Fillable Enrol to vote or update your details (General Public Services)

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Enrol to vote or update your details (General Public Services)

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Country of origin: AUSTRALIA
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Who has access to your enrolment information?
The Commonwealth of Australia
The Australian Electoral Commission (AEC) is authorised under the
Commonwealth Electoral Act 1918 (CEA) to collect and verify the
information you have been asked to complete on this form. The
information provided will assist the AEC to maintain electoral rolls.
The AEC may disclose electoral information to persons
or organisations in accordance with the CEA. This may include:
■
access to the publicly available electoral roll (containing
names and addresses) which may be inspected at
electoral ofces
■
state and territory electoral authorities
■
Members of Parliament, Senators, registered political
parties, and candidates for the House of Representatives
■
approved medical research and public health
screening programs
■
any agencies, persons or organisations prescribed in the
Electoral and Referendum Regulation 2016.
For more information on privacy, visit www.privacy.gov.au
The State of Victoria
The Victorian Electoral Commission (VEC) is authorised under the
Electoral Act 2002 (Vic) to collect and verify the information you have
been asked to complete on this form. The information provided will
assist the VEC to maintain the Register of Electors and to prepare
electoral rolls for Victorian State and local government elections.
You can apply for access to the information that the VEC holds
about you by contacting the VEC. Please view the privacy
information at www.vec.vic.gov.au/PrivacyAtTheVEC.html
Electoral rolls may be inspected at the ofce of the VEC during
business hours. Address details for silent electors will be withheld
from publication. The VEC may disclose electoral information to
others in accordance with Victorian law. This may include:
■
the AEC, other state government bodies (including law
enforcement), and local councils
■
Members of Parliament, registered political parties and
candidates for Victorian State and local government elections
■
persons or organisations that apply, and are approved, to
access enrolment information for a permitted purpose,
which is determined by the VEC in consultation with the
Ofce of the Victorian Information Commissioner as a
purpose that justies the disclosure. The current list of
persons or organisations in this category is published at
www.vec.vic.gov.au
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If you are deaf, or have a hearing or
speech impairment
Contact the AEC through the National Relay Service (NRS):
■
TTY – 133 677 then ask for 13 23 26
■
Speak and Listen – 1300 555 727 then ask for 13 23 26
■
Internet relay – connect to the NRS then ask for 13 23 26
You can use this form to:
■
enrol to vote
■
change your residential or postal address, and/or
■
change your name
on the electoral roll for federal, state and local
government elections in Victoria.
Who can enrol and vote?
It is compulsory for all eligible Australian citizens 18 years and
over to enrol to vote. You are eligible to enrol and vote if you:
■
are an Australian citizen, or a British subject who was
enrolled on 25 January 1984*
■
are 18 years or older, and
■
have lived at your address which is your principal place of
residence for at least one month.
*For Victorian elections only, you are eligible to enrol and vote if
you were a British subject enrolled between 26 October 1983 and
25 January 1984 inclusive.
You can enrol at 16 years of age for federal purposes and at
17 years for State purposes, but cannot vote until you are 18.
^To enrol on the Commonwealth electoral roll, the person conrming
your identity must be on the Commonwealth electoral roll.
Within three weeks of receiving your enrolment form the AEC will
conrm your enrolment. We may seek further information from
you and conrm your enrolment using any of the contact details
you provide.
Special enrolment
Special category enrolment forms are available if you:
■
are temporarily overseas
■
cannot attend a polling place on election day
■
believe that having your address shown on a publicly
available roll may endanger your safety or that of
your family
■
have no xed address
■
are in prison
■
are physically incapable of signing your name
■
are working in Antarctica.
For more information
Australian Electoral Commission
www.aec.gov.au or 13 23 26
Victorian Electoral Commission
www.vec.vic.gov.au or 1300 805 478
Returning your form
Upload
Upload your scanned signed form at
www.aec.gov.au/return
Enrol to vote or update your details
You can complete this form online today at www.aec.gov.au
ER016w_c_
VIC_0918
© Commonwealth of Australia 2018
Office use only –
Date received
NINNotation CATS
Your current name
1
Mr
Mrs
Miss Ms
Other
Family name
Given name(s)
If notifying a
change of name
If notifying a change of
address
Previous given name(s)
Previous residential address
Previous family name
Date of birth (dd/mm/yyyy)
2
Gender
• •
3
Current residential address
4
Current postal address
Leave blank if the same as
your residential address
Clearly identify your residential
address. A locality name or mail
service number is not enough
Email address
Daytime
Mobile
5
Citizenship status
To enrol you must be an
Australian citizen, or a British
subject who was on the
Commonwealth electoral roll
on 25 January 1984
For Victorian electors only,
if you were a British subject
enrolled between
26 October 1983 and
25 January 1984 inclusive
7
• I have read the information overleaf about who can enrol and vote
• I am eligible to enrol at my current residential address as listed at Question 3 and
claim enrolment for federal, state and local government elections in Victoria
• The information I have given on this form is true and complete, and
• I understand that giving false or misleading information is a serious offence.
Your declaration
Your
signature
or mark
Name on citizenship
certificate
Australian citizen by birth
I have become an Australian citizen
OR
OR
Town
of birth
Country of birth
State or territory
Citizenship certificate number
ER016w_c_VIC_0918
Enrol to vote or update your details
for federal, state and local government elections in Victoria
You can complete this form online today at www.aec.gov.au
Phone numbers
( )
NOTE: If the elector makes a mark because they are unable
to sign their name, they must have a witness sign below.
/ /
-
/ /
-
Signature
Postcode
State
Postcode
State
Postcode
State
If completing by hand use a 8
where appropriate.
Use black or blue pen and
BLOCK LETTERS
/ /
-
Signature
6
Evidence of your identity
Complete ONE option only
Australian driver’s licence
Australian passport
OR
OR
Number
Number
State or territory
A person who is on the Commonwealth electoral roll or Victorian Register of Electors^ will confirm my identity
Declaration by person confirming your identity
• I am on the Commonwealth electoral roll or
Victorian Register of Electors, and
• I confirm the identity of the applicant.
Person’s name
and address
(BLOCK LETTERS)
I2
Name on
25 January 1984
British subject who
was enrolled on
25 January 1984
Country of birth
• •
Date of birth
(dd/mm/yyyy)
I2
Instructions
Please print and sign your form before
returning it to an address shown on page 1
Witness to sign, if the elector is unable to
sign their name, before returning it to an
address shown on page 1.
Print
Clear
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Email
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Enrol to vote or update your details (General Public Services)

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Completed 15 October 2021

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