1964_ELECTORAL_PROVISIONS_(PROCEDURE)_REGULATIONS — Page 43

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1987 Ed.]

Electoral Provisions (Procedure) Regulations

[CAP. 367

B 43

FORM 12

[reg. 64.]

ELECTORAL PROVISIONS (PROCEDURE) REGULATIONS

DECLARATION OF SECRECY

ELECTION OF AN URBAN COUNCIL MEMBER/A REGIONAL COUNCIL MEMBER/A DISTRICT BOARD MEMBER

for the

Xin LN426/49. Date of Election:

Constituency . District.

1. I, (Name) of (residential address) solemnly promise and declare that, at the above election, I will not do anything forbidden by regulation 65 of the Electoral Provisions (Procedure) Regulations, which has been read to me.

Date (Signature)

2. Regulation 65 of the Electoral Provisions (Procedure) Regulations has been read to the declarant by me and the above declaration was made before me.

* Delete whichever is inapplicable.

Note:

Signature of *a Justice of the Peace/Returning Officer/Commissioner for Oaths

Name in Block Letters of *a Justice of the Peace/Returning Officer/Commissioner for Oaths

Date

[Subsidiary]

65 of 1984, s. 29. 41 of 1985, s. 24.

A note on regulation 65 of the Electoral Provisions (Procedure) Regulations and how to complete this form will be issued separately.

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1987 Ed.] Electoral Provisions (Procedure) Regulations [CAP. 367 B 43 FORM 12 [reg. 64.] ELECTORAL PROVISIONS (PROCEDURE) REGULATIONS DECLARATION OF SECRECY ELECTION OF AN URBAN COUNCIL MEMBER/A REGIONAL COUNCIL MEMBER/A DISTRICT BOARD MEMBER for the Xin LN426/49. Date of Election: Constituency . District. 1. I, (Name) of (residential address) solemnly promise and declare that, at the above election, I will not do anything forbidden by regulation 65 of the Electoral Provisions (Procedure) Regulations, which has been read to me. Date (Signature) 2. Regulation 65 of the Electoral Provisions (Procedure) Regulations has been read to the declarant by me and the above declaration was made before me. * Delete whichever is inapplicable. Note: Signature of *a Justice of the Peace/Returning Officer/Commissioner for Oaths Name in Block Letters of *a Justice of the Peace/Returning Officer/Commissioner for Oaths Date [Subsidiary] 65 of 1984, s. 29. 41 of 1985, s. 24. A note on regulation 65 of the Electoral Provisions (Procedure) Regulations and how to complete this form will be issued separately. 1 1
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1987 Ed.] Electoral Provisions (Procedure) Regulations [CAP. 367 B 43 FORM 12 [reg. 64.] ELECTORAL PROVISIONS (PROCEDure) RegulatIONS DECLARATION OF SECRECY ELECTION OF AN URBAN COUNCIL MEMBER/A RE- GIONAL COUNCIL MEMBER/A DISTRICT BOARD MEMBER for the Xin LN426/49. Date of Election: Constituency . District. 1. I, of (Name) (residential address) solemnly promise and declare that, at the above election, I will not do anything forbidden by regulation 65 of the Electoral Provisions (Procedure) Regulations, which has been read to me. Date (Signature) 2. Regulation 65 of the Electoral Provisions (Procedure) Regulations has been read to the declarant by me and the above declaration was made before me. * Delete whichever is inapplicable. Note: Signature of *a Justice of the Peace/Returning Officer/Commissioner for Oaths Name in Block Letters of *a Justice of the Peace/Returning Officer/Commissioner for Oaths Date [Subsidiary] 65 of 1984, s. 29. 41 of 1985, s. 24. A note on regulation 65 of the Electoral Provisions (Procedure) Regulations and how to complete this form will be issued separately. 1 1
2026-05-04 15:31:07 · Baseline
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1987 Ed.]

Electoral Provisions (Procedure) Regulations

[CAP. 367

B 43

FORM 12

[reg. 64.]

ELECTORAL PROVISIONS (PROCEDure) RegulatIONS

DECLARATION OF SECRECY

ELECTION OF AN URBAN COUNCIL MEMBER/A RE- GIONAL COUNCIL MEMBER/A DISTRICT BOARD MEMBER

for the

Xin

LN426/49. Date of Election:

Constituency

. District.

1. I,

of

(Name)

(residential address)

solemnly promise and declare that, at the above election, I will not do anything forbidden by regulation 65 of the Electoral Provisions (Procedure) Regulations, which has been read to me.

Date

(Signature)

2. Regulation 65 of the Electoral Provisions (Procedure) Regulations has been read to the declarant by me and the above declaration was made before me.

* Delete whichever is inapplicable.

Note:

Signature of *a Justice of the Peace/Returning Officer/Commissioner for Oaths

Name in Block Letters of *a Justice of the

Peace/Returning Officer/Commissioner for Oaths

Date

[Subsidiary]

65 of 1984, s. 29. 41 of 1985, s. 24.

A note on regulation 65 of the Electoral Provisions (Procedure) Regulations and how to complete this form will be issued separately.

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