Application for registration on the electoral roll (Form 12669*02)

Ministry of the Interior - Cerfa n° 12669*02

Allows a citizen French to register on the electoral list of a town hall.

This form must be completed and supported by supporting documents.

Go to the online administrative form

Verified 23 October 2023 - Legal and Administrative Information Directorate (Prime Minister)

To whom shall I send this form ?

J'ai réalisé une démarche administrative

Je donne mon avis sur Services Publics +. L'administration concernée me répondra.