Application to vote by emergency
proxy in Scotland based on COVID-19
Voting by proxy
Proxy voting means that if you aren’t able to cast your vote in person, you can have someone you trust cast
your vote for you.
If you are self-isolating based on advice from Scottish Government or a medical practitioner that
you became aware of after 5pm on the sixth working day before the poll and you are unable to
vote in person at your polling station, you can apply to vote by emergency proxy (someone else voting
on your behalf). You can apply until 5pm on the day of the poll.
Both you and your proxy must be registered and eligible to vote.
A person can only be a proxy for close relatives and up to two other people at an election.
Close relatives are the spouse, civil partner, parent, grandparent, brother, sister, child or grandchild of
the applicant.
How do I apply to vote by proxy?
You must ask someone who is willing and capable to be your proxy and vote on your behalf.
Fill in the emergency proxy vote application form. You must give a reason why you need to vote by proxy.
Make sure all sections of the form are complete. You need to give your date of birth and signature on
this application form. This information is needed to prevent fraud. If you are unable to sign this form,
please contact us.
Return your form to us by email at ero@grampian-ero.gov.uk or by post to
Grampian Electoral
Registration Officer, Woodhill House, Westburn Road, Aberdeen, AB16 5GE
This form can only be used after 5pm, on the sixth working day before the poll and must reach us
before 5pm on t
he day of the poll.
Y
ou must already be registered to vote, before applying for a proxy vote or emergency proxy vote.
The
deadline to register to vote is midnight, 12 working days before the poll. Register to vote online at
www.gov.uk/register-to-vote
This form and these deadlines only apply for local elections in Scotland.
What happens after I’ve returned this form?
Your proxy must go to your polling station to vote.
You should tell your proxy how you want them to vote on your behalf, for example, which candidates
or parties.
The elections team at your council will tell your proxy when and where to vote on your behalf.
Privacy statement
We will only use the information you give us for electoral purposes. We will look after personal
information securely and we will follow data protection legislation. We will not give personal information
about you or any personal information you may provide on other people to anyone else or another
organisation unless we have to by law.
The lawful basis to collect the information in this form is that it is necessary for the performance of a
task carried out in the public interest and exercise of official authority as vested in the Electoral
Registration Officer as set out in the Representation of the People Act 1983 and associated
regulations.
The Data Controller is Ian H Milton, Grampian Electoral Registration Officer, Woodhill House,
Westburn Road, Aberdeen, AB16 5GE, Tel 01224 068400.
For further information relating to the processing of personal data you should refer to the privacy notice
at www.grampian-vjb.gov.uk/privacy-notice Version 20200930
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Application to vote by emergency
proxy in Scotland based on COVID-19
Only one person can apply to vote by emergency proxy using this form
Please write in black ink and use BLOCK LETTERS. When all sections are complete and you have
signed the form yourself, send it to: Grampian Electoral Registration Officer, Woodhill House,
Westburn Road, Aberdeen, AB16 5GE or email a scanned copy to ero@grampian-ero.gov.uk
1 About you
Surname
First name(s) (in full)
Your address (where you are registered to vote)
Postcode
Phone number
Email
Providing an email and phone number
gives a quick and easy way to contact you
about your application.
2
About your proxy (the person you
have chosen to vote on your behalf)
Full name
Family relationship (if any)
Full address
Postcode
Phone number
Email
3 At which election(s) do you want a proxy?
I want to vote by proxy at the election(s) held on:
D M Y YD M Y Y
4 Emergency proxy vote confirmation
Please confirm the below statement is true:
I am self-isolating after 5pm on the
sixth working day before the poll due to
COVID-19 following Scottish Government
or medical advice.
5 When did you begin self-isolating?
Time:
Date
D M Y YD M Y Y
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D M Y YD M Y Y
Application to vote by emergency
proxy in Scotland based on COVID-19
6 Your date of birth and declaration
Declaration: I have asked the person I have
named as my proxy and confirm that they are
willing and capable to be appointed to vote on
my behalf.
As far as I know, the details on this form are
true and accurate. I understand that to provide
false information on this form is an of fence,
punishable on conviction by imprisonment of
up to two years and/or a fine.
Date of birth: Please write your date of birth
in the boxes below using black ink.
Signature: Sign below using black ink,
keeping within the grey border.
Please contact us if you are unable to sign
this form.
7 Date of application
Today’s date
D M Y YD M Y Y
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