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Medical Services – Appendix V, Voter Registration Page 2 of 3 him/her the form with instructions to mail it directly to the Secretary of State’s office. A declaration form will not be given in this instance, nor will it count on the daily recap report. Customer Acceptance If a customer states she/he wishes to register to vote, she/he will be given a Voter Registration Application to complete. The voter registration application can be completed at the county office and given back to the receptionist or the customer can take it with him or her and mail directly to the designated address. Assistance in completing the form will be provided if requested. It is a local decision as to whether the Agency-Based Declaration Statement will be completed. If it is completed, a copy may be given to the customer if requested. It is a local decision as to whether the "yes" declarations will be kept in the county office. Do not mail the declaration forms to the Secretary of State’s Office. The customer will be advised that a decision on his/her Voter Registration Application will be provided by the County Clerk’s Office. If there are other adult household members a Voter Registration Application may be given to the customer for the other adult(s) to complete. However, if the other adult(s) chooses not to register, a declination form is not needed. The worker will put the agency code on the voter registration application that applies at the time it is being completed. For example, if the customer is applying for Supplemental Nutrition Assistance Program benefits at the time a voter registration application is being completed, the worker would use the SNAP code. If the customer is applying for several programs, just use one code (worker choice). Telephone Interviews and Authorized Representatives Applicants who are interviewed by phone and indicate a desire to register to vote should be mailed a Voter Registration Application no later than the date that a determination (approval or denial) is made on the case. This applies to both initial applications and reevaluation/recertifications. The Voter Registration Application form will be mailed to the applicant/recipient any time an authorized representative is interviewed on the customer’s behalf. If a customer makes a telephone request for a Voter registration Application form, one will be mailed to his/her mailing address. Access Arkansas Applicants who apply through Access Arkansas may apply directly online by following a link to the Secretary of State’s website to register to vote. SNAP/MSP Annual Review Mail in applicants should be mailed an Arkansas Voter Registration Application no later than the date that a determination (approval or denial) is made on the case. This applies to both reevaluation/recertifications.