Form M-6 - Appointment, of Polling Agents
[See Rule 56V (I)]
Appointment, of Polling Agents
Election to the Managing Committee members of......,....................... Co- operative Society Ltd...........................................Tahsil........................ District....................... from ...................... constituency.
To
The Returning Officer /The Presiding Officer .......................................... I ......................................................................, a candidate of the present election do hereby request you that I have appointed Shri ……………as Polling Agent to attend Polling Station/Polling Booth No ..... of Polling Station at
Date :
Signature of the Candidate.
I agree to act as Polling Agent
Date :
Signature of the Polling Agent.
Declaration of the Polling/Counting Agent to be signed before the Returning/Polling Officer.
I hereby declare that I will not at this election for....................................
(name of constituency)
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 Officer/Polling Officer