Form M-7 - Common form for appointment of Polling Agents and also to work as Counting Agents
(See Rule 56V(3)]
Common form for appointment of Polling Agents and also to work as Counting Agents
Election to the Managing Committee members of...................................... Co-operative Society Ltd.,...............Tahsil ...................., District................... for the.................................. Constituency.
To
The Returning Officer/Presiding Officer
I............................................................................. ., candidate of present election do hereby request you that I have appointed Polling Agents at Polling Station No ............................................................... , Place as under for the poll to be held on ................................................ These Polling Agents shall also work and act as Counting Agents at the same of counting of votes on ..............................................................................
1. Shri.,................................. Address.........................................
2. Shri................................... Address..........................................
Date :
Signature of the candidate
I agree to act as Polling/Counting Agent
Signature of the Polling/Counting Agent
Date :
N.B. The form duly filled and signed by the candidate shall be presented in duplicate.
Declaration of Polling/Counting Agent to be signed before the Returning Officer/Polling Officer
I hereby declare that I will not/at this election for..................................... (name of constituency) do anything forbidden by the Act, or these Rules or by-laws thereunder.
Date :
Signature of the Polling/Counting Agent
Signed before me
Date :
Returning/Polling Officer