ELECTORAL ACT (as amended at 24th January 2008) APPENDIX (PARAGRAPH 3(2)) FORM OF NOMINATION PAPER [OBVERSE] NOMINATION PAPER : ELECTION OF PRESIDENT We, the Senators and members of the House of Assembly whose names and signatures appear on the reverse of this form, hereby nominate : .............................................................................................................................................. (full name, in block letters) of ......................................................................................................................................... (address in block letters) as a candidate for election as President. Date : …………………………………………………. DECLARATION OF CANDIDATE I, ………………………………………………………………………………………………… (full name, in block letters) of……………………………………………………………………………………………… … (address in block letters) certify that⎯ 1. I am a citizen of Zimbabwe by birth/descent*. 2. The date of my birth was ………………………………………………………………….. 3. I am ordinarily resident in Zimbabwe. 4. I hereby accept nomination as a candidate for election as President. Signature : .............................................................. Date : ………………………………. Place ……………………………………………… *Delete whichever does not apply. - 116 -