATION (I.E., STATE ROAD NUMBER WHERE YOUR HOUSE IS LOCATED; CLOSEST INTERSECTING ROAD; SIDE OF THE ROAD-NORTH, EAST, ETC.;
NEAREST LANDMARK.)

PCT

TOWN CODE

DENIAL DATE & REASON

COMMENTS

..

OFFICE USE ONLY

OFFICE USE ONLY

OFFICE USE ONLY

NEW LAST NAME

NEW FIRST, MIDDLE/MAIDEN NAME AND SUFFIX

DATE CHANGED

OTHER CHANGES

NEW PCT

DATE CHANGED

AUTHORIZED BY

.
0 DECEASED

0 JUDGED INCAPACITATED

0 OUT OF STATE

0 ERROR DELETED

0 RE-REGISTERED

0 PERSONALREQUEST

0 NVRA PURGE

0 INACTIVE STATUS

0 CONVICTED OF FELONY

0 REACTIVATED

NOTES:t'

f:xpclift,U;r/J (Yt5~~'/)

~ ~- ~ : ~_,/::.A

C-V"T

0 TRANSFERRED OUT

7l2i2J9lt

"

..
Exhibit 7, page 84 of 84

Are you a citizen ol the United States ol America?

~YES

II you checked "no" In response to


either ol these questions, do not
complete this form.

Will you be 18 years ol age on or before election day?

NO

YES

NO

GENDER

SOCIAL SECURITY NUMBER

~ MALE

DATE OF BIRTH

FEMALE

FIRST NAME

ADDRESS (11 dlllerent) VIRGINIA P. 0. BOX OR UNIFORMED SERVICE ADDRESS, IF APPLICABLE (INCLUDE ZIP CODE)

o HAVE YOU EVER BEEN CONVICTED OF A FELONY?

o HAVE YOU EVER BEEN JUDGED MENTALLY INCAPACITATED?

DYES

~No

o IF YES, HAVE YOUR VOTING RIGHTS BEEN RESTORED?

o IF YES, HAS COURT RESTORED YOU TO CAPACITY?

DYES

0No

o IF YES, WHEN RESTORED? (REQUIRED) MO _ _ _ DAY _ _ _ YEAR-- -

o IF YES, WHEN RESTORED? (REQUIRED) MO - --

DAY _ _ _ YEAR -

--

BEGISJBADON STATEMENT; I SWEAR/AFFIRM, UNDER FELONY PENALTY FOR MAKING WIUFUU.Y FALSE MATERIAL STATEMENTS OR ENTRIES, THAT I AM A U.S. !diJZEtl AND A RESIDENT OF VIRGINIA, THE
INFORMAllON I HAVE PROVIDED ON THIS FORM IS TRUE, I AUTHORIZE THE CANCEUAllON (ENTERED IN BOX 1 ABOVE) OF MY CURRENT REGISTRAllON, AND I HAVE READ THE PRIVACY ACT NOllCE ABOVE.

REMINDER: SIGN H
DATE-t

OFFICE USE ONLY

THREATENED/STALKED

OFFICE USE ONLY

NEW LAST NAME

Check here Hyou have a


disability that requires
accommodation In order to vote.

OFFICE USE ONLY

NEW FIRST, MIDDLE/MAIDEN NAME AND SUFFIX

DATE CHANGED

..

~;::r-Lfl~

NEW PCT

5-t&-ID.

AUTHORIZED BY

)2cft~

AfhA-M.< /L_r;-.rk
.

DATE CHANGED

af

CCb:i..uuU :,
c./

DECEASED

JUDGED INCAPACITATED

OUT OF STATE

ERROR DELETED

RE-REGISTERED

PERSONAL REQUEST

NVRAPURGE

INACTIVE STATUS

CONVICTED OF A FELONY

REACTIVATED

NOTES:h~

~-r---~

CIIM.~

")-11-lO

TRANSFERRED OUT

t/-( r;;:-to

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'UOJlJ;!Jil
111Hpilj II UJ ;J}OA no.\ iiWJlJSJ!J ilq} iiAOQ'B (q) JO ('B) JilqlJa SIII!J!JJO UOJJJiiJil Moqs OJ pi!JJObiiJ aq AIIW no.\ 'aSJM.JaqtQ 'SS3Jpp11
pu11 aw11u Jno.\ sMoqs lllqt JU<~WnJop lU<~wuJaAoa J<~qlo Jo lJJaqJ.\IId 'lJJaqJ JuawuJ<~Aoa 'JuawaJets lJUIIq 'mq .\mnn tUiiJJnJ
II JO .\dOJ 'B (q) JO 'UO!JIIJ!JJlUapJ OJOqd p!JIIA pUB JUiiJJOJ JDOA JO .\doJ II ('B) JaqlJ3 UO!JIIJ!Jddu SJql qtJM puas JSOW no.\ 'iiJOj3Q
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0 ' d \ p<..

d-OlS__...

