ELECTORAL REGULATIONS, 2005 Form V.23B (National Assembly) ELECTORAL ACT [CHAPTER 2:13] (Section 65) ___________________ National Assembly COLLATION AT NATIONAL ASSEMBLY CONSTITUENCY CENTRE Section 37(C)(b)(ii) of the Electoral Act [Chapter 2:13] Name of constituency Name of Province Collation of ward returns in respect of National Assembly constituency election Name of candidate Name of candidate Name of candidate Name of candidate Name of candidate Name of candidate Name of candidate 1. 2. 3. 4. 5. 6. 7. Na me of can did ate 8. Votes rejected Name of ward Total votes received Declaration by Constituency Elections Officer I hereby declare that this return is a correct statement of the collated results for the National Assembly constituency results. Full names of Constituency Elections Officer Signature of Constituency Elections Officer Date Name of witness Signature of witness Declaration by candidates/ election agents 24