NOMINATION PAPER

[See Rule 36] NOMINATION PAPER I nominate as a candidate for election to the Municipal Corporation/Municipal Council/Nagar Panchayat______________ from constituency No___________________. Candidate's Name_____________________father's/husband's name_________________His postal Adress _____________________________________________________________ His name is entered at Serial No._______________ in Part No. ____-_______ of the election roll for____________ constituency No._____________ My name is______________________ and it is entered at Serial No.____________in Part No. ___________ of the electoral rolls for________ constituency No.__________ Date _________ (Signature of proposer) I, the above mentioned candidate, assent to this nomination and hereby declare: (a) that I have completed____________________years of age; (b) that I am (set up) at this election by the ___________ party; (C) that the symbols I have chosen are in order of preference (i) _________ (ii) _______and________ (iii) (d) that my name and my father's/husband's name have been correctly spelt out above in __________ (name of the language). (e) that to the best of my knowledge and belief, I am qualified and not also disqualified for being chosen to fill the seat in the Municipal Corp oration/Council/Nagar Panchayat. I further declare that am a member of the _______________*_caste/which is Scheduled *caste/backward Class______________ in relation to___________ (area in that State). Date__________ (Signature of the Candidate) I have examined this nomination paper in accordance with Section 38 and decide as follows: Returning Officer Date_________________ __________________Perforation)____________________ Receipt for Nomination paper and Notice of Scrutiny (To be handed over to the person presenting the nomination paper) Serial No. of nomination paper__________________ The nomination paper of _______________ a candidate for election from the _______________constituency was delivered to me at my office at _____ (hour) on _______ )date)* by the candidate/proper. All nomination papers will be taken up for scrutiny at___________ (hour) On_____ (date) at ___________ ________ (place). Returning Officer Dated__________________ *Score out the word not applicable.