Document ID: chunk:federal_register_of_legislation:F2006C00282:body:0:p9
Version: federal_register_of_legislation:F2006C00282
Segment Type: other
Provision Reference: 
Character Range: 20709–24923

Envelope                                                        13
14.       Subsection 137 (1)                                                Declaration of Result of Election                                                       14
15.       Subsection 138 (1)                                                Return of Election                                                                      15

Schedule 4 Prescribed forms
(section 11)

Form 1 Application for registration on owners and occupiers roll
          (section 37)

Local Government Act 1960 (W.A.)(C.K.I.)

Surname:

Other Names:

Postal Address:

Details of rateable property for which registration claimed:

LOT OR LOCATION NO.(IF KNOWN)  HOUSE  STREET  SUBURB/
                               No.            LOCALITY

To the Shire Clerk, Cocos (Keeling) Islands Shire:

I apply to be registered as an elector in respect of the rateable property described above.

  [INSTRUCTIONS:  Put a tick [] in the box next to each statement that applies to you
  To be eligible to be enrolled on the owners and occupiers roll, you must tick 1 box in each of 1, 2 and 3.]

I declare that:

       (1)  I have attained the age of 18 years.

       (2)  I am an Australian citizen.

         I am not an Australian citizen, but I am ordinarily resident in the Territory of the Cocos (Keeling) Islands.

       (3)  I am the owner of the rateable property described above.
         I am the occupier of the rateable property described above.
         I am the nominee of the corporation which is the owner of the rateable property described above.
         I am the nominee of the corporation which is the occupier of the rateable property described above.

Date:...................................
`
..........................................................................
 SIGNATURE OF APPLICANT

Form 2 Advice on acceptance of application for registration on owners and occupiers roll
          (subsection 38 (1))

Local Government Act 1960 (W.A.)(C.K.I.)

To:

...........................................................................................……..................
(Name of Applicant in full)

.............................................................................……................................
(Address of Applicant)

Your application dated ........................................ for registration on the owners and occupiers roll of the Cocos (Keeling) Islands Shire has been accepted and you have been enrolled as an owner or occupier (as appropriate).

Date:....................................

.............................................................................
SHIRE CLERK

NOTE: Keep this advice as evidence of your enrolment.

Form 3 Notice of rejection of application for registration on owners and occupiers roll
          (subsection 38 (2))

Local Government Act 1960 (W.A.)(C.K.I.)

TO:

.............................................................................................……................
(Name of Applicant in full)

..............................................................................……...............................
(Address of Applicant)

 Your application dated .................................. for registration on the owners and occupiers roll of the Cocos (Keeling) Islands Shire has been rejected for the following reason/s:
................................................................................…….............................

................................................................................…….............................

Date:....................................

..............................................................................
SHIRE CLERK

Form 4 Ballot paper
          (subsections 93 (1), 111 (3), 115 (3) and 122 (4) and section 94 A)

       Local Government Act 1960 (W.A.)(C.K.I.)

       Cocos (Keeling) Islands Shire council election on 1 May 1993

       NOTE: You must not vote for more than 7 candidates

         You may vote for fewer than 7 candidates

         To cast your vote, affix a voting stamp next to the photograph of each candidate for whom you wish to vote