Application for a postal vote for Northern Territory elections

This form is used only for NORTHERN TERRITORY Legislative Assembly or local government (council) elections or by-elections.

Complete this form only if you are on the electoral roll for an address within the Northern Territory.

Required fields are marked with an asterisk (*).

 

Name and date of birth

Family name *

All given names *

Date of birth *

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Contact details

Contact phone number *

Email address

Address to which postal voting papers are to be sent

Address to which postal voting papers are to be sent (line 1) *

Address (line 2)

Suburb/town *

State/territory

NTACTNSWQldSATasVicWA

Postcode

Country

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Enrolled address

Is your address on the electoral roll the same as the above? *

• Yes
• No

Enter your enrolled address

Enrolled address (line 1) *

Enrolled address (line 2)

Enrolled suburb/town *

Enrolled state/territory *

NT

Enrolled postcode

Further information

Do you have any further information to assist us with processing your application?

Note: After you click submit you will not be able to edit this application.