.LN3J.\13l1In~3ll NOI.g',J~;!.LN301
UIIV 1

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t'-

Exhibit 8, page 1 of 4

1111111111111111111111111111111~

11111111!11111111111111111111111111111111111111111

COMMONWEALTH OF VIRGINIA

PRINCE. WILLIAM COUNTY

AFFIRMATION OF CITIZENSHIP

VOTER REGISTRATION ANO


ELECTIONS

24.2-410.1 of the Code of Virginia

SUBJECT TO PENALTY OF LAW, I DO HEREBY AFFIRM THAT I AM A


CITIZEN OF THE UNITED STATES OF AMERICA

SIGNATURE~':{;;;

o(.

PRINTED NAME
OF VOTER:

WI '-LuJM

Date of birth:
Current address:

L.

~ISAV
)

I>

Street!P.O. Box/Apt.# I :l/Lf/J3


City/Town/State/Zip

Mailing address [if


different]:
Daytime telephone
number:

f.JDEJf R.D.

NDt(liS~ti..LC, \JIRG,UJJft

:.2tJl(ll ,

n_ 2

Street!P.O. Box/Apt.#
City/Town/Sta_te/Zip

tDJ' 19}--. .t-Jt J J

Email address:

> INTENTIONALLY MAKING A MATERIALLY FALSE STATEMENT ON THIS


FORM IS A FELONY. THE PUNISHMENT IS UP TO TEN YEARS IN PRISON AND
A FINE UP TO $2,500. YOU ALSO LOSE_Y_O_UB_BI_GHT TO_V_OIE- - - - - - - 1 - - IF YOU ARE A CITIZEN, PLEASE RETURN COMPLETED FORM TO:

PRINCE WILLIAM VOTER REGISTRATION AND ELECTIONS

Exhibit 8, page 2 of 4

,-

}
':1

Completion of this section Is requested but not required to apply for a driver's license or ID Card. (VIrginia Code 2.23806)
INFORMATION FOR THE STATE BOARD OF ELECTIONS
Are you a citizen of the United States of America?
Do you want to apply to register to vote or change your voter registration address?

YES

{INITIAL BOX)

NO~

\
!~'N""'

YES

(INITIAL BOX)

(INITIAL BOX)

NO~

(INITIAL BOX)

INFORMATION FOR THE VIRGINIA TRANSPLANT COUNCIL


Yes, I would like to remain or become an organ, eye and tissue donor.

DRIVER'S LICENSE AND IDENTIFICATION CARD APPLICATION

cam

~~'i:!~,~~"~'

--~

DL1P (07t01t2oo9)

LOG#

00303

Purpose:
Use this form to apply for a V1rgm1a Driver's License or Identification Card
Instructions:
Applicants complete the front and back of this application
.
'-.
Note Va Code 46 2-323 and 46 2-342 requ1re that you provide DMV Wllh the mformat1on on th1s form (mclud1ng your soc1al secunty number) Ills not necessary to provide a social
secunty number for an 1den!Jficabon card Th1s sOCial secunty number 1s for record keep1ng purposes and may be d1ssem1nated only m accordance with Va Code 46 2-208 and
46 2-209 Persons conv1cled of certa1n sexual offenses (as listed m Va Code 9 1-902) must reg1ster or re-reg1sler w1th the V1rg1n1a Department of State Pollee as provided In Va. Code
9 1-901. 9 1-903, and 9 1-904 If you proVIde a non-V1rg1n1a residence/home address or non-V1rg1ma ma1hng address. your application for a dnver's license or 1denl1ficellon (ID) card
maybedemed
APPLICATION TYPE (Check one)
2 0 Leamer's Permit ami Dnve~s License

1.f5i3' Dnver's License

5 D Dnve~s License w1th Motorcycle (Class M)


8

9 0 Heanng Impaired ID Card

ldenllflcabon Card

3. 0 COL Leame~s Perm1t or License 4 0 Motorcycle Leamer's Perm1t


7 0 Dnver's L1cense w1th School Bus Endorsement
(to carry ll!U than 16 passengers)
Emancipated Minor ID Card
11 0 Dnver's License Testing for Foreign Diplomats

COL w1th Motorcycle (Class M)


10

If you are applymg for a replacement hcense or 1denl1ficabon card check one of the followmg
@ I am surrendenng my current license or ldenlifJcalion card
0Lost
Ostolen D Destroyed or Mutilated
0 I hereby certify arl}' current license or ID card 1s unavailable for surrender because 111s
Do you currently have or have you ever held a dnver's license or learner's perrmt from V1rg1ma. another stale, U.S. temtory or foreign country? 181 Yes
If yes , provide the followmg
STATE/COUNTRY
11ssu ~~ATE (mmtddtyyyy)
~NSE_NUMBER
e;;;TI~J DATE (mmldd/yyyy)

I
I

FULG1~ fME (last)

l..J/Lltl}/'1

;c.a.

