Request for Mail-in Ballot

1. Elector Requesting Mail Ballot

This collection of personal information is authorized under Part 3 of the Local Government Act (“LGA”) and the City’s Election and Assent Voting Bylaw and will be used for the sole purpose of administering the local government elections. Your personal information may be disclosed pursuant to sections 110 and 160 of the LGA. Questions can be addressed to the Chief Election Officer or Deputy Chief Election Officer at election@pittmeadows.ca or 604-465-5454.

2. Home Address

3. Non-Resident Property Elector

Are you applying for a ballot as a non-resident property elector (you own property in Pitt Meadows but live somewhere else in BC)?

4. Delivery of Package

I request that you provide me with a mail ballot package in the following way (check ONLY one):
Provide the fill name and mailing address of the individual who will be picking up your mail ballot package.

5. Declaration

By submitting this form I hereby declare that I am: