Date ....................
Office of the Registration Commission
.......... County, Pennsylvania
....... (Address and Telephone No. of County)
We have been notified by the Department of Transportation that you recently changed your address from ................ (old residence address) to ................ (new residence address) and that this change of address is to serve as a change of address for voter registration purposes. Unless you notify this office within ten days from the date of this notice that this information is not correct, your voter registration will be transferred to ............ County. You may notify this office by writing your residence address, the date and your signature on the bottom of this form and mailing this notice to this office. You need not notify this office if this information is correct.
...............................................................................................................................
Chief Clerk
If the address change is within the commission's jurisdiction, the commission shall mail a voter's identification card to the registrant at the new residence address.
Agency employees who violate this subsection shall be removed from employment, provided that the agency at its discretion may impose a penalty of suspension without pay for at least 30 days, but not more than 120 days, if it finds that the violation does not warrant termination.
25 Pa.C.S. § 1323