PUBLIC LAW 103-31—MAY 20, 1993 107 STAT. 81 (iii) Acceptance of completed voter registration application forms for transmittal to the appropriate State election official. (B) If a voter registration agency designated under paragraph (2)(B) provides services to a person with a disability at the person's home, the agency shall provide the services described in subparagraph (A) at the person's home. (5) A person who provides service described in paragraph (4) shall not— (A) seek to influence an applicant's political preference or party registration; (B) display any such political preference or party allegiance; (C) make any statement to an applicant or take any action the purpose or efTect of which is to discourage the applicant from registering to vote; or (D) make any statement to an applicant or take any action the purpose or effect of which is to lead the applicant to believe that a decision to register or not to register has any bearing on the availability of services or benefits. (6) A voter registration agency that is an office that provides service or assistance in addition to conducting voter registration shall— (A) distribute with each application for such service or assistance, and with each recertification, renewal, or change of address form relating to such service or assistance— (i) the mail voter registration application form described in section 9(a)(2), including a statement that— (I) specifies each eligibility requirement (including citizenship); (II) contains an attestation that the applicant meets each such requirement; and (III) requires the signature of the applicant, under penalty of perjury; or (ii) the office's own form if it is equivalent to the form described in section 9(a)(2), unless the applicant, in writing, declines to register to vote; (B) provide a form that includes— (i) the question, "If you are not registered to vote where you live now, would you Uke to apply to register to vote here today?"; (ii) if the agency provides public assistance, the statement, "Applying to register or declining to register to vote will not affect the amount of assistance that you will be provided by this agency. "; (iii) boxes for the applicant to check to indicate whether the applicant would Uke to register or declines to register to vote (failure to check either box being deemed to constitute a declination to register for purposes of subparagraph (O), together with the statement (in close proximity to the boxes and in prominent type), "IF YOU DO NOT CHECK EITHER BOX, YOU WILL BE CONSIDERED TO HAVE DECIDED NOT TO REGISTER TO VOTE AT THIS TIME. "; (iv) the statement, "If you would like help in filling out the voter registration application form, we will help you. The decision whether to seek or accept help is yours. You may fill out the application form in private.; and
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