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2 Please tick the box to indicate how you voted be/ow and complete any address details required
I voted in the above election:
If you have recently changed your enrolment details, please update them by usin the
QR code, v1s1t vec.v,c.gov.aulenrolment or call 131 832 to h .c g
ave a paper ,arm sent to you.
The Electoral Act 2002 provides for a fine of one penalty unit if a person states a false reason for
not having voted, or another person who completes a form on a person's behalf states a false reason
for the other elector not having voted.
You must post or deliver this notice to reach the VEC within 28 days after the date of notice.
If you do not complete and return this form by the due date an infringement notice may be sent to you
[Infringements Act 2006 (Vic)]. ·
Ifyou are unable to complete this form because you are absent from your residence or you are physically
incapacitate<t another person who is enrolled to vote in Victoria may complete this form on your behalf.
Signature of elector
l'or ofperson completing Date ./. . ___
1 __1_ _ ____,
9rm on behalfofelector)
Contact number .....
/ _ _ _ _ _ _ _ ___,
•ed help?
1 or 2.
ns appli es to you. Tick the box for optio n
1 Indic ate whic h of the follo wing optio
Optio n 2
Opti on 1 I voted at the abov e elect ion.
/ did not vote at the abov e election. page.
Please comp lete sectio n 1.2 on the follow ing
Please comp lete sectio n 1.1 below .
ort.
did not vote and attac h any evidence to supp
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