<l03) 7'71"'1137

(middle)

(SU"'X)

Lt:S'L/1;'
STATE

CITY

;U tfr/GS

WEIGHT

11o

HEIGHT

.IJ

LBS

FT

IN.

//

DRIVER'S LICENSE APPLICANTS

'FoR

YES

R.GJfOtiV~ ON/.."{'

13f<ou.J;V
0

2 Do you have a phys1cal or mental conditiOn which reqUires that you take med1cat1on?

g)

3. Have you ever had a seizure. blackout, or loss of consciousness?


4 Do you have a phys1cal cond11ion which reqwes you to use special equ1pmentm order to dnve?

fi(l

5 Have you been conv1cted WJlhm the past ten years m this state or elsewhere of any offense resulting
0
from vour operation of or involvmg, a motor vehicle? (Do not mclude_Q_arkmg t1cketsj_
6 Has your hcense or P...!)Vilege to dnve ever been suspended, revoked, or di~QlJahfied m thls_state_or__ \(]\:'
elsewhere, or 1s 11 currently suspended, revoked or disqualified?

REQUIRED TESTS
VISION

PA~see

rf{\.~

~
~fl
"TQt&
-otlo 4f\!

DL KNOWLEDGE EXAM
DLSKILLS
PV";'IJZl

lb71)3'f4:J-

PROOF OF

(specify)

PROOF OF 10 (sec~)

r_CU_.

PROOF OF LEGAL PRESENCE (s~e~i

~~ON~~

If you answered YES to any of


these quest1ons, please explain (
rAJSIJLt),f- ,V/w .. ;JD fi?J;IJ/.hiJS ~
7

/)/flf!,~Ttc.

~floCK

EJ- c...u~J..'f-s u~PE/IIDF.:D-

FOR DMV USE ONLY- DO NOT WRITE BELOW THIS LINE


REMARKS/PAID STAMP

FAILED

DL ROAD SIGNS EXAM

~CY

8/<0LiJtV

NO

6a

1 Do you wear glasses or contact lenses?

ZIPCODE
:Z.Clftf(- 31 z. 'z...
NAME OF CITY OR COUNlJ OF RESIDENCE
I;;Jf.,t/CE
0 CITY ~ COUNTY OF ILLUJ.tJ..
EYE COLOR
HAIRCOLOR

'IIK((i/;./Ill

t/1L LG

MAILING ADDRESS (If different from above)


IF YOUR NAME HAS CHANGED, PRINT YOUR FORMER NAME HERE

t b:".

\_S_ 1~

ENTER

17iu?r?R~~, ~~~q ~~[E

TRANSACTION TYPE
ORIGINAL
REISSUE

,Jtj.RENEWAL DDUPLICATE

FEE

ff3~.{/))

'ROOF OF SOCIAL SECURITY NUMBER (spec1fy)

627

.. ftC..C.. ...

Docu ... ~.

.~ ....

DAYTIME TELEPHONE NUMBER

l;t~

D FEMALE
(first)

4w.J

V/1?.41#1/J.

APPLICANT INFORMATION
j BIRTHDATE (mm/dd/yyyy)

MALE

STREET ADDRESS

z..:z :z. tJ(tJ

~NDER (check one)

SOCIAL SECURITY NUMBER

J-1'103

0 tJ7 O'?!~DD1

r;; 'f. 35' .391Z

0No

IER SIGNATURE AND NUMBER

Exhibit 8, page 3 of 4

DL1P (07/01/2009) Page 2

PARENT OR GUARDIAN CONSENT FOR APPLICANTS UNDER 18 (Unless applicant is married marriage certificate required)
I aulhonze tssuance of a learner's permtVdnver's hcenselldenllftcallon card lcerttfy that the applicant IS a restdent of V1rg1ma I certtfy that the applicant is
attending school regularly and ts 1n good academtc standtng, but tf not, I authonze tssuance of a Ieamer's permtVdnver's license I certtfy that th1s applicant will
operate a motor vehtcle for at least 45 hours (15 of which Will occur after sunset) whtle holdtng a learner's permit
If my child attends public school, I authonze the pnnc1pal or destgnee of the public school attended by the applicant to notify the JUVemle and domestiC relallons
dtstnct court (w1th1n whose JUnsd1cl1on the applicant res1des) when the applicant has had 10 or more unexcused absences from school on consecutive school
days
I certtfy that the statements made and the 1nformat1on submttted by me regarding thts cert1ficat1on are true and correct
PARENT/GUARDIAN NAME (pnnt)

