To: Date: Dr C Brand Returning Officer Wiltshire Council Bythesea Road Trowbridge Wiltshire BA14 8JN email: elections@wiltshire.gov.uk Dear Dr Brand We, the undersigned, request that an election be held for the vacancy on : __________________________ Parish/Town Council as advertised on the Notice of Vacancy dated ____________________________________ .
If you would like an acknowledgement of this request, please give details below of the one person who should receive the acknowledgement. Name: ____________________________________
Name (please print)  Address (please print)  Signature  1.        2.        3.        4.        5.        6.        7.           Name (Please Print)  Address (Please Print)  Signature  8.        9.        10.
Address: __________________________________________________________________ Email: _____________________________________ Tel: _____________________________________ (NB. The request made by ten registered electors MUST be received by the Returning Officer by the deadline shown on the relevant Notice of Vacancy. This date is not flexible)