Application for Entry on the Supplement to the Postal Voters List

APPLICATION FOR ENTRY ON THE SUPPLEMENT TO THE POSTAL VOTERS LIST

PERSONS IN THE EMPLOYMENT OF RETURNING OFFICERS

PLEASE READ THE NOTES BELOW CAREFULLY BEFORE COMPLETING THE FORM

Part A – Particulars of Elector

1.Name (BLOCK LETTERS): ______

[Please include other details such as Snr., Jnr., other name or an initial if there is another person with the same first name and surname living at the same address].

2.Address (BLOCK LETTERS): ______

______

3.Date of Birth: ______

4.Daytime phone number: ______

5.Number on Register of Electors (if known): ______

6.Constituency where you will be employed: ______

7.I believe the information I have supplied to be true and I apply to be included in the Supplement to the Postal Voters List as a result of my employment in the constituency at 6 above.

Signature: ______Date: ______

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Part B - To be completed by the Returning Officer

I hereby certify that the above named person will be employed by me as a ______on polling day and by virtue of the circumstances of that employment will be unable to vote in person at the polling station in the constituency at which they would otherwise be entitled to vote.

Signature of Returning Officer: ______Date: ______

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NOTES

1.Under electoral law, a person employed by a returning officer and registered to vote in a constituency other than the one where they are employed may apply for entry on the supplement to the postal voters list for the constituency where they are ordinarily resident.

2.To be included in the supplement to the postal voters list because of your employment by a returning officer, you must be:

 already on the register for your constituency; and

 unable to vote in person in the constituency at the polling station at which you normally vote because of your employment on polling day by a returning officer.

3.A separate form must be completed and signed by each person applying for inclusion in the supplement as a result of being employed by a returning officer. To avoid delay in processing your application, make sure to complete the form fully and return it as early as possible by post or deliver it to the County Council or City Council, in whose area you reside.

4.It is an offence to fail to give the registration authority any information required for the purpose of their duties or to knowingly give false information.