ELECTORAL (SPECIAL AND POSTAL VOTING) REGULATIONS, 2013 FORM SV.1 SCHEDULE (Section 2) FORMS FOR SPECIAL VOTE SPECIAL VOTE APPLICATION FORM Electoral Act [Chapter 2:13] (Section 81C) (For electoral officers and members of disciplined forces only) NB : Read instructions overleaf before completing this form. SECTION A (Applicant’s details) I,.......................................................................................ID Number................................EC No. ………………. (Full names in block letters) stationed at ............................................................................................................................................................. (Full Address), hereby apply for authorisation to cast a special vote at ……….................................................... special polling station in .........................………………... District in the forthcoming election. DISCIPLINED FORCES : ZRP ZNA AFZ ZPS ELECTORAL OFFICER : SEX: Female Male (Tick applicable) I,..................................................................................declare that the information given above is true and correct. Signature..............................................................Date..................................................Place.................................. SECTION B (Certifying Officer) I certify that the above named officer who has signed this application before me will be away on election duty/security duty on the ordinary polling day (delete inapplicable). Full Names…................................................Rank……………….……..Appointment......………..................... Signature …………...........…..................... Date……………………………………………… SECTION C (Authentication by designated officer) Checked by…………………………………………………………Signature…………………………………………… Date and Official Stamp 75

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