ELECTORAL (NOMINATION OF CANDIDATES) REGULATIONS, 2014 Date…………………………………………………..…………… Signature…………………………………………………………… Signature..………………………���………………………………. * Delete whichever does not apply. Note: This form must be accompanied by a passport-size photograph of the candidate. FOR OFFICE USE ONLY ____________ Name of Checkers: 1.……………………………………………………I.D. No. ………………………….. (Print) 2.……………………………………………………I.D. No. …………………………... 3.…………………………………………………... I.D. No. ………………………….. Verifier: (Print) …………………………………………………………I.D. No. ………………................ Nominators in voters roll, numbers: Nominators not in voters roll, numbers: A. This nomination paper is approved/accepted. Presiding Officer: ………………………………………………………… I.D. No.: ………………………. (Print full names) Signature: ……………………………………………………………………………Date: ………………… B. This nomination paper is rejected because:  Insufficient nominators:  Candidate not sponsored by given political Party.  Candidate not in constituency voters roll where he or she whishes to contest  Any other reasons, please state ………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… Presiding officer: …………………………………………………………… I/D Number: …………… (Print full names) Signature: …………………………………………. Date ……………………… Time ………………. 48

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