REGISTER OF ELECTORS. An Garda Síochána Registration of Garda Síochána as Postal Voters
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1 Form Version: 08/2015 REGISTER OF ELECTORS An Garda Síochána Registration of Garda Síochána as Postal Voters RFB Under section 14(a) of the Electoral Act, 1992, a member of the Garda Síochána may apply to be registered as a postal voter. If you wish to be registered as a postal voter, complete this form and return it before 25 November to your registration authority. [Form RFA should be completed if you wish to be registered as an ordinary voter.] Please read the notes carefully before completing the form. 1. Name: (block letters) 2. Rank: 3. Date of Birth: 4. State the full postal address at which you were ordinarily resident on 1 September this year: (block letters) Eircode: 5. Is anyone with the same names, who will be 18 years of age or over on 15 February next, living at the same address on 1 September this year? Please tick () the appropriate box: Yes No 6. Please tick ( ) one box only to indicate whether you are: a Citizen of Ireland a British citizen a national of another EU a national of a Member State (other than UK) non-eu country 7. Edited Register: If you wish to be excluded from the edited Register, please tick ( ) the opt out box: Signature of Applicant: Date: Daytime/Mobile Phone Number: Opt out box
2 NOTES TO FORM RFB Registration of Garda Síochána as Postal Voters 1. The purpose of this form is to facilitate members of An Garda Siochána who wish to register as a postal voter. The form is for use in the period 1 September to 25 November each year in respect of the register of electors coming into force the following 15 February. Completed application forms must reach the registration authority (City, County or City and County Council) for the area in which you are resident by 25 November in any given year. 2. Eircode Eircode is the national postcode system for Ireland and comprises a unique 7- digit postcode which has been allocated to every address in Ireland. 3. Edited Register - Two versions of the Register Registration authorities are required to publish two versions of the Register - the full Register and the edited Register. The full Register lists everyone who is entitled to vote and can only be used for an electoral or other statutory purpose. The edited Register contains the names and addresses of persons whose details can be used for a purpose other than an electoral or other statutory purpose, e.g. for direct marketing use by a commercial or other organisation. If you do not want your details to be included on the edited Register, you should tick () the opt out box. If you want your registration details to be included (i.e. available for non-statutory uses), you should leave the opt out box blank. 4. Contact details Your contact details are being sought in case the registration authority needs to contact you to clarify any details of the application. 5. It is an offence to fail to give the registration authority or county registrar any information required for the purpose of their duties or to knowingly give false information.
3 Dáta an Leagain seo den Fhoirm: 08/2015 CLÁR NA dtoghthóirí RFB An Garda Síochána An Garda Síochána a chlárú mar Phostvótálaithe Faoi alt 14(a) d'acht Toghcháin 1992, féadfaidh comhalta den Gharda Síochána iarratas a dhéanamh clárú mar phostvótálaí. Más mian leat clárú mar phostvótálaí, comhlánaigh an fhoirm seo agus seol ar ais chuig d'údarás clárúcháin í roimh an 25 Samhain. [Foirm RFA is ceart a chomhlánú más mar ghnáthvótalaí is mian leat clárú] Léigh na nótaí go cúramach, le do thoil, sula gcomhlánóidh tú an fhoirm. 1. Ainm: (bloclitreacha) 2. Céim: 3. Dáta Breithe: 4. Tabhair an seoladh iomlán poist ag a bhfuil gnáthchónaí ort an 1 Meán Fómhair i mbliana (bloclitreacha) Eircode: 5. An bhfuil aon duine den ainm céanna, a bheidh 18 mbliana d'aois nó níos sine an 15 Feabhra, ina gcónaí ag an seoladh céanna an 1 Meán Fómhair i mbliana? Cuir tic () sa bhosca cuí: Tá Níl 6. Cuir () i mbosca amháin, le do thoil, chun a thaispeáint cén grúpa lena mbaineann tú: Saoránach d Éirinn saoránach Briotanach náisiúnach de Bhallstát AE eile náisiúnach de thír (seachas an Ríocht Aontaithe) neamh-ae 7. An Clár faoi Eagarthóireacht: Más mian leat nach ndéanfar do chuid mionsonraí a chur san áireamh sa Chlár faoi eagarthóireacht, cuir () sa bhosca do rogha an diúltaithe: Síniú an Iarratasóra: Dáta: Uimhir theileafóin i rith an lae/uimhir Fóin Póca: Ríomhphost Bosca chun rogha an diúltaithe a chur i bhfeidhm
4 NOTAÍ A GHABHANN LE FOIRM RFB Comhaltaí den Gharda Síochána a chlárú mar Phostvótálaithe 1. Is é is cuspóir don fhoirm seo ná an bealach a réiteach do chomhaltaí an Gharda Síochána ar mian leo clárú mar phostvótálaithe. Tá an fhoirm seo le húsáid sa tréimhse ó 1 Meán Fómhair go 25 Samhain gach bliain i leith chlár na dtoghthóirí a thiocfaidh i bhfeidhm an 15 Feabhra ina dhiaidh sin. Ní mór foirmeacha iarratais comhlánaithe a bheith faighte ag an údarás clárúcháin (an Chomhairle Cathrach, an Chomhairle Contae, agus an Chomhairle Cathrach agus Contae) a bhaineann leis an gceantar ina bhfuil cónaí ort faoin 25 Samhain in aon bhliain áirithe. 2. Eircode Is é atá in Eircode ná an córas náisiúnta postchód in Éirinn agus cuimsíonn sé postchód uathúil 7 ndigit atá sannta do gach seoladh dá bhfuil ann in Éirinn. 3. An Clár faoi Eagarthóireacht Dhá Leagan den Chlár Tá sé de cheangal ar údaráis chlárúcháin dhá leagan den Chlár a fhoilsiú an Clár iomlán agus an Clár faoi eagarthóireacht. Sa Chlár iomlán, liostaítear gach duine atá i dteideal vóta a chaitheamh agus ní féidir é a úsáid ach amháin chun críche toghcháin nó chun críche reachtúla eile. Sa chlár faoi eagarthóireacht, faightear ainmneacha agus seoltaí daoine ar féidir a gcuid mionsonraí a úsáid ar mhaithe le nithe seachas cúrsaí toghcháin nó cúrsaí reachtúla eile e.g. ar mhaithe lena n-úsáid i gcomhair margaíochta dírí ag eagraíocht tráchtála nó ag eagraíocht de chineál eile. Más rud é nach mian leat do chuid mionsonraí a bheith san áireamh sa Chlár faoi eagarthóireacht, is ceart duit () a chur isteach sa bhosca chun rogha an diúltaithe a chur i bhfeidhm. Más mian leat do chuid mionsonraí a bheith san áireamh (i.e. ar fáil le haghaidh úsáidí neamhreachtúla), ní ceart duit () a chur isteach sa bhosca chun rogha an diúltaithe a chur i bhfeidhm.
5 4. Mionsonraí teagmhála Tá mionsonraí teagmhála á lorg ar eagla gur gá don údarás clárúcháin teagmháil a dhéanamh leat chun aon mhionsonraí atá ann san iarratas a shoiléiriú. 5. Is cion é mainneachtain aon fhaisnéis a theastaíonn ón údarás clárúcháin nó ón gcláraitheoir contae chun críche a ndualgas a thabhairt don údarás nó don chláraitheoir sin nó faisnéis bhréagach a thabhairt go feasach.
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