ELECTORAL (VOTER REGISTRATION) REGULATIONS, 2013 FORM VR.2 Proviso to section 24(1) of ELECTORAL ACT [CHAPTER 2:13] INITIAL VOTER REGISTRATION FOR A PERSON NOT ORDINARILY RESIDENT IN A CONSTITUENCY (Form VR2) (TO BE COMPLETED BY A PROSPECTIVE CANDIDATEFOR MEMBER OF PARLIAMENT WHO DOES NOT RESIDE IN THE CONSTITUENCY) PART A (TO BE COMPLETED IN BLOCK LETTERS IN DUPLICATE) ⚠It is an offence to procure a false registration or to furnish false information to ZEC I am a Zimbabwean citizen aged over 18 years and hereby apply to be registered as a voter in a Constituency where I am not ordinarily resident: I.D. NUMBER SURNAME(as per ID) FORENAME(S) (as per ID) DATE OF BIRTH Day Month SEX M F Year (Tick Applicable) I ORDINARILY RESIDE AT: (Circle the Appropriate and Attach proof of residence) HOUSE/STAND/PLOT/VILLAGE NAME STREET/FARM/HEADMAN SUBURB/FARMING AREA/MINE/CHIEF TOWN/DISTRICT I WOULD LIKE TO BE REGISTERED USING THE ADDRESS BELOW BECAUSE I INTEND TO BE A CANDIDATE FOR ELECTION AS A MEMBER OF PARLIAMENT IN THAT CONSTITUENCY: (Provide address where you shall be deemed to be resident) HOUSE/STAND/PLOT/VILLAGE NAME STREET/FARM/HEADMAN SUBURB/FARMING AREA/MINE/CHIEF TOWN/DISTRICT PHONE/CELL NUMBER email address (If any) ........................................................... TICK THE APPROPRIATE BOX BELOW IF YOU HAVE ANY SPECIAL NEEDS. HEARING VISUAL AMPUTEE OTHER (Please specify) …………………………………………………………………….………………………. I declare that the above information is true to the best of my knowledge. SIGNATURE ……………………………………………...................................................... DATE D D M M M Y Y Y PART B (FOR OFFICE USE ONLY) ATTACH CERTIFICATE OF REGISTRATION AS A VOTER HERE VOTER REGISTRATION OFFICER’S DETAILS IN BLOCK LETTERS FULL NAME:…………………………………………………………………………………………. I.D. ………………………………………………………………………………………….. 89 NUMBER: Y