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Poll card: voting by proxy
Voting on [day] [date] [month] [year]
Election to ______Council
Election to ______Council
Referendum on ______
Voting information
Electoral area
Polling day / [day] [date] [month] [year]
Polling hours / 7am to 10pm
Your polling station is
[Postal mark]
Your details:
Mr X Smith
1 The Grove
The Street
The Town
Any County
PO27 C09
Number on register: AB1234567XY
Voting by proxy
You have appointed the person named on the back of this card as a proxy. This means they can vote on your behalf at these elections and this referendum.
There is more information about your proxy vote on the back of this card.
If undelivered, return to
______
Please turn over >
Helpline number: ______(local rate)
Email
/ If you want to vote yourself
You can vote yourself if you wish, but only if your proxy has not already voted on your behalf and has not got a postal vote for you.
To vote yourself, go to the polling station shown on the front of this card. You do not need to take this card with you to vote.
For these elections and this referendum, the following person is your proxy:
Mrs Z Smith
1 The Grove
The Street
The Town
Any County
PO27 C09 / You can cancel your proxy vote if you wish. The deadline for cancellations is 5pm on ______. For more information phone the helpline straight away.
The Returning Officer issued this card.
If you need any help or to find out if your polling station is accessible, contact us.
Parish [CD1]council election on ______
Your proxy will only be asked to vote in this election if there are more candidates than the number of vacancies. If so, they will be given a ballot paper at the polling station.

[CD1]References to ‘parish’ should be to either ‘parish’ or ‘town’, as appropriate.