NOMINATION (See rule 3) ELELCTION TO THE GENERAL SEATS Sw N A L. A, /-1-0 /71- Election to the constituency of *National Assembly/ 1 )t.).N '41* A S (Name of the Province)
(To be tilled in by the proposer)
(1) Pg YA I B u (name of the proposer)
having National Identity Card No 5iPt2.c;1, q ?.-5 -.3 registered- as an elector at
serial number in the electoral roll for ?e.11.i.1:),Ar.....c.T.r.ff.T.electoral area
in LAE P. in • District/Political Agency do
hereby propose the name of t HA MmA VAAN+ 2-A whose address is
CsC•1■■' n ,-kotZ6 '16 I 1'40 -1.)( 1- as a candidate for election general scat from
A - I 1 4 j /.../:\ H-012_67: 0 - • — constituency.
(2) I hereby certify that I have not subscribed to any other nomination paper either as proposer or seconder. (1144 ,/ Date --' ' SignaturciotProposer
(To be filled in by the seconder)
(I) I .r..H....4.5.m././.....Hti.yi.E.6..P.(name of the seconder) haying National Identity Card No.... ... . ./.1.7...5,5..6.7.5...registered as an elector at serial number In . MS DIVAN the :electoral roll X9.C.kl.A4AP,K.1. for electoral area in .1..Alirgr," ...0 .2 y... TehsilfTaluka in 1-. .110...... District/Political Agency do hereby second the nomination of
QE- 1,Am .4 " A a A"." 14-8 1.A 2 'Sij`"C‘ g' t F." whose address is 9 14, Iv' as , a candidate for election to general seat from A C 1-1\ 1'1012E, IIConstituency.
(2) I heresy certify that I have not subscribed to any other nomination paper either as proposer or seconder.
Signature of Seconder
Please fill in the Form in capital letters. *Strike 'off the words not applicable
Price : Rs.20/-
Saijad Russai 2,Cr N.A. 119 121hcre kii)
DECLAIZATiON AND OATH BY THE PERSON NOMINATED
I, the above mentioned candidate, hereby.declare on oath that,— • (i) 1 have consented to the above nomination and that I fulfill the qualifications specified in Article 62 of the Constitution and I 'am not subject to any of the dis-qualifications speci lied in Article 63 of the Constitution or any other law for the time being in force for being elected as member of the National Assembly/Provincial Asset-6.1)1y.
s..4 SL A.1 *(ii) I belong to PP•;../..k.,STAr.; and a certificate from (Name of political party) • that political party showing that I am a party candidate from the above said constituency is attached. i-Nr••" n•(.6----X- A
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