Enrolment Amendments and Deceased/Non-Voter Report
Total Page：16
File Type：pdf, Size：1020Kb
PP34
Elector Information Report
District
Polling place
Section A Information about an elector provided by another elector
The elector named below is unable to vote because
The elector named below is deceased.
Details of elector as on electoral roll Surname Given names Date of birth Information provided by Please print full name of person providing the information Relationship to elector Contact details in case of enquiry Signature of informant Date: / /
Section B Information provided by elector to request correction of enrolment processing error
An Electoral Enrolment form must be completed for CHANGES of name and/or address
Details of elector as on electoral roll Surname Given names Date of birth Problem requiring correction
Contact details in case of enquiry Signature of elector Date: / /
0a48854925dc73e14c471d8a926e1c07.doc 06/04/2018