4. Signed in the presence of ........................................................................................................... (Candidate/Election Agent/Authorized Representative) Full names ................................................................................................................................ (Block letters) Residential address.................................................................................................................... . National Registration No. .......................................................................................................... 5. Signature .................................... Date..................................................................................... Signed in the presence of ........................................................................................................... (Candidate/Election Agent/Authorized Representative) Full names ................................................................................................................................ (Block letters) Residential address. .................................................................................................................... National Registration No. .......................................................................................................... Signature .................................... Date..................................................................................... Signed in the presence of ........................................................................................................... 6. (Candidate/Election Agent/Authorized Representative) Full names ................................................................................................................................ (Block letters) Residential address.................................................................................................................... . National Registration No. .......................................................................................................... 7. Signature .................................... Date..................................................................................... Signed in the presence of ........................................................................................................... (Candidate/Election Agent/Authorized Representative) Full names ................................................................................................................................ (Block letters) Residential address.................................................................................................................... . National Registration No. .......................................................................................................... Signature .................................... Date..................................................................................... 8. Signed in the presence of ........................................................................................................... (Candidate/Election Agent/Authorized Representative) Full names ................................................................................................................................ (Block letters) Residential address. .................................................................................................................... National Registration No. .......................................................................................................... 9. Signature .................................... Date..................................................................................... Signed in the presence of ........................................................................................................... (Candidate/Election Agent/Authorized Representative) Full names ................................................................................................................................ (Block letters) Residential address..................................................................................................................... National Registration No. .......................................................................................................... Signature .................................... Date..................................................................................... Signed in the presence of ........................................................................................................... - 64 -

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