European Parliament Voter Registration Form Please Fill in All Sections

European Parliament voter registration form Please fill in all sections. Write in black ink and use BLOCK LETTERS. A About you 8 Declaration A1 Your name I declare the following. Last name: 81 I am a citizen of: I I Maiden name: (if applicable) I I Write in the name of the EU member state or I I accession state of which you are a citizen. This is First name (or names) in full: referred to elsewhere in this form as your home I I country. A2 Your address 82 Please tick one box. UK address of where you are applying to register. My current address is as shown in section A2 D The address in section A2 is different from my current address in the UK. My current D address and postcode is: Are you currently living at this address? Yes D No D If 'No', have you made a 'declaration of local connection' by applying to your local electoral registration officer? Postcode I I Yes D No D B3 My name has previously been entered on a register of electors in my home country. A3 Your age Please tick one box. Yes D No D I am 18 or over D I am under 18 D If you ticked 'Yes', please write here the name of the locality or constituency where you were last If you are under 18, please give your date of birth. registered, as far as you know. I I I I B4 I will use any right to vote at the European Where to. send your form parliamentary election only in the UK (and not in my home country) for as long as my name Please return this form to: appears on the UK register of electors for European Parliament. Electoral Services Westminster City Council Declaration: As far as I know, the details on FREEPOST (SW5001) this form are true and accurate. I understand London that to provide false information on this SW1E 6BR form is an offence, punishable on conviction by imprisonment of up to 6 months and/or a fine. Signature: For office use only I I Register: Poll No. Date: Date received: I I European Union Citizens European Parliament voter registration form notes If you are a citizen of one of the European Union (EU) countries listed below, you can register to vote in the UK at a European Parliamentary Election. Elections to the European Parliament take place every five years. Member states (countries that are members of the EU) Austria France Luxembourg Slovenia Belgium Germany The Netherlands Spain Bulgaria Greece Poland Sweden Czech Republic Hungary Portugal Denmark Italy Romania Estonia Latvia Slovakia Finland Lithuania If you are a citizen of the Republic of Ireland, Cyprus or Malta, you are eligible to register to vote at all UK elections and so do not need to use this form. Ask your local electoral registration office for an appropriate registration form. Please read the following information before you fill in this form. n A new electoral register is produced every year on 1 December. Names can be added and removed thoughout the year. You can register to vote if you are 16 or over (but you cannot vote until your 18th birthday). n This form only registers you for European parliamentary elections. You should already have been included on the register of local electors by your electoral registration office. If you are not already registered, you can get a registration form for this purpose from your electoral registration office. n You cannot vote at the European parliamentary elections in more than one country. If you fill in this form, you are agreeing to vote in the UK and not in your home country. But remember, you can cancel this registration at any time. n Each oerson applying must fill in a separate form. .

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