Form V.22 ELECTORAL ACT [CHAPTER 2:13] (Section 125 (1)) _______________ NOMINATION PAPER—COUNCILLOR OR MAYOR _______________ NOTE: Aspiring candidate should produce: 1. a birth certificate together with National Registration Identity Card. Please attach photocopies of the said documents. 2. a passport-size black and white photograph. 3. a written certificate of clearance in terms of section 125 of the Act from – (a) the Zimbabwe Republic Police; (b) the relevant council. _______________ We, the undersigned voters registered in the ……………………………………………… ward, hereby nominate: ...................................................................................................................... I/D No. ……………… (full names in block letters) of ...................................................................................................................................................... (full address in block letters) as a candidate for election to represent the said ward in the local council. 1. Full names ................................................................................................................................ (Block letters) Residential address.................................................................................................................... . National Registration No. .......................................................................................................... 2. Signature .................................... Date..................................................................................... Signed in the presence of ........................................................................................................... (Candidate/Election Agent/Authorized Representative) Full names ................................................................................................................................ (Block letters) Residential address.................................................................................................................... . National Registration No. .......................................................................................................... 3. Signature .................................... Date..................................................................................... Signed in the presence of ........................................................................................................... (Candidate/Election Agent/Authorized Representative) Full names ................................................................................................................................ (Block letters) Residential address.................................................................................................................... . National Registration No. .......................................................................................................... Signature .................................... Date..................................................................................... - 63 -

Select target paragraph3

Add to table of contents