HomeMy Public PortalAboutWATERTOWN 2023 CENSUS FRONT AND BACK BLANK FORMPlease return form within 10 days to:
City of Watertown
City Clerk’s Office
149 Main Street
Watertown, MA 02472
CITY OF WATERTOWN
IMPORTANT LEGAL DOCUMENT
2023
ANNUAL STREET LISTING
General Laws of Massachusetts (Chapter 51, § 4) mandate an annual street listing of residents as of January 1 of each year.
Update and correct the information provided by adding, deleting or making changes below the printed information. Please sign
and respond within ten (10) days, even if no changes are necessary.
For assistance, contact the City Clerk at (617) 972-6486
Mailing Address:
If this address is incorrect, make corrections below:
Failure to respond to this mailing shall result in removal from the active voting list & may result in
removal from the voter registration rolls. (MGL Ch. 51 Sec.4(c))
Pa
r
t
y
NAME
Last First Middle
Ma
i
l
To
Date
of
Birth
mm/dd/yyyy
Occupation
Mo
v
e
d
De
c
e
a
s
e
d
Pu
b
l
i
c
S
a
f
e
t
y
U.S
.
Ve
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r
a
n
Voter’s Signature
Voter(s) making changes
must sign below.
Changes cannot be
processed without
signature.
X
Signature of Respondent Date
Signed under the Penalties of Perjury as prescribed by M.G.L. Chapter 56 §4.
**CHANGE OF ADDRESS** If any voter above has MOVED, provide corrected information and their signature to authorize the change
Name (Last, First, Middle) NEW ADDRESS Required Signature
(if a registered voter) Street Address City/Town, State
FOR RESIDENT(S) AT:
THIS FORM DOES NOT REGISTER YOU TO VOTE
Register to vote at:
https://www.sec.state.ma.us/OVR
Precinct:
INSTRUCTIONS FOR UPDATING INFORMATION ON FRONT OF THIS FORM
Use the QR Code on the right
If you have any questions please call The City Clerks Office @ 617-972-6486
**Are you interested in working at the polls?
Visit www.watertown-ma.gov/pollworker **
MARK YOUR 2023 CALENDARS
September 19thCity Primary
City Election November 7th
PARTY - If a letter appears in this column you are a registered voter."R" for Republican, "D" for
Democrat, "L" for Libertarian and "U" for UNENROLLED. If nothing is listed, you are not a registered
voter in the City of Watertown.
NAME - Check names for any spelling errors or changes.
MAIL TO - This is the designated individual to whom this form has been sent.
DATE OF BIRTH - MM=Month, DD=Day, YYYY=Year. If your date of birth is blank or incorrect, please
make appropriate changes.
OCCUPATION - Enter occupation, not place of employment.
MOVED - Place an "M" to indicate the resident has moved.
DECEASED - If this person is deceased, please provide the date of death or an approximate date.
PUBLIC SAFETY - Residents who work in law enforcement or public safety will be noted as "PSC"
VETERAN - Write a ‘Y’ if you are a veteran of the U.S. Armed Forces.
VOTER'S SIGNATURE - Voter's making changes must sign. Changes cannot be made without
signature.
UPON COMPLETION:
If there are no changes to your census form, you may respond via email at census@watertown-ma.gov
Forms with changes, return in the return envelope provided by d ropping in the drop box beside
Watertown City Hall or place stamp and mail to
City Clerk, 149 Main Street, Watertown, MA 02472
(If Needed)