SARM 2012 - Form S-RM
NOTICE OF APPLICATION FOR REVISION OF VOTERS’ LIST
[Section 160.083 and Section 160.084 of the Act]
Sections 160.083 and 160.084 of The Local Government Election Act state:
“160.083 (1) Any voter may apply to the revising officer at least 15 business days
before the day on which a general election is held to have the name of any person
struck off the voters’ list on the ground that the person is not qualified as a voter.
(2) Every application pursuant to subsection (1) must be in writing and must
specify the grounds on which the applicant alleges the person is not eligible to be
(3) An application pursuant to subsection (1) may be made by a person on his own
160.084 (1) In this section, "applicant" means a person :
(a) who is qualified as a voter , but whose name does not appear on the
(b) whose name is listed in error on a voters’ list; or
(c) whose name is listed on a voters' list in the incorrect division.
(2) An applicant may apply, at least 15 business days before the day on which a
general election is held, to the revising officer to correct the error or omission in
the voters’ list by filing with the revising officer a voters’ registration form setting
out the information necessary to correct the error or omission.”
Persons wishing to apply for revisions to a voters’ list may do so
(address or place)
between the hours of ______________ and ______________ on the _____________
of _______________ , 20 ____ .
Dated this _________________ day of_________________________ , 20 _______ .