ELECTORAL (NOMINATION OF CANDIDATES) REGULATIONS, 2013 FORM VN.5 LIST OF DESIGNATED PARTY OFFICE-BEARERS Section 38A(1)(a) of the Electoral Act [Chapter 2:13] Note Section 38A(1)(a) provides that a political party may provide to the appropriate provincial command centre a list of at least three office bearers of the party in the province who will be authorized to certify as required under Part XIV and section 46. Name of political party………………………………………………………………………………………… NATIONAL DESIGNATED PARTY OFFICE-BEARERS Designated Office Bearer 1 Full names Signature National Identity number Full address and email or number fax Designated Office Bearer 2 Full names Signature National Identity number Full address and email or number fax Designated Office Bearer 3 Full names Signature 63