Go online It s quick and easy to fill in this form at gov.uk/register-to-vote. Register to vote. Registering to vote. 1 Your name and address

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Go online It s quick and easy to fill in this form at gov.uk/register-to-vote Register to vote Registering to vote You can register to vote if you are: Resident (usually live) in the UK and aged 16 or over (but you will not be able to vote until you are 18). You must also be either: A British, Irish or European Union citizen, or A Commonwealth citizen who has leave to enter or remain in the UK or who does not require such leave. It will only take a few minutes and it is quicker and easier online. 1 Your name and address First name(s) Surname Your address Postcode Do you live at another address? No Yes If yes, you do not have to give us this address now but we may ask for more information later. Telephone no (optional) Email (optional) p1

Providing your email address gives a quick and easy way to contact you about your application. Incorrect information If we have printed information which is incorrect, please cross it out and write the correct information. 2 Your nationality If you have more than one nationality, please add them all. (Don t know your nationality? Please see section 7). (more info p6) 3 Moved house in the last 12 months? No Yes If yes, please give any previous address where you have lived during the last year. Postcode If this address was overseas, were you registered in the UK as an overseas voter? No Yes 4 Are you the only person aged 16 or over living at your current address? (optional) Yes, I am the sole occupant (more info p6) 5 Your date of birth D D M M Y Y Y Y If you don t know your date of birth please tick if you are: Under 18 18-75 Aged 76 or over (Don t know your date of birth? Please (more info p6) p2

see section 7) 6 Your National Insurance number You may find this on your payslip, or on official letters about tax, pensions or benefits. (Don t know your National Insurance number? Please see section 7) 7 Don t know your nationality, date of birth or National Insurance number? Please tell us why. (If you are not able to provide these details you may be asked to provide other documentary evidence to process your application to register). 8 Changed your name? Please give us your most recent previous name (optional). Please tell us the date you changed your name (optional). D D M M Y Y Y Y (more info p6) 9 Can t vote in person If you are unable to go to the polling station in person on polling day, please choose how you would like to vote and we will send you an application form, or you can download an application form at aboutmyvote.co.uk By post By proxy (someone voting on your behalf) p3

10 The open register The open register is an extract of the electoral register, but is not used for elections. It can be bought by anyone and is often used to confirm name and address details. Please tick if you do not want your name and address to be included in the open register (more info p7) 11 Declaration I currently live at this address. To the best of my knowledge, the information in this form is true. I understand that the information I have given on this form will be used on the electoral register. I understand that if I do not make an application for registration when required to do so I could face a fine of 80. I understand that it is an offence knowingly to provide false information in this form and if convicted I may be imprisoned for up to six months and/or face an unlimited fine. Signature Today s date D D M M Y Y Y Y If you need help filling in this form please contact us using the details on p1. p4

Your nationality If you have more than one nationality, please include them all. If you are a Commonwealth citizen you can only register to vote in the UK if you have leave to enter or remain in the UK or do not require such leave. We may check your immigration status with the Home Office before we include you on the electoral register. Are you the only person aged 16 or over at your current address? You do not have to answer this question. However, every year, Electoral Registration Officers send letters to every household to help ensure the right people are registered to vote. Your Electoral Registration Officer may not need to send these letters to your household in the near future if you let them know that you are the only person aged 16 or over living at your current address. Your date of birth Please give the date you put on official documents (for example, your passport or driving licence) or tick one of the boxes. Your date of birth identifies you, confirms your eligibility to vote and can be used to call people for jury service. Changed your name? For example, you may have got married and changed your name. You do not have to give us details of your name change but it will help us identify you. If this information is not given then you may need to provide additional documentary evidence. p5

The open register There are two registers. Why? Using information received from the public, registration officers keep two registers the electoral register and the open register (also known as the edited register). The electoral register The electoral register lists the names and addresses of everyone who is registered to vote in public elections. The register is used for electoral purposes, such as making sure only eligible people can vote. It is also used for other limited purposes specified in law, such as: detecting crime (e.g. fraud) calling people for jury service checking credit applications. The open register The open register is an extract of the electoral register, but is not used for elections. It can be bought by any person, company or organisation. For example, it is used by businesses and charities to confirm name and address details. Your name and address will be included in the open register unless you ask for them to be removed. Removing your details from the open register does not affect your right to vote. If you are concerned that having your name or address on the register may affect your safety, there could be other options available to you. In certain circumstances, you can register without your name and address showing on the register. To find out more, please contact your Electoral Registration Officer. You can find their address on p1 of this form. You can find out more information about both registers and how they may be used at gov.uk/register-to-vote p6

Your personal information We will only use the information you give us for electoral purposes. We will look after personal information securely and we will follow the Data Protection Act 1998. We will not give personal information about you and the other people in your household to anyone else or another organisation unless we have to by law. Problems with the form? Contact your Electoral Registration Officer if you need any help understanding or completing this form or if you need this form in large print or in another format. You can find their address on p1 of this form. p7