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City Census

  1. City of Chicopee

  2. City of Chicopee Registrar of Voters City Hall 274 Front Street Chicopee, MA 01013-2885

  3. IMPORTANT LEGAL DOCUMENT ANNUAL CITY CENSUS

  4. IMPORTANT: General Laws of Massachusetts mandate an annual street listing of residents as of January 1 each year. Compliance with this requirement provides proof of residence to protect your voting privilege, veteran’s bonuses, use of the Chicopee Landfill, Social Security and related benefits. Please list ALL family or household members (age 3 and up) whose legal residence is the same. Include any member of the family in military service, away at school or confined to a rest home. For assistance, call CITY REGISTRAR AT 413-594-1550

  5. WARNING: Failure to respond to this mailing shall result in removal from the active voting list and may result in removal from the voter registration rolls.

  6. Active Voter*

  7. Mail To?*

  8. Gender? M/F*

  9. U.S. Veteran?*

  10. Public Safety?*

  11. Active Voter?

  12. Mail to?

  13. Gender

  14. U.S. Veteran?

  15. Public SAfety?

  16. Mail to?

  17. Gender

  18. U.S. Veteran?

  19. Public Safety?

  20. Leave This Blank:

  21. This field is not part of the form submission.