§ Ind. Code § 3-10-11-5Affidavit; required information

An affidavit executed under this chapter must contain the following information:
(1) The person's last, first, and middle name, in that order.
(2) The person's date of birth.
(3) Whether the person is a United States citizen.
(4) The person's current address, including the county. If the person resides in a
municipality, the address must include the street address, including apartment number
or other designation, or the name and room number of the hotel or lodging house. If the
person does not reside in a municipality, the address must include the mailing address
and the street or road.
(5) The address of the person's previous residence, including the county.
(6) The person's statement that the person satisfies the conditions set forth in section
2 of this chapter.
(7) Responses to the questions listed in IC 3-7-22-5(3) and IC 3-7-22-5(4).
(8) The person's voter identification number to permit transfer of the registration under
IC 3-7-13-13.