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City of Surrey
Elector Response Form
I am an elector of the City of Surrey. By my signature below, I hereby indicate that I am opposed to the
adoption of "
Surrey Removal of Reservation of a Portion of Hawthorne Park Bylaw, 2017, No. 19337
Full name of elector (please print) - (e.g. Donald Smith – not D. Smith)
Enter your email address if you want to be kept informed about this campaign and any future campaigns. This information will be kept in strict confidence and not shared with the city or any other organizations. - Steven Pettigrew
√ I am a resident elector (
see page 5, Part 3 – Eligibility Requirement
□ I am a non-resident property elector who lives in another community and owns property in the City of
Surrey located at: __________________________________________________________ (address)
see page 5 for additional eligibility requirements
□ *ATTACHED written consent form for non-resident property elector with jointly owned
property as per Section 66(6) of the
Local Government Act
. (see page 6):
Forms can be submitted by mail, hand delivered, facsimile, or email to:
Address: Office of the City Clerk, 5E - 13450 – 104th Avenue, Surrey, B.C. V3T 1V8
If submitting this form to the City by facsimile, please ensure that the transmission was completed. The
Council may proceed with the adoption of
Surrey Removal of Reservation of a Portion of Hawthorne Park
Bylaw, 2017, No. 19337
unless 30,372 electors sign and submit a completed copy of this Elector Response Form
to the local government.
A person must not sign more than one Elector Response Form in relation to this Alternative Approval Process.
Additional information can be found on the following pages about the elector qualifications eligibility.
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