SURNAME: Carter
FIRST NAME: Thomas
ADDRESS OF RESIDENCE: 3F Armas Avenue
DATE OF BIRTH: 1767
Are you registered and eligible to vote in the Holy Orenian Empire? Yes, I am
Do you have any other title, peerage or military service that may conflict with becoming a Member of the House of Commons, as per the Edict of Reform (1763)?
I do not
If yes, do you understand that you will be required to resign or abdicate from this position should you be elected to the House of Commons, and if this does not occur your seat shall be considered to be vacant?:
Yes
((MC NAME)): Norse_Pixels