Part 8 Appendix of Forms
England and Wales
Note:—The forms contained in this Appendix may be adapted so far as circumstances require.
Form of Ballot Paper: Question in referendum as specified in paragraph 1 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 2 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 3 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 4 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 5 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 6 of Schedule 1
Corresponding Number List L1
Corresponding Number List L2
Form of Postal Voting Statement
Official Poll Card (to be sent to a voter voting in person)
Official Postal Poll Card (to be sent to a voter voting by post)
Official Proxy Poll Card (to be sent to an appointed proxy voting in person)
Official Proxy Postal Poll Card (to be sent to an appointed proxy voting by post)
F1Ballot Paper Refusal List
Form of directions for the guidance of the voters and proxies in voting
Form of Certificate of Employment
Declaration to be made by the companion of a voter or proxy with disabilities
Form of Ballot Paper: Question in referendum as specified in paragraph 1 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 2 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 3 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 4 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 5 of Schedule 1
Form of Ballot Paper: Question in referendum as specified in paragraph 6 of Schedule 1
Corresponding Number List - L1
Corresponding Number List - L2
Official Proxy Poll Card (to be sent to an appointed proxy voting in person)
Front of form

Rear of form

Official proxy postal poll card (to be sent to an appointed proxy voting by post)
Front of card

Back of card

F4Ballot paper refusal list

F5Form of directions for the guidance of the voters and proxies in voting

F6Certificate of employment
Annotations
Textual amendments
- F1
Words in Sch. 3 Pt. 8 list of forms inserted (16.1.2023) by The Voter Identification Regulations 2022 (S.I. 2022/1382), regs. 1(3), 48(17)(a) (with reg. 1(6)(7))
- F2
Sch. 3 Pt. 8 Forms substituted (with effect in accordance with reg. 1(2) of the amending S.I.) by The Representation of the People (Postal Vote Handling and Secrecy) (Amendment) Regulations 2023 (S.I. 2023/1225), Sch. 4 Pt. 1
- F3
Sch. 3 Pt. 8 Forms substituted (4.12.2024) by The Voter Identification (Amendment of List of Specified Documents) Regulations 2024 (S.I. 2024/1275), reg. 1(1), Sch. 4 Pt. 1 (with reg. 1(5)-(7))
- F4
Sch. 3 Pt. 8 Form inserted (16.1.2023) by The Voter Identification Regulations 2022 (S.I. 2022/1382), regs. 1(3), 48(17)(d), Sch. 8 Pt. 1 (with reg. 1(6)(7))
- F5
Sch. 3 Pt. 8 Form substituted (16.1.2023) by The Voter Identification Regulations 2022 (S.I. 2022/1382), regs. 1(3), 48(17)(e), Sch. 8 Pt. 1 (with reg. 1(6)(7))
- F6
Sch. 3 Pt. 8 Form substituted (6.4.2014) by The Local Authorities (Conduct of Referendums) (England) (Amendment) Regulations 2014 (S.I. 2014/924), regs. 1(3), 9(g), Sch. 1 (with reg. 1(4))
- F7
Sch. 3 Pt. 8 Form substituted (29.12.2022) by The Assistance with Voting for Persons with Disabilities (Amendments) Regulations 2022 (S.I. 2022/1309), reg. 1(3), Sch. 3 Pt. 1 (with reg. 1(4))
Modifications
- C1
Sch. 3 Pt. 8 Forms modified (temp.) (31.1.2024) by S.I. 2023/1147, Sch. 2 para. 13(4)(5) (as inserted by The Representation of the People (Postal and Proxy Voting etc.) (Amendment) Regulations 2024 (S.I. 2024/99), regs. 1(1), 2(4))







