Appointment of Polling Agent

FORM 28 (See Rule 46(2)] Appointment of Polling Agent Election to the Municipal Corporation/Council/Nagar Panchayat who is a Candidate at the above election do hereby appoint ________________________ (Name and address)____________________ as a polling agent to attend polling station No. ________________, at place fixed for the poll___________at_________________.

Place_________________ Date__________________

Signature of candidate/election agent

I agree to act as such polling agent Place_________ _____ Date_______________

Signature of polling agent

Declaration of polling agent to be signed before Presiding Officer I hereby declare that at the above election I will not do anything forbidden by the Punjab State Election Commission Act, 1994 which I have read/has been read over to me.

Date________________

Signature of Polling Agent/ Election Agent

Signed before me.

Date_____________

Presiding Officer.