ŠDeclaration under oath or solemn affirmation of an electorŠwishing to vote in the advance poll because he will be absent orŠunable to vote on polling dayŠŠMunicipality of ................................................ŠŠPolling subdivision No .........................................ŠŠI, .............................................................Š Given name SurnameŠŠ ...............................................................Š OccupationŠŠ ...............................................................Š AddressŠŠdeclare that I have reason to believeŠŠ( ) that I shall be absent from the municipality on polling dayŠŠ ORŠŠ( ) that I shall be unable to vote on polling day.ŠŠI, therefore, wish to vote in the advance poll.ŠŠ ...........................Š ElectorŠŠDeclared under oathŠ(or solemnly affirmed)Šbefore me,Šthis ................., 19.....ŠŠ ............................Š Deputy returning officerŠ