<p> PP34</p><p>Elector Information Report</p><p>District</p><p>Polling place</p><p>Section A Information about an elector provided by another elector</p><p>The elector named below is unable to vote because</p><p>The elector named below is deceased.</p><p>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: / / </p><p>Section B Information provided by elector to request correction of enrolment processing error</p><p>An Electoral Enrolment form must be completed for CHANGES of name and/or address</p><p>Details of elector as on electoral roll Surname Given names Date of birth Problem requiring correction</p><p>Contact details in case of enquiry Signature of elector Date: / / </p><p>0a48854925dc73e14c471d8a926e1c07.doc 06/04/2018</p>