Application to Amend

Application to Amend Voters’ List

Required fields are marked with asterisks (*)

Municipal Elections Act, 1996 (s. 25)

Application to Amend Voters' List - Municipal Elections Act, 1996 (s.17, s.24, s.25) Form EL15

Check only one *

Add applicant's name to list

Correct applicant's information on list

Delete applicant's or family member's name from list

Reason for deletion

Moved away

Deceased

Last Name of Applicant *

First Name of Applicant *

Middle Name of Applicant

Date of Birth (Applicant) *

Qualifying address on voting day

Is the qualifying address on voting day commercial property? *

Yes

Street Number and Name *

Apartment Number

Roll Number

Ward Number *

Postal Code *

If house apartment, indicate floor level - e.g. basement, 1st floor, etc.)

At the qualifying address, applicant is: *

Owner

Tenant

Other

Spouse

S.S.P. (Same Sex Partner)

Unqualified (deleted name only)

Previous qualifying address (if applicable)

Street Number and Name

Apartment Number

Roll Number

Ward Number

Postal Code

If house apartment, indicate floor level - e.g. basement, 1st floor, etc.)

At the previous address, applicant was:

Owner

Tenant

Other

Spouse

S.S.P. (Same Sex Partner)

Unqualified (deleted name only)

Current Mailing Address

Street Number and Name *

Apartment Number

Post Office Box

Town/City *

Province *

Postal Code *

School Support *

Applicant is Roman Catholic (includes Greek and Ukrainian Catholics)

Applicant has French Language Education Rights

Applicant is not Roman Catholic and does not have French language rights

Applicant wishes to be an elector for the following school board *

English-Public (anyone can support English-public)

English-Separate (must be Roman Catholic)

French-Public (must have French Language Education Rights)

French-Separate (must be Roman Catholic and have French Language Education Rights)

View Acceptable Forms of Proof of Identity

Please upload proof of identify - must have a picture of applicant and current address (e.g. driver's licence, passport) *

Drag and drop files here or Browse

Allowed extensions pdf, jpg, jpeg, gif, png, doc, docx

I, the undersigned, hereby declare that I am a Canadian citizen, that I have attained the age of eighteen (18) on or before Voting Day, and that on Voting Day, I am entitled to be an elector in accordance with the facts or information submitted on this form, and that I understand the effect thereof. I hereby apply to have my name included or amendments made on the Voters' List in accordance with such facts or information.

By clicking "I Agree" you certify that the information you provide is true and accurate. It is a punishable offence under the laws of Canada to misrepresent one’s identity or to knowingly provide false or misleading information and Township of Rideau Lakes reserves the right to share information with law enforcement authorities where suspicious activity is detected, fraud is suspected or there is reason to believe an offence may have been committed.

Do you agree with the statement above? *

Agree

Disagree

Name of Applicant *

Email address *

Primary Phone Number *

Date form submitted *