Ballot Paper Account

FORM 33 (See Rule 70) Part 1— Ballot Paper Account Election to the Municipal Corporation/Council/Nagar Panchayat from Constituency ________________ No. and name of Polling Station ____________________________ Serial No. ____________________ Total No. ___________________

From To 1. Ballet paper received _________________ 2. Ballet papers unused (i.e. not issued to voters) (a) With the signature of Presiding Officer (b) Without the signature of Presiding Officer____________________ Total : (a+b) ___________________ 3. *Ballot papers used at the Polling Station ___________________ (1-2=3) ______________________ 4. Ballot Papers used at the polling station but NOT INSERTED INTO THE BALLOT BOX: (a) Ballot papers cancelled for violation of voting procedure under Rule 68_________________________________ (b) Ballot papers cancelled for other reasons_______________________ (c) Ballot papers used as tendered ballot papers__________________ Total; (a+b+c)__________________________________ 5. *Ballot papers to be found in the ballot box (3-4)=5) *(Serial numbers need not be given) Date______________

Signature of the Presiding Officer

Part-11 Result of Counting [.Name of candidate Number of valid votes/cast 1 2 3 etc. II Rejected Ballot Papers II TOTAL Whether the total number of ballot papers shown against item No. III above tallies with the total shown against item No. 5 of Part I or any discrepancy noticed between these two totals. Place _____________

Signature of the Counting Supervisor Date___________________ Place_______________

Signature of the Returning Officer Date_____________________