Isle of Wight Council

Overseas Elector Application

Please use BLACK INK and BLOCK CAPITALS. Click here for instruction on completing this form, If you need help filling in this form, please phone 01983 821000. This form is to be used for the application to register or renew registration as an Overseas Elector. Return this form to: Electoral Services, County Hall, Newport, Isle of Wight, PO30 1UD.

(Section 1) About You

This section MUST always be completed. Only one persons details per form

	Title
*	Forename
	Middle name/Initials
*	Surname

Change of name (if applicable)

	Former name in full
	Reason for change of name

Present postal address (non-UK)

	Building/house name/number
	Street address
	Town Name
	County
	Country
	Postcode
	Tel Number (include area code)

Full UK Registration address

	Building/house name/number
	Street address
	Town Name
	County
	Postcode
	Tel Number (include area code)
	If you were registered at the above address as one of the following please tick the appropriate box	Service Voter Mental Patient Local Connection

If you were too young to register see the notes

Only fill in one box, A, B or C My last UK electoral registration was as:

	Either (A)	An overseas elector, Enter date of register	Now go to section (4)& (6)
	Or (B)	A UK resident / Service voter, Enter date you left the UK / ceased to have a service qualification	Now go to section (3), (4), (5) & (6)
	Or (C)	I was too young to have been registered, Enter date of birth	Now go to section (2), (3), (4), (5) & (6)

(Section 2) Parent or Guardian

	You must complete this section if you filled in Box C in section (1) Otherwise go to section (3)
	Parent / Guardian Details

	Title
	Forename
	Middle name/Initials
	Surname
	Select Relationship	Parent Guardian
	Photocopy of applicants birth certificate is included	Tick Box if certificate is included

Other Name (if applicable)

	Other name in full (if any, see notes)
	Reason for other name

(Section 3) Citizenship

	You must complete this section if you filled in Box (B) or (C) in section (1) Otherwise go to section (4)
	Complete only the statement that applies to you

	Either	My British passport, number
		issued at (place)
		on (date)
		states that I am a British citizen.

	Or	I do not hold a British passport describing me as a British citizen but I was born at (place)
		in the UK before 1 January 1983.

	Or	I was born on (date)
		at (place)
		In (country)
		I do not hold a British passport describing me as a British citizen but I became a British citizen on (date)
		Now explain how you became a British citizen

(Section 4) Declaration

This section MUST always be completed

	Declaration	I am a British citizen I am not resident in the UK on the date of this declaration
	Edited register	I do not wish my details to appear on the edited register (see notes)

	Either	I ceased to be resident in the UK on (date)
	Or	I ceased to have a service qualification on (date)

I hereby declare that the statements I have made on this form are true to the best of my knowledge and belief.

Signature

Signed............................................................... Name................................................................ Date..................................................................

(Section 5) Declaration in Support

You must complete this section (5) if you filled in Box (B) or (C) in section (1) Otherwise go to section (6)

Supporters Declaration

I am aged 18 years or over, I am the bearer of a British passport which describes my national status as British citizen. I am not resident in the UK. I know the declarant but am not his/her husband, wife, parent, grandparent, brother, sister, child or grandchild. To the best of my knowledge and belief the declarant is a British citizen and not resident in the UK on the date of the declaration.

Supporters Name

	Forename
	Middle name/Initials
	Surname

Supporters Address

	Building/house name/number
	Street address
	Town Name
	County
	Postcode
	Tel Number (include area code)

Supporters passport

	Passport number
	Date of issue
	Place of issue

Supporters signature

Signed.............................................................................. Name............................................................................... Date.................................................................................

	(Section 6) Postal / Proxy Voting Application for an overseas elector
	You must complete this section (6) to enable you to vote from outside the UK. You may choose to vote by post or by proxy (someone to vote on your behalf)
	POST Complete this part only if you wish to vote by post
	Address for Ballot Paper

	Building/house name/number
	Street address
	Town Name
	County
	Postcode

	(Section 6 continued) PROXY Complete this part only if you wish to vote by proxy
	Proxys name

	Title
	Forename
	Middle name/Initials
	Surname

Proxys address

	Building/house name/number
	Street address
	Town Name
	County
	Postcode

Other Details

	Relationship (of proxy to you, if any)
	Statement (Please select whichever one applies)	I, the person named above, confirm that I am willing and allowed to vote on behalf of the applicant. (Proxy sign at Proxys signature) I have consulted the person named above and I confirm that he/she is willing and is allowed to vote on my behalf. (You sign at Your signature)

	(Section 6 continued) Application of Proxy to vote by Post
	If your proxy is unable to vote on your behalf at your polling station then your proxy may wish to complete this section
	Address for Ballot Paper Only complete if you wish to vote by post. Leave blank if you wish to vote in person at the polling station

	Building/house name/number
	Street address
	Town Name
	County
	Postcode

Signature

Proxys signature

Signed............................................................... Name................................................................ Date..................................................................

	Applicants Details
	This part must be completed even though you have completed section (1)
	Your name

	Title
	Forename
	Middle name/Initials
	Surname

Present postal address (non-UK)

	Building/house name/number
	Street address
	Town Name
	County
	Country
	Postcode

Full UK Registration address

	Building/house name/number
	Street address
	Town Name
	County
	Postcode

Signature

Your signature

Signed............................................................... Name................................................................ Date..................................................................

	For Office Use

	Data Protection Act 1998
	This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request. The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy . Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest. Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law. Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box

Date printed: 07/03/2013