If the form used by an applicant to decline to register to vote is on a separate form from the voter registration application, the declination form must contain the following:(1) A statement reading 'If you decline to register to vote, this is confidential, and can only be used for voter registration purposes.'.(2) A statement reading 'If you decide to register to vote, information about the office at which you register is confidential, and can only be used for voter registration purposes.'.(3) A line for the signature of the person who declines to register to vote.(4) A line for the date that the person declined to register to vote.As added by P.L.12-1995, SEC.24.
Indiana Legal Code