3rd Sched. (Part IV)
FORM B (Continued)
Signature
126
Number on Register of Electors and Distinctive Letter of Folling District.
Proposer
Seconder
We the undersigned, being respectively registered electors for the said Municipality do hereby assent to the foregoing nomination.
1.
2.
3.
4.
5.
6.
7.
8.
I,
, being the person nominated as a
candidate in the within-written nomination paper do hereby consent to
the said nomination.
Dated this
Signature of Candidate
Witness
day of
19
Instructions for filling up Nomination Paper
4.
The nomination of each candidate must be made on a separate
nomination paper.
2.
The surname of the candidate must be inserted in colum 1 and
the other names of the candidate must be inserted in full in
colum 2.
3.
4.
If none,
insert some such description as
"gentleman", "married woman", "spinster".
Insert in colum 3 the place of residence of the candidate.
Insert in colum ↳ the trade, profession or calling, if any,
of the candidate.
(3)
(Form B continued)