| Issued by the counting officer |
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| INSTRUCTIONS TO THE VOTER |
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| Complete the ballot papers yourself and in private. If you need help, contact |
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| the counting officer’s staff as shown below. |
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| [contact details for assistance; include address as appropriate] |
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| | You must provide your [#signature and] date of birth. If you do not, the |
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| | postal voting statement will be invalid and your vote(s) will not be counted. |
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| | When you are voting in the referendum on the voting system for United |
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| | Kingdom parliamentary elections ([insert colour of ballot paper] ballot paper), |
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| | mark a cross (X) in the box on the right hand side of the ballot paper |
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| | opposite the answer you are voting for. Vote in one box only. Do not mark |
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| | the ballot paper in any other way or your vote may not be counted. |
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| | [When you are voting in a local government election ([insert colour of ballot |
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| | paper] ballot paper), mark a cross (X) in the box on the right hand side of the |
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| | ballot paper opposite the name of the candidate[s]* you are voting for. [Vote |
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| | for ONE candidate only.]* [Vote for no more than [specify number] |
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| | candidates.]* Do not mark the ballot paper in any other way or your vote |
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| | [When you are voting in a [specify parish council] election ([insert colour of |
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| | ballot paper] ballot paper), mark a cross (X) in the box on the right hand side |
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| | of the ballot paper opposite the name of the candidate[s]* you are voting for. |
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| | [Vote for ONE candidate only.]* [Vote for no more than [specify number] |
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| | candidates.]* Do not mark the ballot paper in any other way or your vote |
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| | [When you are voting in a [specify] referendum ([insert colour of ballot paper] |
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| | ballot paper) mark a cross (X) in the box on the right hand side of the ballot |
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| | paper opposite the answer you are voting for. Vote once only. Do not mark |
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| | the ballot paper in any other way or your vote may not be counted.]* |
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| | [When you are voting for an elected Mayor ([insert colour of ballot paper] |
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| | ballot paper), mark a cross (X) in the box on the right hand side of the ballot |
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| | paper opposite the name of the candidate[s]* you are voting for. [Vote for |
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| | ONE candidate only.]* [Vote ONCE (X) in column one for your first choice |
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| | and vote ONCE (X) in column two for your second choice.]* Do not mark |
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| | the ballot paper in any other way or your vote may not be counted.]* |
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| | If you need help voting, the person helping you must not tell anyone how |
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| | Put all the ballot papers in the small envelope marked A and seal it. |
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| | Complete the postal voting statement by [#signing it, and] providing your |
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| | Then put the envelope marked A together with the postal voting statement |
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| | in the larger envelope marked B. Return it straightaway. |
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| | After receiving this postal vote, you cannot vote in person at a polling |
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| | station in the referendum[s]* or election[s]*. |
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