FORM OF CLAIM TO VOTE.
The following is the form in which claims to be placed upon the electoral roll should be sent in. If no printed forms are obtainable, the claimant may make the application in writing :
To the Registrar of the Electoral District of I hereby claim to have my name inserted on the Electoral 801 l of ; and I declare that my name, place of abode, and occupation Lor addition] are correctly stated at the foot hereof; and that I have resided within the colony of New Zealand for twelve months and within the said district for the sir months immediately preceding the date hereof. [Note. —When the claim is in respect of a qualification other than residence, state particulars of same, and omit reference to residence.] Dated the day of , 188 . (Name.) (Address.) (Occupation.) Signed and declared by 'J the claimant this ( day of ,in the year C 18 , before me. J
[Signed] An Elector of the District [or Registration Officer or J.P.]
Permanent link to this item
https://paperspast.natlib.govt.nz/newspapers/GLOBE18811020.2.16
Bibliographic details
Globe, Volume XXIII, Issue 2355, 20 October 1881, Page 3
Word Count
167FORM OF CLAIM TO VOTE. Globe, Volume XXIII, Issue 2355, 20 October 1881, Page 3
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