FORM III - Nomination form for elections of Board of Directors
[See paragraph 3 (a) of the Schedule]
1. Name of the Multi-State Cooperative :
Society and Address
2. Name of the candidate in case of an :
Individual member or name of the delegate and the member cooperative Society or multi-state cooperative society which he is representing
3. Serial no. in the register of members :
4. Father’s or husband’s name (in case : of individual member)
5. Address :
6. Name of the proposer in case the :
proposer is an individual member and the name of the society and The delegate in the case proposer Is a delegate of a society
7. Serial no. of the proposer in the :
Register of members
8. Signature of the proposer :
9. Name of the seconder when the :
seconder is an individual member and name of the society 10. Serial no. of the seconder in the register : of members
10. Serial no. of the seconder in the register :
of members
11. Signature of the seconder :
CANDIDATES DECLARATION
I declare that I am willing to stand for election and that, to the best of my knowledge and belief I have not incurred any disqualification for membership of the board of ______________ multi-state cooperative society in terms of the Act, the rules and the bye-laws of the multi-state cooperative society.
(Signature of the candidate)
ENDORSEMENT BY THE RETURNING OFFICER
This nomination paper was presented to me in person by ___________/ received by registered post on _____ at _____ hrs.
Place _________
Signature of Returning Officer
Or person authorized by him