!PARENT/GUARDIAN SIGNATURE

DATE (mm/dd/yyyy)

APPLICANT UNDER AGE 18 Have you ever been found not mnocent of any offense 1n a Juvenile and Domestic Relations Court rn thrs or any other state?
If you answered YES, a court wrthrn your 1unsdrctron must provrde court consent below
COURT CONSENT In my oprnron the applicant's request for a learner's permrVdnver's licenseD should be granted
Remarks

YES

D NO

should not be granted

JUDGE NAME (pnnt)

JUDGE SIGNATURE

DATE (mm/dd/yyyy)

COMMERCIAL DRIVER'S LICENSE APPLICANTS


Complete thts CERTIFICATION OF QUALIFICATION by checkrng the box for the category
Regulatrons or VA Motor Carner Safety Regula!tons)
INTERSTATE DRIVER
D I meet the qualificatiOn requrrements of Part 391 of the Federal Motor Carner
Safety Regulattons
D I am exempt from the qualification requtrements of Part 391 of the Federal Motor D
Carner Safety Regulations

VEHICLE TYPE

A- Combtnatron.vehtcle wrth GVWR or GCWR of 26,001 lbs or more


B - Stngle vehtcle wtth GVWR of 26,001 lbs or more, or towtng a
vehtcle less than 10,000 lbs GVWR
C -Any vehrcle that does not fit the defrmtron of a Class A or Class B
vehtcle and ts etther used to transport hazardous matenals or
destgned to carry 16 or more passengers, mcludtng the dnver

IAIR BRAKES

D Wtth

INTRASTATE DRIVER
I meet the qualiftcatton requtrements of the Vtrgtma Motor Carner
Safety Regulattons
I am exempt from the qualification requtrements of the Vrrgmia
Motor Carner Safety Regulatrons

ENDORSEMENT

I want to be licensed to operate the type of vehtcle(s) checked below

0
0

that applies (For requtrements refer to the Code of Federal

Wtthout

I want to apply for the followtng


vehtcle endorsement(s)
H - Hazardous Matenals

0
0
D

ldentrfy any state(s) m whrch you have been prevrously


licensed wtthtn the past 10 years Provrde addrbonal
rnformatron usrng the Supplemental Dnver's Ltcenstng
Hrstory Sheet, form DL 1PA
STATE(S)

N -Tank
P - Passenger Carrytng Vehtcle LICENSE NUMBER
(16 or more passengers)

S - School Bus
(16 or more passengers)

LICENSE ISSUE DATE (mm/dd/yyyy)

T- Double/Tnple Trailer

LICENSE EXPIRATION DATE (mm/dd/yyyy)

. ''

GOVERNMENT EMPLOYEES (Fee waiver certification)


I certtfy that I am employed by the
D Commonwealth of Vtrgtma or

D Ctty of D County of

Town of

-----------------------------------------

to operate a motorcycle or commercral motor vehicle and, because of such employment, I am entitled to the watver of the motorcycle class and/or commercral
motor vehtcle endorsement fee, provtded I have patd for and hold a valid Vtrgtma dnver's license or have made application for such

SELECTIVE SERVICE
All males under the age of 26 are requtred to check one of the followmg
am already regtstered wtth- Selecllve Servtce

-o-1

Fatlure to provtde a response wtll result tn dental of your applicatton

I am a non-tmmtgrant allen tn the U S and not requtred to regtster

I authortze DMV to forward to the Selecbve Servtce System personal tnforrnatlon necessary to regtster me wtth Selecttve Servrce

By s1gnmg th1s appltcallon, I consent to be regtstered With Selecttve Servtce, tf requtred by federal law If under age 18, an appropnate adult must complete
'
and stgn below I authonze DMV to send tnformatton to Selectrve Servtce which Will be used to regtster applicant when he ts 1B years old
SIGNATURE (check one and srgn)
PARENT/GUARDIAN
JUDGE, JUVENILE DOMESTIC RELATIONS COURT
EMANCIPATED MINOR

~
[

'1;._

~..... ICERT!FI'G~TION AND SIGNATURES

. ,., ... ... ! ...

I certify and afftrm that I am a restdent of Vtrgmra, that allrnformatron presented m thts applicabon IS true and correct, that any documents I have presented to
DMV are genutne, and that my appearance, for purpo~e 1pf. my DMV .Photograph, ts a true and accurate representation of how I generally appear m public I
make thts certtficatron and afftrmatton under penalty of perjuryan'd understand that knowtngly maktng a false statement on th1s application ts a crtmmal vtolation

APPWA~TtA~E GtR tty

, .A~P~I$;::uRE d'. ~

ID~Ez;;~;~

010

1(~~~--~~~~6~~,~.~--~

Exhibit 8, page 4 of 4

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