Request a Proxy Vote form

If you can't get to your polling station on Election Day, you don't have to miss your chance to vote. Registered electors can apply to vote by post or by proxy. To apply for a postal vote, follow the instructions below.

How to apply for a proxy vote

Request the application form online by completing the form below;
We will verify your address and check your name is on the Electoral Register;
We'll then post a form & prepaid envelope to you, pre filled with your name and address.
You just need to sign and return the form.

If you can't get to your polling station on Election Day, you don't have to miss your chance to vote. Registered electors can apply to vote by post or by proxy. To apply for a postal vote, follow the instructions below.

How to apply for a proxy vote
- Request the application form online by completing the form below;
- We will verify your address and check your name is on the Electoral Register;
- We'll then post a form and prepaid envelope to you, pre filled with your name and address.
- You just need to sign and return the form.
If you can't get to your polling station on Election Day, you don't have to miss your chance to vote. Registered electors can apply to vote by post or by proxy. To apply for a postal vote, follow the instructions below.

How to apply for a proxy vote
- Request the application form online by completing the form below;
- We will verify your address and check your name is on the Electoral Register;
- We'll then post a form and prepaid envelope to you, pre filled with your name and address.
- You just need to sign and return the form.
Fields marked with * are required
Contact Details
1. Please list the names of the person(s) requiring a Proxy Vote at this address:*
2. Name*
3. Do you have an email?*
  
  Yes
  
  No
4. Email Address
5. Contact telephone number*
6. Please enter your address postcode and click on 'Find Address'. Then click on the drop down arrow on the address box and choose the correct address
7. Postcode:*
9. Address:
10. Address 1*
11. Address 2
12. Town*
13. Postcode*
14. Are you completing this form on behalf of someone else?*
  
  Yes
  
  No
Assisted service details
1. In what capacity are you completing this form?
  
  CC Staff
  
  Agent/Solicitor
  
  Relative/Friend
  
  Carer
  
  Other
2. Name of person completing this online form
3. Email of person completing this form
Privacy statement

Breckland Council is collecting this information, via this form, in order to perform this service or function, and if further information is needed in order to do so, you may be contacted using the details provided.

In performing this service, the Council may share your information with other organisations or departments, but only when it is satisfied that it is necessary to perform a public task, or to exercise its statutory duties to do so.

The Council may also share your personal information for the purposes of the prevention, investigation, detection, or prosecution of criminal offences, but will not share your personal information, or use it for any other purpose, unless provided for by law.

More detailed information about the Council's handling of your personal data can be found in our privacy policy.
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Last updated: 07/06/2023 08:57:47

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Request a Proxy Vote form

How to apply for a proxy vote

How to apply for a proxy vote

Privacy statement