| You must sign the postal voting statement (unless you have been granted a waiver |
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| by prior arrangement with the electoral registration officer) and provide your date |
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| of birth. This is a security measure. It will not affect your vote or mean it can be |
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| identified. Without your signature and date of birth the statement will not be valid |
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| and your vote will not be counted. The counting officer can cross check your |
| | 5 |
| signature against other records that they hold. |
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| If you lose or accidentally spoil the postal ballot paper, please call the helpline |
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| number below as soon as possible. We can only issue replacement postal ballot |
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| papers before 5 pm on [day/date of poll]. |
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| Complete and return the postal vote as soon as possible. The counting officer must |
| | 10 |
| receive the postal vote by 10 pm on [day/date of poll]. You can deliver your |
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| completed voting papers to any polling station in the voting area. |
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| If you want to vote in person as a proxy in this referendum, you must cancel your |
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| postal vote before 5 pm on [-11 day/date deadline]. |
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| It is illegal to do any of the following: |
| | 15 |
| • | Vote more than once (unless you are appointed as a proxy for another |
| | |
| person) in this referendum. |
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| • | Vote as a proxy in this referendum for more than two persons unless you |
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| are their spouse, civil partner, parent, grandparent, brother, sister, child or |
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| | | 20 |
| • | Vote as a proxy for a person if you know that the person is subject to a legal |
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| Issued by the Counting Officer |
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| [Where poll card sent to the proxy of an anonymous elector substitute for the text |
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| | | 25 |
| This poll card is to tell you that for this referendum you will be able to vote as |
| | |
| proxy for the person whose electoral number is shown below and you will be |
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| | | |
| You are entitled to vote as proxy for the person whose electoral number is shown |
| | |
| | | 30 |
| .................................................................................................................................. |
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| (Person’s number on electoral register) |
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