ELECTORAL REGULATIONS, 2005 Form V.9 OBVERSE ELECTORAL ACT [CHAPTER 2:13] _______________ PARLIAMENTARY ELECTIONS: FORM OF BALLOT PAPER FRONT NAME OF CANDI- NAME OF PARTY SYMBOL PHOTOGRAPH DATE BACK --------------- --------------- CONSTITUENCY BY- CONSTITUENCY BY-ELECTION ELECTION SERIAL NO. - - - - 000001 SERIAL NO. - - - - 000001 OFFICIAL MARK --------------- --------------- ELECTION OF MEMBER OF ELECTION OF A MEMBER OF PARLIAMENT PARLIAMENT Note.—The numbers on the counterfoil and the ballot paper must be identical. 11 MARKING SPACE