request that the recommended abolition and amalgamation of the districts of (names of the 2 or more local government districts to be abolished or amalgamated) ________________________________________________________________________ be put to a poll of electors of those districts under the Local Government Act 1995. Address which entitles you to vote in the Signature of Date Full name of elector* elections of the local government elector recommended for amalgamation *An is one of the following “elector” — a resident owner or occupier enrolled to vote at State elections; an owner of rateable property (e.g. an absentee land owner or an owner of business premises, vacant land or other non-residential property); an occupier of rateable property (e.g. tenant of business premises or other non-residential property).
request that the recommended abolition and amalgamation of the districts of (names of the 2 or more local government districts to be abolished or amalgamated) ________________________________________________________________________ be put to a poll of electors of those districts under the Local Government Act 1995. Full name of elector* Address which entitles you to vote in the elections of the local government recommended for amalgamation Signature of elector Date *An “elector” is one of the following — a resident owner or occupier enrolled to vote at State elections; an owner of rateable property (e.g. an absentee land owner or an owner of business premises, vacant land or other non-residential property); an occupier of rateable property (e.g. tenant of business premises or other non-residential property).