(full name of Party in block letters) and wishes the following abbreviation of the Party’s name to appear on the ballot paper in conjunction with his/her name .................................................................................................. .................................................................................................................................................. (block letters) Signature ................................................................................................................................... Candidate*/Candidate’s Chief Election Agent* 3. Party authorization (to be completed by a duly authorized party official if the candidate has indicated that he/she wishes the abbreviation of a party’s name to appear on the ballot paper in conjunction with his/her name) I, ............................................................................................................................................... (full names) being the ................................................................................................................................... (state office held) on the ........................................................................................................................................ (full name of political party) and, as such, duly authorized in terms of the constitution of the party, certify that the candidate to whom this nomination paper relates will stand for, or be sponsored by, the party. Date .................................................... .................................................................................................................................................. Signature *Delete whichever does not apply Note: This form must be accompanied by a passport-sized black and white photograph of the candidate. - 27 -